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Medical marijuana is on the rise in Australia, but we still don’t know a lot about how it works

Thousands of Australians are now using medicinal cannabis to treat conditions like chronic pain and anorexia.

Yesterday, the ABC revealed more than 3,100 medicinal cannabis scripts had been approved by the Therapeutic Goods Administration (TGA) since the Federal Government relaxed restrictions in March 2018.

According to experts, these people were just the tip of the iceberg. It has been estimated as many as 100,000 Australians self-medicate with cannabis they’ve acquired illegally.

Advocates of the drug say it offers a safe and effective solution to people with intractable medical conditions.

But critics, and some of Australia’s leading medical experts, argue there’s limited quality evidence to support the use of medicinal cannabis in most conditions.

Research into the safety and efficacy of cannabis has traditionally been very difficult.

This is partly because of the illegal nature of cannabis, and partly because of the complexity of the cannabis plant itself.

Cannabis contains more than 400 bioactive molecules, about 100 of which are cannabinoids — a diverse group of natural chemicals that bind to the body’s endocannabinoid receptors to produce various effects.

The two main cannabinoids that have been found to have therapeutic benefits are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

THC is known for its psychoactive effects — it’s what makes a person ‘high’, and is why people use marijuana recreationally. CBD, on the other hand, is not psychoactive, and is thought to moderate the ‘high’ caused by THC.

The ratios of THC and CBD (and other cannabinoids) determine choice of product for treatment of disease.

Despite suggestions medicinal cannabis may help with everything from chronic pain to reducing anxiety, scientific literature to date has painted a mixed, and largely inconclusive picture.

Amid growing public interest in the drug in recent years, the National Drug and Alcohol Research Centre (NDARC) conducted a systematic review of medicinal cannabis in 2017, which formed the basis of current TGA guidelines.

On the whole, the review found the evidence was “limited”, and suggested cannabis only be used when registered medicines have been “tried and proven unsuccessful”.

Iain McGregor from the Lambert Initiative For Cannabinoid Therapeutics at Sydney University said although much more research into medicinal cannabis was needed, it was important not to conflate “poor evidence” with an “absence of evidence”.

“In many cases the TGA guidelines state that good quality evidence has not been done in a particular area,” Professor McGregor said.

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Posted on: February 21 2019

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