The Medicinal Cannabis Library

Finding the right medicinal cannabis dose for you

Everything you need to know about cannabis dosage and titration as a medicinal cannabis patient.

Author

medically reviewed by

Published

January 27, 2023

Switch to Polln for care that goes above and beyond
Get 20% discount on your first consultation
Ready to start feeling better, naturally?

Our caring doctors are here to help every step of the way.

Book your online consultation
Looking for care that takes a natural approach?
Join Polln
Speak to the experts in plant medicine, on your schedule

Appointments available same day, after hours and weekends.

Join Polln

What is the recommended medicinal cannabis dosage?

You’ve probably heard by now that medicinal cannabis (historically known as marijuana, learn more about cannabis language here) is a very personalised medication. Unlike many other medications, there are no standardised dosages for medicinal cannabis. This means that what works best for you in terms of dosage, format, cannabinoid content and other factors may not work for another patient, even if you share the same condition. 

So while finding your recommended dosage is a personalised journey you will undertake with your prescribing doctor, there are some general guidelines you can follow.

The main piece of advice you’ll hear is to ‘start low and go slow.’ This is particularly important for beginner cannabis consumers. Your doctor will likely prescribe a low dose and get you to slowly increase this at small increments until you find the best dosage for relieving your symptoms. They will also give you an ideal dose range to work within so that you’re not exceeding the recommended cannabis dosage and flooding your cannabinoid receptors. Through careful monitoring of your symptoms with the support of your prescribing doctor, you should be able to and gradually increase and adjust your treatment plan to find a dose that works best for you. 

Let’s look at some of the factors that will play a part in finding your ideal medicinal cannabis dosage.

Factors that can influence dosage: 

Bioavailability and methods of consumption 

Bioavailability refers to the ability of a drug or other substance to be absorbed and used by the body for its intended purpose. When it comes to medical cannabis, bioavailability determines the rate at which cannabinoids are absorbed and effects are produced in the body. This means that bioavailability determines how quickly and how effectively your medicine will relieve your symptoms, which in turn determines what your ideal dose might be.

Cannabis bioavailability varies greatly depending on your method of consumption. This is because different routes of administration have differing effects on the way the human body absorbs, distributes, processes, and eliminates a substance like medical cannabis. 

There are a number of different ways to take medicinal cannabis, and a number of different types and formats of medical cannabis treatment that you may be prescribed. We’ll explore some of these below.

Inhalation

Vaping medical cannabis 

Vaping is the process of heating cannabis flower or extract at a high temperature without burning it, allowing cannabinoids and terpenes to be released in the form of a vapour, which is then inhaled.

In terms of bioavailability, a 2016 study found that some medical-grade cannabis vaporisers, including the Volcano Medic by Storz & Bickel, are capable of reaching bioavailability ratings of between 50–80%.1 This makes the bioavailability of cannabis vapour (with the right vaporiser) significantly higher than other cannabis formats, which may suit medical patients who require more rapid onset and faster relief from symptoms.

For medical uses, vaping is preferable to smoking not only because of its increased bioavailability, but because it maintains cannabinoid content and contains far fewer toxins and carcinogens. It is also supported by the TGA when a medical-grade dry-herb vaporiser is used.

Only use a medicinal cannabis vaporiser if you are advised to by your prescribing cannabis doctor. Learn more about vaping medicinal cannabis here.

Smoking medicinal cannabis 

Although smoking cannabis is the most common route of administration for non-medical cannabis use, it is not recommended for medical patients due to the health risks and the variability and unpredictability of each individual patient and their response.

Compared to vaping cannabis with a TGA-approved vaporiser, smoking cannabis comes with far greater health risks, reduced bioavailability (about 30%2) and less active ingredients. At least 40% of the THC dose in cannabis is lost in side stream/combustion when smoked,3 making it difficult to estimate the amount of THC a patient is receiving. 

In the aforementioned 2016 study1 which compared the quality of cannabis vapour and cannabis smoke, only 3 non-cannabinoids were found in the cannabis vapour produced by the Volcano Medic, while about 150 chemicals were identified in the smoke of combusted cannabis, including 5 polycyclic aromatic hydrocarbons (PAHs), which are strong carcinogens.

Learn more about the benefits of vaping vs. smoking medicinal cannabis here.

Sublingual 

The sublingual method of cannabis medication delivery allows active ingredients to be absorbed directly into the blood vessels of your tongue, bypassing the digestive system. Patients who use this delivery method will place their sublingual medicinal cannabis treatment under their tongue so that mucous membranes – similar to those in the lungs – absorb the cannabis medication into the bloodstream. 

Because this method allows the active ingredients in your cannabis medication to bypass the digestive system, its bioavailability is higher than that of edibles and other oral medicinal cannabis treatments, allowing for faster onset and higher concentrations of cannabinoids. 

The bioavailability of sublingual medicinal cannabis treatments varies, and can range from slightly higher than oral methods (about 4–20%4) to as much as 92–98% for one studied oromucosal (sublingual) prescription spray.5

Ingestion

Ingestion methods of medicinal cannabis consumption refer to any cannabis medication that is consumed orally – including edibles, oils, tinctures, capsules and extracts. Oral bioavailability is lower than other delivery methods, and is said to range somewhere between 4–20%.4

Despite the lower bioavailability of oral cannabis medications, they typically last longer than other methods of consumption,6 with peak effects occurring about two to four hours after consumption.3 Given the slower onset and longer duration of oral administration this method may be more useful for medical conditions or symptoms where control over longer periods of time is required, much like any other slow release medication.

The active ingredients (e.g. cannabinoids) within your cannabis

Before you find the right dose, your doctor will also need to help you find the right type of cannabis treatment for you and your needs. One of the most important factors they will consider is the active ingredients within your cannabis, including cannabinoids like CBD and THC, other cannabinoids, terpenes and other cannabis compounds. 

The active ingredients within your medicinal cannabis treatment will influence the effects your medication has, as well as the dose you will need to take to get relief from your symptoms. Some cannabinoids or cannabinoid combinations and doses may be more effective for relieving certain symptoms, and your doctor will help guide you to find what works for you. 

Because of their varying effects, it’s important to note that when consuming THC, you may notice effects more quickly than with CBD. Finding the right balance between CBD and THC and exploring different cannabis treatments, formats and dosage requirements will be an individual process. The goal is to find your optimal therapeutic window where you get the most benefit without unwanted adverse effects. 

Tolerance 

Whether you are a regular cannabis consumer or entirely new to medical cannabis, your tolerance to your prescribed treatment will impact your cannabis dose. Patients who are new to cannabis are likely to have a low tolerance, and may only need 0.1–0.5 of the starting dose of a regular cannabis user3 to feel its effects. Patients who are regular cannabis consumers may have a higher tolerance, and may be able to start on a slightly higher dose. These patients should be advised to consider their tolerance and the accumulation of THC in fat stores and adjust their dose or take tolerance breaks accordingly.

We know that regular/prolonged use of THC-containing cannabis treatments may cause patients to develop a tolerance7 to the therapeutic benefits of their treatments. This means they may stop experiencing the same results or relief that they usually would with their regular THC dose. Tolerance breaks can help patients reset their cannabinoid receptors and return to their ideal dose (or even lower) to get the desired effects from their treatment, resulting in lower costs over time and a more balanced endocannabinoid system.

Learn more about cannabis tolerance and tolerance breaks here.

Individual differences in ECS

Each of us – whether we consume cannabis or not – has an endocannabinoid system. The endocannabinoid system (ECS) is a molecular system made up of a vast network of chemical signals and cellular receptors located all throughout our brains and bodies. These help regulate and balance many processes in the body – including immune response, communication between cells, sleep, pain, appetite, hormone levels, metabolism, memory, and more. 

Because no two bodies are the same, the endocannabinoid system will vary between each individual patient depending on age, sex, health, weight, illness, potential endocannabinoid deficiency and other individual factors. 

For example, age and sex of individuals are important determinants for the consequences of cannabinoid exposure on conditions like anxiety, with women having an increased propensity to anxiety-related disorders and biological differences in the endocannabinoid system compared with men.8

So, because the endocannabinoid system varies from person to person, so will our individual responses to medical cannabis treatments, which interact with the endocannabinoid system in a number of ways. This is why finding the right dose for you and your symptoms is an individual process that can only be done through trial and error and with the support of a healthcare professional. 

Learn more about how cannabis interacts with the endocannabinoid system here.

Your treatment goals and what you are using medical cannabis to treat

Depending on your treatment goals and the condition/s and symptom/s you are using medicinal cannabis to treat, your ideal dose may be lower or higher than that of another patient, and that’s something only you and your doctor can determine together based on your individual patient needs. So while there may be general guidelines that your doctor can follow in terms of the type of treatment, the active ingredients and the dose that might be best for your condition and symptoms, it will all come down to how you as an individual respond to your cannabis treatment once you’ve started taking it.

For example, a patient with generalised anxiety, PTSD or sleep issues may see greater results with a lower dose of CBD (e.g. 25 to 75 mg)9,10 than with a higher dose (e.g. 600 mg).11 A patient with epilepsy however, might require 300 to 1500 mg of CBD each day to reduce seizures.12 It all depends on the individual patient’s response to treatment.

By monitoring your progress (a treatment journal which measures your symptoms over time as you find your ideal treatment and dose is a great tool for this) and regularly checking in with your prescribing doctor, you should be able to find a treatment plan and an ideal dose for your treatment goals.

Titrating and microdosing medical cannabis

What is titration? 

Titration simply refers to the process of slowly increasing your medication dosage to find the right amount of cannabis that will produce your desired therapeutic effects.

Getting to this point requires a bit of patience, especially for beginner cannabis consumers. Try and follow these steps to find your ideal dosage:

How to find your ideal dosage

1. Start low and go slow

When you are prescribed a medical cannabis treatment, your doctor should discuss your starting dose range with you. Always start with a dose on the lower end of that spectrum and wait until the estimated onset time for your particular product has passed to see if you begin to feel any therapeutic benefits or side effects.

If you’re not feeling the desired effects, you can gradually increase your dose by an amount advised by your doctor until you find your ‘sweet spot,’ ensuring you stick to that dose for at least two to three days each time you increase to give your body a chance to adjust. This process of determining the minimal amount of your medicine that will give you your desired results with minimal side effects is known as titration

When it comes to medical cannabis, titration also involves finding the right balance between the different cannabinoids (eg. CBD and THC) in your medications, your condition and your body’s individual response. 

2. Stay consistent

Cannabinoids take time to build up their effect within your body. For best results, make sure you’re sticking to your treatment plan consistently. 

3. Less is sometimes more

Depending on your condition, when it comes to dosing medical cannabis, more is not always better. For some patients living with chronic conditions, smaller doses over a prolonged period of time may be more effective than a high dose. Ensure you’re working with your doctor to figure out what dose works best for you.

4. Pay attention to your body

Like with any medicine, your ideal dosage of medical cannabis can change over time. Whether increasing or decreasing your dosage, the important thing is to listen to your body and what it needs and to check in with your prescribing doctor regularly.

What is microdosing? 

In the cannabis world, microdosing refers to taking small, low dose amounts daily (or on most days). Many patients do this in order to reap the medical benefits of THC while avoiding its psychoactive effects of THC that can interfere with the demands of daily life. Depending on your symptoms and condition, some patients may see greater results from a lower THC dose than with medium or high doses. Microdosing should always be done with the guidance and support of your prescribing doctor.

Microdosing may be suitable for patients who want to get the medical benefits of their THC treatment without any of the impairing effects. Microdosing is not suitable for patients who drive on a daily basis, as it is illegal to drive with any amount of THC in your system in Australia. 

Microdosing may also suit certain conditions better than others. For example, a 2012 study of patients with advanced cancer who were unresponsive to opioid painkillers found that patients who received the lowest dosage of cannabinoids (CBD/THC) showed the greatest reduction in cancer pain, while those receiving higher doses actually experienced more pain.13 Similarly, another 2014 study of 104 incarcerated male inmates with serious mental illness found that PTSD-associated symptoms like insomnia, nightmares, general symptoms and even chronic pain were significantly improved in participants who received regular, smaller doses of the synthetic cannabinoid Nabilone.14

So while high doses of cannabis may be needed to treat significant symptoms or flare-ups for certain conditions, a lower daily dose or microdose of cannabis over time may actually be more suitable for maximum safety and efficacy in some patients.

How to microdose cannabis medication

To explore microdosing your treatments, you will need to talk to your prescribing doctor and work within the dosage range they recommend for your particular treatment. If you are using cannabis regularly, your doctor may advise that you take a tolerance break before starting your microdosing regime so that you can reset your cannabinoid receptors and start at a lower dose, gradually increasing until you get the minimal noticeable effect. 

The way you microdose will also depend on the type of medical cannabis treatment you take and the method you use to take it, as well as whether you use one or a combination of medicinal cannabis treatments. Again, your doctor will be able to help you explore microdosing and find the lowest daily dose that works for you and your condition, so ensure you’re checking in with them regularly and monitoring your progress as you go.

The bottom line

There are no hard and fast rules when it comes to finding the right dose for your medical cannabis treatment, and treatment results will vary from person to person. Your best bet is to ensure you’re working with a qualified and experienced medical cannabis doctor on a treatment plan and dosing regimen that works for you. Monitor your progress, check in with your practitioner regularly and pay attention to how you’re feeling over time. With the right support, you should be able to find a dose that helps you reach your treatment goals.

Medicinal cannabis dosing and titration FAQs

Should you stick to the recommended standard dosage?

Always follow the dosage guidelines provided to you by your doctor, unless you experience unwanted side effects and need to stop your treatment (make sure you let your doctor know if this happens to you). Your doctor will provide you with a dose range to work within for your specific treatment and needs. You should start at the low end of that range and gradually increase / titrate your dose up until you get the effects you desire. Where your ideal dose ends up sitting within the standard dose range will depend on you and your symptoms as an individual.

If you reach the high end of your dose range and still don’t experience relief from your symptoms, you should reach out to your prescribing doctor for further advice on what to do. Be careful about increasing your dose beyond your recommended dose range, as this can flood your endocannabinoid receptors and create an imbalance, leading to symptoms like anxiety and sleep issues. Instead, you should talk to your doctor about other options, including tolerance breaks (if you are already a regular cannabis user), other medical cannabis formats and delivery methods, or other treatment options altogether. 

Can you overdose on cannabis? 

You can’t overdose on cannabis in the same way that you can overdose on other drugs or pharmacological medications, such as opioids. However, it is possible to have a bad reaction or experience adverse effects, especially when cannabis use is combined with other substances like alcohol. 

Cannabis compounds interact with receptors in the brain that influence things like memory, pleasure, and cognition. Unlike substances like opioids and alcohol, these molecules aren't found in areas that control breathing, meaning cannabis is unlikely to cause death on its own. Opioids can kill in high doses by binding to receptors that depress breathing, while large amounts of alcohol can similarly impair the body’s ability to control breathing. 

CBD is generally well tolerated as a cannabinoid and is non-impairing, even at high doses.15 On the other hand, the effects of THC can include the ‘high’ feeling commonly associated with cannabis, and can be impairing or sedating in some people at certain doses. Because of this, THC is more likely to cause unwanted side effects like anxiety, confusion, dizziness, slower reaction times and increased heart rate at high doses. In rare cases and at very high doses it can also cause hallucinations, panic attacks, nausea and vomiting. These adverse events are highly unlikely to occur in patients who stick to the dose recommended by their prescribing doctor.

To date, there have not been any reported deaths in teens and adults resulting solely from cannabis use or toxicity. 

References
  1. Lanz C, Mattsson J, Soydaner U, Brenneisen R. Medicinal Cannabis: In Vitro Validation of Vaporizers for the Smoke-Free Inhalation of Cannabis. PLoS One. 2016 Jan 19;11(1):e0147286. doi: 10.1371/journal.pone.0147286. PMID: 26784441; PMCID: PMC4718604.
  2. McGilveray IJ. Pharmacokinetics of cannabinoids. Pain Res Manag. 2005 Autumn;10 Suppl A:15A-22A. doi: 10.1155/2005/242516. PMID: 16237477.
  3. TGA, Guidance for the use of medicinal cannabis in Australia: Overview, https://www.tga.gov.au/resources/publication/publications/guidance-use-medicinal-cannabis-australia-overview#route-rules, December 2017.
  4. Huestis MA. Human cannabinoid pharmacokinetics. Chem Biodivers. 2007 Aug;4(8):1770-804. doi: 10.1002/cbdv.200790152. PMID: 17712819; PMCID: PMC2689518.
  5. Karschner EL, Darwin WD, Goodwin RS, Wright S, Huestis MA. Plasma cannabinoid pharmacokinetics following controlled oral delta9-tetrahydrocannabinol and oromucosal cannabis extract administration. Clin Chem. 2011 Jan;57(1):66-75. doi: 10.1373/clinchem.2010.152439. Epub 2010 Nov 15. PMID: 21078841; PMCID: PMC3717338.
  6. Poyatos L, Pérez-Acevedo AP, Papaseit E, Pérez-Mañá C, Martin S, Hladun O, Siles A, Torrens M, Busardo FP, Farré M. Oral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review. Medicina (Kaunas). 2020 Jun 23;56(6):309. doi: 10.3390/medicina56060309. PMID: 32585912; PMCID: PMC7353904.
  7. Mason NL, Theunissen EL, Hutten NRPW, Tse DHY, Toennes SW, Jansen JFA, Stiers P, Ramaekers JG. Reduced responsiveness of the reward system is associated with tolerance to cannabis impairment in chronic users. Addict Biol. 2021 Jan;26(1):e12870. doi: 10.1111/adb.12870. Epub 2019 Dec 22. PMID: 31865628; PMCID: PMC7757162.
  8. Maldonado R, Cabañero D, Martín-García E. The endocannabinoid system in modulating fear, anxiety, and stress
. Dialogues Clin Neurosci. 2020 Sep;22(3):229-239. doi: 10.31887/DCNS.2020.22.3/rmaldonado. PMID: 33162766; PMCID: PMC7605023.
  9. Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019 Apr;25(4):392-397. doi: 10.1089/acm.2018.0437. Epub 2018 Dec 13. PMID: 30543451; PMCID: PMC6482919.
  10. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. doi: 10.7812/TPP/18-041. PMID: 30624194; PMCID: PMC6326553.
  11. Linares IM, Zuardi AW, Pereira LC, Queiroz RH, Mechoulam R, Guimarães FS, Crippa JA. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Braz J Psychiatry. 2019 Jan-Feb;41(1):9-14. doi: 10.1590/1516-4446-2017-0015. Epub 2018 Oct 11. PMID: 30328956; PMCID: PMC6781714.
  12. Henderson LA, Kotsirilos V, Cairns EA, Ramachandran A, Peck CC, McGregor IS. Medicinal cannabis in the treatment of chronic pain. Aust J Gen Pract. 2021 Oct;50(10):724-732. doi: 10.31128/AJGP-04-21-5939. PMID: 34590094.
  13. Portenoy RK, Ganae-Motan ED, Allende S, Yanagihara R, Shaiova L, Weinstein S, McQuade R, Wright S, Fallon MT. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial. J Pain. 2012 May;13(5):438-49. doi: 10.1016/j.jpain.2012.01.003. Epub 2012 Apr 5. PMID: 22483680.
  14. Cameron C, Watson D, Robinson J. Use of a synthetic cannabinoid in a correctional population for posttraumatic stress disorder-related insomnia and nightmares, chronic pain, harm reduction, and other indications: a retrospective evaluation. J Clin Psychopharmacol. 2014 Oct;34(5):559-64. doi: 10.1097/JCP.0000000000000180. PMID: 24987795; PMCID: PMC4165471.
  15. McCartney D, Suraev AS, Doohan PT, Irwin C, Kevin RC, Grunstein RR, Hoyos CM, McGregor IS. Effects of cannabidiol on simulated driving and cognitive performance: A dose-ranging randomised controlled trial. J Psychopharmacol. 2022 Dec;36(12):1338-1349. doi: 10.1177/02698811221095356. Epub 2022 May 30. PMID: 35637624; PMCID: PMC9716488.

The information on this website is provided for educational and informational purposes only and not intended for use as medical advice. Polln is not promoting the use of medicinal cannabis. Medicinal cannabis in Australia is scheduled medication and regulated by the Therapeutic Goods Administration (TGA). Details about medicinal cannabis as a scheduled drug can be found on their website. If you would like to explore medicinal cannabis for your chronic condition, please consult with a doctor.

Switch to Polln for care that goes above and beyond
Get 20% discount on your first consultation
Ready to start feeling better, naturally?

Our caring doctors are here to help every step of the way.

Book your online consultation
Looking for care that takes a natural approach?
Join Polln
Speak to the experts in plant medicine, on your schedule

Appointments available same day, after hours and weekends.

Join Polln
Related articles
Patient Education

Addiction Management: Medicinal Cannabis and Alcoholism

4
min read
Read Article
Addiction Management: Medicinal Cannabis and Alcoholism

Alcoholism is a challenging condition that requires a lot of care, understanding, and treatment options.  In recent years, there has been growing interest in the potential link between medicinal cannabis and alcoholism management, sparking scientific exploration into whether natural therapies can offer support to people trying to recover from alcohol addiction.

Research suggests that medicinal cannabis may act as an effective harm-reduction strategy for some patients. It may help some people manage withdrawal symptoms, reduce cravings, and serve as an alternative to alcohol in certain cases. However, its effectiveness varies from person to person and there may be associated risks, including the potential for developing cannabis use disorder.

Today, we'll explore the connection between medicinal cannabis and alcoholism, discuss the potential benefits of medicinal cannabis and highlight key considerations for those considering medicinal cannabis for alcoholism treatment. Let’s get started. 

What is Alcoholism: How Much is Too Much? 

Alcoholism, formally known as Alcohol Use Disorder (AUD), is a complex and challenging condition. It's not just about enjoying a social drink or two; it involves a persistent, compulsive need for alcohol, and heavy drinking to the detriment of a person's health and well-being.

According to the National Health and Medical Research Council (20200, men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.

However, alcoholism is characterised by an inability to control the amount you drink and also experiencing increased tolerance (needing more alcohol to achieve the same effect), withdrawal symptoms when not drinking, and spending a significant amount of time obtaining, using, and recovering from the effects of alcohol.

For many, an inability to stop drinking leads to neglect of other responsibilities, strained relationships, and a strong desire to keep drinking, even when it's causing problems.

Many Australians may be at risk for an AUD. 1 in 4 Australians aged 14 and over drink at a risky level (more than 4 standard drinks on any one occasion) at least monthly. Continuing to drink above recommended levels may put your health at risk.

Is There a Safe Level of Alcohol Consumption?

A recent report from The Lancet Public Health highlights a clear message from the World Health Organization: there's no safe amount of alcohol that won't affect your health. Studies show that even light drinking is linked to a higher risk of alcohol-related cancers, and there's no specific level where these harmful effects begin.

It’s hard to pinpoint a safe amount of alcohol when it comes to preventing cancer and maintaining overall health. While some studies suggest a small protective effect of light drinking on certain heart and diabetes risks, this finding isn't consistent across all research.

What is Alcoholism: Am I at Risk? 

To be diagnosed with an Alcohol Use disorder, your doctor or healthcare professional will assess your symptoms against the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)  criteria. They’ll also be able to determine the severity of your AUD, as alcohol use disorders can be categorised as mild (2–3 criteria), moderate (4–5 criteria), or severe (6 or more criteria).

The official criteria for AUD is:

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 or more of the following, occurring at any time in the same 12-month period:

  • Alcohol is often taken in larger amounts or over a longer period than was intended.
  • There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
  • A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
  • Craving, or a strong desire or urge to use alcohol.
  • Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home.
  • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
  • Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
  • Recurrent alcohol use in situations in which it is physically hazardous.
  • Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
  • A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
  • A markedly diminished effect with continued use of the same amount of alcohol.
  • Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid alcohol withdrawal symptoms

If you believe that you may be at risk of an Alcohol Use Disorder (AUD), it's important to reach out for help and seek support from healthcare professionals, addiction specialists, or support groups.

The Physical and Mental Health Effects of Alcoholism

The impact of alcoholism on physical and mental health can be profound. Excessive and chronic alcohol use can lead to liver disease, and damage the heart and brain. It can also increase the risk of various types of cancer, contribute to digestive issues, and weaken the immune system.

Mentally, alcoholism can lead to depression, anxiety, and other mental health disorders. The relationship between alcohol and mental health is complex, often creating a cycle where alcohol is used to cope with emotional distress, which, in turn, exacerbates the problem. This can result in a dual diagnosis of alcoholism and a co-occurring mental health condition.

How Common is Alcoholism?

If you struggle with alcohol usage, you’re not alone. Alcohol addiction is a widespread issue — which is understandable considering how interlinked regular alcohol use is within many cultures.

In Australia, 6.5% adults meet the criteria for an alcohol-use disorder. While men have a higher risk than women of developing alcohol use disorders, alcoholism can affect anyone — it doesn’t discriminate against class, gender, or social standing.

Although anyone can be affected by an alcohol use disorder, there are some risk factors that may increase your chances of developing a problem with drinking These include: 

  • Starting drinking at a young age: People who began drinking before age 15 are more likely to report having AUD than those who waited until age 21 or later to start drinking.
  • Having a family history of disordered drinking: Genetics and a parent’s drinking patterns may play a role in whether someone develops an AUD.
  • Having mental health conditions or childhood trauma: Many mental health conditions (including depression, PTSD, and ADHD) are often linked to an increased risk of AUD.

Remember, while these risk factors can increase the likelihood of developing an Alcohol Use Disorder (AUD), it’s not set in stone. Many people with these risk factors do not develop AUD, just like how some people without these risk factors may still develop a problematic relationship with alcohol.

What is Medicinal Cannabis?

Medicinal cannabis (historically known as medical marijuana or medical weed, learn more about the importance of language here) is the cannabis plant used for medical purposes.

The therapeutic compounds within medical cannabis are called cannabinoids, the most well-known of which are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These compounds interact with our body's endocannabinoid system, which plays a crucial role in regulating various physiological functions, including pain, mood, and appetite.

Medicinal cannabis is available in different forms, including dried flower, oils, capsules, and edibles. Each form may have unique properties, and their effects can vary based on the specific cannabinoid and terpene composition.

Potential Therapeutic Effects of Medicinal Cannabis on Alcoholism

Research suggests that medicinal cannabis may help some patients address certain challenges associated with alcoholism. While it's important to note that individual responses can vary, here are some potential benefits:

If you’re thinking about exploring natural therapies, make an appointment with an experienced doctor. They can help you assess your conditions, connect with your regular GP, and create a personalised treatment plan to help you overcome your addiction to alcohol.  

Potential Risks of Medicinal Cannabis for Alcohol Use Disorder

While some studies suggest that medical cannabis may have the potential to help individuals with alcohol use disorder, there are also potential risks. It’s also important to remember that the effectiveness of medical cannabis for alcohol use disorder may vary from person to person, and that more research is needed to fully understand its potential benefits and drawbacks. 

Here are some of the risks associated with using medical cannabis for AUD:

  • Potential for addiction or dependence: Medicinal cannabis itself can be addictive for some patients, and so some individuals with alcohol use disorder may be at risk of developing a dependence on both alcohol and medical cannabis. Using one substance to replace another may not address the underlying issues related to addiction.

  • Psychiatric side effects: Medicinal cannabis may have unwanted psychoactive effects in some patients, including anxiety, paranoia, and impaired cognitive function. Individuals with alcohol use disorder may be more vulnerable to these effects, which could complicate their recovery efforts.

  • Interaction with medications: If a person with alcohol use disorder is taking medications to manage their condition or related health issues, there may be potential drug interactions between medical cannabis and their prescribed medications. This could lead to adverse effects or reduced medication efficacy.

  • Individual variability: People with AUD have diverse needs and experiences, and what works for one person may not work for another. Medical cannabis may be more effective for some individuals and less so for others.

  • Potential to increase alcoholism: Because your chance of developing alcohol dependence is higher in people with current cannabis dependence, it’s possible that hazardous alcohol use may increase cannabis usage. Additionally, studies indicate that the patterns of cannabis and alcohol use tend to be connected.

It's important for people considering medical cannabis as a treatment for AUD to consult with medical professionals who can provide personalised guidance and monitor their progress — trying to treat an AUD by yourself with recreationally sourced cannabis can be risky for people with addiction.

You may want to also explore other alternative treatments for alcoholism, such as behavioural therapy, support groups ((like alcoholics anonymous), and medications. These can all be considered as part of a comprehensive treatment plan outside of pharmaceutical options.

Remember, medicinal cannabis is not a first-line treatment in Australia. To qualify for access to medicinal cannabis, you must have experienced a chronic condition for over three months and have tried other treatments that were either ineffective or resulted in unwanted side effects. 

Creating a safe alcoholism treatment plan

While exploring the potential benefits of medicinal cannabis as a treatment for alcoholism, the goal should never be to swap one addiction for another or to continue using medical cannabis alongside alcohol. Instead, the aim should be to find a balanced and personalised approach to recovery where your physical and mental health needs are met.

Here are some steps to follow if you’re thinking about trying medicinal cannabis to manage an alcohol use disorder. 

  • Seek professional advice: Before considering the use of medicinal cannabis, individuals facing alcoholism should consult with a healthcare professional, preferably one experienced in addiction medicine. An addiction specialist can assess your unique situation, including the severity of your alcoholism, co-occurring conditions, and treatment history. This assessment will help determine whether medicinal cannabis might be a suitable component of the treatment plan.
  • Link in with your regular GP: Collaboration with one's regular General Practitioner (GP) is also essential. GPs can offer continuity of care and ensure that any potential use of medicinal cannabis aligns with the patient's overall health and wellness. They can monitor progress, address potential side effects or complications, and provide comprehensive support.
  • Avoid unsupervised use: Unsupervised use of medicinal cannabis can pose risks. Self-medicating or obtaining cannabis from non-regulated sources may undermine your recovery process. A regulated and controlled approach, guided by healthcare professionals, is the safest and most effective way to explore the potential benefits of medicinal cannabis.
  • Book a consultation with a doctor: For personalised advice on using medicinal cannabis as part of an alcoholism treatment plan, individuals can consider booking a consultation with a healthcare provider experienced in medical cannabis.

Ultimately, the goal of incorporating medicinal cannabis into alcoholism treatment is to enhance the overall quality of life and facilitate the recovery journey. By combining medicinal cannabis and conventional treatment methods, guided by medical professionals, patients may be able to achieve a  holistic approach to recovery.

The Wrap Up

Alcoholism is a complex and challenging condition that requires comprehensive care and treatment options. Medical cannabis may act as an effective harm-reduction strategy for some patients due to its potential to reduce cravings, manage anxiety and depression, alleviate pain, improve sleep, and stimulate appetite.

However, current research presents conflicting results, and the effectiveness of medical cannabis as a harm-reduction strategy for alcoholism is still a topic of ongoing investigation and debate in the scientific community.

The key to a successful approach to medicinal cannabis in alcoholism treatment lies in seeking professional advice, collaborating with one's regular General Practitioner, avoiding unsupervised use, and considering a consultation with a healthcare provider experienced in medical cannabis and addiction medicine.

Patient Education

Natural Therapies: Medicinal Cannabis and Mental Health

5
min read
Read Article
Natural Therapies: Medicinal Cannabis and Mental Health

Anxiety, depression, and post-traumatic stress disorder (PTSD) are complex, and sometimes interconnected, mental health conditions that can significantly impact your emotional well-being, daily functioning, and overall quality of life.

Anxiety, depression, and post-traumatic stress disorder (PTSD) can be caused by a variety of factors, including our genetic predisposition, environmental stressors, traumatic experiences, and neurochemical imbalances in the brain. Additionally, societal pressures, childhood upbringing, and personal coping mechanisms also play a role in the development and manifestation of these conditions.

While conventional pharmacological treatments, like antidepressants and anti-anxiety medications, can be beneficial for many people, alternative mental health therapies may provide support with reduced risk of side effects or addiction for some patients. Medical cannabis, in particular, has been growing in popularity as a natural treatment option for managing the symptoms of anxiety, depression, and PTSD.

With the right support and treatment, people with anxiety, depression, or PTSD can achieve better mental health. Read on to find out how medical cannabis helps people improve their mental health and whether medicinal cannabis could be the right for you.

Understanding Anxiety, Depression, and PTSD:

Anxiety, depression, and post-traumatic stress disorder (PTSD) are three common mental health conditions that can significantly impact your well-being and daily life.

What is Anxiety?

Anxiety is more than just feeling stressed before an important event; it's a persistent and often overwhelming sense of unease that can interfere with daily activities. Symptoms may include excessive worry, restlessness, rapid heartbeat, and difficulty concentrating. 

If you think you might be dealing with anxiety, you’re not alone. Around 1 in 3 people will have an anxiety disorder during their lifetime. Generalised Anxiety Disorder (GAD), social anxiety disorder, and panic disorder are common subtypes of anxiety. The physical and emotional toll of anxiety can be overwhelming, often leading to a cycle of fear and avoidance behaviours that further worsen symptoms.

People living with Generalised Anxiety Disorder (GAD) experience persistent and excessive worry about various aspects of life, even when there's no apparent reason for concern.

Social anxiety disorder, on the other hand, brings about intense fear and discomfort in social situations, with individuals often worrying about being judged or embarrassed.

Panic disorder is characterised by sudden and recurrent panic attacks, which are intense episodes of fear accompanied by physical sensations like a racing heart, shortness of breath, and dizziness.

Anxiety symptoms can be felt in the body too. Physically, anxiety can manifest as tension headaches, muscle pain, digestive issues, and even cardiovascular problems over time. Sleep disturbances, fatigue, and difficulty concentrating are also common. 

What is Depression?

Depression is a complex and debilitating mental health condition that affects around 1 in 10 people. While everyone experiences occasional moments of sadness, depression goes beyond normal fluctuations in mood.

Common symptoms of depression include a persistent low mood, fatigue, changes in appetite and sleep patterns, difficulty concentrating, and a lack of motivation. People with depression may experience a sense of worthlessness or excessive guilt, which can further contribute to their emotional distress.

Depression can vary in its intensity and duration. Major depressive disorder (MDD) is a specific subtype of depression characterised by the presence of depressive symptoms for at least two weeks. Other types of depression include seasonal affective disorder (SAD),  a type of depression that occurs in the autumn and winter months, and Dysthymia, also known as Persistent Depressive Disorder, which involves a more chronic but less severe form of depression lasting for at least two years

Emotionally, depression can lead to a long term feeling of sadness, hopelessness, and emotional numbness. It can distort one's perception of themselves and the world around them, making it challenging to see a way out of their struggles. This emotional pain can also manifest as physical symptoms such as aches, pains, and a general feeling of being unwell.

What is PTSD (Post-Traumatic Stress Disorder)?

PTSD extends far beyond a normal stress response to a distressing event; it's a multifaceted and profound mental health condition that affects many aspects of your life. Unlike short-term feelings of anxiety or unease, PTSD involves persistent and distressing symptoms triggered by exposure to a traumatic experience. This experience may involve incidents like accidents, violence, abuse, or other life-threatening events.

C-PTSD, known as complex post-traumatic stress disorder (complex PTSD), is a similar condition to PTSD that can develop in response to repeated or intense trauma (such as growing up with childhood abuse). C-PTSD symptoms are similar to those of PTSD, but include an ongoing sense of emptiness or a distorted self-image.

The hallmark of PTSD lies in its diverse range of symptoms, which can be broadly categorised into four groups: intrusive thoughts, avoidance behaviours, negative alterations in mood and cognition, and heightened arousal.

Intrusive thoughts encompass vivid and distressing memories of the traumatic event, often accompanied by flashbacks and nightmares. Avoidance behaviours involve efforts to steer clear of reminders associated with the trauma, which can lead to detachment from activities and situations that were once enjoyed.

Negative alterations in mood and cognition involve a shift in one's emotional landscape, leading to feelings of guilt, blame, and a distorted sense of self-worth. These changes can also translate into difficulties in maintaining relationships and a sense of detachment from the world. Heightened arousal is shown as an enhanced state of vigilance, marked by irritability, difficulty concentrating, and an exaggerated startle response.

The impact of PTSD is profound and far-reaching, often affecting various facets of life. Physically, it can also cause headaches, gastrointestinal disturbances, and cardiovascular issues. Sleep disturbances and chronic fatigue are also common, contributing to an overall sense of poor well-being. 

Challenges of Traditional Anxiety, Depression and PTSD Treatments

While traditional pharmaceutically-based treatments for anxiety, depression, and PTSD are often effective in managing various mental health symptoms, they are not without some drawbacks. 

While antidepressants and anti-anxiety drugs can help reduce mental health symptoms, they often also come with unwanted side effects that can include drowsiness, weight gain, nausea, sexual dysfunction, or even an emotional “numbing”.

The process of finding the right medication can be challenging too. Not all mental health medications work the same way for everyone, and so finding effective treatment for you can involve a lot of trial and error. This can be frustrating and disheartening for people who are already dealing with depression or anxiety.

Pharmaceutically-based treatments for anxiety, depression or PTSD can also come with a higher risk of addiction or withdrawal problems. Some people can become dependent on their medications, while discontinuing medications can lead to withdrawal symptoms that are severely uncomfortable or even dangerous. 

For example, if someone were to suddenly stop taking higher doses of benzodiazepines (such as valium for anxiety) they could have serious withdrawal symptoms, including seizures and psychotic reactions.

It's important to engage in open and honest conversations with healthcare providers to discuss the benefits and risks of different medications for mental health conditions and explore alternative or complementary approaches to treatment.

Medicinal Cannabis and Anxiety, Depression, and PTSD

While research into medicinal cannabis for anxiety, depression, and PTSD is ongoing, current studies and anecdotal evidence suggest its potential as a natural therapeutic for some patients.

Research shows that specific natural compounds within medicinal cannabis, including CBD (cannabidiol) and THC (tetrahydrocannabinol), may help improve the symptoms of some mental health conditions by positively affecting the brain's neurochemical pathways.

  • Anxiety: Research suggests that CBD may have anti-anxiety effects, potentially reducing symptoms of anxiety by interacting with the brain's receptors that regulate stress responses. While higher doses of THC may increase anxiety, lower doses may have a positive impact on anxiety disorders in some patients.
  • Depression: Research into the antidepressant properties of cannabinoids, particularly CBD, shows promise in influencing mood-related neurotransmitters. CBD's potential to regulate serotonin levels in the brain, a neurotransmitter associated with mood regulation, may help some people manage depressive symptoms.
  • Post-Traumatic Stress Disorder (PTSD): Medical cannabis, particularly with a balanced CBD-to-THC ratio, may be a potential treatment option for PTSD. CBD's impact on fear-related memories and its ability to modulate stress responses may contribute to its efficacy in mitigating PTSD symptoms for some patients. However, further clinical trials are necessary to further establish its effectiveness.

How Medical Cannabis May Impact Mental Health

The potential role of medical cannabis in potentially supporting mental health has gained increasing attention, particularly in relation to anxiety, depression, and post-traumatic stress disorder (PTSD). Understanding how medical cannabis interacts with the body can shed light on its potential therapeutic effects.

Medicinal cannabis may help support mental health in some patients with its:

  • Neurotransmitter Regulation: Medical cannabis compounds, notably CBD and THC, interact with the endocannabinoid system (ECS), a complex network of receptors and neurotransmitters in the brain and body. CBD, for example, may influence serotonin receptors, which play a crucial role in mood regulation. By modulating serotonin levels, CBD may offer relief from symptoms of anxiety and depression for some patients.
  • Stress Response Modulation: Both CBD and THC may impact the body's stress response. CBD's calming properties have the potential to reduce stress and anxiety by influencing the body's physiological reactions to stressors in some patients. THC, on the other hand, may help induce a sense of relaxation by binding to specific receptors in the brain. However, it's important to note that higher THC levels could also exacerbate anxiety in some individuals.
  • Memory and Emotion Regulation: CBD's interaction with brain regions responsible for memory and emotional processing holds promise for managing conditions like PTSD in some patients. By influencing the consolidation of fear-based memories and promoting emotional regulation, CBD may help alleviate some distressing symptoms associated with traumatic experiences.
  • Inflammation and Immune Response: Chronic inflammation has been linked to mental health conditions. CBD's anti-inflammatory properties may contribute to its potential benefits for anxiety and depression in some patients by reducing overall inflammation levels in the body. By modulating the immune response, CBD could help mitigate the physiological effects of stress on mental well-being.

It's important to remember that the effects of medical cannabis on mental health can vary from person to person. Factors such as dosage, cannabinoid ratios, and an individual's unique response to the medication will play a role in determining the outcome. 

Possible Risks of Medical Cannabis for Mental Health

When deciding on any kind of medication, it's also essential to acknowledge any possible risks. A comprehensive discussion with a caring medical professional can help you make an informed decision about whether medical cannabis is the right option for you and your health.

While medical cannabis is a natural treatment option, some potential risks of medicinal cannabis include: 

  • Cognitive Effects: Depending on the compounds present and their concentrations, medical cannabis can sometimes lead to cognitive changes, including impaired memory and concentration.
  • Interactions and Side Effects: Just like any medication, medical cannabis could interact with other medications you're taking. Although side effects are fewer than with traditional medications, it’s still worth talking them over with your doctor. 
  • Psychoactive Effects of THC: The psychoactive nature of THC may not be appropriate for people with certain mood disorders, such as bipolar disorder or schizophrenia. 

The Wrap Up

Medical cannabis is becoming a more widely studied natural treatment for anxiety, depression, and PTSD. While traditional therapies have many benefits, they also come with their share of challenges too.

Medical cannabis may help some patients address the complex nature of mental health conditions with fewer side effects than traditional pharmacological drugs. Its potential to improve mental health may also help some people who have not found relief in other medication or management plans. 

If you’re thinking about exploring natural therapies, then it’s important to approach it as part of a comprehensive treatment plan, guided by healthcare professionals who can access individual risks and benefits.

Medical Cannabis and Mental Health: FAQs
Is medical cannabis good for anxiety?

The effects of medicinal cannabis on anxiety can vary widely from person to person. While some individuals might experience temporary relief from anxiety symptoms due to the relaxing properties of certain compounds like CBD, others may find that medical cannabis increases their anxiety or induces feelings of paranoia.

Medical cannabis, specifically formulations with higher CBD content and lower THC levels, has shown potential in alleviating anxiety for some individuals. However, it's important to consult with a healthcare professional before using any form of medicinal cannabis to address anxiety, as individual reactions can differ and potential risks need to be carefully considered.

Can PTSD be overcome?

Yes, PTSD can be overcome with the right treatment and support. Effective medications and therapies, such as cognitive-behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR), along with support from mental health professionals and a strong social network, can help individuals manage and eventually relieve the symptoms of PTSD.

Additionally, emerging research suggests that medical cannabis, particularly with balanced CBD-to-THC ratios, may hold promise in mitigating PTSD symptoms by impacting fear-related memories and stress responses, although further clinical trials are necessary to establish its safety and effectiveness as a potential treatment option.

Is medicinal cannabis a depressant?

Medical cannabis (historically known as medical weed or medical marijuana, learn more about the importance of language here), contains compounds like THC and CBD, producing a mix of effects. It's not a straightforward depressant but can have varying properties including depressive, stimulant, and hallucinogenic effects.

While some individuals may feel temporary mood enhancement or relief from depression after using medical cannabis, its impact on mental health is complex. While certain compounds like CBD show potential, more study is needed for a clear understanding of its effects, dosages, and safety.

Patient Education

The Caregiver's Guide to Medicinal Cannabis

6
min read
Read Article
The Caregiver's Guide to Medicinal Cannabis

Welcome to the Caregivers’ Guide to Medicinal Cannabis. As a caregiver, we understand that ensuring the well-being of your loved one during an illness can be challenging. Whether you’re looking after elderly parents, taking care of elderly family members, or caring for someone else important in your life – caregiving is a big responsibility. That’s why we’re dedicated to helping caregivers and providing them with the knowledge and support they need to care for themselves and their loved ones.

Medicinal cannabis has been shown to help people with a variety of physical and mental health issues. From glaucoma to chronic pain, chemotherapy and even sleep problems, medicinal cannabis has the potential to help some chronically or terminally ill people, including ageing parents, to manage symptoms, enhance their comfort, and improve quality of life.

This guide has been created for caregivers just like you, so that they can better understand the fundamentals of medicinal cannabis, explore the science behind medicinal cannabis, and find out how to potentially integrate medicinal cannabis into your loved one's care routine. 

Understanding Medicinal Cannabis as a Caregiver

If you’re thinking about medicinal cannabis for an elderly parent or loved one, a good first step is to get to know the medicinal cannabis basics, including its therapeutic effects, potential risks, administration methods, how medicinal cannabis differs from recreational use, and the legalities of medicinal cannabis in Australia. Let’s get started. 

What is a caregiver?

A caregiver is someone who provides care and support to another person who may be unable to fully take care of themselves due to age, illness, disability, or other challenges.

Caregivers help with daily tasks, offer emotional support, and ensure the well-being of those they care for. You may be looking after elderly parents, taking care of elderly family members, or caring for a child or a friend.

What Is Medicinal Cannabis? 

Medicinal cannabis is a type of natural therapy with therapeutic chemical compounds, most notably tetrahydrocannabinol (THC) and cannabidiol (CBD) that have been shown to provide a range of health benefits and manage various conditions.

These chemical compounds engage with the body's endocannabinoid system (a network of receptors that control numerous bodily functions) to help people manage short-term, chronic, and end-of-life conditions.

Cannabis plants contain a wide variety of cannabinoids, each with its own potential effects and properties. Some of the most well-known and studied cannabinoids found in cannabis plants include:

Just like there are different types of common medications, there are different types of medical cannabis treatments. Treatments vary in terms of the format they come in (e.g. oils, dry herb flower that is vaporised, topicals, wafers and more), the cannabinoid and terpene content and potency.

Caring for Elderly Parents: How Medicinal Cannabis May Help

Caring for elderly parents comes with its own unique set of challenges but medicinal cannabis can support you in providing ageing parents with additional pain relief and comfort. In Australia, medicinal cannabis is becoming recognized for its wide-ranging therapeutic benefits for age-related conditions.

From providing chronic pain and arthritis relief to tackling sleep disorders and glaucoma in some patients, medicinal cannabis has the potential to offer a multifaceted approach to enhancing the well-being of seniors.

What are Cannabinoids and What Do They Do?

Cannabinoids are a group of naturally occurring chemical compounds that interact with the endocannabinoid system (ECS). In medicinal cannabis, there are several types of cannabinoids that work in the body in different ways.

  • Delta-9-tetrahydrocannabinol (THC:) This is one of the main cannabinoids found in the cannabis plant. THC is commonly known as a psychoactive cannabinoid as it gives people a ‘high’ euphoric sensation that many people associate with cannabis use. THC modulates the ECS by binding with CB1 receptors in the brain. In addition to creating a high THC has many therapeutic applications, including reducing pain, alleviating nausea, and boosting appetite.

  • Cannabidiol (CBD): This is another common cannabinoid found in medicinal cannabis. Unlike THC, CBD is not psychoactive and doesn’t create a ‘high’ sensation as CBD does not bind with the CB1 receptor responsible for the euphoric feeling.
    Instead, CBD interacts indirectly with our endocannabinoid system to modulate our opioid, dopamine, and serotonin receptors, which may help reduce anxiety, reduce inflammation, and regulate our mood and emotions

There is also increasing evidence for the therapeutic potential of minor cannabinoids:

  • Cannabinol (CBN): This cannabinoid is being researched for its anticonvulsant, and sedative potential. CBN is created during the breakdown of the psychoactive cannabinoid THC. Like THC, CBN also binds to the CB1 receptor, but at a much lower strength than THC.

    While CBN is technically a psychoactive compound, it doesn’t produce a significant ‘high’. This is because CBN primarily modulates CB2 receptors that are associated with immune system regulation.
  • Cannabigerol (CBG): CBG is considered a precursor to other cannabinoids, as it is converted into THC, CBD, and other compounds as the plant matures. It is present in lower concentrations compared to THC and CBD. CBG may have potential as an anti-inflammatory and neuroprotective agent.
  • Tetrahydrocannabivarin (THCV): THCV is a cannabinoid that is structurally similar to THC, but it produces different effects. It is found in trace amounts in most cannabis strains, but some strains are bred to have higher THCV content. THCV may have appetite-suppressing and potential antiepileptic properties.

  • Cannabichromene (CBC): CBC is a non-psychoactive cannabinoid that is being studied for its potential anti-inflammatory and analgesic effects. It is found in relatively low concentrations in medicinal cannabis.

  • Cannabidivarin (CBDV): CBDV is structurally similar to CBD and is being investigated for its potential anti-epileptic properties. It is found in minor amounts in medicinal cannabis. 
  • Delta-8-Tetrahydrocannabinol (Delta-8-THC): Similar to Delta-9-THC, Delta-8-THC has psychoactive effects, albeit typically milder. It is found in very low concentrations in medicinal cannabis.

The cannabinoid profile of a medicinal cannabis treatment can vary significantly based on factors such as genetics, growing conditions, and processing methods. Researchers are continuing to study these cannabinoids to better understand their individual effects and potential therapeutic applications.

What are Medicinal Cannabis Terpenes and What Do They Do? 

Terpenes (pronounced tur-peens) are the organic, aromatic compounds found in plants, including cannabis. Until recently, much of the cannabis industry has been focused almost solely on the therapeutic qualities of cannabinoids like THC and CBD.

However, as our knowledge of terpenes continues to grow and cannabis science expands, it’s becoming increasingly apparent that these aromatic compounds are medicinal powerhouses in their own right.

Within different strains, you’ll find specific terpenes. Again, just like with wine or other plants, terpenes are aromatic compounds that contribute to the plant's distinct smell and flavour. They also interact with cannabinoids and may influence the effects of medicinal cannabis consumption

There are more than 100 different terpenes identified in cannabis plants, each with its own unique aroma, flavour, and potential therapeutic properties, however, some common terpenes include:

  • Myrcene: This is one of the most abundant terpenes in medicinal cannabis. It has an earthy, herbal, and slightly fruity aroma. Myrcene is also found in hops or basil or even earthy Merlots.
  • Limonene: As the name suggests, limonene has a citrusy aroma. It's associated with elevated mood and stress relief. 
  • Pinene: There are two types of pinene: alpha-pinene and beta-pinene. Alpha-pinene has a piney aroma, while beta-pinene has a spicier scent. It's also found in pine trees and rosemary.
  • Caryophyllene: This terpene has a spicy, peppery aroma. It's thought to have anti-inflammatory properties. Caryophyllene is also found in black pepper and cloves.
  • Linalool: Linalool has a floral, lavender-like scent. It's often associated with relaxation and stress relief. Linalool is found in many flowers and herbs, including lavender.
  • Humulene: With an earthy, woody aroma, humulene is also found in hops and has potential anti-inflammatory properties.
  • Terpinolene: This has a complex aroma that can be floral, piney, and even a bit herbal. It's thought to have sedative effects and is also found in nutmeg and cumin.
  • Ocimene: Ocimene has a sweet, herbal, and sometimes fruity scent. It's thought to have antiviral and antifungal properties.
  • Borneol: Borneol has a menthol-like scent and is often associated with calming effects. It's also found in herbs like mint and camphor.
  • Eucalyptol: This has a fresh, minty aroma. It's commonly found in eucalyptus trees and has the potential for respiratory benefits.

Each medicinal cannabis treatment will vary in cannabinoid and terpene content and each patient has unique needs so it’s important to work with experienced medical cannabis clinics or an experienced doctor to determine the best treatment plan for your loved one.

How to Administer Medicinal Cannabis

As a caregiver, you might wonder how your loved one or your ageing parents would take medicinal cannabis. Many people unfamiliar with this medication may only know of the inhalation method for medicinal cannabis (smoking/vaping) but there are actually many administration methods for medicinal cannabis that can be personalised to your loved one’s preferences and needs.

Common administration methods include:

  • Sublingual:  This involves placing the treatment under the tongue, a method which allows active ingredients to be absorbed directly into the blood vessels of your tongue, bypassing the digestive system and therefore making it suitable for elderly people seeking quick relief. Treatments taken sublingually can come in the form of oils, tinctures, wafers, sprays and more.
  • Ingestion: Ingestion methods of cannabis consumption include any cannabis treatment that is consumed orally – such as cannabis edibles, tinctures, oils, capsules and extracts. While the effects of cannabinoid medicines will take longer to kick in when taken orally, they will also last longer. This method can be particularly appealing to people who prefer something familiar and convenient.
  • Topical: These are infused creams, balms, or patches that are applied directly to the skin, providing targeted relief for localised discomfort. This non-intrusive method can be helpful for targeting specific areas.
  • Inhalation: Vaporising medicinal cannabis provides fast relief, but this method might not be suitable for individuals with respiratory problems. Learn more about vaporising in the next section. Smoking is not a recommended administration method.

How Does Medicinal Cannabis Differ from Recreational Cannabis?

As a caregiver, you may not have a lot of knowledge about medicinal cannabis or you may have only heard of recreational cannabis before. If that’s the case — don’t worry! We’re here to help.

Medicinal cannabis (historically known as medical weed or medical marijuana, learn more about the importance of language here), is quite different from recreational cannabis. It involves the controlled and therapeutic use of cannabis plants to alleviate symptoms or manage specific medical conditions by modulating the body’s endocannabinoid system.

Unlike recreational use, which focuses on the THC component of the cannabis plant (sometimes known as a cannabis ‘high’), medicinal cannabis focuses on providing therapeutic relief. This may be achieved by using a medication that is not psychoactive, such as those containing CBD only, and/or by using a THC-containing medicine but at a lower dose than that required to produce a significant cannabis ‘high’.

Medicinal cannabis is prescribed by healthcare professionals who specialise in natural therapies. Like any medication, dosages, strains, and compositions will be carefully selected to cater to specific medical needs. Similarly, medicinal cannabis is highly regulated, requiring prescriptions and quality adherence to medical standards.

Is Medicinal Cannabis Legal in Australia?

Yes. Medicinal cannabis (also known as medical cannabis prescriptions) is legal in Australia and has been so since 2016. It’s recognised for its therapeutic benefits and can be accessed with a doctor's prescription. To ensure high-quality medication and treatment, it’s a good idea to go with a specialised medicinal cannabis clinic.

What Conditions May Be Supported with Medicinal Cannabis?

There is no predetermined list of conditions for which medicinal cannabis can be prescribed — instead a doctor will work with a patient to determine whether or not medicinal cannabis could help depending on the symptoms someone is experiencing.

However, some medical conditions where medicinal cannabis may offer potential therapeutic benefits, include: 

As many of these conditions affect older adults or ageing parents, natural treatment options, like medical cannabis, can be a good option to be used alone or in conjunction with other medications to relieve symptoms without significant side effects.

However, the effects of medicinal cannabis can vary from person to person. Caregivers should prioritise communication with medical experts when considering medicinal cannabis as part of their loved one's care plan.

What Are Some Potential Therapeutic Benefits of Medicinal Cannabis

Medicinal cannabis products have shown promise in providing various therapeutic effects and can potentially improve a range of symptoms and overall quality of life in some chronically ill or even terminally ill people.

Some ways your loved one may benefit from medicinal cannabis include:

  • Pain Management: Chronic pain is a common issue, often stemming from conditions such as arthritis, neuropathy, and musculoskeletal disorders. Medicinal cannabis, particularly with a balanced ratio of THC and CBD, has been reported to alleviate pain and improve mobility. By interacting with the endocannabinoid system, medicinal cannabis compounds may even help reduce inflammation to provide pain relief.
  • Anxiety Reduction: Anxiety and stress can significantly impact the mental well-being of people living with a chronic or life-limiting illness. CBD, a non-psychoactive compound found in medicinal cannabis, has shown potential in reducing anxiety symptoms. It may have a calming effect on the nervous system without the ‘high’ effects of THC.
  • Appetite Stimulation:  Many people living with severe illnesses (such as cancer) may experience an associated loss of appetite, leading to nutritional deficiencies and weight loss. Certain strains of medicinal cannabis, particularly those high in THC, have been known to increase appetite and improve food intake. This can be particularly helpful when caring for people undergoing chemotherapy.

  • Anti-Inflammatory Effects: Cannabinoids, especially CBD, have shown anti-inflammatory effects, which could be beneficial for conditions characterised by inflammation, such as autoimmune disorders and inflammatory bowel disease (IBD).
  • Neurological Condition Management: Some research suggests that medicinal cannabis might have neuroprotective properties and could be investigated for its potential in managing neurological disorders like multiple sclerosis, Parkinson's disease, and epilepsy.
  • Muscle Spasm and Tremor Management: Medicinal cannabis is being explored for its muscle relaxant properties, which may benefit individuals with conditions causing muscle spasms, tremors, or spasticity.
  • Eye Health: Medicinal cannabis may help reduce intraocular pressure, which could potentially benefit individuals with glaucoma.

  • Bone Health: Some research has suggested that cannabinoids might play a role in promoting bone health and even aiding in the healing of fractures.

Remember: individual responses to medicinal cannabis can vary greatly and what works well for one person may not work the same way for someone else.  As a caregiver, it’s important to talk with a healthcare professional, like a doctor who has experience in the prescription of natural therapies, before incorporating medicinal cannabis into your loved one’s care plan.

How to Access Medicinal Cannabis as a Caregiver

As a caregiver, exploring alternative treatment options like medicinal cannabis may be a new and unfamiliar territory, but we’re here to guide you through the process of helping your loved one access this potentially beneficial treatment. By understanding the steps involved, you can ensure an informed journey towards integrating medicinal cannabis into their care plan.

Check their eligibility for medicinal cannabis

To see if a loved one might be eligible for medicinal cannabis in Australia, ask yourself the following questions:

1) Do they have a chronic medical condition? Have they been experiencing symptoms for over three months? 

2) Have they tried other treatments prior to medicinal cannabis?

3) Have these other treatments failed to alleviate their symptoms, have they had adverse effects, or are you or your loved one concerned about the side effects?

If you said yes to the above, then their doctor could consider them a candidate for medicinal cannabis.


Start by Educating Your Loved One About Medicinal Cannabis

Take the time to talk to your loved one about medicinal cannabis and how it could potentially benefit them. Medicinal cannabis can sometimes be confusing for older patients, as it may have connotations of recreational cannabis or unconscious biases attached to it.

Talk to them about how medicinal cannabis works, explain the risks and benefits, and reassure them that medicinal cannabis is prescribed and monitored by qualified doctors.

Find the Right Medical Partner for You

Once you and your loved one feel on the same page about a potential course of medicinal cannabis, the next step is to consult with your regular healthcare professionals and medicinal cannabis specialists who have experience working with elderly patients.


Work with Your Healthcare Team to Develop a Care Plan

Once you find the right healthcare team, you can work closely with them to create a personalised care plan. By having a knowledgeable medicinal cannabis expert to guide you, you can make informed decisions about your loved one’s care and ensure that the plan aligns with their overall health goals and existing treatment regimen.

Their doctor will determine the appropriate starting dosage and strain of medicinal cannabis based on your loved one’s medical history and health condition. 

Access Your Loved One’s Prescriptions

Depending on the doctor or clinic you choose, your loved one will be able to access their medication in several ways. Some doctors will provide a prescription that can be picked up at a limited number of specialist pharmacies. Not every pharmacy will stock medicinal cannabis, or stock the medication that your loved one has been prescribed. In this case, make sure you do your research first to save time. 

Other medicinal cannabis clinics can arrange for medications to be sent express to your loved one's home or care facility. This can be particularly helpful to fit in with caregivers' busy lives and reduce the wait time between appointments and treatment. 

Help Administer Medicinal Cannabis to Your Loved One

Depending on your loved ones’ capabilities, you can either teach them how to use a medication administration method (such as vaping) or administer the medication to them each day.

There are many ways your loved one can consume medicinal cannabis — including ingestion (edibles), capsules, sublingual (under-the-tongue), and topicals. A doctor specialising in the prescription of medicinal cannabis will talk you through the application or consumption of whichever your loved one needs so that you can provide the medication to them.

If your loved one can take their own medications, it can be helpful to set up a pill box (i.e., for gummies, capsules or other edibles) or medication reminders, to ensure they are getting the correct dosage at the right times. 

Set Up Regular Doctor Check-Ins

Once your loved one has started a course of medicinal cannabis, you and your loved one’s doctor can schedule regular check-ins to assess their response to medicinal cannabis. At these appointments, the doctor can review changes in their symptoms, mood, sleep patterns, and overall well-being, and adjust their dosage of medication frequency if required. 

By following these step-by-step guidelines and working closely with healthcare experts, you can provide effective support and contribute to a positive experience for your loved one in exploring medicinal cannabis as a treatment option.

How to Monitor Your Loved One’s Medicinal Cannabis Treatment

As a caregiver, closely monitoring your loved one’s response to medicinal cannabis is an important part of ensuring their well-being and optimising their treatment's effectiveness. After they first start their course of medication, get a notebook or online document, to record the following:

  • Track Your Loved One’s Baseline:
    Before they are treated, document your loved one’s baseline symptoms — how do they feel? Track details such as pain levels, sleep patterns, mood, appetite, and any adverse effects. This baseline will serve as a reference point for assessing the impact of medicinal cannabis.

  • Track Any Symptom Changes:
    After your loved one begins their medicinal cannabis treatment, keep a daily or weekly journal to record any improvements or worsened or new symptoms, such as alterations in sleep quality, changes in mood, and overall comfort. By keeping these records you and your loved one’s doctor can evaluate the treatment's efficacy.

  • Make Note of Any Dosage Adjustments:
    Your doctor will typically start your loved one on a low dose of medicinal cannabis and gradually increase it if needed. See how they respond to any adjustment in dosage and monitor for changes, symptoms, or side effects.

  • Be Aware of Potential Tolerance:
    As with many other medications, some individuals may develop a tolerance to the effects after prolonged use. If you notice that there is a decrease in the efficacy of the medication over time, make an appointment with your loved one’s healthcare team for guidance on adjusting dosages or taking a tolerance break.


  • Book Follow-Up Appointments:
    It can be helpful to pre-book follow-up appointments so that you and your loved one can regularly check-in with their healthcare team and update them on your observations, seek guidance, and adjust the medication treatment plan as necessary.

    Remember: if something seems off, you don’t have to wait until your next appointment for help.

Understanding Potential Risks of Medicinal Cannabis as a Caregiver

While medicinal cannabis can offer significant benefits for many people with chronic or life-limiting conditions, as a caregiver, it’s still important to be aware of potential risks so that you can make well-informed healthcare decisions for your loved one.

  • Impaired Motor Skills: Like many sedating medications, medicinal cannabis can sometimes impair motor skills and coordination. Take precautions to prevent falls or accidents, especially in elderly people, and remind your loved one to not drive after taking medicinal cannabis.

  • Potential Addiction: While the risk of addiction to medicinal cannabis is lower than with opioids, dependency is possible. Make sure your loved one only takes medicinal cannabis only as prescribed and keep an eye out for signs of dependency.
  • Drug Interactions: Medicinal cannabis can interact with certain medications. Always check in with your loved one’s healthcare team to avoid any potentially dangerous interactions with other prescribed medications.
  • Cardiovascular Health: Medicinal cannabis use may lead to changes in heart rate and blood pressure. Caregivers should be cautious, especially if the patient has a history of heart conditions. Regular monitoring and communication with the healthcare provider are crucial.

By being proactive, well-informed, and attentive to potential risks, you can minimise the chances of adverse effects and help your loved one undergo a safer course of medicinal cannabis treatment. 

Remembering Caregiver Self-Care

Let’s take a moment to appreciate all you do as a caregiver! Caregiving is such an important and inspiring experience — but it can be emotionally and physically exhausting too.

We understand that as a caregiver, you might feel guilty about taking time for your needs.  But remember that caring for yourself doesn't mean you’re neglecting your loved one! In fact, prioritising self-care will help continue to care for your loved one without burning out.

Here are some tips for ensuring you don’t put your needs last. 

  • Set Boundaries: You don’t have to do it all. Establish clear boundaries between your caregiving responsibilities and personal life.

  • Seek Support: Whether you’re reaching out to your healthcare team, a support group, friends, or family members, connecting with others can help you manage the stress of caregiving responsibilities.
  • Maintain Your Health: When you're caring for someone who’s unwell, it can be easy to forget about your own physical health. Take regular exercise, eat a balanced diet, and make sure you’re getting enough sleep. 
  • Schedule Breaks: Even caregivers need a break! Don’t be afraid to organise caregiving breaks where another family member or friend can step in for a few days so you can unwind and come back refreshed.  

The Wrap Up

This Caregiver's Guide to Medicinal Cannabis can help you understand the ins and outs of medicinal cannabis so that you can make informed choices for your loved one’s care. Caregiving is a deeply rewarding yet challenging role that requires significant support from medical communities to ensure that caregivers have the education and resources they need to help their loved ones.

Medicinal cannabis has shown significant potential in helping with a range of physical and mental health issues — from chronic pain management to sleep improvement, anxiety reduction, and appetite stimulation. By following the step-by-step guides included above, caregivers can navigate getting their loved one started with medicinal cannabis, help monitor and adjust treatments, and be aware of any potential risks


Glossary of Medicinal Cannabis-Related Terms

Cannabinoids: These are the active chemical compounds found in cannabis plants, each with its own potential therapeutic effects. Two well-known cannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol), both of which interact with receptors in the body's endocannabinoid system.

Endocannabinoid System (ECS): A remarkable biological system within the human body that plays a crucial role in maintaining balance (homeostasis). The ECS consists of receptors, enzymes, and endocannabinoids, and it regulates processes such as mood, appetite, sleep, pain perception, and immune response.

Terpenes: These are natural aromatic compounds found in medicinal cannabis, as well as in many other plants. Terpenes contribute to the distinct scent and flavour of different strains and may also have therapeutic properties. 

Tincture: A tincture is a liquid medicinal cannabis extract that is typically placed under the tongue (sublingually) for rapid absorption. Tinctures offer a discreet and efficient way to administer medicinal cannabis, allowing for precise dosing and control over the effects.

Edibles: Edibles are food products infused with medicinal cannabis extracts. These products provide an alternative method of consumption by ingesting medicinal cannabis, which is metabolised through the digestive system. 

Vaping: As a caregiver, one of the common methods for administering medicinal cannabis to a loved one is through a vaporizer. Vaporisation can help ensure fast onset of the active ingredients and is considered a safer option than smoking cannabis due to reduced exposure to harmful combustion byproducts. Smoking medicinal cannabis is not recommended. 

Dosing: Dosing refers to determining and administering the appropriate amount of medicinal cannabis for therapeutic purposes.

Patient Education

Can You Use Medicinal Cannabis with Other Pain Medications?

6
min read
Read Article
Can You Use Medicinal Cannabis with Other Pain Medications?

Chronic pain is a complex and challenging condition that affects millions of people worldwide. Managing chronic pain can be difficult for both patients and healthcare providers, especially when dealing with other conditions and potential interactions between different pain medications.

In recent years, medicinal cannabis has emerged as a potential natural alternative for chronic pain management, offering promising results in providing pain relief for some patients. However, using medicinal cannabis alongside other pain medications requires careful consideration and open communication with healthcare providers to ensure safe and effective pain management.

Let’s explore the potential benefits and risks of using medicinal cannabis with other pain medications, and discuss how to safely incorporate medicinal cannabis into your pain management plan.

What is Chronic Pain?

The International Association for the Study of Pain (IASP) defines chronic pain as pain that lasts for more than 12 weeks. Unlike acute (short-term) pain, chronic pain can persist even after the initial issue is treated. Chronic pain is complex and can be caused and influenced by many factors, including injury, illness, and underlying medical conditions.

Chronic pain affects about 20% of adults worldwide. For people with chronic pain, it’s typical for them to experience more than one type, for example, people may have a chronic pain condition like fibromyalgia and chronic back pain at the same time.

In addition to feeling the physical effects of pain, many chronic pain patients will have their symptoms amplified or influenced by their mental health. Over 67% of people with chronic pain also live with a mental health issue, such as major depressive disorder or generalised anxiety disorder.

Why is chronic pain so difficult to manage?

If you’re looking to manage your chronic pain, it can be difficult to know where to start, which medications to use, or which medications shouldn’t mix. Chronic pain is complex and difficult to manage, for patients and healthcare providers alike. Some reasons why people might find it hard to manage chronic pain include:

  • Managing Multiple Medications: Chronic pain often has comorbidities (other conditions happening at the same time). People with chronic pain may also live with other conditions, like hypertension, diabetes mellitus, tuberculosis, depression, anxiety or arthritis — all of which may have different medication schedules that may not interact well with certain pain medications.

    Managing multiple conditions alongside chronic pain effectively can be challenging as practitioners need to address the larger picture of your overall well-being. It’s important to find a practitioner who will look at your health history and goals holistically to ensure safe pain management.

  • Chronic pain is unique to everyone: The exact experience of chronic pain can vary greatly from person to person. This means that management strategies need to be tailored to each patient. Some factors that affect how your pain is felt and processed in your body include your genetics, your past experiences with pain, and your psychological well-being.
  • Multiple Causes: There isn’t just one cause of chronic pain. Chronic pain can have various underlying causes and can have physical, psychological, and environmental factors, making it challenging to pinpoint a single cause for treatment.
  • Growing Tolerance: Long-term use of some pain medications, including opioids and NSAIDs, can lead to tolerance, where higher doses are needed to achieve the same pain relief. 
  • Avoiding Side Effects and Dependency: Some pain medications, including opioids and NSAIDs, carry the risk of side effects and/or addiction, making them less ideal for long-term management.
  • Limitations of Current Treatments: While there are various treatment options available for chronic pain, not all patients respond the same way to these treatments. Some individuals may find relief with one approach, while others may not experience significant improvement.

Due to the complicated nature of chronic pain, a comprehensive approach is often required to manage the condition effectively. This may involve a combination of medical treatments, physical therapy, psychological support, lifestyle modifications, and patient education.

To learn more about your chronic pain treatment options, speak to a trusted doctor or healthcare professional today.

Common Pain Medications for Chronic Pain and How They Work?

There are several types of pain medications used to manage chronic pain which work in different ways to relieve pain. Before starting any course of pain medication, it’s important to talk to your doctor — even if you’re taking over-the-counter products. Here are some common types of pain medications for chronic pain:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs, such as over-the-counter ibuprofen (Nurofen), naproxen, and aspirin, are commonly used to reduce inflammation and provide pain relief. They work by inhibiting the production of prostaglandins, which are chemicals in the body that promote inflammation, swelling, and pain. NSAIDs are particularly effective for musculoskeletal pain, such as arthritis and low back pain.
  • Acetaminophen: Over-the-counter  acetaminophen (paracetamol, or brand name Panadol) is a pain reliever that is often used to manage mild to moderate pain. Unlike NSAIDs, acetaminophen does not have anti-inflammatory properties, so it is more suitable for pain that is not caused by inflammation. While paracetamol is widely used, scientists aren’t sure exactly how it works — though it may take effect by reducing pain signals in the brain.
  • Opioids: Prescription opioids, such as oxycodone, hydrocodone, morphine, and fentanyl, are powerful pain medications that are used for moderate to severe chronic pain. Opioids work by binding to specific receptors in the brain and spinal cord, reducing the perception of pain. They can be effective in providing short-term pain relief but can come with risks of tolerance, dependence, and addiction, so they are typically reserved for cases where other treatments have not been effective or are not suitable.
  • Medicinal Cannabis: Medicinal cannabis contains cannabinoids like CBD and THC, which interact with the body's endocannabinoid system. It may provide pain relief through its interactions with cannabinoid receptors, anti-inflammatory properties, and potential neuroprotective effects. Medicinal cannabis has gained attention as an alternative or adjunct therapy for chronic pain management, particularly when other treatments have been ineffective or come with unwanted side effects.
  • Antidepressants: Certain antidepressants, particularly tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can be used to manage certain types of chronic pain, such as neuropathic pain. These medications may help by increasing the levels of certain neurotransmitters in the brain, which can modulate pain signals and improve pain perception.
  • Anticonvulsants: Anticonvulsant medications, such as gabapentin and pregabalin, can be used to treat neuropathic pain, which results from nerve damage or malfunction. These medications work by reducing abnormal nerve firing and stabilising overactive pain pathways.
  • Muscle Relaxants: Muscle relaxants, like cyclobenzaprine and baclofen, are used to relieve muscle spasms and associated pain. They work by reducing muscle contractions and promoting relaxation.
  • Topical Analgesics: Topical analgesics, such as creams, gels, or patches containing substances like capsaicin or lidocaine, can be applied directly to the skin over the painful area. These medications provide localised pain relief by numbing the nerves or reducing pain signals in the affected area.

Before deciding to take any of the medications described above, it’s important for every patient with chronic pain to first talk with their healthcare provider to decide on the most appropriate pain management approach.

In some cases, a combination of different medications or treatments might be the best option to achieve pain relief and minimise potential side effects and risks. Additionally, non-pharmacological treatments, such as physical therapy, cognitive-behavioural therapy, and lifestyle modifications, can be included in the overall pain management plan.

Medicinal Cannabis and Chronic Pain Management

Medicinal cannabis may work for chronic pain management through its interactions with the body's endocannabinoid system, which regulates various physiological functions, including pain perception. The cannabis plant contains cannabinoids such as CBD and THC, responsible for its potential therapeutic effects on pain.

Medicinal cannabis has been shown to provide an effective and relatively safe chronic pain management treatment, especially when compared with traditional opioid-based therapies. Medicinal cannabis contains active components called cannabinoids, such as THC and CBD. These cannabinoids work in our body by interacting with specific receptors called endocannabinoid receptors. The two main receptors are CB1 and CB2. When THC and CBD bind to these receptors, they can provide relief from pain. Learn more about cannabinoids and how they interact with the human body here.

This interaction affects the release of neurotransmitters (chemical messengers in the body) and dampens the transmission of pain signals, providing pain-relieving effects. Additionally, medicinal cannabis possesses anti-inflammatory properties, further adding to its effectiveness as a treatment for chronic pain. 

Individuals considering medicinal cannabis for chronic pain should always consult with knowledgeable healthcare professionals to make informed decisions about its use in their specific cases.

Can Medicinal Cannabis Interact with Other Pain Medications?

Medicinal cannabis, containing cannabinoids like CBD (cannabidiol) and THC (tetrahydrocannabinol), has the potential to interact with other pain medications commonly used alongside chronic pain management. These interactions can affect the way medications are metabolised and how they work in the body. Here's an overview of how medicinal cannabis may potentially interact with some of these medications:

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medicinal cannabis and NSAIDs are considered safe to take together. Cannabis, particularly CBD, may have complementary anti-inflammatory effects with NSAIDs. This means that combining the two may enhance the overall anti-inflammatory response.

However, one recent study suggests that cannabinoids could interfere with the metabolism of NSAIDs in the body potentially leading to altered levels of the NSAIDs in the bloodstream, affecting their effectiveness. However, more research is needed to confirm this.

When CBD inhibits this enzyme, it can cause the levels of certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, antipsychotics, beta-blockers, and opioids, to increase in the bloodstream. This could potentially lead to stronger effects or an increased risk of side effects from these medications.

This doesn’t mean patients can’t take antidepressants and medicinal cannabis — it does mean, however, that people taking antidepressants and considering using medicinal cannabis should discuss potential interactions with their healthcare providers to ensure safe and effective use of both medications.

  • Anticonvulsants: The interactions between medicinal cannabis (specifically CBD) and anticonvulsant medications can be quite complex. CBD can affect how anticonvulsants are metabolised in the body and may also influence their effectiveness. Doctors should carefully monitor patients using CBD alongside anticonvulsants to ensure effectiveness and minimise any potential adverse effects.
  • Muscle Relaxants: Medicinal cannabis may enhance the effects of muscle relaxants, leading to increased sedation and motor impairment. Combining these kinds of medications can be dangerous and require careful monitoring by a healthcare provider.
  • Topical Analgesics: There are no significant interactions between medicinal cannabis and topical analgesics, as these are applied externally and have limited systemic absorption.
  • Anti-anxiety Medications: Medicinal cannabis, particularly THC, may not be safe to combine with some anti-anxiety medications (e.g., benzodiazepines). It can heighten sedative effects when combined with antianxiety medications and lead to excessive drowsiness and impaired cognitive function. Interestingly, medicinal cannabis may help some patients stop taking benzodiazepines. One study even shows that almost 50% of patients were able to discontinue their pre-existing benzodiazepine therapy after a two-month course of medicinal cannabis. 
  • Sleep Aids: Combining medicinal cannabis with sleep medications (like benzodiazepines or Ambien) can be problematic. It can lead to increased drowsiness and sedation. Some people may also experience impaired judgement, thinking, and motor coordination. Dosage adjustments may be necessary to avoid excessive sedation.

It's important to remember that the above list is not exhaustive and individual responses to these combinations of medications can vary. Whenever you start a new course of medication, it’s important to talk to your doctor first. New medications require professional guidance to ensure a safe and effective pain management plan.

How to Safely Take Medicinal Cannabis with Other Medications

Taking medicinal cannabis safely alongside other medications requires careful consideration and open communication with your doctor. Here are some guidelines to follow for safe and effective use of medicinal cannabis alongside other medications:

  • Talk to your Healthcare Provider: Always disclose your use of medicinal cannabis to all healthcare providers, including doctors, specialists, and pharmacists. Provide them with a complete list of all medications, supplements, and herbs you are taking, including the specific medical cannabis treatments and dosages. The more they know, the less chance something can slip through the gaps. 
  • Watch for Drug Interactions: Be aware of potential drug interactions between medicinal cannabis and your other medications. Check websites like drugs.com to look up specific interactions. Give special attention to risks associated with opioids, benzodiazepines, and other sedative medications and keep an eye out for side effects.
  • Seek Expert Guidance: Consult with knowledgeable medicinal cannabis practitioners for specialised advice on how to add medicinal cannabis to your medicine regimen. They can provide personalised advice for your specific condition in conjunction with other pain medications.
  • Individualise Your Treatment: Everyone's response to medicinal cannabis and other medications is unique. Make sure you work with a healthcare provider who will take the time to create an individualised treatment plan that considers your medical history, condition, and specific medications.
  • Regular Follow-ups: Schedule regular follow-up appointments with your healthcare provider to assess your progress and address any concerns or changes in your condition. Adjustments to medications or dosages may be necessary over time.
  • Use Regulated, Reputable Products: By working with a qualified doctor to access medicinal cannabis treatments, you can rest assured the treatments prescribed to you have undergone rigorous testing for quality, purity, and consistency. More on the differences between legal and illegal cannabis in Australia here

Honesty and open communication with healthcare providers are vital for a safe and effective pain management plan. Always follow medical advice, report any changes in your condition, and prioritise your well-being throughout your treatment journey.

The Wrap Up 

Chronic pain is a complex condition that affects many people. Managing it can be challenging due to balancing multiple medications, understanding your body’s unique responses, and weighing potential risks. Medicinal cannabis, with its interactions with the body's endocannabinoid system, has shown promise as an alternative therapy for chronic pain. However, its interactions with other medications require careful consideration. Make sure you work closely with experienced healthcare providers who understand the complexities of medicinal cannabis to personalise your pain management plan. Remember: if in doubt, talk it out. Ensuring open communication with your doctor before combining medications can help ensure you receive safe and effective treatment.