The rise of medicinal cannabis has been an exciting development over recent years in pain management. To find out more, and to learn more about the role of pharmacists in this space, I spoke with Danielle Holloway, Nurse Educator at Vitura Health, which is promoted as one of Australia’s leading medical cannabis and digital health solutions groups, working to bridge the gap between suppliers, doctors, pharmacists and patients. This article discusses BHC’s CanView platform, a proud subsidiary of Vitura Health.
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.
