Eli Turner uses cannabidiol, or CBD oil, to help ease his chronic pain.(ABC Goulburn Murray: Jackson Peck)
Doctors have labelled medicinal cannabis prescriptions a "bureaucratic nightmare" requiring "a massive learning curve", as patients say people in pain cannot wait months for relief.
After refusing to use opioids, former soldier Eli Turner says medicinal cannabis is helping ease his chronic back pain
Medical specialists say gaining approval from the TGA to prescribe cannabis is time-consuming and difficult
A Senate committee has recently recommended widespread changes to the medicinal cannabis industry
Wodonga's Eli Turner, suffers from a spinal condition called spondylosis after his time in the military and said he was "very lucky" to have a prescription for medicinal cannabis after waiting six months in unbearable pain.
"It doesn't eliminate the pain totally — nothing will," he said.
"But it definitely makes me able to move more and function more."
But the 39-year-old said receiving the prescription was very difficult.
"People are in a lot of pain and they can't wait because you can't function in that much pain," Mr Turner said.
Eli Turner joined the army at the age of 21 and was posted to a parachuting unit.(Supplied: Eli Turner)
The former soldier asked his doctor about medicinal cannabis after he found out about a Department of Veterans' Affairs subsidy program.
"It costs so much for pain treatment of any type … there's no way I could have afforded it on my own," he said.
"No medicinal cannabis product is subsidised through the Pharmaceutical Benefits Scheme [PBS], making it too expensive for many patients."
But Mr Turner has been determined to avoid opioids to treat his pain after seeing his mother's experience with morphine before her death from lung disease.
"She was on a lot of morphine and it was just inhumane," he said.
"It was horrible. It was absolutely horrible.
"She was less than 40kg when she passed away."
Some days Eli cannot move much at all due to spondylosis.(ABC Goulburn Murray: Jackson Peck)
Mr Turner has also seen the addictive effect of opioids on some of his mates from the army who have endured chronic pain.
"I was posted to a parachuting unit, so [back pain] comes with the area," he said.
"And a lot of them are having trouble getting off opioids … they probably never will."
TGA process time-consuming, out of date
His local doctor referred him to Mark Hardy, a Sydney-based addiction medicine specialist and the medical director at Cannabis Access Clinics.
Dr Hardy helps doctors and patients around the country navigate the cannabis prescription process.
Mark Hardy says there has been an "absolute explosion" in medicinal cannabis research.(Supplied: Dr Mark Hardy)
"One of the pitfalls for a lot of our GPs who we get referrals from is that they're very time pressured," he said.
"The writing to the Therapeutic Goods Administration (TGA) is time-consuming.
"Watching over the [cannabis] use, and potential for misuse, for a GP with little training in the area may be another impost on their time."
Doctors wishing to prescribe medicinal cannabis must apply to the TGA to seek individual patient approval — an approach Dr Hardy believed was lagging behind the latest research.
"We're seeing new evidence coming out in the medicinal cannabis space every month and if you're looking at guidelines from three years ago then you're looking at out-of-date guidelines," he said.
"This, for us, is one of our biggest challenges.
"Most of the opinion that is formed in regards to the legitimacy of our treatment is outdated by the time it's published and put to peer review."
Medical specialists navigate bureaucratic hurdles
Albury-Wodonga radiation oncologist, Craig Macleod, has looked into prescribing medicinal cannabis but said the process was too much of a "bureaucratic nightmare".
"We investigated it through the hospital pharmacy but it's a heavily bureaucratic process so it's quite hard to get to order it in a simple fashion," he said.
"I think that there would be people interested in prescribing it … but, unless you've got a volume of patients that you're doing it for, it's too hard to do it for one or two patients."
Palliative care physician at Albury Wodonga Health, Chi Li, has prescribed medicinal cannabis for cancer patients but said there was "a massive learning curve".
"That's a disincentive for people to learn how to do it," he said.
But he said that it was a relatively straightforward process after the initial barrier.
TGA proposes ease in cannabis restrictions
A Senate committee has recommended widespread changes after a recent investigation into the problems around access to prescription cannabis and regulation.
Following this inquiry the TGA has proposed loosening restrictions for low-dose cannabidiol (CBD), a medicinal cannabis product.
Eli Turner says CBD oil allows him to live a more normal life.(ABC Goulburn Murray: Jackson Peck)
But many medical bodies believe there is still not enough evidence to support medicinal cannabis.
Australia's peak medical body, the Australian Medical Association (AMA), said medicinal cannabis was a "last resort".
"The AMA position is that while there is widespread interest in medicinal cannabis, there is still insufficient information on efficacy, product availability, and education regarding its use," an AMA spokesperson said.
Dr Hardy was optimistic this would change soon.
"I'm hopeful that in the coming years we'll be able to update the evidence based upon which people make their decisions," he said.
Orignally published here: https://www.abc.net.au/news/2020-05-08/wodonga-veteran-chronic-pain-relief-medicinal-cannabis/12216404