Since the introduction in 2016, Australia’s Special Access Scheme has received widespread criticism for its limitations on access, red tape, and product limitations. Here is the lowdown on Medical Cannabis Australia and how to access it.
According to an article by Danica Cullinane on smallcaps.com.au, Medical Cannabis Australia is changing for the better.
Australian medicinal cannabis ancillary services provider Cannvalate’s chief executive officer Dr Sud Agarwal gave Small Caps the lowdown on exactly how access works in Australia.
Dr Agarwal said since legalisation occurred, there has been an increased “softening of the regulations to prove eligibility for medical use”.
“It’s federally open – it’s the same essentially everywhere [in Australia],” he said.
“Some people say there’s a patient access problem but it’s not really a government problem anymore; it’s more a function of cost or efficiencies of the system,” Dr Agarwal added.
So, it seems, according to Dr. Agarwal, there isn’t an access issue at all.
I suppose the judgments laid on the scheme could be a hangover from the teething issues experienced by the scheme in the early days. One of the biggest criticisms was having to go through a ‘special doctor’ to get access. But apparently, this is no longer the case.
“Any doctor can prescribe it now – GP or specialist,” he said.
“The vast majority of prescriptions, probably 98%, are not prescribed by authorised prescribers. It’s probably the biggest misconception. They’re prescribed by regular doctors under the Special Access Scheme,” Dr Agarwal explained.
But, surely it’s not as easy as getting a prescription filled and walking away right? If that were the case, I would undoubtedly know at least one person that was on the scheme. Which I don’t.
“The doctor makes an application to the TGA to certify that it’s a condition that would be an appropriate use of cannabis and that the product the doctor selected is an appropriate one too,” Dr Agarwal said.
“Usually there needs to be some form of clinical justification, which is usually done by attaching some form of medical literature evidence. Once you’ve got that, within very short period of time, the TGA will confirm: yes, it’s approved, or no, we need further information.”
Dr Agarwal said the process is “usually very quick now”.
“It used to take weeks or months – now it’s often the same day or next day approved,” he said.
So, it is quick once you are approved.
But, approval is based on getting the green light from the TGA on whether or not your condition meets the criteria. So it appears we are still stuck in some kind of political agenda here where one condition is of higher value than another. Incredibly, people have to explain themselves in this way, but that’s another story.
According to the TGA, 2893 Special Access Scheme Category B applications were approved in August 2019. This is almost 12 times more than the 229 approvals recorded in August 2018.
Well that’s certainly something, isn’t it? 2893 is a good number for a single month. Maybe it isn’t as hard as everyone is making out.
But who can be prescribed Medical Cannabis?
The medical conditions that cannabis can be prescribed for is quite extensive – but you can’t use it to treat the common cold.
Clinical trials and medical research has shown medicinal cannabis can assist in the treatment of symptoms for conditions including but not limited to: chronic pain syndrome; neurological conditions such as epilepsy; multiple sclerosis and motor neuron diseases; inflammatory bowel diseases, Crohns disease and ulcerative colitis; chronic cancer pain and malaise; chemotherapy-induced nausea and vomiting; arthritis; and dementia.
Dr Agarwal said chronic pain is the most common reason medicinal cannabis is prescribed, followed by neurological illnesses and inflammatory diseases.
‘Quite extensive’ I would consider a relative term. Yes, there are a few conditions on there, but there are quite a few missing also. One thing that the list doesn’t seem to be addressing is mental health issues such as PTSD, depression, anxiety and the rest. I can partly understand why. After decades of settling for toilet weed grown in Asia or whatever people could get their hands on, it’s no wonder people’s mental health was affected by cannabis and this makes it terrifying to give ‘crazy’ people cannabis. But look at what is happening in the US now.
Cannabis has been taken to scientific levels in terms of prescribing it for specific conditions. It’s not like there is just one strain for cannabis. there literally thousands. many of these strains have been used by people to treat mental health issues. In recent times, a lot of publicity has particularly sprung up around PTSD and the role of cannabis in treating the symptoms.
The majority of medical cannabis use is as an adjuvant, which helps to improve the efficacy of other drugs. This means it can enable a patient to lower the dose of their existing medication so they are not suffering the same level of side effects.
According to Dr Agarwal it is “not uncommon” for patients to take medical cannabis in conjunction with their pain meds and “reduce their total opiate dosage by 50%”.
“We have seen people who are taking anti-inflammatory medication, such as steroids like prednisolone, for inflammatory conditions like rheumatoid arthritis or inflammatory bowel disease and they have reduced their steroid dose by 30%,” he added.
Well, getting people off prescription drugs can only be a good thing surely. Especially since deaths from prescription opioid abuse in Australia are apparently up 40% in the last decade (source)
So is it easy to get approved then?
Despite anecdotal stories of people being rejected by the TGA and ‘forced’ to obtain cannabis elsewhere (i.e. illegally), Dr Agarwal said it is not too difficult to be approved but conceded there is an “art” to writing the TGA justification letter.
“I think it would be unheard of for somebody who is a bona fide candidate to get disapproved now,” he said.
If a patient is rejected by the TGA, there is usually a Request for Further Information issued and Dr Agarwal said he has never had somebody he thought was a bona fide candidate disapproved on the second round application.
Note here, Dr. Agarwal mentions that he never had a bona fide candidate disapproved on the second round application. If there is a second-round application, then the first round application must have already been rejected. We must also not forget here that Dr. Argawal is not entirely without political motivation since he is the CEO of Cannvalate, a major supplier of cannabis products to the scheme.
What about THC?
Depending on the condition being treated, prescriptions could be for pure cannabidiol (CBD) or CBD plus tetrahydrocannabinol (THC), which is the psychoactive ingredient associated with producing the euphoric effects of cannabis.Dr Agarwal said in the case of paediatric epilepsy, patients tend to be prescribed a pure CBD mixture.
However, in the case of chronic pain, some THC would assist.
“Some people might have more THC than CBD – it might be a 1:5 ratio. It depends what underlying pathology you have,” he said.
It is an exciting prospect that people suffering from seizures are treated with pure CBD oil. Incredibly, this wonderful substance is still restricted under this scheme. Especially since it doesn’t get you high at all.
You got your Prescription: Making it Happen
Dr Agarwal said a pharmacy near the patient can organise for the product to be despatched from Cannvalate’s warehouse to wherever they live in Australia.
“We’ve got just over 600 pharmacies now in our network and 98% of the population should have to go less than 2km as most people live in urban areas with a pharmacy nearby,” he said.
So great, you got your script, just pop down to the chemist and they will organize for your product to be dispatched. Easy as pie.
But how much is this all going to set you back?
Dr Agarwal said the typical “ballpark figure” was between $200 to $600 per month.
So pretty much the same as an average daily weed smoker buying through the black market. Even less actually. or, it would be if one was receiving the same amount of weed in a big bag as you would illegally.
It has been some time since I bought weed. But, I remember when I was a full-time smoker back in the day, I would go through a quarter every three days or an ounce every ten days. I think that was a lot. But, I know that an ounce in Australia can cost between $230-$300 depending on various factors.
Smoking at this rate would, therefore, cost $600-$800 per month. But through the Special Access Scheme, your dose is controlled and not anywhere near this amount.
Dr. Agarwal goes on to talk down quite a lot about the downsides of growing your own weed versus buying from a corporation such as Cannavalate.
Of course, he would. That is his job. But deep down, everyone knows that growing your own organically at home beats anything.
This article is a collection of ideas by the author. It does not constitute facts or advice in any form. Please consult a medical professional and check the legality in your area before purchasing or taking CBD products.
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