The information below has been prepared in conjunction with our partner, Little Green Pharma.
What is medicinal cannabis?
Medicinal cannabis (also called medical cannabis or medical marijuana) is the cannabis plant and its component cannabinoids (such as THC and CBD) used for therapeutic purposes to alleviate symptoms.
In Australia, medicinal cannabis is a pharmaceutical product prescribed by a medical practitioner and taken to treat the symptoms of a medical condition or the side effects of certain treatments. These products are highly regulated to ensure patient safety and consistency of product formulation.
What is the difference between street cannabis and medicinal cannabis?
Street cannabis and medicinal cannabis are very different, particularly in relation to quality control, potency, known cannabinoid concentration and the potential for harmful additives in street cannabis.
Medicinal cannabis in Australia is highly regulated to ensure patient safety, consistency of product formulation and the absence of potentially dangerous contaminants such as pesticides and moulds.
What is the difference between THC and CBD?
The cannabis plant contains up to 545 chemical compounds including 114 different cannabinoids, many of which have been clinically demonstrated to interact with the endocannabinoid system in the human body. To date, the most researched cannabinoids have been Δ 9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC is a cannabinoid in the cannabis plant that also has intoxicating effects.
CBD is a non-intoxicating cannabinoid that is non-addictive and less potent than THC with very low toxicity.
Patients who wish to avoid THC can access cannabis medications that are CBD only products.
How do I take medicinal cannabis?
Medicinal cannabis is available in various delivery forms, as well as a range of strengths and varieties. In Australia your doctor can prescribe you medicinal cannabis in oil form, tablets/pills, sublingual spray or flower/cannabis extract for vaping. The dose and strength of the medicinal cannabis will depend on your condition and the recommendation from your prescribing Doctor.
How much does medicinal cannabis cost?
The cost of medicinal cannabis in Australia can vary greatly and depends on a number of considerations such as a patient's condition and the product being prescribed.
A helpful guide to the average costs of medicinal cannabis products can be found in an independent report conducted by Freshleaf Analytics ‘Australian Medicinal Cannabis Market Patient, Product and Pricing Analysis – Q1 2020’. The report advised that the average patient taking prescribed medicinal cannabis is spending less than $10 per day.
Please note, this cost does not take into consideration the HIF benefit which eligible patients can receive.
What benefit does HIF provide for medicinal cannabis products?
HIF will pay a benefit towards prescription medicines like medicinal cannabis products if your Extras cover includes Pharmacy. The benefits are payable from 9th September 2020.
Benefits are payable under your Pharmacy Limit and are subject to individual policy limits and waiting periods.
Please refer to your policy factsheets for details on your eligibility and individual benefit.
Where Little Green Pharma products are prescribed, HIF members receive an additional $25* benefit per script until 30 September 2024.
*The additional $25 benefit is not applicable to HIF members that are registered in the Quest Initiative as they will receive subsidised products directly through the study.
How to claim for medicinal cannabis?
You can submit your claim for medicinal cannabis through the app, email or post. (pharmacy is not accepted through OMC).
What is required to claim?
A copy of the official pharmacy receipt will be required in order for HIF to assess your claim.
Is medicinal cannabis currently unapproved by the Australian Register of Therapeutic Goods ARTG?
Yes, all but one product is currently unapproved. However, Doctors are still able to prescribe medicinal cannabis to patients by applying for approval from the Therapeutic Goods Administration (TGA).
How can a doctor prescribe medicinal cannabis if it's unapproved by the Australian Register of Therapeutic Goods ARTG?
Despite medicinal cannabis not being currently listed on the ARTG, there are several ways that doctors can still access medicinal cannabis for their patients even though it is an unapproved product in Australia.
The three access pathways are:
· Special Access Scheme (SAS)
· Authorised prescribers
· Clinical trials
If you’re interested in trialling medicinal cannabis for your condition, we encourage you to speak with your Doctor about your options.
How do I discuss medicinal cannabis with my doctor?
Medicinal cannabis is a relatively new treatment option in Australia.
Before you meet with your practitioner there are some steps you can take to learn more about this new treatment choice and share this information with your doctor:
1) Do some research and take it to your next appointment
There are clinical studies available online that patients are able to print and share with their medical practitioner. Peer-reviewed studies can help a practitioner understand more about medicinal cannabis as a treatment option for your condition and help support your doctor’s understanding of your decision for wanting to consider medicinal cannabis.
2) Be honest and talk about your experience
When discussing your condition, it is important to discuss with your doctor how you feel and the effects of the medications you have tried. It’s important to be honest and advise your practitioner if you’ve already tried cannabis and what the effects were.
3) Have patience and work together
Doctors have a legal obligation to comply with regulations in relation to medicinal cannabis and the prescribing guidelines, however education around these guidelines is still new in Australia. Showing patience towards your doctor if they still have questions or need more information to feel comfortable prescribing, is important.
There is still much to learn about the potential benefits of medicinal cannabis, how to prescribe it accurately and the pathways to access this medication. Both doctors and patients are exploring the science behind this treatment for various conditions and how it compares to established medications. Together, you’re more likely to find the best medical outcome for you.
4) Share your point of view
When considering any new treatment, you should consider the possible impact on your overall life e.g. will any side effects interfere with a regular activity that’s important to you e.g. operating heavy machinery? Driving? Employment drug testing? Can you afford this treatment?
Any doctor can prescribe medicinal cannabis in Australia and they don’t need additional qualifications. However, some doctors may be reluctant due to a lack of training, familiarity or due to the application process involved.
We can assist you in feeling confident to talk to your doctor about this treatment option, to reach out to them with education or to find a doctor comfortable discussing medicinal cannabis (including CBD Oil) with you.
What is the cost of medicinal cannabis?
The cost of medicinal cannabis in Australia is varied and depends on a number of considerations such as a patient’s condition and the product being prescribed.
Your doctor needs to know about these practical matters so they can choose the right treatment for you and develop a treatment plan that works for your circumstances.
How to find a Doctor?
If you would like to find a doctor who is familiar with medical cannabis, then please visit the QUEST Initiative study website for more information. You can check your eligibility for this study and find a list of doctors who are recruiting participants to see if this treatment can impact patient quality of life and health economics.
Please note it is advised that patients considering medicinal cannabis treatment should first discuss this option with their treating GP or specialist medical practitioner before talking to a new doctor.
What do I need to take to my doctor?
If you are visiting a new doctor, you will need to discuss with them the following information so they can consider your suitability for medicinal cannabis as a treatment option:
· Previous medicinal history (around the condition you would like to discuss medicinal cannabis as a treatment)
· Previous medications taken (for this same condition)
· List of your current medications
· Summary of prior medical history and diagnosis (eg high blood pressure, asthma etc).
When is it advised not to use medicinal cannabis?
As with all medical treatments, medicinal cannabis isn't for everyone. In Australia medicinal cannabis is not a first-line treatment for any condition. This means that doctors only use medicinal cannabis for people who have tried other medicines without success.
History of Psychotic Illness
Medicinal cannabis is not safe for people who have a personal or family history of certain mental health conditions, such as:
· Psychotic illnesses e.g. schizophrenia
If You Are Pregnant or Breastfeeding
Typically, women who are pregnant or are planning to become pregnant will be advised by their doctor not use medicinal cannabis.
In addition, cannabis can pass into a woman’s breast milk at high concentrations.
Driving and Operating Machinery
People who use medicinal cannabis, especially with THC present can experience dizziness, fatigue and concentration problems as side effects. This makes it difficult to carry out skilled tasks and can impair judgement. People who need to drive or operate dangerous machinery should not take medicinal cannabis with THC.
Hypersensitivity
A small number of people are hypersensitive to cannabis or other ingredients in medicinal cannabis products. These people should avoid using medicinal cannabis as it can cause a severe allergic reaction.
Will I feel ‘high’ when taking medicinal cannabis?
The cannabinoid in cannabis which is well-known as being responsible for numerous psychoactive properties is THC (tetrahydrocannabinol).
Not all medicinal cannabis products have THC or enough of this cannabinoid to make a patient feel ‘high’. There are alternative options for patients that don't want an intoxicating 'high' effect so patients have the option to talk to their medical practitioner about using strains which do not include THC.
Can I drive whilst taking medicinal cannabis?
Patients will be advised by their doctor not to drive while using a product that contains THC. This is because THC, a psychoactive cannabinoid of the cannabis plant, can affect cognitive and motor skills necessary for safe driving such as attention, judgement, memory, vision and coordination.
Roadside drug testing in Australia tests for Tetrahydrocannabinol (THC) in saliva. Currently, in all states and territories it is an offense to drive (a) with the presence of THC in oral fluid, blood or urine; or (b) under the influence of THC.
Can I buy CBD oil?
Yes, Cannabidiol (CBD) oil is legally available via a doctor prescription. Please note that any CBD oil you can purchase online without a prescription is considered illegal.
Is CBD available over the counter without a doctor’s script?
From 1st February 2021, the Therapeutic Goods Administration (TGA) approved the sale of low-dose (up to 150mg/day) Cannabidiol (CBD) over the counter. This change means low-dose Cannabidiol has been moved from a Schedule 4 item to Schedule 3 (Pharmacist Only).
How do I purchase low-dose Cannabidiol?
The purchase of low-dose Cannabidiol will be restricted to Pharmacies and is not currently available to purchase over the counter without a doctor’s script. (September 2022).
Do I need a doctor’s script for low-dose Cannabidiol?
No, any dosage under 150mg/day does not need a doctor’s script and when it is available in future patients will be able to purchase directly from a pharmacy with no referral or script required.
What if I need a higher dose of Cannabidiol?
Doses over 150mg/day are still available through the SAS-B and MAP approval process (via an Authorised Prescriber) and doctor script but are not available over the counter.
What benefits are payable on low-dose Cannabidiol?
Benefits will not be payable on low-dose Cannabidiol. As an over the counter product, HIF’s Fund Rules do not allow a benefit to be paid on pharmaceuticals that are not S4, S7, S8 or Rx.
When can I purchase low-dose Cannabidiol?
Whilst approval has been given from 1st February 2021 by the TGA, it is expected to take much longer before low-dose Cannabidiol is available in pharmacies. This is due to suppliers having to manufacture low-dose products specifically for pharmacy sale. It could be years before low-dose Cannabidiol is available in pharmacies.
Where can I get more information on low-dose Cannabidiol?
More information is available directly from the TGA – visit their website here: Over-the-counter access to low dose cannabidiol | Therapeutic Goods Administration (TGA)
To find out more visit: littlegreenpharma.com