Cannabis

News stories on access to and use of medicinal cannabis often capture the interest of people living with motor neurone disease (MND). There are many online claims that treatments derived from cannabis could slow progression or relieve symptoms for people living with MND; however, currently there is limited evidence or research supporting these claims. 


What ARE cannabis and medicinal cannabis? 

cannabisCannabis is a generic term for drugs made from cannabis plants. When consumed, cannabis can alter the user’s mood and make them feel 'high'. The use and supply of cannabis for non-medicinal purposes is illegal in Australia under Commonwealth, state and territory laws.

Cannabis consists of over 400 chemicals, and over 60 of these are cannabinoids. When ingested, cannabinoids activate the cannabinoid receptors in the body. This produces changes in movement, appetite, emotion, memory and cognition. Principal cannabinoids with therapeutic potential are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

Medicinal cannabis is cannabis and cannabinoids (usually tablet or oromucosal spray) that are prescribed by doctors for their patients. While Australia has recently legislated to allow for controlled cultivation of cannabis for medicinal and related scientific purposes, a viable industry is still some way off. In the meantime, legal cannabinoids can only be imported from a country where cultivation and manufacturing meet strict medicinal-grade standards. 

Australia's regulatory authority for therapeutic goods, the Therapeutic Goods Administration (TGA), has not approved cannabis as a treatment for MND.  Decisions on whether particualr cannabis products may be appropriate for a particular patient are made by the treating prescriber and patient on a case by case basis. The TGA has prepared some guidance documents on the use of medicinal cannabis.

 

Is cannabis an effective treatment for MND?

The ALSUntangled group has prepared a review on several small studies that looked at the effects of cannabis in MND. 

One study showed that while the cannabinoid THC was well tolerated, it had no effect on cramp frequency or intensity, or on secondary outcomes measuring fasciculation frequency, quality of life, sleep or depression.  

The ALSUntangled report concludes that cannabis plays a role in regulating the immune system and protecting against excitotoxicity, which suggest it could be useful in MND. ALSUntangled supports further careful study of cannabis and cannabinoids.

A recent Phase II clinical trial conducted in Italy investigated the safety and efficacy of a Cannabis Sativa extract on spasticity and muscle pain/cramps in MND and reported safety and some improvements for some patients. A Phase III trial is planned to address limitations of the study.


 

How do you access medicinal cannabis in Australia?  

Medicinal cannabis in MND has not been evaluated by the TGA for quality, safety and efficacy, therefore it is not an approved treatment for MND.  

The TGA recognises that there are circumstances when people need to access unapproved drugs, such as medicinal cannabis. Federal legislation allows doctors to prescribe medicinal cannabis through the Special Access Scheme (SAS) or Authorised Prescriber Scheme, and most states and territories have implemented regulations to support this. Read more

Doctors need to provide sufficient evidence that use of medicinal cannabis is warranted for each specific patient they are prescribing for, balancing potential harms and benefits. Legal medicinal cannabis can only be imported from a country where cultivation and manufacturing meet strict medicinal-grade standards.  


 

MND Australia’s position on medicinal cannabis

MND Australia recognises that there is insufficient evidence on the safety and efficacy of medicinal cannabis in MND. It is important that further, well-designed scientific studies are conducted to investigate the effects of cannabis on people living with MND.
 
MND Australia believes any drug must have been proven to be safe and to improve health outcomes of people living with MND before it is made available for widespread use. Read the position statement on Development and approval of drugs to treat MND.

People living with MND have the right to accept, refuse, or discontinue treatment or intervention within the legal framework of the person’s state or territory to ensure choice, control and the best quality of life possible, including access to preservation of personal dignity and to humane care, without discrimination. Read the position statement on Unproven and alternative therapies and people diagnosed with MND.

MND Australia and the State MND Associations will continue to work collaboratively to ensure that therapies that have been proven to be safe and effective are made available to people living with MND in Australia as quickly as possible.

As an active member of the International Alliance of ALS/MND Associations, MND Australia will continue to monitor the latest research related to medicinal cannabis and make this information available to the MND community in Australia as we learn more.


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