Medihuanna founder and medical director Dr Teresa Towpik says lobbying to get medicinal cannabis listed on the PBS should be an industry priority.

Medicinal cannabis is becoming more affordable and accessible. More patients are asking for it and attitudes among doctors are changing as well. Just a few years ago, they were rather suspicious and not really willing to be involved.

Dr Teresa Towpik

Some of my patients would comment: “My GP is against it and told me it will cause schizophrenia” or “they said it is against their religious beliefs to prescribe’’. 

Thankfully, it is different now and an increasing number of doctors are joining Medihuanna’s workshops and online courses.

Most of them are very open. They say: “I need to be involved because so many patients are asking about it” or “I am tired of pushing drugs which, quite often, are not working and causing adverse effects’’.

So, the situation is definitely improving. More doctors are becoming educated and involved in prescribing and more patients are experiencing the benefits of this amazing medicine. However, there are still many unresolved problems.

Doctors are worried about the penalties for driving while taking medicinal cannabis products containing any amount of THC. Unfortunately, clinical decisions are often based on these outdated drug-driving laws rather than the clinical needs of patients.

Medicinal cannabis is also still very expensive and the price is prohibitive for many. Expense is often cited by patients as a reason for ceasing treatment. Consultations in cannabis clinics can also be expensive and often not Medicare rebatable.

And many patients seeking treatment come from low socio-economic backgrounds. Unfortunately, the ones that need it most are least able to afford it.

As a patient myself, using medicinal cannabis in conjunction with conventional and other treatments, I definitely understand how it is.

There are many reasons why medicinal cannabis should be listed on the Pharmaceutical Benefits Scheme (PBS) and the industry should do more to lobby for it.

It is a multi-target drug interacting with the human body on many levels, allowing us to treat multiple clinical conditions and symptoms simultaneously and to reduce polypharmacy, especially the use of opioids and benzodiazepines.

There are no reported deaths from cannabis overdose, a significant issue with conventional drugs which also come with a long list of adverse effects. Data from Victoria shows that, between 2009 and 2015, pharmaceuticals consistently played a role in around 80% of overdose deaths each year, especially benzos and opioids.

Additionally, it has been estimated that in 2018, around 3.24 million people in Australia lived with chronic, poorly treated pain and about A$73.2 billion was spent that year on treating this medical condition.

Clinical observations show medicinal cannabis patients experience not only better symptom control, but improved functionality as well. They make healthier lifestyle choices around diet and exercise and many go back to work, having been forced to stop by their chronic pain.

Listing medicinal cannabis on the PBS would allow easy and affordable access and significant savings in healthcare costs.

It would give doctors an opportunity to treat patients more efficiently in the community, thus reducing unnecessary hospital admissions and preventable surgeries.

As patients become more functional, they return to work, thus reducing the burden on Centrelink.

“Unfortunately, clinical decisions are often based on outdated drug-driving laws rather than the clinical needs of patients.”

I’d like to share a typical story of one of my patients.

A 40-year-old male was referred to me by his GP with a long-term history of lower back pain due to a L5/S1 disc prolapse and PTSD following a car accident a few years ago.

He experienced daily pain, insomnia, nightmares, flashbacks and panic episodes. His overall quality of life was poor, he lost his job and was on disability allowance. His relationship with his wife was affected, he became socially withdrawn, stopped playing with his children, and was unable to do much around the house.

Various conventional drugs caused adverse effects and were ineffective in controlling his symptoms. He smoked illicit cannabis for many years, but preferred to use legal products and wanted to be guided by his doctor. He wasn’t driving due to PTSD.

He was started on a THC 10mg/ml and CBD 10mg/ml medicinal cannabis formulation and titrated slowly to the optimal dose of 0.5ml in the morning and 1ml at night.

He stopped using illicit cannabis and commented that he felt better not smoking.

He showed improvements on many levels, such as reduced pain and periods of no pain, improved sleep and mood. He became more functional, more social and more interested in doing things for himself, including gentle exercise.

Unfortunately, after about six months, he decided to stop his legal medication and went back to smoking because it was much cheaper for him.

That’s just one example of the many patients who could and should be guided by their doctor towards better healthcare outcomes.

Lobbying to list medicinal cannabis on the PBS should be a priority for the industry. 

It would be a reasonable, practical and logical step.

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