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Medicinal cannabis guidelines could deter doctors prescribing drug, AMA warns

The Government recommendation to avoid prescribing medicinal cannabis products containing THC to under 25s may anger those with conditions such as drug-resistant epilepsy. QUEENSLAND doctors will be warned not to prescribe the strongest forms of medicinal cannabis to anyone under 25 years of age, in new guidelines to be sent out across the state. The Queensland Health guidelines recommend doctors do not prescribe any medicinal cannabis products containing tetrahydrocannabinol (THC) – the main psychoactive ingredient of cannabis – to children or young adults due to a belief they are more harmful than other forms of the drug. The guidelines – due to come into effect in March – also caution doctors that they will bear full responsibility for any medicinal cannabis they prescribe to patients. They also repeatedly state that medicinal cannabis products are untested and their safety and efficacy are unknown. The Australian Medical Association Queensland says the guidelines will leave doctors “very much out on a limb’’ and make doctors reluctant to prescribe. AMAQ president Chris Zappala said he believed the guidelines showed the legislation was politically motivated. “The documents say this has not been approved by the TGA, there is limited evidence for all these things, but the politicians have decided that we are going to use it anyway, which is not the system we use for approving any other drug therapy in this country ever,’’ he said. “And so why we have made an exception for medicinal cannabis remains beyond me, and I think it requires a proper explanation from the politicians.’’ Health Minister Cameron Dick has defended the guidelines, saying new laws which passed late last year provide a “legitimate pathway for Queensland patients of any age and with a range of conditions to access legal medicinal cannabis products”. He said the guidelines should be seen as a “starting point” for medical practitioners. “Importantly, the documents will give doctors the confidence to consider the use of medicinal cannabis as part of the treatment plan for their patients, and ensure they do so in a safe way,” he said. The recommendation to avoid prescribing any product containing THC to under 25s will potentially anger parents of children with conditions such as drug-resistant epilepsy. Some will reportedly be unable to legally access the products they claim provide effective and lifesaving treatment, with the Government refusing to grant approval to products for which the exact ingredients are unknown. However the guidelines make clear that children with severe and drug-resistant epilepsy can have access to the drug Epidiolex, which is 98 per cent cannabidiol (CBD), through a trial. CBD is the non psychoactive form of medicinal cannabis. The guidelines also state that prescribers would be required to get a full patient history, including any family history of schizophrenia or past drug abuse, and report to Queensland Health every three months. The guidelines also recommend a “starting low and going slow” approach to dosage, warning there was no established dosing schedule.

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