New data from Australia, shows cannabis has been prescribed over 140 conditions since 2016, with anxiety among the most common.
The first in-depth study of Australia’s medicinal cannabis programme, shows the treatment has been prescribed for over 140 different conditions since it began in 2016.
In total, 248,000 prescriptions have been approved for Australians since the inception of the scheme.
Researchers at the University of Sydney’s Lambert Initiative for Cannabinoid Therapeutics, analysed data from the Therapeutic Goods Association’s (TGA) medical cannabis dataset – Australia’s Special Access Scheme B – which is the only one of its kind in the world.
No other country has monitored prescriptions in this way since launching their own medical cannabis programmes.
The study found anxiety was among the top three reasons for patients being prescribed cannabis, the other two being pain and sleep disorders.
This reflects similar patterns in the UK, where chronic pain and anxiety are the most frequently prescribed for conditions, according to data from Project Twenty21.
The team also found that the number of medicinal cannabis prescriptions have increased significantly since 2020 – over 85 percent of total prescriptions to date have been given since January 2020. They are currently unable to say whether the rise was pandemic related.
Lack of clinical evidence
However, the researchers have warned that there is a limited number of high-quality clinical trials investigating the drug’s efficacy for these conditions.
Senior author Dr Elizabeth Cairns said the current evidence base for medicinal cannabis for anxiety is limited to only a few studies investigating CBD-dominant products, rather than THC-containing products
“Historically, the effects of THC have been described as anxiety-inducing, although this may depend on dose size and other factors.”
The evidence of effectiveness for medicinal cannabis in the treatment of pain is controversial, at least in Australia, where the Australian Faculty of Pain Medicine suggests not to prescribe medicinal cannabis for this purpose. Very few studies have also been done examining cannabis for the treatment of sleep disorders.
Study co-author and medicinal cannabis prescriber in her capacity as a GP, Associate Professor Vicki Kotsirilos AM from Western Sydney University, says the top reasons for prescriptions didn’t surprise her.
“Pain, anxiety and sleep issues are often interconnected – chronic pain can also cause mental health and sleep issues,” she says.
Associate Professor Kotsirilos, who prescribes medical cannabis for pain, says this should only be done as a last resort, after more evidence based behavioural and drug therapies, such as counselling, exercise and deep breathing for pain, anxiety and/or sleep disorders, have failed or are of limited clinical benefit.
Other interesting findings
The size of the dataset allowed the researchers to find prescribing patterns in small, but significant, populations that otherwise might have been overlooked.
“Apart from the link between anxiety and flower products, we found other interesting associations, for example, prescriptions of topical CBD for convulsions,” Dr Cairns said.
“This usage has not been extensively explored.”
The authors note, however, that the data doesn’t include patient outcomes.
Dr Cairns said: “Unfortunately, we just don’t know if these treatments were effective for these patients, but this data highlights where we can focus our attention next – to do focused studies and/or clinical trials.”
“There is a clear, unmet need for effective drug treatments across a variety of conditions that may be being helped with medicinal cannabis. For example, it could be worth conducting high-quality clinical trials on the use of flower products for anxiety, and that is certainly something that the Lambert Initiative and its collaborators may look to do in future.”
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