Is the disconnect between medical colleges and current cannabinoids use for chronic pain justifiable?

Pharma News: Eighty percent (80%) of patients expressed a strong desire for more doctors to prescribe medical cannabis, according to a recent survey conducted by Alternaleaf. Despite the increasing demand, only approximately 5% of Australian doctors currently prescribe this alternative form of treatment.

Chronic pain is a major health issue, adversely affecting millions of Australians and costing billions of dollars annually.

The findings also revealed a compelling aspect of patient experiences with medical cannabis. A significant 62% of respondents reported discontinuing other pain medications after initiating medical cannabis treatment. This comes at a crucial time when opioid-related drug-induced deaths are claiming three lives per day in Australia, as per recent statistics from the Australian Institute of Health and Welfare.

Despite this, the Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists (ANZCA) recommends “Do not prescribe currently available medicinal cannabis products to treat chronic non-cancer pain (CNCP) unless part of a registered clinical trial,” explaining “There is a critical lack of evidence of consistent benefit from cannabinoids of any type for chronic non-cancer pain. The evidence available is either unsupportive or is of such low quality that no valid scientific conclusion can be drawn.”

Many patients participating in the Alternaleaf survey disclosed their struggles in convincing their general practitioners to consider medical cannabis.

One such patient, shared her disappointment, stating, “My doctor told me he wouldn’t prescribe it. He refused to even say the word.”

Another patient who has endured two decades of chronic pain and opioid use, emphasised the challenges he faced in seeking a viable form of pain relief.

“I have a high tolerance to opioids after being on them for twenty years to treat my chronic pain,” Hunter explained. “When I tried talking to several doctors about medical cannabis as an option, all they did was shrug off my suggestions and suggest a different opioid.”

Despite these challenges, patients have experienced positive outcomes after transitioning to medical cannabis. “Since being on medical cannabis, I don’t use my opioids as much, and I’m not seeing a doctor every two weeks for a new script – I also don’t get side effects from it,” the patient shared.

Rhys Staley, Vice President of Montu, the parent company of Alternaleaf, is urging doctors to consider medical cannabis as a viable option for eligible patients.

“Every day, Alternaleaf doctors see patients who have benefited from making the switch to medical cannabis,” Staley emphasised. “If more doctors were as comfortable prescribing medical cannabis as they are opioid and other pharmaceutical medication for pain relief, Australian patients wouldn’t have to suffer unnecessarily when looking for alternatives.”

According to a paper by Henderson et al published in the AJGP “Despite the fact that current supportive evidence is of low overall quality, there are tens of thousands of patients with chronic pain being prescribed medicinal cannabis products in Australia. Many have legitimate lived experience of lasting pain reduction with cannabis that is not easily disregarded. There is clearly a disconnection between the pronouncements of specialist medical colleges and current prescribing and community use of cannabinoids in Australia. It is hoped that the results of the next generation of clinical trials of cannabinoid products and pain will help to resolve this tension.”

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