We’ve all heard about it. Medicinal cannabis is making headlines across the country each month, with updates from government bodies and medicinal cannabis companies. So, what’s going on? What are the things we really need to know? The team at CANNect Group, an education body for Australian Healthcare Professionals, talk to us about the what, why and where of medicinal cannabis options for Australian patients.

Medicinal cannabis has become a hot topic for patients and health professionals alike. And it’s not surprising, after almost 80 years of prohibition, the reintroduction of cannabis and its compounds to medicine was always going to cause a stir. Yes, you read that right, reintroduction. Cannabis was commonly added to many medications prior to prohibition in 1938. There were research papers describing the benefits to both people and animals across the 19th and 20th century.

But let’s not all rush to finish line; our understanding of science and medicine has improved markedly since 1938, and so there is a lot of catching up needed for medicinal cannabis and cannabinoids (the active compounds) to become pharmacy staples.

Let’s start with some science

Inside every cannabis plant is hundreds of compounds that affect its colour, smell, and impact on us. Cannabinoids are the fancy molecules that can help us heal. Most of us have heard about THC and CBD, but in fact there are over 140 cannabinoids within cannabis. In time, we will learn more about what each of them do.


THC is short for tetrahydrocannabinol. Yes, we just say THC too. It’s the most well-known cannabinoid and is the main source of the psychoactive effects of cannabis. The medicinal effects of THC are dose-dependent, and even small doses (less than 5 mg) can make a noticeable change. These include euphoria, relaxation and pain relief. It can suppress nausea, moderate appetite and support sleep.

Extra Credit

For the medical buffs among you, THC is a partial agonist to both CB1 and CB2 receptors, and has preferential binding to the CB1 receptor. It is also an agonist of other receptors including PPAR-γ and TRPA1. It is likely to be THC’s actions at the CB1 receptor that is responsible for its psychoactive effects, by modulating both the glutamate and GABA systems.

Medical Cannabis - CBD Oil


Cannabidiol (CBD) is the second major cannabinoid. It’s gained worldwide attention for being the non-psychoactive cannabinoid. The World Health Organization (WHO) has stated that there’s no evidence of public health problems with its use and it’s even been removed from the World Anti-Doping Agency’s banned list. CBD has been shown to have anti-inflammatory and anti-anxiety effects. In some instances, it can reduce seizures and improve sleep.

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Here’s a little more pharmacology. CBD is a non-competitive antagonist for CB1 and CB2 receptors. It has a much lower affinity for these receptors compared to THC.

CBD’s antagonism to THC’s agonism of CB1 receptors may be how CBD can neutralise some of THC’s effects, including anxiety, tachycardia and sedation. CBD is also an inverse agonist at the CB2 receptor, which may contribute to its anti-inflammatory benefits. As with THC, CBD interacts with many other receptors and ion channels. Its effect as a positive allosteric modulator at α1 and α1β glycine receptors has been implicated as a pathway by which CBD reduces chronic pain after inflammation or nerve injury.

Medical Cannabis - CBD Oil

Our balancing system

On their way to discovering more about cannabis and its compounds, scientists realised we have a built-in body system that cannabinoids directly impact – the endocannabinoid system (eCS). Yes – every day you have a range of cannabinoids moving around your body assisting in the operation and fine-tuning of many of your cells and organs.  The eCS is involved in the regulation of sleep, pain, heat regulation, metabolism, appetite regulation, digestion, inflammation, cardiovascular and immune function, emotions, stress response, memory, cognition, neuroprotection and development…
Let’s just say its presence and impact are far reaching. A leading eCS researcher in Italy, summarised its effects as “relax, eat, sleep, forget and protect”.

When our eCS needs rebalancing

As with any bodily system, our genetics, environment and lifestyle choices can sometimes negatively impact our eCS. Scientists are starting to find many symptoms related to an under-functioning eCS; such as epilepsy, fibromyalgia, depression, nausea, irritable bowel syndrome, multiple sclerosis, Parkinson’s disease, autism spectrum disorder. Clusters of these symptoms are indicative of chronic endocannabinoid deficiency syndrome (CEDS). These conditions can be mitigated and other treatments enhanced by improving eCS function.

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Medicinal cannabis can sometimes help

Research shows THC and CBD medicines have been used to impact many of the above conditions in people around the world. These medicines are legal in Australia; our federal and state governments, along with your health professionals, are able to provide safe access to these medicines where appropriate (more on the regulations below).

Before beginning a trial of medicinal cannabis, it is important for both the practitioner and patient to assess the risks and benefits. The vast majority of medicinal cannabis options available for health practitioners to prescribe are not listed on Australian Register of Therapeutic Goods (ARTG). This means that they haven’t been assessed by the Therapeutic Goods Administration (TGA) for their safety and effectiveness, although this does not mean all products not listed are unsafe or ineffective.

During the consultation, your general practitioner, nurse practitioner or eCS Clinic will be able to assess your symptoms and diagnosis, the outcomes you are currently receiving with any current conventional treatments and how medicinal cannabis medicines may support your results. They will monitor your results over time and adjust your medication where necessary.

Regulations today

Rules for accessing medicinal cannabis varies across the world. In Australia, the TGA and the Office of Drug Control work together to schedule and control the access of medicinal cannabis. These regulations have evolved since medicinal cannabis was first legalised in 2016. The TGA is the best source for up-to-date regulatory information. To date, medicinal cannabis is scheduled in 4 different ways.

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S3: Pharmacist Only Medicine. This is the category you may have heard about recently. A late-2020 change in scheduling has created a new option for the future. As soon as a medicinal cannabis company registers an oral, low dose CBD medication on the ARTG, people will be able to access it by speaking directly to their pharmacist. This is still at least a year away.

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S4: Prescription Only Medicine. Schedule 4 medicinal cannabis products can be divided into two categories: “CBD Isolate”, which is 100% CBD and “CBD Full-Spectrum” which includes up to 2% of other compounds, including THC. When a medical or nurse practitioner decides that CBD is a suitable option, they may prescribe a trial. Speak to your general practitioner, nurse practitioner or eCS Clinic to assess your eCS health.

Medical Cannabis - CBD Oil

8: Controlled Drug. While the schedule name might sound scary to some, it’s a response to the powerful effect THC may have for some people. When a practitioner decides that a medicine containing more than 2% THC is a suitable option, they may prescribe a trial. Speak to your general practitioner, nurse practitioner or eCS Clinic to assess your eCS health.

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S9: Prohibited substance. This is the “everything else” pile, the wild-west where illegal cannabis sits. This includes the places you might see online from sites offering “Best Quality CBD Oil” through to your mate’s mate’s secret stash. Do not be fooled, it is all illegal. The legal avenues exist. Speak to your general practitioner, nurse practitioner or eCS Clinic to access them.

There’s more than just medicinal cannabis

As we spoke about earlier, our eCS is intertwined with many bodily systems. Which means there are many ways we can all support our body’s eCS health and production natural cannabinoids (endocannabinoids) right now.

Medical Cannabis - CBD Oil
Medical Cannabis - CBD Oil
Medical Cannabis - CBD Oil

Manual therapies such as osteopathic treatments, even the humble massage, have been recorded to change our production natural cannabinoids (endocannabinoids).

Exercise, particularly middle intensity exercise, have shown a doubling of endocannabinoid levels! Indeed, even the runner’s high we know and love is linked to our eCS.

And one of the big ones, as always, is good nutrition. Our eCS needs lots of healthy omega-3’s to make endocannabinoids! So consider adding fish or krill oil to your routine. Your eCS will thank you for it.

Is Medicinal Cannabis Right for You?

It’s estimated that more than half a million Australians access illegal cannabis for medicinal purposes every day in Australia. Many more people still, are looking for new options to treat symptoms associated with CEDS. Speak to your general practitioner, nurse practitioner, or access your free assessment appointment at eCS Clinic to find out whether these new therapies are right for you. You can call eCS Clinic on 1300 4 Relief or go to www.ecsclinic.com.

CANNect Group is an education provider for the RACGP. They support health professionals to learn about, and safely access, medicinal cannabis for their patients. CANNect Group work with individual clinicians and specialised clinics across Australia. The eCS Clinic, Australia’s first specialist eCS clinic for managing eCS health, is supported by CANNect Group’s education and prescribing platform.

APA recommends patients consult their doctor prior to starting or making decisions about any health or medical treatment. Additional information including scientific benefits are available at NPS MedicineWise click here The Australian Centre for Cannabinoid Clinical and Research Excellence click here. Deakin University click here.

Authorised by Stephen Mason, CEO, APA.