Arrive at least 15 minutes early to allow for preparation time
Avoid wearing brightly patterned or reflective clothing, as this may not show up well on camera
Switch your mobile off or to silent mode
Speak clearly so your voice can be picked up by the microphone
Look at the camera, so you can achieve good eye contact with the specialist
Do not hesitate to ask if you need help during the video consultation
- Have a history of hypersensitivity to any cannabinoid or products used in manufacture (e.g. sesame oil).
- Have severe and unstable cardio-pulmonary disease (angina, peripheral vascular disease, cerebrovascular disease and arrhythmias) or risk factors for cardiovascular disease—THC acts through the CB1 receptors to decrease blood pressure, increase cardiac demand and causes vasodilation. In those who smoke cannabis, there is a four-fold risk of myocardial infarction in the hour following smoking in those patients with unstable ischaemic heart disease.
- Have a previous psychotic or concurrent active mood disorder or severe anxiety disorder.
- Are pregnant/breastfeeding—there are some reports of pre-term labour and low birth weight, and cannabinoids appear in the breast milk. Patients with a past history of adverse reactions to cannabis These patients may be able to use a CBD product with no THC. This will depend on the symptoms being treated. Relative contraindications These conditions may not prevent prescribing, though should also be considered by the medical practitioner.
- Severe liver or renal disease.
- Drug dependence, including nicotine and heavy users of alcohol or other medications especially other sedatives such as opioids and benzodiazepines
- Paediatric and elderly patients—little is known about how these patient groups react to cannabis. As metabolism in the elderly is slower it is likely they will be more sensitive to the pharmacological effects of cannabis. Treatment should therefore be commenced at very low doses and adjusted very slowly.
- Individuals with a past medical history of schizophrenia or family history of schizophrenia may be contraindicated for cannabis use. Cannabis may elicit schizophrenic episodes in patients who are predisposed to schizophrenia.
- Patients should not drive or operate heavy equipment while impaired or participate in responsibilities and activities that require focus and attention such as childcare
- Care should be taken in prescribing medicinal cannabis products containing THC to patients under 25 due to the potentially adverse effects on the developing brain. A risk analysis should be undertaken prior to prescribing these products.
2 reasons: (1) quality assurance and (2) knowing the dose.
The medicinal cannabis products that are prescribed by our doctors have to meet the quality assurance standards that are mandated by the Therapeutic Goods Administration, or the TGA. The TGA is part of the federal Department of Health and they govern all the medicines that are available in Australia. They have mandated a standard for medicinal cannabis products that is known as Therapeutic Goods Order No. 93. This ensures that all cannabis used to make medicinal cannabis products is tested for potency, tested for microbiological contamination, tested for toxins that could come from the plant, tested for any residual pesticides and must come from a 100% natural source. Any other cannabis that is sold in Australia (usually illegally) does not have to be tested and there is no way to know if it is safe to use.
All medicinal cannabis products prescribed by our doctors have to be a known concentration so patients can be sure exactly how much active ingredients they receive with each dose. With this information, a patient can tell exactly how well the product works at the first dose. If the patient needs to increase the dose, they can do this very precisely, to see if the product delivers more benefit at the higher dose. With any other cannabis, there is no way to know how much of the active ingredients are contained in the products. They do not have to be tested. All medicinal cannabis products prescribed by our doctors have to be tested and the analytical results have to be shown to the TGA before they can be used to treat Australian patients.
The NSW Centre for Road Safety website states THC can typically be detected in saliva by a Mobile Drug Testing (MDT) stick for up to 12 hours after use. This could vary for each patient depending on the dose being administered. At this point in time, drivers will be penalised if they test positive for THC at a roadside MDT.
To be considered for inclusion on to the Pharmaceutical Benefits Scheme (PBS), the product must first be registered and approved for use by the TGA. To get approval by the TGA, a company has to submit many clinical trials that take years to complete. Some clinical trials for medicinal cannabis products are underway, but they are many years away from having enough data for a TGA submission.
Cannabis Access Clinics fees are NET of medicare rebates and cover our consultation costs and the administrative costs of applying for approval and monitoring patient progress.
Cannabis Access Clinics charges an out-of-pocket fee of $80 for screening for our doctor to assess the suitability of the patient for medicinal cannabis. If the doctor decides to proceed with an application then the patient will be advised of what documentation is required in order to proceed and a follow-up consultation arranged. This follow-up consultation will allow for the Cannabis Access Clinics doctor to confirm received documentation is correct, obtain additional patient information and initiate the application to the TGA. The follow-up consultation will cost $120. An admin fee of $250 is payable after the follow-up consultation. This covers the associated costs of application to the TGA and the associated back-office administrative duties.
If the application to the TGA is approved then the patient will require a post-approval consultation with a Cannabis Access Clinic doctor to discuss their medication, prescription and dosage details. The post-approval consultation will cost $120. Monitoring consultations will be an out-of-pocket cost of $80 respectively. We request a 50% deposit from you at the time of booking.
The TGA requires that there is some evidence medicinal cannabis will work for your condition before they approve it, so many other conditions not listed here may be approved, if there is some support in the medical literature.