Our Top Recommendations (MED)

The lack of formal education on medicinal cannabis makes it difficult for patients and medical practitioners to discuss medical cannabis as part of a treatment plan, despite a growing demand from patients for alternative medications.1  A report found that general practitioners (GPs) felt uncomfortable discussing medicinal cannabis with patients due to their limited knowledge, concerns about safety, and confusion around the appropriateness of medical cannabis for certain patients.2 This course aims to address this knowledge gap by providing doctors with information on absolute and relative contraindications, adverse events associated with medicinal cannabis, and the social impact around medicinal cannabis on driving and safety-sensitive tasks. Estimated Duration: 1.5 hours Access Duration: 12 months from date of purchase

As medicinal cannabis becomes increasingly encountered in clinical practice,1 healthcare professionals are navigating a growing range of products alongside evolving regulatory requirements.2 In this 5-part video series, learn about the different forms of medicinal cannabis products currently available in Australia, including formulations, administration methods, pharmacokinetic and pharmacodynamic profiles and how these factors influence prescribing considerations. Additionally, explore the five categories of medicinal cannabis products relevant to prescribing via the TGA's Special Access Scheme and Authorised Prescriber access pathways. With a focus on foundational understanding and practical implications, this video series is suitable for beginner to intermediate prescribers and those wishing to broaden their understanding of the range of medicinal cannabis products available in Australia today. Estimated Duration: 15 minutes Access Duration: 12 months from date of purchase References Hallinan et al. Implementation of medicinal cannabis in Australia: innovation or upheaval? Perspectives from physicians as key informants, a qualitative analysis. BMJ Open. 2021;11:e054044. Martin et al. Exploring access to medicinal cannabis through general practitioners in Australia. Aust J Gen Pract. 2025;54:101–108.

While well-known systems like the sympathetic nervous system are widely understood, doctors may be less familiar with the more recently identified endocannabinoid system (ECS).1,2 The ECS is thought to be involved in regulating pain, immunity, stress, appetite, weight, and nausea, yet it remains largely absent from traditional medical education in Australia.3 What will you learn?This module aims to equip you with the skills and confidence to integrate medical cannabis into patient care when clinically appropriate. Drawing on current evidence and theoretical case studies, the module explores the ECS, cannabinoid pharmacology, proposed therapeutic effects, and the clinical implications of both ECS function and use of medical cannabis. Through interactive scenarios and evidence summaries, you’ll explore how this knowledge may be relevant to clinical applications—ranging from the potential involvement of the ECS in patient presentations to identifying possible treatment approaches. Estimated Duration: 4 hours Access Duration: 12 months from date of purchase Learning Outcomes Upon completion of this module, you’ll be able to: Identify the endocannabinoid system’s components, role and functions, as currently understood Describe how endocannabinoid system function and dysfunction may contribute to symptoms such as pain, anxiety, sleep disturbance and inflammation Interpret how the mechanism of the endocannabinoid system may inform the therapeutic potential of medical cannabis Explain the pharmacological effects of THC and CBD Identify clinical features suggestive of cannabinoid tolerance or receptor desensitisation Describe the limitations and uncertainties in the current evidence relating to the endocannabinoid system References Harvard Health Publishing. The endocannabinoid system: Essential and mysterious. https://www.health.harvard.edu/blog/the-endocannabinoid-system-essential-and-mysterious-202108112569 (accessed Aug 2025). Parliament of Australia. Current barriers to patient access to medicinal cannabis in Australia. https://parlinfo.aph.gov.au/parlInfo/download/committees/reportsen/024403/toc_pdf/CurrentbarrierstopatientaccesstomedicinalcannabisinAustralia.pdf (accessed Aug 2025). Hillard CJ. Circulating Endocannabinoids: From Whence Do They Come and Where are They Going? Neuropsychopharmacology. 2018;43:155–172.

Understanding Medical Cannabis Strength: A Guide for Healthcare Professionals Published: July 2025 When prescribing medical cannabis, it’s essential to understand and accurately communicate the “strength” of the product. However, the lack of standardisation in the way cannabis strength is represented can lead to confusion, complicating safe prescribing, patient education, and effective transitions between products.1 In this article, we will simplify the key concepts used to describe medical cannabis strength and highlight how these terms impact clinical practice. Methods of Describing Medical Cannabis Strength Current methods for expressing medical cannabis strength are determined by the amount of the two primary cannabinoids, CBD (cannabidiol) and THC (tetrahydrocannabinol) in a product. THC is considered the primary psychoactive component, whilst CBD is thought to modulate THC’s effects.2 The dose at which THC’s psychoactive properties become clinically apparent is generally regarded to be 5 mg.3 Medical cannabis strength can be described in different ways, each with its unique meaning: Total Cannabinoid Content (mg) This measurement describes the actual amount of THC and/or CBD per unit, such as per capsule, gummy, or spray. For example, a capsule might contain 5 mg of THC and 5 mg of CBD. Total cannabinoid content is the most clinically meaningful way to describe cannabis product strength and aligns with the dosing nomenclature used for other medications. For example, a drug may be prescribed with a specific dose in milligrams (such as 5 mg of morphine), and cannabis dosing follows this same principle. Cannabinoid Ratios (e.g. CBD:THC) This ratio describes the balance of two primary cannabinoids in a product. For example, a product with a 20:1 ratio has 20 parts CBD for every 1 part THC. The ratio can help you quickly compare products but doesn’t indicate the actual dose of THC or CBD. For instance, both a 1:1 product containing 2.5 mg of each cannabinoid and one containing 25 mg of each would have the same ratio but differ in dose. Therefore, clinical decisions must reference the exact quantities or percentages of the cannabinoids, not just the ratio. Potency (%) Potency refers to the percentage of a product’s weight that consists of THC or CBD. For instance, a product labeled as 15% THC means each gram of dried flower contains 150 mg of THC. Potency is often used to describe the strength of products like oils, tinctures, and flower, helping to compare their strength quickly. This is especially helpful when assessing products used for inhalation or topical application. Patient tolerance - a key factor affecting dosage and strength Tolerance to cannabis varies significantly from patient to patient.4 Cannabis-naïve patients (first-time users or those with limited experience) are much more sensitive to cannabinoids.4 Therefore, it’s essential to start with a low dose and gradually increase as needed.1 Conversely, experienced users may require higher doses to achieve the desired effect and may benefit from short breaks in therapy to reduce the likelihood of developing tolerance.4 Prescribers should always consider the patient's history when determining dosage.1 TGA Categorisation In Australia, the Therapeutic Goods Administration (TGA) classifies medical cannabis products based on their CBD content.5 This classification can be confusing as it reflects only the proportion of CBD in the product, not its THC or other cannabinoid content. For example, products in the "CBD dominant" category may still contain significant amounts of THC, which could have psychoactive effects. The TGA categorises products into five categories based on CBD percentage: Category 1: ≥98% CBD (Schedule 4) Category 2: ≥60% and <98% CBD (Schedule 8) Category 3: ≥40% and <60% CBD (Schedule 8) Category 4: CBD 2%-<40% (Schedule 8) Category 5: <2% CBD (Schedule 8)5 The categorisation system does not indicate the total strength or amount of THC, which can lead to misunderstandings in clinical practice. Standardising Cannabis Dosing Unlike opioids, where doses are standardised using measures such as oral morphine equivalents (OME), medical cannabis currently lacks a universally accepted standard dosing unit. Researchers have proposed using THC content as a common measure, such as defining a “standard THC unit” as 5 mg of THC6, which is considered a typical psychoactive dose.3 However, this concept is not yet universally adopted, as cannabis contains multiple active compounds, and individual factors (such as patient tolerance) play a significant role in how patients respond to cannabis.6 Clinical Implications and Best Practices Healthcare professionals should focus on the actual quantities of THC and CBD when determining dosages. This ensures safe and effective prescribing. When prescribing, always refer to the total milligrams (mg) of THC and CBD in the product, as this reflects the actual dose a patient will receive. Consider the patient’s tolerance when determining the appropriate dose. Cannabis-naïve patients should start with low doses and increase gradually. Be cautious with TGA categorisation: A product in the "CBD dominant" category may still have enough THC to cause psychoactive effects, so it’s essential to check the cannabinoid breakdown, not just the CBD percentage. Summary The strength of medical cannabis is described in multiple ways - through ratios, potency percentages, and total milligrams - making it vital for healthcare professionals to understand the clinical implications of each. To ensure accurate dosing and patient safety, always refer to the total amount of THC and CBD in the product, and consider patient factors such as experience and tolerance. As the medical cannabis market evolves, the need for clearer and more standardised labeling becomes increasingly important for effective prescribing and patient education. By adhering to these best practices, healthcare professionals can reduce medication errors, improve patient outcomes, and promote best practices in prescribing and dispensing medical cannabis.