Medicinal Cannabis



What to expect at your initial consultation

A medicinal cannabis consultation involves a comprehensive assessment and discussion between a patient and a qualified healthcare professional, typically a doctor, who is authorised to prescribe medicinal cannabis. Here's an overview of the process:

Please be aware that you must have a valid referral from your GP.

Medical History Review: The consultation begins with a thorough review of your medical history. The doctor will inquire about your current medical condition, past treatments, medications you've tried, and any relevant health information.

Assessment of Eligibility: The doctor will assess whether your medical condition meets the criteria for medicinal cannabis treatment as outlined in the Australian regulations. Generally, medicinal cannabis is considered for patients who have tried conventional treatments without success for conditions like chronic pain, epilepsy, multiple sclerosis, and certain other conditions.

Discussion of Treatment Options:
If the doctor determines that medicinal cannabis could be beneficial for your condition, they will discuss the potential benefits, risks, and alternative treatment options. They will also explain the different types of medicinal cannabis products available, such as oils, tinctures, capsules, and vaporizers.

Informed Consent: Before proceeding, the doctor will ensure that you understand the treatment plan, its potential effects, and any legal or regulatory considerations. You'll provide informed consent to move forward with medicinal cannabis treatment.

Prescription and Dosage:
You must pay for the consultation prior to your application being sent to the TGA for approval and before your prescription can be created and sent to the pharmacy.

If approved your approval and the prescription will be submitted to a licensed pharmacy that dispenses medicinal cannabis products.

Ongoing Monitoring:
Medicinal cannabis treatment involves ongoing monitoring of its effectiveness and any potential side effects. You'll likely have follow-up appointments with the doctor to assess your progress and make any necessary adjustments to your treatment plan.

Access to Medicinal Cannabis:
Once your prescription is filled by a licensed pharmacy, you can obtain your prescribed medicinal cannabis product. In Australia, medicinal cannabis is tightly regulated, and only authorised patients with valid prescriptions can access these products.

Legal and Regulatory Considerations: It's important to note that medicinal cannabis is subject to strict regulations in Australia. The doctor prescribing the medication must be authorised by the Therapeutic Goods Administration (TGA), and the patient must meet the eligibility criteria for medicinal cannabis treatment.

Aftercare

Dosage and Timing:
Follow your healthcare provider's instructions on dosage and timing. Start with the recommended dose and adjust as needed under their guidance.

Monitoring:
Keep track of how the cannabis is affecting your symptoms, and communicate any changes or concerns with your healthcare provider. Regular check-ins will help them tailor your treatment plan.

Side Effects:
Be aware of potential side effects, which can include dizziness, dry mouth, increased heart rate, and cognitive impairment. If you experience any adverse effects, notify your doctor.

Driving and Operating Machinery:
Cannabis can impair your ability to drive or operate machinery, similar to alcohol. It's important to avoid such activities if you're experiencing any impairment.

Interaction with Other Medications:
Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Cannabis can interact with certain medications, potentially affecting their efficacy or safety.

Storage:
Store your medicinal cannabis in a secure, child-proof container in a cool, dark place to maintain its potency and freshness.

Gradual Changes:
If you and your healthcare provider decide to make any changes to your treatment plan, such as adjusting the dosage or trying a different strain, do so gradually and under their supervision.

Nutrition and Hydration:
Maintain a healthy diet and stay hydrated, as this can support your overall well-being while using medicinal cannabis.

Mindfulness:
Pay attention to how medicinal cannabis affects your mood, mental clarity, and overall well-being. Consider keeping a journal to track your experiences.

Tolerance and Dependence:
Regular and prolonged use of cannabis can lead to tolerance and potential dependence. It's important to work with your doctor to manage these aspects.

Informed consent

Informed consent is a critical aspect of any medical treatment, including the use of medicinal cannabis. It involves providing patients with comprehensive and understandable information about the treatment, its benefits, potential risks, alternatives, and the patient's rights and responsibilities. Patients can then make an informed decision about whether to proceed with the treatment. Here are some key points that may be included in the informed consent process for medicinal cannabis:

Nature of Treatment: Clearly explain that the proposed treatment involves the use of medicinal cannabis to manage specific medical symptoms or conditions.

Benefits: Detail the potential benefits of using medicinal cannabis, such as symptom relief, improved quality of life, or enhanced appetite, depending on the patient's condition.

Risks and Side Effects: Provide an honest and comprehensive overview of potential risks and side effects associated with medicinal cannabis use. This may include dizziness, dry mouth, cognitive impairment, potential interactions with other medications, and the risk of developing tolerance or dependence.

Alternative Treatments: Discuss alternative treatment options available for the patient's condition, including conventional medications, therapies, or procedures.

Uncertainties: Highlight any uncertainties or areas where the medical community may still be gathering information about the effectiveness or safety of medicinal cannabis for specific conditions.

Legal and Regulatory Considerations: Inform the patient about the legal status of medicinal cannabis in their region, including any regulations they need to follow.

Dosage and Administration: Explain the recommended dosage, how the medicinal cannabis will be administered (smoking, vaping, oils, etc.), and how the patient should adhere to the prescribed regimen.

Monitoring and Follow-Up: Discuss the need for regular monitoring, check-ins, and adjustments to the treatment plan based on the patient's response to medicinal cannabis.

Patient Rights and Responsibilities: Outline the patient's rights to refuse or discontinue treatment, as well as their responsibility to provide accurate medical history and communicate any changes or concerns.

Confidentiality and Privacy: Assure the patient that their medical information will be kept confidential and that their privacy will be respected.

Long-Term Considerations: If applicable, discuss the potential long-term implications of using medicinal cannabis, such as potential effects on memory or cognitive function.

Withdrawal and Discontinuation: Discuss the potential challenges of discontinuing medicinal cannabis, including withdrawal symptoms or a return of symptoms.
Informed consent is a critical aspect of medical ethics, and it ensures that patients are empowered to make well-informed decisions about their healthcare and treatments. If you have further queries prior to your consultation, please email bookings@hermedical.com.au

Medicinal Cannabis Consent Form


Fees



Medicinal Cannabis

Consultation Fee Medicare Rebate Out of Pocket
Consultation 240.00 0 240.00

Prescription costs vary dependent on your dosage

Consultation Fee Medicare Rebate Out of Pocket
Prescription daily der $5-$15.00 0 $5-$15.00

FAQ



What happens if I need to cancel my appointment?

We request that all cancellations are made within 24 hours where practical.

Cancellations in less than 2 hours or failure to attend will result in your deposit being retained as a cancellation fee.

How does medicinal cannabis work?

Cannabis contains chemicals called phytocannabinoids (‘phyto’ is a Greek word meaning ‘of a plant’).
There are more than 100 different types of phytocannabinoids which are commonly referred to simply as ‘cannabinoids’. Two of the most common cannabinoids used in medicinal cannabis are:
• THC (delta 9-tetrahydrocannabinol) may be used to reduce symptoms of nausea, vomiting, pain
and muscle spasticity, as well as to improve sleep and appetite. In some individuals THC may cause
a ‘high’*
• CBD (cannabidiol) does not cause a ‘high’* and may reduce the unwanted adverse effects of THC.
Research is continuing into the medicinal uses of CBD and THC combined, but it is thought to be
useful in the management of seizures and pain and may also reduce anxiety.

Cannabinoids act on receptors in the brain – and in other parts of the body – by mimicking naturally
occurring cannabinoids (called ‘endocannabinoids’). In the human body, the endocannabinoid system
affects physical processes including appetite, sleep, memory, pain and inflammation.

What are some of the conditions where medicinal cannabis has been approved?

In Australia, the TGA has approved applications for the use of medicinal cannabis in conditions
including, but not limited to:
• nausea and vomiting due to chemotherapy
• epilepsy in children
• palliative care
• cancer pain
• neuropathic pain
• spasticity from neurological conditions (such as multiple sclerosis)
• anorexia and wasting associated with chronic illness (such as cancer).

How do I take medicinal cannabis?

Medicinal cannabis is not considered to be a ‘first line’ treatment for any health condition. It should
only be considered as a treatment if standard approved treatments have not worked effectively.
Before starting any medicine, seek advice from your doctor or pharmacist about how much to take,
how to take it and what side effects you need to be aware of.

If you have been prescribed medicinal cannabis, always take the dose (amount) as directed.
Medicinal cannabis products can be taken in several ways:

• Spray. When sprayed into the mouth or under the tongue, medicinal cannabis can start to take
effect between 10 minutes and 90 minutes, and effects are usually strongest after 2–4 hours. Using
a spray may make it easier to get the right dose (amount) of cannabis medicine.
The only medicinal cannabis product registered for use in Australia by the TGA is an oral (mouth)
spray called Sativex. This product is approved for use in people with multiple sclerosis (MS) who have
tried other standard therapies without success.

• Swallowing. When swallowed as oils, liquid capsules or tablets, medicinal cannabis effects usually
start after 30–90 minutes and are strongest after 2–4 hours. The effects may last 24 hours.
Medicinal cannabis: What would you like to know? FAQs
Swallowing cannabis medicine is best for longer term relief.
As it takes longer to feel the effects when swallowing a cannabis medicine, it is important to wait
at least 3 hours before taking another dose to avoid accidental overdose.

• Vaporising. Vaporising heats the cannabis without burning it and releases the cannabinoids and
other chemicals in the form of a vapour which is then inhaled. The effects can start after 90
seconds and are usually strongest after 15–30 minutes. Vaporising is best for fast-acting, shortterm relief.
A variety of vaporising technologies are on the market, the majority of which are not indicated for
therapeutic use. If vaporised cannabis is to be used it is recommended that those which have been
studied in a research setting and found to be safe and feasible are chosen for use.

What are the side effects of medicinal cannabis?

The known side effects from medicinal cannabis treatment include, but are not limited to; fatigue
and sedation, dizziness, confusion, nausea and vomiting, fever, decreased or increased appetite, dry
mouth, and diarrhoea. Products high in tetrahydrocannabinol (THC) has been associated with feeling
‘high’ or feeling dissatisfied, depression, confusion, hallucinations, paranoid delusions, psychosis, and
cognitive distortion (having thoughts that are not true).
Medicinal cannabis side effects are commonly dose-dependent, so it’s important to follow the dosing recommendations.
Medicinal cannabis should only used under medical advice because it may interact with other medicines or cause side effects.

When should medicinal cannabis not be used?

Medicinal cannabis is not appropriate for:
• people with an active or previous psychotic disorder, or active mood or anxiety disorder
• women who are pregnant, planning to become pregnant or breastfeeding
• people with unstable heart disease.
There is no information available on the most effective or safe dose (amount) of medicinal cannabis for various conditions. For this reason, starting doses should be low and increased slowly over time.
If your doctor prescribes medicinal cannabis for you, note that:
• Like all medicines, medicinal cannabis may have side effects. Find out ‘What are the side effects of medicinal cannabis’.
• You should not drive or operate machinery while taking medicinal cannabis. Measurable concentrations of THC (tetrahydrocannabinol – the main psychoactive substance in cannabis) can be detected in urine, blood and saliva many days after the last dose. Drug-driving is dangerous. It is also a criminal offence. You should discuss the implications for safe and legal driving with your doctor.
• Depending on the laws in your state or territory, driving while using medicinal cannabis could be illegal. Check with your state/territory health department.
• Some workplaces may have a ‘drug-free policy’ and enforce regular or random drug screening. If you have been prescribed medicinal cannabis, it is important to investigate your workplace policy before commencing treatment. Speak to your prescribing doctor who may wish to refer the matter
to an occupational health specialist

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