The history of medicinal cannabis in Australia has been fraught with anger, disappointment and confusion. In the eyes of medicinal cannabis advocates, Australia had fallen behind the rest of the world, with countries such as the United States, Canada, Israel and the Netherlands having already passed legislation.
In 2016, the Federal government decriminalised the use of Australian-cultivated and processed medicinal cannabis, subject to state and territory regulations. Victoria was the first state to introduce legislation to enable patient access to medicinal cannabis, with other states and territories quickly following. Now, despite each state and territory having their own legal subtleties and nuances, medicinal cannabis is accessible by patients with certain conditions in some shape or form across the country.
The importance of legalising medicinal cannabis cannot be understated, considering its widespread use in managing debilitating diseases and disorders, and improving quality of life. Medicinal cannabis oil has been demonstrated to be a potential anti-epileptic in humans. Most notably, it has been used to manage Dravet syndrome, a form of severe epilepsy that often begins in infancy. In addition to this, medicinal cannabis is commonly used to manage painful muscle spasms caused by multiple sclerosis, and also in the final stages of cancer to combat pain and chemotherapy-induced nausea. However, this all still needs to be verified in greater detail through clinical trials as there remains a gap in knowledge of the permutations of compounds, dosage levels, and the effects on conditions and symptoms.
Such clinical trials are now in their early phases, with studies investigating the use of medicinal cannabis in paediatric epilepsy, terminal cancer, chemotherapy-induced nausea and vomiting taking place in Victoria, New South Wales, Queensland and the Australian Capital Territory. Studies are also exploring the use of medicinal cannabis in the management of type 2 diabetes, inflammatory bowel disease and drug dependency. Such research and work in the clinical trials space is vital in determining the efficacy of a drug in treating or managing a particular disease and disorder, informing policy and medical practice.
Legalising medicinal cannabis facilitates the creation and enforcement of a robust regulatory framework, allowing greater control by the government and regulatory bodies, such as the Therapeutic Goods Administration (TGA). This also means standardising manufacturing and quality control, ensuring that cannabis products used in the medical context are safe and effective. Prior to this change in the law, it was an open secret that parents of children who suffer from epilepsy often procured, illegally, cannabidiol to manage the seizures their children endured. The major concern with this practice was that this medicinal cannabis came from home-grown or black-market sources, meaning that safety, quality, purity and efficacy were unknown. With uncertainty in composition and contaminant level, there were real dangers to the health of sick and vulnerable children and adults. Legalisation and regulation mitigates this risk, while expanding the access to a treatment that can help manage chronic and debilitating diseases and disorders for all patients.
Despite this, there are still struggles today. Many states and territories are still refining their bureaucratic apparatus and processes. The New South Wales government, in partnership with the TGA, only recently announced the implementation of a single application process. For doctors wanting to prescribe medicinal cannabis to a patient, streamlining this process would decrease approval wait times from months to under 36 hours. While the relatively high price point, exacerbated by the lack of subsidies from the Pharmaceutical Benefits Scheme, creates a barrier to access for patients. It may cost $120 per day to obtain TGA-approved cannabis products to treat a child with epilepsy. Compared to the black market, government-sanctioned products are much more expensive, raising concerns that patients and their families may return to illegal sources.
Evidently, there is still a long way to go. Despite there being legislation in place to facilitate access to medicinal cannabis, the therapeutic effects are still under investigation. As such, clinical trials are of paramount importance in informing the future directions of this treatment. With a strong, sensible and robust regulatory framework and administrative processes, meaningful consultation with medical professionals and researchers, and data from clinical trials, there is no doubt that medicinal cannabis can be used to ease the suffering and improve the quality of life of thousands of people in Australia safely and effectively.