education
Medicinal cannabis By ANMF Federal Education Team
As medicinal cannabis products become more readily available to consumers for therapeutic use, nurses and midwives will be involved in the dispensing of the products and monitoring their therapeutic effects.
The following excerpt is from the ANMF’s Medicinal cannabis tutorial on the Continuing Professional Education (CPE) website. To ensure nurses and midwives have the underpinning knowledge to enter into this practice and to truly understand how medicinal cannabis works, the ANMF is offering this tutorial which is a basic introduction to medicinal cannabis. Cannabis is one of the most investigated therapeutically active substances in history, far exceeding nearly all pharmaceutical agents (Hergenrather et al. 2017). Cannabis has had a long and colourful history. Its use originated in central Asia or western China where it was used for its alleged healing properties for millennia. The first documented use dates back to 2800 BC when it was listed in the Emperor Shen Nung’s pharmacopoeia (regarded as the father of Chinese Medicine) (Lambert Initiative 2019). Medicinal cannabis is currently available in Australia via the Special Access Scheme (SAS) or Authorised Prescriber Scheme. The term ‘medicinal cannabis products’ covers a range of cannabis preparations intended for therapeutic use, including pharmaceutical cannabis preparations such as oils, tinctures and other extracts.
between states and territories and could affect access in those jurisdictions. The Commonwealth developed amendments to the Narcotic Drugs Act 1976 to decriminalise the use and supply of medicinal cannabis (Therapeutic Goods Administration, 2018). The Therapeutic Goods Administration (TGA) in 2017 rescheduled certain medicinal cannabis products to schedule 8 of the Poisons Standard, making the prescription of medicinal cannabis legal in Australia. Victoria was the first state in Australia to introduce legislation to legalise medicinal cannabis, but other states and territories have quickly followed (Canstar, 2017). WHAT IS CANNABIS AND IS IT THE SAME AS HEMP? Cannabis is a genus of flowering plant in the family of Cannabaceae. It is indigenous to central Asia and the Indian subcontinent. The number of species within the genus is disputed. Three species may be recognised: 1. Cannabis Sativa 2. Cannabis Indica 3. Cannabis Ruderalis (Wikipedia, 2019)
The Australian government is facilitating access to medicinal cannabis products to appropriate patients for medical conditions where there is evidence to support its use (Therapeutic Goods Administration, 2018).
Cannabis, sometimes called marijuana, is a family of plants with two primary classifications Indica and Sativa. While cannabis can be considered a member of either the Indica or Sativa families, Hemp is a member of the cannabis Sativa family. Hemp and cannabis can appear similar, yet each plant has very clear distinctions (Cadena, 2018).
However, to fully achieve this, several legislative and regulatory changes have been implemented at the Commonwealth level. Additionally, the rules relating to medicinal cannabis products may vary
Cannabis features broad leaves, dense buds and has a short, bushy appearance. In stark contrast, Hemp features skinny leaves that concentrate towards the top of the plant. Hemp grows taller and leaner than
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cannabis, with few branches beneath its upper portion. When compared side by side, the two plants can each be clearly identifiable. As we dive deeper into the anatomy of the two plants, each has crucial differences in their chemical composition (Cadena, 2018). Cannabis contains a variety of different compounds called Cannabinoids, two of which, and the most dominant, are Tetrahydrocannabinol (THC) and Cannabidiol (CBD). Both cannabinoids have shown to provide profound benefits to the human body; however, THC induces psychoactive effects (gets the user “high”), while CBD does not contain any psychoactive properties (Cadena, 2018). When comparing Hemp vs cannabis, Hemp contains a very low concentration of THC (0.3% or less), cannabis is abundant in THC with concentrations between 15 to 40%. Because of this, Hemp is grown primarily for industrial purposes, while cannabis is grown for recreational and medicinal purposes (Cadena, 2018). Cannabis produces a variety of compounds known as cannabinoids, many of which have not been detected in any other plant (Leafly, 2019). Cannabis is a complex plant with over 400 chemical entities, of which approximately 140 are cannabinoid compounds. The active ingredients of the cannabis plant fall into three categories: 1. Cannabinoids 2. Terpenes 3. Flavonoids (Entoura Medicinal Nutrients, 2019) Terpenes and flavonoids help enhance the therapeutic effects of cannabinoids, as well as providing individual health benefits. For example, terpenes have analgesic and/or anti-inflammatory effects, while flavonoids also benefit the immune system. The entourage effect means that many of these compounds work synergistically to enhance the medicinal benefits of cannabis while diminishing the adverse effects, including psychoactivity. Found throughout the brain, nervous systems and organs of humans and all mammals, birds, fish and reptiles, too, the Endocannabinoid System (ECS), is the body’s internal system of cannabis molecules and receptors. Native and primitive, scientists predict that humans evolved to possess this system over 500 million years ago.
