Medicinal cannabis is prescribed to alleviate the symptoms of medical conditions like epilepsy, depression, anxiety, cancer, etc. In the case of individuals suffering from chronic or terminal ailments, conventional medicines prove ineffective and do not work in the way as medicinal cannabis does. Also, conventional medicines may work in certain patients but may result in debilitating side effects that can be relieved by cannabis.

This particular study mentions that from 10 March 2017 onwards, Physicians have been permitted to prescribe cannabis to patients with serious ailments and in cases where no alternative therapies are available. Patients can obtain it in the form of dried flowers or extracts in standardised pharmaceutical quality by prescription in pharmacies. Prior to prescribing cannabis, physicians have to consider certain things. The first criteria is to decide the therapeutic effects which are to be achieved and to select the most suitable cannabis product. Cannabis for medical use has to meet the regulations for pharmaceutical quality. An identity check must be performed in the pharmacy based on the monographs of the German Pharmacopoeia (DAB) or the German Pharmaceutical Codex/New Prescription Form (DAC/NRF).

With regard to the production of prescription drugs such as capsules, drops or inhalates, there are also equivalent monographs for the preparation of prescription medications. These standardised, quality guaranteed prescription formulas should be given precedence over medical prescription. When oral or inhalative type of application are prescribed, it should be noted that the onset and duration of action are not the same. Further, because of the complex pharmacology of cannabinoids, interindividual genetic dissimilarities in the metabolization of THC, the individual shape and function of the cannabinoid receptors, and also differences in receptor density and distribution, the dosage and frequency of application must be considered separately. Finally, it is also equally important that the dosage also depends on the kind of disease and the vulnerability of an individual to its side effects. When prescribed for the first time, a creeping dosage with an extremely low initial dose is advised.

Prescribing Cannabis

Cannabis could be prescribed only when there is evident published evidence of its effectiveness and benefit and various treatment alternatives have been exhausted. The cannabis therapy can be prescribed in cases of

  • Children having rare, severe forms of epilepsy
  • Adults with nausea or vomiting resulting from chemotherapy
  • Adults having muscle stiffness caused by multiple sclerosis (MS)

Previously, three main types of cannabis could be utilized medicinally:

  1. Pharmaceutical cannabis products that are authorized by an organization such as the Therapeutic Goods Administration (TGA), which includes nabiximols (Sativex) and synthetic cannabinoids like Drobabinol. Sativex, which is available as a nasal or oral spray has been approved across 24 countries for treating spasticity caused by multiple sclerosis.
  2. Controlled and standardised herbal cannabis (plant products) like the products manufactured in the Netherlands,
  3. Unregulated and illegal herbal cannabis (plant products), which possess unknown cannabinoid concentrations and likely harmful impurities like bacteria and mould (USA only).

 

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