Medicinal Cannabis: we talk to an expert

Mr Sinclair is a research fellow at the NICM Health Research Institute, Western Sydney University, who has dedicated the past 15 years of his life to researching medicinal cannabis in the United States and Australia. His knowledge about medicinal cannabis is broad, encompassing botany, genetics, cultivation, ethnopharmacology, therapeutic applications and phytochemistry. He took time out to chat to Surfers Health Medical Centre health and wellness writer Suvi Mahonen about what he says is an “incredibly misunderstood plant medicine”.     

Suvi: In what medical conditions do you feel that there is the best evidence for benefits of medicinal cannabis?

Justin: There is a continually growing evidence base for medicinal cannabis across many different clinical indications, but the conditions with the best evidence so far would be chronic pain, the spasticity of multiple sclerosis, chemotherapy induced nausea and vomiting, epilepsy and intractable seizure disorders, and also in palliative care. Conditions where research is currently focussing include post-traumatic stress disorder (PTSD), fibromyalgia, Parkinson’s disease and even the pain associated with endometriosis – which is currently a focus of my PhD research at NICM Health Research Institute.

Suvi: Why do you believe many governments around the world have been so slow in legalising medicinal cannabis?

Justin: I would think that the main point is that cannabis is still scheduled internationally as a controlled drug by the United Nations, and until this changes, many countries will be reticent to defy international regulations. Also, the time it takes to translate scientific research into meaningful policy change at a government level can sometimes be glacially slow.

Furthermore, the current educational curriculums of medical doctors still does not cover the endocannabinoid system in great detail, and most mentions of cannabis have only focussed on the harms associated with its use, rather than covering the large body of evidence emerging associated with its therapeutic benefit across a wide range of diseases and conditions. I think it is safe to say that it is a lack of education that has also been a contributing barrier to the delay in seeing more countries adopt medicinal cannabis programs.

Suvi: In your experience have the large pharmaceutical industries been for or against medicinal cannabis?

Justin: The pharmaceutical industry has been conducting its own research into cannabis, cannabinoids and the endocannabinoid system since the early 1990s, and numerous synthetic cannabinoids have been developed. Considering that cannabis is being used by patients around the world to replace numerous pharmaceutical drugs, particularly opiates, non-steroidal anti-inflammatory agents (NSAIDs) and benzodiazepines such as Valium, I would imagine medicinal cannabis is viewed as being somewhat of a disruptor.

Suvi: Do you believe there is risk of addiction for users of medicinal cannabis?

Justin: The literature is pretty clear that recreational cannabis use does have the potential for addiction, but I think it is important to highlight that the statistics for dependence to cannabis are far lower than dependence to legal substances like tobacco and alcohol, which already generate huge burdens on our healthcare system.

Suvi: Can you tell me of a couple of cases where you have seen a marked improvement in someone’s life after they were able to access medicinal cannabis?

Justin: Two notable accounts where I have personally witnessed a marked improvement include a child with epilepsy, where medicinal cannabis dramatically reduced her daily seizures and greatly improved her quality of life, as well as providing her parents with hope and reducing their trips to the hospital.

Another is a lady with chronic neuropathic pain in whom legally prescribed medicinal cannabis was a game changer. It allowed her to manage the pain, get more sleep and get back to many of the activities that were previously impossible. Whilst just two of my personal experiences, the scientific literature is full of similar experiences across a growing range of medical conditions.

Medicinal cannabis is certainly not a panacea for everyone or all medical conditions, but for those it helps, it can certainly be life changing.  

• Listen to Justin talk about the complex phytochemistry and pharmacognosy of the different medicinal cannabis species in his interview with Andrew Whitfield-Cook on the FX Medicine Podcast:

Suvi Mahonen is a Surfers Paradise-based journalist. Her work appears in The Australian, The Australian Quarterly, CHILD and other health and lifestyle publications. Follow her on Facebook and online art-selling platform Redbubble

Photo credit: Chokniti Khongchum