Nicolette Senserrick joins as General Manager of Medical Relations, and Craig Thompson steps in as General Manager of Medical Sales.

The new hires follow significant developments for the company, including the introduction of same-day pharmacy delivery in Sydney through its Leafio brand and a new strategic distribution partnership with the IPA network.

Rhys Staley, Executive Director and Vice President at Montu, says he is excited about the new appointments.

“These new appointments reflect our intention to continue leading from the front throughout 2025.

“Moreover, they further our dedication to shaping the future of medical cannabis in Australia,” he says.

GM of Medical Sales, Mr Thompson, who brings 7 years’ experience working within the medicinal cannabis industry, says he is looking forward to being part of a dynamic and innovative home-grown business.

“Montu has consistently stood out to me as a key player in driving growth and change within the medicinal cannabis industry,” says Mr Thompson.

He aims to ensure the field team is well-equipped for success in their healthcare practitioner relationships.

GM Medical Relations, Ms Senserrick joins from WooliesX B2B and Woolworths at Work where she led dynamic teams to push powerful products to market.

At Montu, Ms Senserrick will be responsible for engaging with practitioners who may be unfamiliar with treating patients with medicinal cannabis.

“I am beyond excited to join Montu to help Australian health practitioners better navigate the medicinal cannabis landscape and prescribe with greater confidence,” she says.

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Consistent Growth Throughout 2023:

• Both the quantity of medicinal cannabis dispensed and the sale value experienced consistent growth throughout each quarter of 2023.
• The data showcases the industry’s resilience and sustained momentum, quarter by quarter, as more patients turn to medicinal cannabis for relief.

Figure 1 2022 & 2023 comparative quarterly performance of medicinal cannabis in retail pharmacy. NostraData pharmacy data (n=~4,500); Sales Jan 2022 – December 2023 – Patient Value. 

Queensland Dominates Sales:

• Queensland maintains its stronghold on the market, accounting for a staggering 59% of total sales in 2023.
• NSW demonstrated steady growth throughout the year, elevating its market share by 2.7% to become the second-largest state market at 19.4%. South Australia’s market share grew by 4.5% off a low base and incredibly QLD continued to demonstrate market share growth.

Key Players Driving Growth:

• Industry leaders Cannatrek and MedReleaf collectively contribute to over 50% of the total sales value of medicinal cannabis.
• MedReleaf increased its market share by an impressive 6.6%, while Cannatrek continues to lead the way in both sales amount (32%) and volume (29%).

Industry Insight:

• “Growth in the sector has come largely from the flower variant, and we expect to see even more significant developments in the future,” notes Nick Biggs, Pharmacist and General Manager at NostraData.
• Beyond the top 10 companies in Q4 there is 18% of sales which comprises 50 cannabis companies, prompting discussions of potential industry consolidation to ensure long-term viability.

Pharmacies as Catalysts for Success:

• Pharmacies that have embraced medicinal cannabis and invested in patient and staff education have thrived in this evolving landscape.
• While once the domain of niche pharmacies, NostraData advocates for a broader understanding of medicinal cannabis among all pharmacies. It is crucial for them to be well-versed in the therapeutic applications, ordering processes, and patient support to ensure optimal health outcomes.
  Figure 2 Comparative analysis by quarter of distinct count of pharmacies who have dispensed medicinal cannabis. NostraData pharmacy data (n= ~4,500)

The medicinal cannabis market in Australia is not just growing; it’s thriving. As patients increasingly turn to cannabis for relief, the industry is poised for further expansion and innovation.

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The most recent study demonstrates that Aqua Phase delivers six times greater bioavailability in comparison to CBD oil, as well as triple the maximum concentration levels. It also showed that Aqua Phase is fast-acting, reaching its maximum concentration in two an a half hours as compared to six hours for CBD oil. This significantly enhances its absorption and tolerability for users, with no taste or smell, and will go a long way in improving existing lipophilic products used to help a number of health conditions.

“In particular, the enhanced tolerability of Aqua Phase has the potential to improve the experience of patients who can’t tolerate the oils used in most CBD products. Excessive oil consumption can cause various digestive symptoms such as nausea and indigestion,” explained Janet Wilson, Head of Research & Development at Bod.

Aqua Phase’s boosted bioavailability also has the potential to reduce adverse side-effects of lipophilic drugs, while also reducing dose levels and increasing absorption. Lipophilic drugs can pose certain challenges in terms of their formulation, absorption, distribution, metabolism and excretion.

Jo Patterson, CEO of Bod, said this creates scope for Bod to pivot from being a CBD-focused drug developer to one that enters the broader medicines market globally.

“This is an important advancement for the global pharma industry and has the potential to redefine the pharmaceutical market for lipophilic compounds across the world,” she said.

Aqua Phase is delivered in a dry powder form, giving it the versatility to be adapted into multiple formats including capsules, creams and aqueous solutions.

“With Aqua Phase, we have a significant opportunity to reshape food and beverage markets across the globe,” continued Patterson. “In its powder format, we can add lipophilic compounds like CBD to sports drinks and even go a step further in adding them to oral products and topical creams in the burgeoning nutraceutical industry.

“From a healthcare perspective, Aqua Phase is a game-changer. It will enhance the wellbeing and quality of life for those who are taking CBD to support a number of medical conditions and paves the way to further strengthen the quality and efficacy of life-changing drugs, both in development and currently in the market,” Patterson concluded.

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Please tell us about CanView. How did the group come about?

When medical cannabis was legalised in Australia, doctors struggled to navigate complex regulations, while pharmacists grappled with where and how to order products.

The result was a disjointed patient experience. CanView was designed to solve these issues by connecting prescribers, pharmacies and patients with its seamless workflows and process management solutions.

What is the aim of the group?

To provide a single destination where doctors, pharmacists, suppliers and patients can seamlessly integrate and benefit from a streamlined, user-friendly ordering experience, ultimately resulting in an improved, positive experience for patients on their medical cannabis journey.

How can CanView support pharmacists in the medicinal cannabis space?

CanView’s connected ecosystem allows pharmacists to receive, order and dispense medical cannabis prescriptions online. CanView is a single destination to access Australia’s widest range of cannabis medications, including viewing and ordering stock.

The platform gives pharmacists time back in their day by eliminating the need to set up multiple supplier accounts (each with its own requirements) and by streamlining the manual paperwork normally required for compliance.

CanView is more than just an ordering platform. It gives pharmacists the knowledge and resources to provide the best service and grow their businesses.

Benefits that elevate the medical cannabis dispensing process include:

• Digital catalogue for quick and easy ordering.
• Live and transparent stock-level viewing.
• Auto-matching functionality for products and dosage forms based on TGA approvals.
• Receiving script and TGA approvals direct from prescribers.
• Automation of MB/MAP storage.
• Documenting auto-recognition for improved order accuracy and increased dispatch efficiencies.
• Electronic submission of goods received acknowledgements.
• Order history, approvals and tracking linked with patient profiles for better management.
• Built-in compliance features.

What makes CanView stand out from similar companies/groups on the market? And why would pharmacists choose to work with CanView around medicinal cannabis?

CanView is the only online platform in Australia to offer pharmacists, patients and prescribers access to a majority of medical cannabis products (230-plus) on the market. Unlike other platforms, CanView’s unique agnostic nature means the platform is not restricted to one brand, clinic, product or prescriber.

The artificial intelligence behind its document auto-matching feature is the first of its kind in Australia’s medical cannabis industry. Mitigating human error, CanView automatically flags when a script does not match a TGA approval, and prompts the prescriber to find the correct product or approval before the script can be completed.

In turn, pharmacies are never presented with an incorrect script that is unable to be dispensed, and patients avoid experiencing extended wait times for their medication while the issue is rectified.

Through CanView, prescribers can generate prescriptions via a step-by-step template, and store prescriptions and approvals in one location before sending them direct to pharmacy, which reduces a substantial amount of cumbersome administration and mitigates countless issues and errors.

Given CanView facilitates correct prescribing practice, pharmacies using CanView reduce time spent chasing prescribers for accurate documentation or engaging in conversations about correctly writing a medical cannabis script.

How can pharmacists start working with CanView? What are the steps required for a pharmacist to work with the group?

CanView’s nationwide, dedicated team of medical science liaisons are available to answer any questions or conduct a demo of the platform.

Request a callback: canview.com.au/call-back-request
To register with CanView, visit: canview.com.au/register

Where can pharmacists learn more about CanView?
canview.com.au.

This feature was originally published in the June issue of Retail Pharmacy magazine. 

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What is medicinal cannabis? 

Medicinal cannabis, also known as ‘natural plant therapy’, is a medicine derived from the Cannabis sativa plant and grown in a clean environment under strict requirements. The cannabis plant is made up of cannabinoids, flavonoids and terpenes. It has many potential therapeutic properties, including pain relief.

Cannabinoids are the main active ingredient in cannabis. Cannabinoids can be produced by the human body – called endocannabinoids – and are found in plants, known as phytocannabinoids (‘phyto’ meaning ‘of a plant’).

Phytocannabinoids are concentrated in the sticky crystals, or trichomes, on the flower of the female cannabis plant.

In medicinal cannabis therapy, these trichomes are utilised or separated from the plant material to produce medicinal cannabis medicine.

The two most widely used cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD is more commonly used for its anti-inflammatory benefits and THC is used for nerve pain. 

Are there any side effects related to medicinal cannabis use that people should be aware of?

Even though medicinal cannabis has fewer side effects than other medications, some of the potential side effects may include:

• Dry mouth.
• Nausea.
• Diarrhoea.
• Dizziness.
• Red eyes.
• Increased appetite.
• Drowsiness.
• Euphoria.
• Paranoia.

Correct dosing advised by the patient’s health practitioner can help to avoid some of these potential side effects. The ‘start low and go slow’ approach allows patients to reach their minimum effective dose and achieve pain management with minimal side effects.

How does medicinal cannabis help in the area of pain management?

Every human has an endocannabinoid system in their body that restores homeostasis by promoting sleep, appetite, stress reduction, and modulation of pain and inflammation. Cannabinoid compounds in cannabis interact with the endocannabinoid system to produce various effects.

Cannabinoid type 1 (CB1) receptors are found in the brain and on nerve cells. Activated CB1 receptors downregulate the upstream neuron to protect the downstream neurons. CB1 receptors target motor activity, thinking, motor coordination, appetite, and pain perception.

Cannabinoid 2 (CB2) receptors are found in the immune system, brain and through the body. Activated CB2 receptors activate inflammatory modulation and various other effects. They’re much broader than CB1 and influence most of the body, including gut, kidneys, pancreas, adipose tissue, reproductive system, skin, central nervous system, cardiovascular system, liver and tumours.

What type of pain does medicinal cannabis help?

Inflammatory, neuropathic pain, phantom pain, headache and migraines, endometriosis, fibromyalgia, arthritis, rheumatoid arthritis, psoriatic arthritis, TMJ, scoliosis, IBS, and post-op pain, just to name a few.

What are the contraindications in terms of using medicinal cannabis for pain management? 

• Unstable or severe cardiovascular disease.
• Hypotension (low blood pressure).
• Psychotic illness or a risk of psychotic illness – eg, familial risk factors.
• Addiction risk factors.
• Pregnancy/breastfeeding.
• Under 25 years old.
• Lung or liver or renal disease.
• Some medications.

What does this mean for pharmacists? How can pharmacists work with such companies as BHC’s (Burleigh Heads Cannabis’) CanView, one of the brands that Vitura Health showcases, to support their patients with pain management? 

CanView is a streamlined, compliant and free-to-use platform where pharmacies can order and dispense medical cannabis prescriptions online.

Using intuitive software that is backed by machine learning, CanView eliminates the need to set up multiple supplier accounts and streamlines the manual paperwork required for compliance. Once registered on BHC’s CanView, pharmacists can learn about cannabis medicine, order products and start dispensing.

How can pharmacists learn more about the health benefits of medicinal cannabis?

Pharmacists can learn more about medical cannabis by taking our free online course at canview.com.au.

Through our online course, pharmacists will gain confidence in different aspects of cannabis medicine, including, among others:

• The endocannabinoid system.
• Administration routes and interactions.
• Indications, conditions and dosing guidelines.

This feature was originally published in the April issue of Retail Pharmacy magazine.

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What is CBD?

Broadly speaking, two components make up the emerging area of healthcare referred to as medicinal cannabis: THC (or tetrahydrocannabinol), which is intoxicating, and CBD (or cannabidiol) which is not.

According to pharmacist Zeeta Bawa, research assistant and PhD candidate within the Lambert Initiative for Cannabinoid Therapeutics at the Brain and Mind Centre of the University of Sydney, these are “the two most well-studied active ingredients found in the Cannabis sativa plant”.

She adds that while evidence is still emerging, CBD has demonstrated health benefits, including “anxiolytic, anti-inflammatory, antipsychotic, anti-addiction and anticonvulsant properties”.

“CBD can be found in a wide variety of formulations, some of which include oils, capsules, wafers, flower (flos, plant material) and other oral products – for example, tablets, lozenges,” she said.

Dr Joe Kosterich, medical adviser to medicinal cannabis company Little Green Pharma says CBD is “one of the main cannabinoids in the cannabis plant”.

“It comes mainly as an oral form – oils or tablets – but also as dried flower,” he said. “There are [also] some sublingual formulations.”

Considering the regulations 

Medicinal cannabis, and in this case, the use of CBD within Australian healthcare, is governed by tight regulations.

Regulatory authorities the Therapeutic Goods Administration (TGA) and the Australian Register of Therapeutic Goods (ARTG) have set in place restrictions related to the use of medicinal cannabis, which all healthcare professionals need to be aware of.

“Formulations containing mostly CBD have been largely available via Schedule 4 using the Authorised Prescriber (AP) and Special Access (SAS) schemes that are overseen by the TGA,” Ms Bawa said.

“Recently, Schedule 3 access has been approved but no CBD products have been registered with the TGA or are currently available in this schedule. It’s expected that this will happen sometime next year.”

Dr Kosterich adds that the TGA down-scheduled CBD to Schedule 3 in early 2021.

“This only applies to those formulations on the ARTG,” he said. “Currently there are none on this register, thus CBD is Schedule 4 and must be prescribed by a doctor.

“However, as CBD products are not on the ARTG, a doctor must get approval from the TGA to prescribe, in contrast to regular Schedule 4 drugs, which do not require authorisation.”

Despite the current regulations, the use of medicinal cannabis, specifically CBD in this case, is an evolving area of healthcare. As CBD offers health benefits, it’s an area in which pharmacists should be upskilling.

CBD: the health benefits

Referring to a summary provided by the TGA, Ms Bawa lists some of the evidence supporting the benefits of CBD for various health conditions:

• “There is reasonable well-established efficacy in paediatric epilepsy and anxiety from randomised controlled trials.
• “There is emerging evidence of efficacy in chronic pain and addictions from randomised controlled trials.
• “There are only pre-clinical/animal studies around the use of CBD for anti-inflammatory or neuroprotective effects.”

Ms Bawa continued: “The main uses for CBD have been chronic pain, anxiety, insomnia, neuropathic pain, cancer pain/symptoms and epilepsy. It should be noted that these uses are not always supported by robust evidence from clinical trials. This is not to say that CBD doesn’t work, but that we simply require more randomised controlled trials to confirm efficacy.”

She adds that currently, “CBD is often used when other treatment options are unsuitable or have failed”.

Conversations around CBD oils and products often refer to benefits in reducing inflammation. Ms Bawa says that while CBD has been “seen to help with modulating some of the inflammatory responses and pain associated with inflammation”, more “robust clinical trials are required to confirm these findings in humans”.

“The efficacy data of inflammation has largely come from pre-clinical and animal trials, which are an early marker of efficacy in inflammation,” she said.

Pharmacist and herbalist Gerald Quigley says that given its role within the inflammatory response pathways and the fact that “inflammation is the root cause of so many chronic diseases”, there’s an opportunity for CBD to help in this space.

He adds that evidence supports the role of CBD in aiding inflammatory conditions such as polymyalgia, fibromyalgia, osteoarthritis and rheumatoid arthritis.

“If you look at some mental health conditions that may involve inflammation in the brain, then CBD will play a role there,” he said. “In fact, … [CBD] has been used in an autism spectrum disorder study … there are some children whose autism has been resolved … so we know that it works as an anti-inflammatory.”

Similarly, when it comes to pain management, Ms Bawa says more “randomised controlled trials are required to truly understand the analgesic effects of CBD in various types of pain”.

“It’s important to [remember] that pain is a complex condition that varies in aetiology,” she said. “It’s not a one-dimensional condition, and therefore the treatment of pain is not simple either.”

Ms Bawa continued: “Despite the lack of robust clinical evidence, it [CBD] has certainly been prescribed a great deal for pain, and there’s a lot of interest in CBD as an alternative therapy. Some patients may find relief from their pain with CBD, while others may not.

“Currently, CBD is used on a case-by-case basis and is considered a last resort therapy or an ‘add-on’ therapy when conventional treatment options haven’t managed to control pain sufficiently. I recommend that patients speak to their doctors about using CBD for pain.”

While more clinical studies are needed, Dr Kosterich says numerous studies in the US have shown “reduced use of opiates when medicinal cannabis is introduced”, which may be a better alternative here, given the fact that “CBD is non-intoxicating and non-addictive”, he says.

“It’s important to point out that these studies generally include CBD and combinations of CBD and THC,” Dr Kosterich said. “It’s certainly the case that for some people, they can reduce other pain medications, and that reduction can be all the way down to stopping [this medication]. Currently in Australia, it [medicinal cannabis] can only be prescribed when other treatments have failed or caused adverse effects.”

Regarding the management of stress and anxiety, Ms Bawa says that “CBD has demonstrated anxiolytic effects in some clinical trials in doses of 300mg and above”.

“[This] is promising,” she said. “However, there are very few trials to confirm these effects … As I’ve mentioned, further high-quality trials are required to clarify the anxiolytic effects of CBD.”

Dr Kosterich says CBD, and combinations of CBD and THC, are “a viable option” for the management of stress/anxiety, as they are for pain management – and have “a more benign side effect profile than many currently used medications”.

“And [they’re ] non-addictive,” he said.

CBD precautions

Ms Bawa says “CBD generally has a good safety profile”, but she cautions that “it can interact with a number of medications”.

“This will, of course, depend on the dose and frequency of CBD use,” she said. “CBD can affect a number of enzymes in the liver, which will affect how various substances are metabolised. Therefore, care should be taken if patients are using other medications.”

In terms of drug interactions, Ms Bawa says CBD has been known to interact with “clobazam and sodium valproate”.

“CBD can also interact with warfarin, and recent research by the Lambert Initiative for Cannabinoid Therapeutics found a CBD and citalopram interaction,” she said.

According to Mr Quigley, CBD is generally safe and doesn’t have any significant side effects.

“It appears that the biggest issue with CBD and CBD oil is taste,” he said.

Ms Bawa agreed: “CBD is generally well tolerated, [although] some of the side effects of CBD can include fatigue, sedation and gastrointestinal upsets, including nausea, vomiting and diarrhoea,” she said. “However, these effects tend to happen at higher doses, and will depend on the dose and frequency of use.”

According to Dr Kosterich, CBD is also contraindicated in pregnancy and lactation, while “care needs to be taken in those with liver or kidney issues – albeit CBD is non-toxic to these organs”.

Reiterating the warnings regarding warfarin use, he says those considering CBD who are on warfarin will “need their INR levels monitored” as would be the case “with the addition of any new medication”. He adds that “care needs to be taken when adding it [CBD] to current medications that perform a similar role”.

“However, one can start at a low dose and titrate upwards slowly, in some instances while reducing other medications, if appropriate,” Dr Kosterich said. “In clinical practice, drug interactions are rarely a problem.”

The role of community pharmacy

When CBD products that comply with TGA regulations and are listed on the ARTG become available, this will be a space in which community pharmacies will have a role. It’s pertinent, therefore, for pharmacists to upskill in this area.

“It’s important for pharmacists to keep up to date with all of this,” Mr Quigley said. “I think they need to start learning about cannabis … they need to become educated in the latest work being done so that when these things come on the market, they’re ready to go because there’ll be people coming from everywhere wanting to give it [CBD] a try.”

He adds that it will also be important for pharmacists to “be supportive and engaging in customers’ requests”.

“[As pharmacists],” he said, “we should be able to confidently inform people, bearing in mind their history, their medications, their particular issues, their pain, and what effect [CBD] is having.”

Ms Bawa said: “Medicinal cannabis is an emerging area of pharmacy practice, and there’s a need for pharmacists to have knowledge about this drug class. This need is emphasised given the recent legislation, which will permit the Schedule 3 supply of low-dose CBD products.”

She continued: “In terms of Schedule 4 CBD supply, pharmacists should approach this medication as they would any other: Are the prescribed dose, frequency and indications suitable? Are there any drug interactions, contraindications or precautions? What counselling point should you provide?

“In terms of Schedule 3 CBD supply, pharmacists will be able to supply these products based on the indications approved by the TGA (these are yet to be determined). Over-the-counter supply of CBD by pharmacists will not be suitable for complex or unstable chronic conditions, and these customers will need to be referred to their doctor for further advice.

“I believe pharmacists will play a critical role in educating customers on CBD products and the available evidence, whether pharmacists decide to participate in supply or not.”

To read the feature in full, as it appears in the December issue of Retail Pharmacy magazine, visit: retailpharmacymagazine.com.au/magazine/retail-pharmacy-december-2022

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Montu Managing Director Christopher Strauch founded the company with the mission to provide patients with an alternative to conventional medication and help millions of people worldwide live better lives.

Mr Strauch says the company is proud to provide Australians with a “powerful alternative to traditional medications” and to “create a new standard in patient care”.

“Our ongoing growth is a result of our patient-centric approach and streamlined process, which gives patients access to a natural plant-based alternative to manage their chronic conditions in a fast and affordable way,” he said.

“Our key focus is to provide the best care and outcomes for our patients so they can experience the many benefits of medicinal cannabis when used and administered correctly.”

Conducting more than 50,000 patient consultations every year, Montu is making medicinal cannabis accessible and affordable to Australians with chronic medical conditions.

Consultations are conducted via the integrated telehealth platform, alternaleaf, with practitioners including registered nurses and qualified doctors.

The company’s clinical team provides patients with individualised care and alternative treatments for a range of chronic conditions, including chronic pain, anxiety, insomnia, and depression, to name a few.

Dr Parul Agarwal has been a doctor for the past 18 years and became an authorised medicinal cannabis prescriber two years ago after seeing a significant improvement in her patients with chronic pain.

“I started to prescribe medicinal cannabis as my patients were looking for natural remedies, especially cancer patients who needed help with chronic pain,” she said.

“I found that it worked beautifully for chronic pain, anxiety, depression, PTSD, ADHD and insomnia. I have seen how it has given my patients a better quality of life. I believe this is the beginning of how we perceive alternative medicine.”

For more information about Montu, visit: montu.com.au.

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Under the new licence, CSIRO says it will support the growing local industry and partner with local manufacturers to drive the development of new cannabis therapeutics, in a move that will create new jobs in Australia.

According to CSIRO, the global market for medicinal cannabis is projected to be worth USD $44 billion by 2024 and this licence places CSIRO at the forefront of research into the development of new cannabis medicines.

“Around the world, researchers are exploring the potential for medicinal cannabis to help with conditions such as epilepsy and the nausea and vomiting associated with chemotherapy treatment, multiple sclerosis and chronic pain,” CSIRO Scientist, Adjunct Professor Peter Duggan says.

“We had been able to do early-stage work with cannabis, but the new licence will enable us to develop cannabis-derived cannabinoid medicines using innovative extraction, refinement and formulation techniques,” he says.

The agency says, CSIRO is currently the only independent research institute in Australia able to develop drug manufacturing protocols in the medicinal cannabis space.

It says that its work will bridge the gap between the growing of plants and the manufacture of medicines, with the researchers developing the manufacturing protocols and preparing the first prototype products before transferring the technology to manufacturers for large scale production.

The use of cannabis for medicinal purposes is highly regulated in Australia.

However, in December the Therapeutic Goods Administration (TGA) approved over-the-counter pharmacy sales of a low dose form of cannabidiol (CBD), one of the key components of cannabis that can help with a range of medical conditions.

Medicinal cannabis products, in the form of oils, capsules, oral sprays, lozenges or other drug formats, can also be prescribed through the TGA’s Special Access Scheme.

Peter Crock, CEO of industry leading medicinal cannabis company, Cann Group, and Chair of Medicinal Cannabis Industry Australia (MCIA), says there were over 20 medicinal cannabis companies currently listed on the ASX, and a growing number of licenced cultivators and manufacturers now in Australia.

“Cann Group has worked closely with CSIRO over the past three years and has been pleased with the results,” says Mr Crock.

“With this independent license CSIRO will be able to play a key role in helping establish a vibrant industry in Australia.

“Research that creates new and enhanced medical products and improves manufacturing processes is important if we want Australia’s medicinal cannabis industry to be competitive in a global market.”

The post CSIRO set to develop medicinal cannabis appeared first on Retail Pharmacy.

While medicinal cannabis is controversial and its use within healthcare hotly debated, there is a lot more to the product than meets the eye.

Speak with the experts and you soon discover there might just be a place for medicinal cannabis – tetrahydrocannabinol (THC) and cannabidiol (CBD) – within mainstream Australian healthcare.

The topic that has interested both healthcare professionals and consumers alike for years – those with chronic conditions desperate to try something that ‘might just work’ for them yet experiencing significant barriers in accessing the so-called complementary drug; that includes both CBD and/or THC.

In Australia, “almost all medicinal cannabis is scheduled under the Special Access Scheme and thus can only be prescribed by a registered medical practitioner”, the Therapeutic Goods Administration (TGA) states.

“With the exception of one product (Nabiximols), medicinal cannabis products are not registered medicines in Australia, so they must be accessed through special pathways available for unapproved medicines … such access can only be arranged through an Australian-registered medical practitioner with appropriate qualifications and/or expertise for the medical condition requiring treatment,” the TGA continues.

“This doctor can notify/apply on the patient’s behalf for approval to import and supply these products through the Special Access Scheme (SAS Category A or B). Alternatively, the doctor can apply to us [the TGA] to become an Authorised Prescriber (AP).”[1]

In addition, some states and territories may have their own qualification criteria.

While currently THC (Schedule 8) and CBD (Schedule 4) both remain drugs that can only be prescribed through the SAS or an AP, access to low-dose CBD is being reviewed.

“It’s critical that pharmacists have the facts … a lot of the time people go to a pharmacist first [so] pharmacists need to play a key role [in this space],” says Pharmacy Guild Queensland Branch Vice-President Kos Sclavos, a passionate supporter of medicinal cannabis use in healthcare.

What is medicinal cannabis?

While the cannabis plant contains up to 100 cannabinoids, CBD and THC are typically those being referred to when we speak of medicinal cannabis.

CBD and THC both have therapeutic uses and differ based on their psychoactive effects. According to the TGA, “unlike THC, CBD does not cause psychomotor or cognitive impairment, or strong psychoactive effects”. [2]

THC is the cannabinoid “responsible for the psychoactive effects of cannabis and is the reason cannabis is used recreationally”. [3]

“Essentially, the difference between medicinal cannabis and illicit cannabis is one of quality assurance and the standardisation of cannabinoids, the former being an important aspect of safety,” says Justin Sinclair, research fellow at NICM Health Research Institute, Western Sydney University.

Dr Ben Jansen, Clinical Director of Cannabis Doctors Australia and CDA Health, adds: “When you say medicinal cannabis, it’s a broader term because it’s not just CBD by any means. We’re prescribing THC as well.

“About 40% of our prescriptions are CBD alone, the other 40% are THC alone and then 20% are blended products.

“Commonly we’ll prescribe a CBD and a THC so that a patient can adjust the dose of the CBD for their conditions that respond to the CBD, which will be different, in general, from what will respond to the THC.”

What conditions does medicinal cannabis manage?

Dr Jansen says the medical team at Cannabis Doctors Australia prescribe CBD and/or THC for a variety medical issues, including “neuropathic pain, inflammatory pain, degenerative pain, and beyond that, the next most common [condition] is anxiety”, which makes up “anywhere from 5-10% of prescriptions”.

Dr Jansen says medicinal cannabis is also prescribed for:

• Palliative care.
• Restless leg syndrome.
• Parkinson’s disease.
• PTSD.
• Ulcerative colitis.
• Migraines.
• Tremor.
• MS pain or spasms.
• Dystonia otherwise undiagnosed.
• Blood glucose control (“a couple of patients are on CBD for their diabetes”).
• Chemotherapy-induced nausea.
• Autism.
• Asperger’s syndrome.
• Mood disorder.
• Depression.
• ADHD.
• Schizophrenia.
• Epilepsy.
• Cystic fibrosis.
• Crohn’s disease.
• Other conditions.

The role of a pharmacist 

While dispensing of medicinal cannabis is largely the domain of Approved Prescribers and doctors who have received approval through the SAS, given the potential change in low-dose CBD scheduling, all pharmacists may soon play a role within this arena, and will need to know how to dispense medicinal cannabis appropriately, and according to health conditions.

Mr Sclavos says all pharmacists will “need to step up”.

Dr Jansen says: “[At present] CBD is a Schedule 4; THC is a Schedule 8 – any product that has more than two per cent of any other cannabinoid apart from CBD is considered a Schedule 8 as well.”

“The government is looking to change the scheduling of smaller bottles of CBD to across-the-counter pharmacy only (Schedule 3) … so [if this goes ahead] pharmacists would have more of a role in dispensing CBD … [and] would need to give accurate advice,” says Dr Jansen, adding the need for pharmacists to upskill in this area.

“We do have pharmacists referring onto us and … we try to support our pharmacists as much as we can.

“There’s been a lot of red tape in preceding years for our pharmacists and [it’s been] really hard for them to get past a lot of that. So … we have released our new platform to try and help our pharmacists out, called CanView.”

To help pharmacists upskill, courses and platforms such as CanView are becoming available. Dr Jansen adds that through CanView, an educational platform will be released that pharmacists can access for further training around medicinal cannabis.

In addition to the option of the CanView platform, on 1 July NPS MedicineWise released a new portal to “help health professionals and consumers navigate evidence-based information about medicinal cannabis”.

For more information on the educational platforms, visit:

• CanView: canview.com.au
• NSP MedicineWise: nps.org.au/professionals/medicinal-cannabis-what-you-need-to-know

To read the full feature as it appears in this month’s issue of Retail Pharmacy magazine, visit: retailpharmacymagazine.com.au/magazine/ to subscribe to the magazine.

References:

1. Guidance for the use of medicinal cannabis in Australia: Patient information, gov.au/publications/guidance-use-medicinal-cannabis-australia-patient-information [Accessed 1.7.2020].
2. Review on the safety of low dose cannabidiol, gov.au/alert/review-safety-low-dose-cannabidiol [Accessed 2/7/20]
3. Guidance for the use of medicinal cannabis in Australia: Patient information, gov.au/publications/guidance-use-medicinal-cannabis-australia-patient-information [Accessed 1/7/20].

The post The case for marijuana as medicine appeared first on Retail Pharmacy.

A new portal by NPS MedicineWise will help health professionals and consumers navigate evidence-based information about medicinal cannabis.

The new information helps explain the regulatory framework and process to access medicinal cannabis for both consumers and health professionals, and provides summaries on the latest evidence for medicinal cannabis.

The content supplements clinical guidance provided by the Therapeutic Goods Administration (TGA) for health professionals and provides additional information for consumer and pharmacist audiences.

Consumer-friendly content on the website includes answers to frequently asked questions in a downloadable article Medicinal cannabis: What would you like to know?, an infographic resource: Is medicinal cannabis suitable for me?, and an explainer article: Medicinal cannabis, explained.

There are also important resources for pharmacists: 7 questions pharmacists are asking about medicinal cannabis and Medicinal cannabis: dispensing process for pharmacists as well as resources for prescribers including full evidence summaries with links to the TGA’s clinical guidance and a flowchart for prescribers that outlines the steps to accessing medicinal cannabis. 

NPS MedicineWise CEO Adj A/Prof Steve Morris says there’s a lot of interest in how cannabis can be used as medicine—and this means navigating the online information which can be a daunting task.

“Medicinal cannabis is a medicine that Australians want to know more about,” says Mr Morris.

“Accessing clear, accurate and up-to-date information about medicinal cannabis can be challenging for consumers and health professionals because there are many groups with an interest in this area, and a complex regulatory environment.

“Doctors and pharmacists are fielding questions from their patients about medicinal cannabis. Patients want to know if medicinal cannabis is suitable for them, and if so, how they can access safe and standardised medicinal cannabis products.

“At NPS MedicineWise, our role is to deliver accurate, balanced, evidence-based information about the quality use of medicines.

“This is why we’ve developed a portal where consumers and health professionals can find the evidence-based and practical information they need, presented in a clear, user-friendly format, with links to further information about State and Territory regulations and access pathways,” he says.

NPS MedicineWise worked with the TGA, health professionals, research and consumer organisations to gather the most up-to-date evidence for the use of medicinal cannabis in Australia and produce this content, which will be updated regularly.

“Medicinal cannabis is a fast-moving area where we will continue to see changes over the coming years as prescribers and patients become more familiar with these products and their potential uses.

“As the body of evidence grows, we will ensure our medicinal cannabis resources remain relevant and up-to-date for those seeking this information,” says Mr Morris.

To find out more go to: www.nps.org.au/medicinal-cannabis.

Text by: NPS MedicineWise 

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