Medicinal cannabis

2021, Responses from: Justin Sinclair and Dr Mike Armour

Could medicinal cannabis help my endo symptoms?

Based on preliminary survey evidence compiled from women self-reporting the use of illicit cannabis to manage their pain and endometriosis-associated symptoms it appears that cannabis can not only assist with pain, but also mental health (i.e. depression and anxiety symptoms), gastrointestinal upset (e.g. endo belly), nausea and vomiting and sleep. The fact that cannabis has numerous phytochemicals that have well reported analgesic, anti-inflammatory, anxiolytic (reducing anxiety), sedative and anti-inflammatory actions goes some way to explaining the pharmacological effects it has and why it may benefit women with a wide constellation of symptoms with endometriosis.

I am a bit confused, what’s the difference between medicinal cannabis and weed?

Medicinal cannabis is grown to incredibly high quality assurance standards and must meet regulatory guidelines to be free of things such as microbes, aflatoxins, heavy metals and pesticide and fungicide residues. It is also grown in consistent and highly monitored  environments that allow for standardisation of key active ingredients, such as d-9 tetrahydrocannabinol (THC) and cannabibidiol (CBD). This latter point is incredibly important when one considers the desire for reproducible results every time you take a medicinal cannabis product. Illicit cannabis is generally bred to contain very high amounts of just THC, which is the main constituent involved with the analgesic and intoxicating activity, making the user feel stoned if taken in high doses. In short, whilst both ‘ types’ of cannabis essentially come from the same plant, the main differences are in the scientific rigour that goes into utilising specific cannabis varieties for their medicinal benefits whilst also being manufactured to a high quality standard, whereas illicit cannabis is not able to provide similar levels of assurance. Another key difference which we are hoping changes soon is the cost – for obvious reasons medicinal cannabis products are currently quite expensive, sometimes double or more in cost to that which could be obtained from the illicit market.

Can I get ‘high’ by taking medicinal cannabis?

This depends on the type of medicinal cannabis product you are taking. In Australia and New Zealand currently, two major products are available medicinally; one standardised to have high levels of CBD and virtually no THC, and another which is a balanced ratio of both CBD and THC. CBD dominant products are unlikely to cause any intoxicating effects and are probably best known for being of benefit in patients with epilepsy, but under the guidance and supervision of a medical practitioner well-versed in prescribing medicinal cannabis, you should not necessarily feel high using THC dominant products either. An important point here is not to demonise THC, as it is medically useful particularly when pain management is concerned, and many women I have spoken to who use balanced products with both THC and CBD report not experiencing any high after getting their dosage titrated correctly in conjunction with their medical doctor.

How does someone take medicinal cannabis?

The majority of products on the Australian and New Zealand market are oral products, either in an oil that is measured out and swallowed or as a capsule. When using cannabis orally like this, it has a longer onset to take effect (anywhere between 30-120 minutes) depending on the individual patient, but it also has a longer duration of effect, lasting anywhere between 4-8 hours. When cannabis is smoked or vaporised, which is rarely prescribed medically, it has a much faster onset of effect (usually under 5 minutes), but has a shorter duration of effect of between 2-4 hours. Your medical doctor will have the best idea of which dosage form is best for you and your presenting symptoms.

Can I get addicted to medicinal cannabis?

This is an important question and one commonly asked by women in our research focus groups. Studies on illicit cannabis do demonstrate that cannabis has an addictive potential, but it is much lower than other legal drugs such as tobacco or alcohol. Studies on the addictive potential of medicinal cannabis prescribed by a medical doctor are lacking, but based on the constituent profile should still be considered a possibility. Should this be a concern of yours, ensure to discuss this with your prescribing medical doctor who will be able to monitor for this as part of any ongoing management plan with medicinal cannabis.

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