Editor's Note
The latest issue of the Medical Journal of Australia includes four articles exploring the safety and effectiveness of cannabidiol (CBD) for children with a rare forms of epilepsy, patterns of cannabis use for medical purposes, and challenges in providing safe, effective, affordable cannabis-based medicines for unapproved indications.
September 3, 2018
Medical Journal of Australia

The authors of this study conclude that cannabidiol as an adjunct treatment had some subjective benefit for overall health, with a manageable adverse event profile. Monitoring changes in liver function and awareness of potential drug interactions is essential. Whether the reported benefit is attributable to cannabidiol cannot be established in an open label study of participants with severe intractable epilepsy.

This study concludes that adverse events were generally mild, transient and not dissimilar to those associated with other add-on therapies. "While medicinal cannabis products are portrayed in the media and perceived by the public to be effective, natural therapies, cannabidiol is still a pharmaceutical in development, with potential benefits that require further delineation, and with short term adverse effects that must be understood and mitigated," the authors state.

The most frequent reasons for medical cannabis use were anxiety (50.7%), back pain (50.0%), depression (49.3%), and sleep problems (43.5%). Participants reported high levels of clinical effectiveness and frequent side effects, including drowsiness, ocular irritation, lethargy and memory impairment; 17% met DSM-5 criteria for moderate or severe cannabis use disorder. Many reported harms or concerns related to the illicit status of cannabis. Participants believed that medical cannabis should be integrated into mainstream health care, and that products should be required to meet consistency and safety standards.

In Australia, parents of children with cancer or intractable forms of epilepsy have recently persuaded state and federal governments to permit access to cannabis-based products for medical use under the Special Access Scheme of the Therapeutic Goods Act. The authors recommend that a cautious response to public interest in medical uses of cannabis products remains appropriate.