In the second part of an exclusive interview with Cannabiz, Medcan Australia managing director Craig Cochran sets out the underlying reasons for the spike in demand for dried flower. Chief correspondent Steve Jones reports.
It may be against the instincts of doctors to prescribe it, but something is happening with dried cannabis in Australia.
While still regarded as the spiritual, go-to product of the “stoner hippie” – a perception that continues to endure – change is in the air.
From an industry perspective, flower has, of course, always been a legitimate and respectable delivery format.
The medical community, on the other hand, has not been quite so receptive.
Yet according to Medcan Australia managing director Craig Cochran, Australia is in the midst of an evolution of the medicinal cannabis market, and it’s one where flower is becoming more socially acceptable.
No detailed data
Precisely how much flower is prescribed in Australia, or any other format for that matter, is hard to gauge.
Aside from the TGA’s Special Access Scheme figures released on its website each month, little else is publicly available.
We know there were close to 10,000 approvals in March. What exactly was prescribed, or any other detail around those prescriptions, remains unclear.
Anecdotally, however, interest in flower appears to be growing, with suggestions that rising demand, along with an export backlog in Canada, was partly responsible for Australia’s recent flower shortage.
Cannatrek reported an “exponential” increase in the uptake of flower – up three or four times since the turn of the year – while Cann Group also recognised the recent surge.
Additionally, Little Green Pharma is now tapping into the flower market, having launched its first product last month on the back of rising demand.
All would seem to support Medcan’s assertion that vaporising dried flower – so prevalent in markets like Germany – is gaining traction in Australia.
Cochran believes this evolution, as he calls it, has a number of contributing factors.
One is the improving knowledge and understanding of medicinal cannabis among prescribers.
A second is the indications the TGA has listed as being ‘approved’ for medicinal cannabis treatment through the Special Access Scheme.
According to Cochran, when the list of indications was expanded to include pain relief, doctors initially became familiar with the benefits of CBD oil, before acknowledging the pain-relieving qualities of THC and a balanced oil ratio.
But while recognising the benefits for “maintenance” purposes, oil is unable to prevent breakthrough pain in a way that vaporising can, given its rapid bioavailability.
“With some paediatric epilepsy for example, for a 16 or 17-year-old who is having a seizure, taking oil won’t stop that because it’s not quick enough to react, but vaporising can,” Cochran told Cannabiz.
“What we have seen is an evolution of the Australian industry. People walked the path from CBD to THC and one-to-one oil which is great for maintenance, but it won’t stop that breakthrough seizure. The market has evolved as doctors have become more aware of different indications, or different uses within these indications, and as social acceptance increases [of flower].”
Cochran says he is witnessing a “changing mindset” among doctors, many of whom “know what they know because that’s what they’ve been taught”.
“And they’ve been taught that cannabis is a gateway drug, that it’s bad,” he says.
But the amount of real-world evidence confronting GPs – gathered from real patients with compelling stories of improving health – is leaving them little choice but to rethink outdated attitudes that remain indelibly linked to the decades of cannabis prohibition.
Cochran cites the example of a close acquaintance, a medical practitioner, who refused to prescribe medicinal cannabis, and who reserved particular hostility for flower.
“Then he started to refer patients, and when he saw those patients return to him and demonstrate the positive impact that oil and flower had on their lives, his duty of care made him think, ‘okay, if this is available I need to learn about it’,” Cochran recalls
“He might still have been thinking, ‘whoa, dried flower, that’s bad’. But doctors who have genuine patient care at the forefront of their minds, when they see enough people it has helped, and where they see that vaporising cannabis has stopped seizures and breakthrough pain, they have a duty of care to explore it.”
Faced with such eye-opening examples of its life-enhancing qualities, denying patients the opportunity to at least try medicinal cannabis in its various forms, flower included, is getting “harder and harder”, he contends.
Social outcasts no more
In addition to rising doctor appreciation of its therapeutic benefits for certain indications, increasing uptake of flower can be traced to gently shifting tides among illicit users, says Cochran.
For many years, Australian patients denied legal access to cannabis have self-medicated, with the vast majority smoking dried flower. But some, inherently uncomfortable with the “criminal” label attached to black market-sourced cannabis, are now choosing to navigate the legal pathways open to them.
“We believe there will be a continual increase in dried flower simply because people who have legitimately needed to self-medicate, sometimes for 20 years or more, no longer want to be seen as a ‘criminal’,” he says. “They want to transition from the black market to the legal market. These people genuinely want to look after their health, they’ve been demonised for years because they smoked cannabis and they no longer want to be a ‘social outcast’, for want of a better word.
“They want to be able to use their medicine in a way that is more socially acceptable, where they can use a vaporiser as opposed to rolling and smoking a joint.”
Cochran adds, pointedly: “There has always been this stigma around cannabis flower, the image of the ‘stoner hippie’. But it’s just not like that. That is not the type of people who use the product.”
Furthermore, illicit users only familiar with smoking cannabis are unlikely to have been exposed to the well-being benefits of quality oil products, he says.
Those who transition to a legal pathway will not only benefit from vaporising, rather than smoking dried flower, they can also be introduced to oil to assist with the “maintenance” previously mentioned by Cochran. That, in turn, may reduce their historical over-reliance on flower, he points out.
To illustrate the inaccuracies of the stoner image, Cochran lists doctors, lawyers and barristers among the professional cohort who use Medcan’s flower products, which make up 75% of its sales.
“If a barrister gets chronic headaches and the only thing that works is vaporising dried flower, that is what they will do,” he says. “And if that barrister goes to his GP and says I want to vaporise dry flower because it works, the GP’s duty of care is to think, ‘if this works, and nothing else does, I should have a look at it’.”
But as long as medical bodies like the Faculty of Pain Medicine pour scorn on medicinal cannabis, the job of eradicating negative perceptions and outright discrimination will never be over.
And it’s a fact not lost on Cochran.
“Of course there are doctors who will just say no to flower. There are certain clinics in Australia which just say, ‘no, we won’t prescribe dried flower’,” he says.
“And that means there are still a lot of patients who are missing out.”