Medical Marijuana Creates Clinical and Financial Opportunity for Pharmacists

The Australian Government intends to amend the Narcotic Drugs Act to allow cannabis to be grown for medicine or science and ensure that Australia is not in breach of international drug treaties.
In Australia currently Cannabis is prohibited or otherwise managed through Drug Scheduling:

(a)  when separately specified in these Schedules; or

(b) processed hemp fibre containing 0.1% or less of tetrahydrocannabinol and products manufactured from such fibre.

Cannabis is Schedule 9.
Prohibited Substance – Substances which may be abused or misused, the manufacture, possession, sale or use of which should be prohibited by law except when required for medical or scientific research, or for analytical, teaching or training purposes with approval of Commonwealth and/or State or Territory Health Authorities.

Nabiximols and Dronabinol are Schedule 8.
* NABIXIMOLS (botanical extract of Cannabis sativa which includes the following cannabinoids: tetrahydrocannabinol, cannabidiol, cannabinol, cannabigerol, cannabichromene, cannabidiolic acid, tetrahydrocannabinolic acid, tetrahydrocannabivarol, and cannabidivarol, where tetrahydrocannabinol and cannabidiol (in approximately equal proportions) comprise not less than 90 per cent of the total cannabinoid content) in a buccal spray for human therapeutic use.

* DRONABINOL (delta-9-tetrahydrocannabinol) when prepared and packed for therapeutic use.

* Additional controls:
Poisons available only from or on the prescription or order of a medical practitioner authorised or approved by the Secretary of the Commonwealth Department of Health and Ageing under section 19 of the Therapeutic Goods Act 1989.
Source: Poisons Standard 2012.

Ms Ley said new proposed legislation would allow cultivation similar to the way Tasmania has grown opium poppies for the world’s morphine market.
She said it is possible a medicinal cannabis industry could flourish

“It is, and that is something that some state governments I am sure will be interested in,” Ms Ley said.

“You can import the product from overseas, but it is almost impossible because the demand in, for example Europe, is very high and the cost is very high too.

“So I don’t want to place these difficulties in the way of patients who are terminally ill who may be able to get relief from medicinal cannabis.”

With that statement, Sussan Ley has opened up a wide range of economic opportunity for Australian investors in health and other industries that can use the by-products of the hemp plant.

In fact, i2P would suggest that pharmacists, particularly those that have already invested in a compounding pharmacy would find that a licence to grow marijuana might prove to be a useful investment.
If that licence was held by a pharmacist cooperative formed up as a processing/manufacturing operation developing standardised oil extracts, it could provide a valuable resource for pharmacies, particularly compounding pharmacies.

The spectrum of evidence being published over the Internet suggests that various forms of cannabis have the ability to help manage a range of chronic conditions without addiction or serious adverse events.
And because of these emerging benefits being uncovered for using this substance for a wide range of medical conditions, it is becoming apparent that with correct use of mixes of cannabinoids and THC there is potential to treat or assist in the treatment of some very serious chronic illnesses.

Here are ten surprising health benefits of medical marijuana.

Because marijuana is a scheduled controlled substance, it has to be tested under the strictest of circumstances.
However, as research begins to emerge from countries around the world (particularly Israel), exciting benefits are being seen, including that some of the forms of medical marijuana are not addictive or psychoactive, and in fact are less toxic than many medicines that are currently available.

  1. It can stop HIV from spreading throughout the body
    In perhaps the most unexpected news yet, scientists announced recently that THC, an active ingredient in cannabis, was effective in stopping the spread of HIV in monkeys. The monkeys that received daily THC doses had higher levels of healthy cells as well.
  1. It slows the progression of Alzheimer’s
    During his much-lauded congressional appearance as an Alzheimer’s activist, actor Seth Rogen joked, “This has nothing to do with the legalization of marijuana.”
    Well, he might be surprised to learn that it does.
    2006 study found that marijuana can block an enzyme that is behind the progression of Alzheimer’s
    It also prevents “protein clumps that can inhibit cognition and memory.”
  1. It slows the spread of cancer cells
    2012 study found that a marijuana compound “can stop metastasis in some kinds of aggressive cancer.” 

    Last year, a similar study found that certain non-psychoactive cannabinoids “resulted in dramatic reductions in cell viability” and “caused a simultaneous arrest at all phases of the cell cycle” in leukemia cells.
    Researchers in the U.K. have already been able to use marijuana compounds to kill cancer cells in leukemia patients.
  1. It is an active pain reliever
    Marijuana’s anti-inflammatory pain relief has shown to be effective in treating a host of illnesses and conditions, such as multiple sclerosis, rheumatoid arthritis and migraines.
    The effects “are several hundred times more powerful than that of aspirin.”
  1. It can prevent or help with opiate addiction
    Because marijuana acts as such effective medication, it can reduce dependence on opiate-based medication, which has more addictive qualities.
  1. It combats depression, anxiety and ADHD
    Via: Wikimedia
    2005 study found that “those who consume marijuana occasionally or even daily have lower levels of depressive symptoms than those who have never tried marijuana.” In small doses, it relieves anxiety and symptoms of ADHD.
  1. It can treat epilepsy and Tourette’s
    In December, the FDA gave the go-ahead to study the efficacy of medicinal marijuana in treating pediatric epilepsy. 

    Research has shown that it can alleviate symptoms of Tourette’s in certain cases as well.
    A Colorado non-profit has already developed a strain called “Charlotte’s Web,” which they provide for free to those who suffer from epilepsy, Parkinson’s and similar conditions. 

    The strain is named after a 6-year-old epileptic patient who inspired the move.
  1. It can help with other neurological damage, such as concussions and strokes
    Research indicates that marijuana has neuroprotective qualities, which can limit neurological damage after stroke or trauma.
    There has already been talk over where the NFL could introduce marijuana to deal with concussions.
    Even NFL Commissioner Roger Goodell signaled his willingness to consider the idea: “We will follow medicine and if they determine this could be a proper usage in any context, we will consider that,” he said in January.
  1. It can prevent blindness from glaucoma
    By decreasing the pressure inside the eye, marijuana can prevent blindness for those who suffer from glaucoma. Research found that marijuana was effective in lowering eye pressure when ingested orally, intravenously or by inhalation.
  2. It’s connected to lower insulin levels in diabetics
    “The most important finding is that current users of marijuana appeared to have better carbohydrate metabolism than nonusers,” according to a Harvard researcher.
    The 2005-2010 study found that “the current marijuana users showed fasting insulin levels that were 16% lower than those of former or never users, along with a 17% reduction in another measure of insulin resistance as well.”

It is clear even at this early stage of the introduction of medical marijuana that it represents an important medication that has the potential to reduce the impact of lifestyle disease associated with the ageing process.

Australia can already grow and produce cheaply the varieties of marijuana required for medicinal use and concurrently support the economy through supporting other industries.

* It can be grown in sugar cane growing areas as a form of crop rotation and soil-enrichment.
Crops like sugarcane can also be used as a form of security, by hiding the marijuana crop within existing sugar cane plantations.

* The fibre from marijuana can be used to produce paper or fabrics equivalent to cotton, thus reducing the sourcing of fibre from existing forest resources.

* If investment remains under Australian control, then the price of medical marijuana will remain low.
This means that expenditure on PBS will dramatically reduce because it impacts on so many medical conditions.
Government therefore should be very interested in assisting pharmacist investors to develop cooperatives to process and manufacture cannabis oil to recognised standards and compounding pharmacists to be able to create dispensed products tailored for individual patients under the prescription of a GP.
New Israeli research indicates that admixtures of cannabinoids and THC work better than synthesised single cannabinoids.
If we allow global pharma companies to take control of this Australian resource, then future opportunity involving pharmacist and government revenue streams will be lost.
Already the state of Colorado in the US is showing social benefits accruing through lower instances of prescription drug addiction coupled with a lower crime rate.
The taxes and excise duties levied on medical marijuana crops are already finding their way back into free education and the underwriting of other public health initiatives.
Medical marijuana is an important resource for Australia and opportunities at all level should be taken advantage of and encouraged through appropriate legislation.

Several states have already announced clinical trials for medicinal cannabis, but until the change is made they have not been able to legally grow the crop.

The NSW Government has committed $9 million for clinical trials and up to $12 million to set up a Centre for Medicinal Cannabis Research and Innovation. (See Medical+cannabis,+Issues+Backgrounder+June+2014 NSW Government paper)

Greens leader Richard Di Natale welcomed the plan but said more needs to be done to ensure patients can access the medicine.

“We’re seeing legislation that would license growers but really ignores the most important part of the equation and that is making sure that people who need this drug can get access to it,” he said.

“We’ve got a bottleneck in the approval of medicinal cannabis and this legislation  proposed by Sussan Ley does nothing to address that.”

Additional reading:
i2P has accrued a surprising amount of information over a short period of time for the subject of medical marijuana.
i2P has nearly always provided the thought leadership and stimulus for what lies ahead in Australian pharmacy.
The legalisation of marijuana for medical use will have a profound effect on pharmacy if pharmacy leaders wake up in time to prevent the market from falling into hands that have association with global pharma.
It’s been around for a long time in Australia and has flourished legally and illegally.
Everyone has just been asleep at the wheel for the past 70 years which has inhibited growth in the research of this valuable product

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