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TGA Medicinal Cannabis – Guidance Documents

Over the past few years, a number of Australians have expressed interest in the use of cannabis for medicinal purposes. There have only been a limited number of well-designed clinical studies on medicinal cannabis and so it is hard for some doctors to find quality evidence to support decisions to prescribe medicinal cannabis.

The Commonwealth Department of Health, in conjunction with state and territory governments, has helped coordinate the development new clinical guidance documents for prescribers of medicinal cannabis products for treating chemotherapy-induced nausea and vomiting, epilepsy, multiple sclerosis, chronic non-cancer pain and palliative care, as well as an overview document.

Medicinal Cannabis Products: Patient Information
Guidance for the use of medicinal cannabis in Australia: Patient information
Guidance for the use of medicinal cannabis in Australia: Overview
Guidance for the use of medicinal cannabis in the treatment of chronic non-cancer pain in Australia
Guidance for the use of medicinal cannabis in the treatment of multiple sclerosis in Australia
Guidance for the use of medicinal cannabis in the treatment of palliative care patients in Australia
Guidance for the use of medicinal cannabis in the treatment of epilepsy in paediatric and young adult patients in Australia
Guidance for the use of medicinal cannabis for the prevention or management of nausea and vomiting in Australia

Treatment Considerations, Dosing & Titration

Practical Considerations in Medical Cannabis Administration
“Hallucinations” Following Acute Cannabis Dosing: A Case Report and Comparison to Other Hallucinogenic Drugs
Cross‐sectional and prospective relation of cannabis potency, dosing and smoking behaviour with cannabis dependence
The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration
A burning problem: cannabis lessons learned from Colorado
Oral fluid/plasma cannabinoid ratios following controlled oral THC and smoked cannabis administration
Cannabis Contaminants - sources, distribution, human toxicity and pharmacologic effects
Influence of ethanol on cannabinoid pharmacokinetic parameters in chronic users

Pallative Care

The Medical Necessity for Medicinal Cannabis: Prospective, Observational Study Evaluating the Treatment in Cancer Patients on Supportive or Palliative Care
Use of cannabinoids in cancer care: palliative care
Opioid complications and side effects.

Cancer

Anticancer mechanisms of cannabinoids
An update on PPAR activation by cannabinoids
Cannabinoid-induced apoptosis in immune cells as a pathway to immunosuppression
Cannabinoids as therapeutic agents in cancer: current status and future implications
Preclinical and Clinical Assessment of Cannabinoids as Anti-Cancer Agents
The endocannabinoid system in cancer—Potential therapeutic target?
The orphan G protein-coupled receptor GPR55 promotes cancer cell proliferation via ERK
The putative cannabinoid receptor GPR55 affects osteoclast function in vitro and bone mass in vivo

Chronic Pain

A selective review of medical cannabis in cancer pain management
Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain
Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes
The Comorbidity of Insomnia, Chronic Pain, and Depression: Dopamine as a Putative Mechanism
The Endocannabinoid System and Pain
The Endocannabinoid System, Cannabinoids, and Pain

CINV

A review of oral cannabinoids and medical marijuana for the treatment of chemotherapy-induced nausea and vomiting: a focus on pharmacokinetic variability and pharmacodynamics
Cannabinoids As Potential Treatment for Chemotherapy-Induced Nausea and Vomiting
Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy
Dronabinol for chemotherapy-induced nausea and vomiting unresponsive to antiemetics
Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system
Regulation of nausea and vomiting by cannabinoids

Epilepsy

Anticonvulsant Effects of N-Arachidonoyl-Serotonin, a Dual Fatty Acid Amide Hydrolase Enzyme and Transient Receptor Potential Vanilloid Type-1 (TRPV1) Channel Blocker, on Experimental Seizures: The Roles of Cannabinoid CB1 Receptors and TRPV1 Channels
Effect of cannabis on glutamate signalling in the brain: A systematic review of human and animal evidence
Endocannabinoid control of glutamate NMDA receptors: the therapeutic potential and consequences of dysfunction
Neuroprotection by the Endogenous Cannabinoid Anandamide and Arvanil against In Vivo Excitotoxicity in the Rat: Role of Vanilloid Receptors and Lipoxygenases

Inflammatory Bowel Disease

Cannabis finds its way into treatment of Crohn’s disease

Neurodegenerative Diseases

Cannabidiol: A Promising Drug for Neurodegenerative Disorders?
Cannabinoids in health and disease

Spasticity in Multiple Sclerosis

Cannabinoids in the management of spasticity associated with multiple sclerosis
Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis
The Endocannabinoid Anandamide Protects Neurons during CNS Inflammation by Induction of MKP-1 in Microglial Cells