Frequently asked questions

Cost

Are there any PBS rebates for medicinal cannabis?


Medical Cannabis in Australia is not listed on the Pharmaceutical Benefits Scheme (PBS). Unfortunately, there is no entllitlement to a medicare rebate for this medicine at this time.




Is medicinal cannabis covered by any private health cover?


Each health fund varies depending on the level of cover, however they will only subsidise a pharmaceutical prescription benefit when the following criteria are met: 1. The drug is only available by prescription. 2. The drug is listed within the MIMS schedule. (The prescribing reference for general practice.) 3. The drug does not appear in the Schedule of Pharmaceutical Benefits. Many of our current patients have had success with Health Fund's claiming a portion of their consultations and prescriptions depending on their level of cover. Please check with your own Health Fund and be persistent as your level of cover may mean they have to cover non-PBS listed prescription fees.




Why is medicinal cannabis so expensive?


The cost of Medicinal Cannabis products is not currently subsidised by the Commonwealth Government’s Pharmaceutical Benefits Scheme (PBS), and therefore must be paid for by the patient. The costs vary upon the product prescribed, and the dose recommended by the Doctor. Here at Greenhouse Medical Clinics, we are doing our very best to keep costs as reasonable as possible for our patients.




Will Department of Veteran Affairs cover the cost of MC?


DVA does subsidise Medical Cannabis for veterans through an approval process. The process may be undertaken both in-clinic and via teleHealth consultations however in clinic consulations only, will be covered by the DVA. 1. Patient specialists required to complete Greenhouse Medical Clinicl DVA Referral form. 2. A GMC doctor will consult with you regarding the application process, and they will submit the application to the DVA for you. 3. The DVA VAPAC either approve or ask for more information. 4. An approval letter is sent to the Doctor for a prescription. (The process can take a few weeks to months). 5. This approval lasts for 3 months. Please note that the DVA may not reimburse any costs already incurred.




Am I eligible to participate in a research study or clinical trial?


We are currently taking expressions of interest for the Quest Project sponsored by Little Green Pharama. Please talk to our doctor to be apart of this incredible Cannabis trial in conjunction with the University of Sydney.




Products cost approximately $4 to $10 per day on average


Factors including: the ratio of THC and CBD in the prescribed product; the amount individually used; the product form (i.e. flower, capsules, oil). For e.g. epileptics are often prescribed doses 4 times that of those with chronic pain or other conditions. Medical condition is a huge factor in dosage and therefore cost. Age is also a factor. Most children will not be prescribed THC. Medical Marijuana product costs can also vary depending on the pharmacy dispensing fee.









Conditions and Eligibility

Am I eligible to apply for medicinal cannabis?


You are eligible if previous treatment or medication options for your condition have failed. Medicinal Cannabis is not considered a first line medication and therefore you would have had to be diagnosed with a condition for which previous medication or treatment options have failed. This would circumstance would make you eligible to apply for approval which is granted by the TGA. Greenhouse Medical Clinic will assists patients with the application process.




What forms of Medicinal Cannabis are available in Australia?


There are many forms of cannabis medications. Typically Medicinal Cannabis oral/ submucosal liquids (drops applied under the tongue) are used. Tablets, capsules, sprays, and vaporisations are available depending on the symptoms, the treatment plan, patient age and patient preference.









CBD & THC Cannabinoids

What is CBD?


CBD, short for Cannabidiol, is a non-psychoactive compound found in the Cannabis plant which interacts with the body’s Endocannabinoid system. It has potential to play a role in many of the body’s biological responses, including balance in our body’s immune system, , appetite, metabolism, memory, sleep and more.




What is THC?


THC, short for Delta 9-Tetrahydrocannabinol, is a psychotropic Cannabinoid compound. THC is being currently being studied for its potential analgesic, appetite stimulant, anti-emetic, antispasmodic properties and diabetes. THC is promotes the euphoric effect described by patients.




What is the difference between THC and CBD?


Chemsical structure CBD and THC are chemically similar to your body’s endocannabinoids. This allows them to interact with your cannabinoid receptors. The interaction affects the release of neurotransmitters in your brain. Neurotransmitters are chemicals responsible for relaying messages between cells and have roles in pain, immune function, stress, and sleep, to name a few. Psychoactive components CBD is a non-psychotropic Cannabinoid compound. THC or delta 9-Tetrahydrocannabinol is a psychotropic compound, that has the potential for euphoric effects dependant upon titration. THC binds with the cannabinoid 1 (CB1) receptors in the brain and it produces a high or sense of euphoria. CBD binds very weakly, if at all, to CB1 receptors. CBD needs THC to bind to the CB1 receptor and, in turn, can help reduce some of the unwanted psychoactive effects of THC, such as euphoria or sedation.




What are the side effects of CBD?


CBD has a narrow side effect profile, they include dry mouth, low blood pressure, light-headedness, and drowsiness, however these are uncommon. Patients with autoimmune disorders or those who suffer from allergies may experience a negative response from the carrier oil or capsule container. In such cases we recommend a, CBD Isolate (which is 99% pure CBD. Signs of liver injury have also been reported in some patients, but this is extremely uncommon. In general, the side effects from CBD are very uncommon but they might include dry mouth, nausea or even allergy to the carrier oil in the CBD. We also look for other interactions with other medications, most commonly the P450 metabolism medications.




What are the potential medical benefits of CBD vs THC?


CBD and THC have many of the same medical benefits. They can provide relief from several of the same conditions. However, CBD doesn’t cause the euphoric effects that occur with THC. Some people may prefer to use CBD because of the lack of this side effect. CBD is used to help with: seizures inflammation pain psychosis or mental disorders inflammatory bowel disease nausea migraine depression anxiety THC is used to help with pain muscle spasticity glaucoma insomnia low appetite nausea anxiety




What is the entourage effect of CBD?


The term “entourage effect” was coined in 1998 by Israeli scientists Shimon Ben-Shabbat and Raphael Mechoulam. The entourage effect happens when CBD is ingested with other compounds from the cannabis plant, rather than in isolation. The theory is that by using the whole hemp plant rather than a singular aspect, there's a boost in the health benefits and overall therapeutic effect of cannabinoids




How Do Cannabinoids Work?


The plant cannabis sativa contains more than 400 natural compounds; at least 60 of these are classed as cannabinoids. Cannabinoids are a type of chemical that interacts with the endocannabinoid system in the human body to produce a wide range of effects. The endocannabinoid system is a signalling network in the human body. Endocannabinoids, messengeing molecules, are very similar to the cannabinoids in Cannabis sativa. Endocannabinoids communicate with different body tissues by binding to sites called cannabinoid receptors., made up of two types of cannabinoid receptors: CB1 and CB2. CB1 receptors are found in the brain and spinal cord, where they are involved in nerve signalling,in the reproductive system, pituitary and thyroid glands, digestive tract, lungs and kidneys as well as fat, muscle and liver cells. CB2 receptors are mainly found in the immune system.




What are the potential benefits that have been reported using CBD?


Benefits & uses: acne, anti-cancer properties, anxiety & depression, arthritis, autoimmunity, bacterial infections, bone health, depression, diabetes, epilepsy & seizures, heart health, inflammation, inflammatory bowel disease, insomnia, movement disorders, natural pain relief, nausea, neurodegenerative diseases, pain, quitting smoking, rheumatoid arthritis, schizophrenia, seizures, substance use disorders, symptoms of multiple sclerosis, to reduce nausea/pain/improve appetite in cancer patients, vomiting and eating disorders and more.




What is the Endocannabinoid System and what does it regulate in the body?


The endocannabinoid system seems to regulate many functions in the body, including learning and memory, mood and anxiety, drug addiction, feeding behavior, perception, modulation of pain and cardiovascular functions. The endocannabinoid system consists of cannabinoid receptors, endogenous cannabinoids (endocannabinoids), transport proteins and enzymes that synthesize or degrade the endocannabinoids.




What are Phytocannabinoids


Phytocannabinoids are cannabinoids derived from the cannabis plant. The phytocannabinoids are most concentrated in the glandular trichomes (hairy outgrowths) of the flowering heads of the female plant. There are about 100 different cannabinoids isolated from the cannabis plant. The main psychoactive compound is (Δ9-tetrahydrocannabinol (THC), which is produced mainly in the flowers and leaves of the plant. The THC content varies from 5% in marijuana to 80% in hashish oil. It is responsible for most of the pharmacological actions of cannabis, including the psychoactive, analgesic, anti-inflammatory, anti-oxidant, antipruritic, bronchodilatory, anti-spasmodic, and muscle-relaxant activities. It has been reported that a number of side effects of THC, including anxiety, impaired memory and immunosuppression, can be reversed by other constituents of the cannabis plant (cannabinoids, terpenoids, and flavonoids).




What are Cannabinoid receptors and how do they affect the body?


Endocannabinoids interact with cannabinoid (CB) receptors to influence biological function. The two types that have been discovered thus far are CB1 and CB2, which are found in tissues throughout the body. In the brain, CB1 is found on neurons, and this is the receptor with which tetrahydrocannabinol (THC) binds to produce its psychoactive effects. It is noteworthy that many phytocannabinoids do not bind to CB1, and are therefore unlikely to be intoxicating. CB2 is found largely in immune tissues, including the brain’s immune cells, the microglia. Triggering CB2 on these cells reduces inflammation of the brain. Targeting CB2 may then offer hope in treating various conditions that involve brain inflammation such as epilepsy, multiple sclerosis, Alzheimer’s disease and various psychiatric conditions




What is the Enteric Nervous system?


The enteric nervous system or intrinsic nervous system is one of the main divisions of the autonomic nervous system and consists of a mesh-like system of neurons that governs the function of the gastrointestinal tract





Dosing

How will I know when the optimal dose is reached?


A self-report mood, sleep and symptoms diary will assist you and the doctor in identifing the precise individual dose that works best for you .




Can I overdose on Medicial Cannabis?


There is no achievable lethal overdose that has ever been recorded in the taking of Medicinal Cannabis.




When can I reduce my current medication?


Physical addiction and potential withdrawal symptoms determined by the type of medication and the duration it has been prescribed, will dictate when and how a patient can reduce their current prescribed medication. Titrations of medications must be discussed with your doctor, before any alteration of medication is undertaken.




What if I have an allergic reaction to the medicinal cannabis?


If you experience an allergic reaction that presents as anaphylaxis, you must contact 000 and your prescribing doctor. All adverse reactions must be recorded as per the Medical Code of Conduct guidelines.





Administration

What’s the difference between vapourising MC and taking it orally?


When Medicinal Cannabis is vapourised, the effects are immediate and can last for 2-4 hours. When Medicinal Cannabis is consumed orally, the onset is delayed, and effects range from 30 mins up to 2 hours post ingestion. The effects of oral consumption last between 4-8 hours, depending on the dose.




What are the types of administration available in Australia?


Currently, Medical Cannabis is administered via inhalation or orally.




What's a vapouriser?


A vapouriser is an electronic device which allows patients to release the active ingredients and therapeutic compounds of Cannabis via inhalation rather than smoke. A vapouriser heats dry herb to just below the point of combustion, which produces the flavour and effect of the plant into a vapour form. Vapourising results in significantly more efficient extraction (a 46% increase) of Cannabinoids, terpenes and flavonoids, as well as decreases the irritation and harmful effects caused by smoking. Since no plant matter is being burned, no potential carcinogens are consumed. Vapour is much more flavourful and smoother to inhale than smoke, which makes the entire experience more enjoyable and comfortable for the user.




Why is vapourising recommended over smoking?


At least 40% of product is lost to combustion when smoked, making it difficult to estimate the dose of your Cannabinoids that your are receiving. Evidence also indicates that smoking is harmful to your lungs and smoking of Cannabis products is not supported. Vapourisation with temperature controlled devices, allow you to heat the the cannabis to an optimal temperature for the procession of decarboxylation without combustion occurring.





Legal

How will this effect drug testing at work?


Every workplace has their own policies and procedures in accordance with government guidelines, and ultimately it is each employers decison as to whether special consideration will be applied for this prescription medication.




Can I drive which taking CBD?


CBD is non-psychoactive and non-sedative and it is therefore deemed safe to drive while using. CBD will not show up on a roadside drug test. Please note: It is illegal to drive in Australia if you are impaired from any substances whether a legally prescribed drug or not.




Can I dirve while taking THC?


THC is regarded as psychotropic, which may result in psychedelic effects and as a result, driving whilst under the influence is not legal. Currently, mobile roadside testing includes THC but not CBD. Please consult your prescribing Doctor for more information on driving and the operating of heavy machinery.




How long do I have to wait to drive after taking THC?


Roadside drug testing detects THC (the active component in medical cannabis) for several hours and up to several days after use. The potency of the cannabis medication, an indivudals metabolism and the method of ingestion, are all factors which will effect a roadside oral drug test.





Process

How long will the approval process take?


Applications time can vary depending on the complexity of the application. We allow 7-14 days for Government approval to be granted.





Safety

Is CBD dangerous during pregnancy and breast-feeding?


Cannabidiol is POSSIBLY UNSAFE to use if you are pregnant or breast feeding.

1. Pregnancy and contraception.

Pregnant women and women planning to conceive or not using contraception should not use medical cannabis. Early research is currently insufficient to determine the precise effects of medical cannabis on the foetus of pregnant women.

2. Lactation

Concentrations of cannabinoids can accumulate in breast milk, leading to growth delay in the infant. Due to the potential developmental risks, medical cannabis is harmful to the infant during lactation.




Is CBD addictive?


There are currently no reported cases physical addiction have been identified in animals nor humans.





Dispensary

How do I get my Product?


Greenhouse Medical Clinic and Biolabs, will send your package through a postal service to your home or nominated address.









Adverse reactions

What are the potential side effects of medicinal cannabis?


Research indicates that medical cannabis is generally well tolerated, while around 25% of patients may experience the occasional adverse side effect. Nervous disorders were the most commonly reported adverse side effects, followed by gastrointestinal disorders.

The most common adverse effects occurred around 10% of patients including: mild dizziness, dry mouth, sedation, somnolence, nausea and fatigue. Most side effects occur during the first four weeks of treatment and can be reduced with an alteration in the titration schedule.





Contraindications

Are there medical conditons that would prevent the prescription of medicinal cannabis?


1. Serious cardiovascular disease

Patients with serious cardiovascular disease, including ischemic heart disease, arrhythmias, hypertension and heart failure.

2. Previous diagnosis of psychotic disease

Patients with a personal or family history of psychotic disease including a history of delusions or hallucinations, are not suitable for medical cannabis prescription.

3. Pregnancy and contraception.

Pregnant women and women planning to conceive or not using contraception should not use medical cannabis. The presence of CB1 receptors in the reproductive system. Early research is currently insufficient to determine the precise effects of medical cannabis on the foetus of pregnant women.

3. Lactation

Concentrations of cannabinoids can accumulate in breast milk, leading to growth delay in the infant. Due to the potential developmental risks, medical cannabis is contraindicated during lactation.





Address

Where is our office?


Suite 3, Podium Level Lakeside 1, 1 Lake Orr Dr, Varsity Lakes QLD 4227





ADHD

What are the known causes of ADHD?


Research suggests that the development of ADHD may be a result of Genetics, where a parent or sibling has ADHD or another mental health disorder, Environment - smoking, drinking alcohol or drugs during pregnancy or exposure to environmental toxins during childhood, and complications prior to and during development, such as premature birth.




Disorders that may occur alongside ADHD


Other disorders often occur alongside ADHD which can make treatment more challenging, they include: Mood disorders - depression, bipolar disorder and a repeated pattern of failures due to ADHD can worsen depression. Anxiety disorders - overwhelming worry, nervousness and other symptoms which can be made worse by the challenges and setbacks of ADHD. Other psychiatric disorders - increased risk of personality disorders, intermittent explosive disorder and substance use disorders.




How is it possible that a diagnosis of ADHD could have been missed?


Because the symptoms of ADHD are similar to anxiety and various mood disorders, and the fact that research indicates, more often than not, individuals with ADHD have a co-morbid mental health condition such as anxiety or depression, it can oftentimes be missed as a diagnosis




What is adult ADHD?


Adult attention-deficit/hyperactivity disorder (ADHD) is characterised as a disorder with symptoms ranging from difficulty paying attention (inattention), hyperactivity and impulsive behavior. Adult ADHD can lead to substance abuse, unstable relationships, poor work or school performance, low self-esteem, and interference with daily functioning ranging from mild to severe. Science indicates that adult ADHD symptoms start in early childhood and continue into adulthood, however, in many cases, ADHD was not diagnosed until adulthood. Adult ADHD symptoms are often less obvious than ADHD symptoms in children. In adults, hyperactivity may decrease, but challenges with impulsiveness, restlessness and difficulty paying attention continue. Often adults with ADHD are unaware they have it, they just experience life’s tasks as more challenging. Adults with ADHD may find it difficult to focus, prioritise and organise, leading to forgotten social plans and meetings and missed deadlines at work or school. The inability for impulse control ranges from general impatience to mood swings and/or outbursts of anger.




How does CBD help with depression, ADHD and ASD?


The Anti-inflammatory effect of CBD has been shown to help with depression, ADHD, and even autism spectrum disorders. In ADHD, reduced inflammation can stabilise the nervous system, reducing symptoms which can aggravate ADHD.





History of MC

What are the historial uses of Medical Cannabis?


The medicinal properties of the cannabis plant have been known for millennia. As far back as 2800 BC, cannabis was used to treat a vast array of health problems and was listed in Emperor Shen Nung's pharmacopoeia. Cannabis has a long and colourful history. The use of cannabis originated in central Asia or western China. Cannabis has been used for its alleged healing properties for millennia. The first documented case of its use dates back to 2800 BC, when it was listed in the Emperor Shen Nung's (regarded as the father of Chinese medicine) pharmacopoeia. Therapeutic indications of cannabis are mentioned in the texts of the Indian Hindus, Assyrians, Greeks and Romans. These texts reported cannabis to treat a vast array of different health problems, including arthritis, depression, amenorrhea, inflammation, pain, lack of appetite and asthma. Hindu legend holds that Shiva, the supreme Godhead of many sects, was given the title ‘The Lord of Bhang’, because the cannabis plant was his favourite food. The ancient Hindus thought the medicinal benefits of cannabis were explained by pleasing the gods such as Shiva. Ancient Hindu texts attribute the onset of fever with the ‘hot breath of the gods’ who were angered by the afflicted person's behaviour. Using cannabis in religious rites appeased the gods and hence reduced the fever. Recent scientific evidence provides an alternative explanation of course. Tetrahydrocannabinol (THC) acts on the hypothalamus to reduce body temperature.
Source: University of Sydney Lambert Initiative.