Six conditions that can be treated with medical marijuana

The potential of medicinal cannabis is being increasingly recognised throughout the world and Australia, with the Australian representative at the UN voting to reclassify cannabis with acknowledgement of its therapeutic benefits.

In addition, low-dose cannabidiol (CBD) was down-scheduled by the Therapeutic Goods Administration (TGA) at the end of 2020, opening the possibility of over-the-counter sales of medicinal cannabis. While no products are currently approved for over-the-counter sale, this is likely only a matter of time.

To understand what medicinal cannabis is and how it may be beneficial, it’s important to know what conditions it may be used to treat. As research into medicinal cannabis is still in its early days, its full potential isn’t yet known. The below conditions represent just some of the more common uses of medicinal cannabis.

Post-traumatic stress disorder (PTSD)

PTSD can be a life-altering mental health problem wherein a patient who has witnessed or suffered a traumatic event may experience lasting anxiety, aversions, dissociation, flashbacks and insomnia. The symptoms of PTSD can have wide-reaching consequences in a patient’s occupational, academic, social and personal life.

Medicinal cannabis has proven useful in a number of applications for the treatment of PTSD as well as general anxiety. Notably, studies have seen that medicinal cannabis can:

• reduce the frequency of nightmares¹,
• improve sleep quality and reduce PTSD hyperarousal²,
• and replace prescription medications from GPs^3.4.
   

Endometriosis

Endometriosis is an inflammatory condition affecting one in nine Australian women, according to Endometriosis Australia⁵. Symptoms can include especially painful or problematic periods, IBS-like stomach issues, general pain and fatigue, and subfertility.

Medicinal cannabis for endometriosis may help to manage symptoms such as pain, sleep disturbance and nausea and vomiting. An Australian study showed women with endometriosis who self-manage with cannabis self-report pain reduction of 7.6 out of 10, while 56% of cannabis users reported reducing pharmaceutical medications by at least half⁶.

Chronic pain

Pain Australia reports 3.37 million Australians were living with chronic pain in 2020⁷. Chronic pain is the name given to a variety of persistent pains that can be felt most days of the week for a period lasting longer than six months.

Medicinal cannabis can be prescribed as an analgesic for chronic pain. In particular, studies have shown evidence of efficacy in reducing pain intensity or pain event frequency associated with:

• fibromyalgia⁸,
• migraines⁹,
• and chronic neuropathic pain¹⁰.

Cancer

The Australian Institute of Health and Welfare estimates one in two Australians will be diagnosed with a form of cancer by the age of 85¹¹. Cancer can affect all of us, either directly or through friends and family. The impacts of both cancer and chemotherapy can be far-reaching and difficult to reconcile for many patients.

Medicinal cannabis holds promise for cancer patients, with early evidence suggesting it may help to address:

• intractable and advanced cancer pain, especially as an alternative to opioids^12.13,
• palliative care associated with advanced cancer¹⁴,
• changes in smell, taste and appetite associated with chemotherapy¹⁵,
• and chemotherapy-induced nausea and vomiting¹⁶.

Multiple sclerosis

Multiple sclerosis (MS) is a condition of the central nervous system affecting over 25,600 Australians, according to MS Australia¹⁷. Patients with MS experience a range of symptoms including chronic pain, muscle spasticity, visual disturbances, fatigue and impaired cognition.

Nabiximols, a cannabis extract containing both tetrahydrocannabinol (THC) and cannabidiol (CBD), is one of the only approved medicinal cannabis products in Australia. Currently, nabiximols is only approved for the treatment of muscle spasticity related to multiple sclerosis¹⁸.

Epilepsy

Roughly 250,000 Australians are currently diagnosed with epilepsy, according to Epilepsy Action Australia¹⁹. Epilepsy is a neurological disorder characterised by a tendency to have spontaneous, recurrent seizures. Not all seizures involve convulsions, but may present in a variety of different ways including changes to sensation, awareness, behaviour or movement.

Studies have shown that medicinal cannabis therapies could be beneficial for:

• reducing seizure frequency in paediatric patients with refractory epilepsy²⁰,
• reducing seizure count and improving quality of life in patients with Dravet syndrome²¹,
• and decreasing frequency of drop seizures associated with Lennox-Gastaut syndrome^22.23.
   

Whilst medicinal cannabis holds great promise for many patients with treatment-resistant symptoms, research into the efficacy and side effects of these treatment options is still ongoing.

Patients seeking access to medicinal cannabis should educate themselves on the possible side effects and health outcomes associated with medicinal cannabis. For more information about medicinal cannabis, its side effects and how it could help you, visit the Cannatrek website.

¹ The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study. Jetly, et al. https://pubmed.ncbi.nlm.nih.gov/25467221/

² Preliminary, open-label, pilot study of add-on oral Δ9-tetrahydrocannabinol in chronic post-traumatic stress disorder. Roitman, et al. https://pubmed.ncbi.nlm.nih.gov/24935052/

³ Experiences with medical cannabis in the treatment of veterans with PTSD: Results from a focus group discussion. Krediet, et al. https://www.sciencedirect.com/science/article/pii/S0924977X20301280

⁴ Cannabis use behaviors and prevalence of anxiety and depressive symptoms in a cohort of Canadian medicinal cannabis users. Turna, et al. https://www.sciencedirect.com/science/article/abs/pii/S0022395618304783

⁵ Endometriosis Facts. Endometriosis Australia. https://www.endometriosisaustralia.org/research

⁶ Cannabis Use, a Self-Management Strategy Among Australian Women With Endometriosis: Results From a National Online Survey. Sinclair, et al. https://www.jogc.com/article/S1701-2163(19)30808-4/fulltext

⁷ Painful Fact. Pain Australia. https://www.painaustralia.org.au/about-pain/painful-facts

⁸ Medical Cannabis for the Treatment of Fibromyalgia. Habib, et al. https://pubmed.ncbi.nlm.nih.gov/29461346/

⁹ Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Rhyne, et al. https://pubmed.ncbi.nlm.nih.gov/26749285/

¹⁰ Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. Ware, et al. https://pubmed.ncbi.nlm.nih.gov/20805210/

¹¹ Cancer data highlights. Australian Institute of Health and Welfare. https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/cancer/overview

¹² Results of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as an Adjunctive Therapy in Advanced Cancer Patients with Chronic Uncontrolled Pain. Lichtman, et al. https://pubmed.ncbi.nlm.nih.gov/28923526/

¹³ Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. Johnson, et al. https://pubmed.ncbi.nlm.nih.gov/19896326/

¹⁴ The Medical Necessity for Medicinal Cannabis: Prospective, Observational Study Evaluating the Treatment in Cancer Patients on Supportive or Palliative Care. Bar-Sela, et al. https://www.hindawi.com/journals/ecam/2013/510392/

¹⁵ Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized, double-blind, placebo-controlled pilot trial. Brisbois, et al. https://www.sciencedirect.com/science/article/pii/S0923753419383607

¹⁶ Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Smith, et al. https://pubmed.ncbi.nlm.nih.gov/26561338/

¹⁷ Facts and key figures about MS. MS Australia. https://www.msaustralia.org.au/file/2090/download?token=o1WFW9mC

¹⁸ Nabiximols for multiple sclerosis. Australian Prescriber. https://www.nps.org.au/australian-prescriber/articles/nabiximols-for-multiple-sclerosis

¹⁹ About epilepsy. Epilepsy Action Australia. https://www.epilepsy.org.au/about-epilepsy/

²⁰ Efficacy of CBD-enriched medical cannabis for treatment of refractory epilepsy in children and adolescents - An observational, longitudinal study. Hausmam-Kedem, et al. https://pubmed.ncbi.nlm.nih.gov/29674131/

²¹ A prospective open‐label trial of a CBD/THC cannabis oil in dravet syndrome. McCoy, et al. https://onlinelibrary.wiley.com/doi/full/10.1002/acn3.621

²² Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Thiele, et al. https://pubmed.ncbi.nlm.nih.gov/29395273/

²³ Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. Devinsky, et al. https://pubmed.ncbi.nlm.nih.gov/29768152/