Cannabis is a plant rich with potential therapeutic compounds and centuries of cultural resonance. At this moment in Australia, media accounts are full of patient stories and lab data suggesting benefit from cannabis for scores of different conditions, while politicians discuss laxer regulation of the drug and a new lucrative industr

However, only a few of the claimed medical effects of the plant have been proven by rigorous clinical trials in people. Nabiximols is the only medicinal cannabis product currently registered in New Zealand and Australia, and it's indicated only for­­ the treatment of spasticity in patients with multiple sclerosis (MS). Systematic reviews of the research note strong evidence that cannabis can also help with the pain associated with MS, the nausea induced by chemotherapy and some cases of epilepsy. But for many other conditions like post-traumatic stress disorder, irritable bowel syndrome, immune disorders and Parkinsonism, reviewers concluded that meaningful clinical recommendations could not be made—there simply aren't enough studies of good quality. 

Cannabis is complex. The flower bud contains mostly cannabidiol and tetrahydrocannabinol (THC), but there are about 100 other cannabinoid compounds. On this episode, Pomegranate Health guests explain how important it is to separate the effect of these various components in a systematic way, and why well-regulated research and prescribing will be safer for patients. 

Guests
A/Prof Peter Grimison FRACP (Chris O'Brien Lifehouse, University of Sydney)
Prof Meera Agar FRACP (UTS, USNW, IMPACCT)
A/Prof Carolyn Arnold FRACP (Monash University Alfred Health)
Prof Samuel Berkovic AC FRACP (Epilepsy Research Centre, University of Melbourne)
Prof Jennifer Martin FRACP (Australian Centre for Cannabinoid Research Excellence, University of Newcastle, John Hunter Hospital).

Production
Written and produced by Mic Cavazzini. Additional audio recording from James Milson. Music courtesy of Blue Dot Sessions (“Cloud Line”), 4T Thieves (“New Times”), Mystery Mammal (“Asylum”) and Jahzarr (“Please Listen Carefully”). Image courtesy of iStock. The production manager was Anne Fredrickson.

Editorial feedback for this episode was provided by RACP members Dr Michael Herd, Dr Pavan Chandrala, Dr Marion Leighton, Dr Rosalynn Pszczola, Dr Mahesh Dhakal, Dr Rhiannon Mellor, Dr Rebecca Grainger, Dr Philip Gaughwin and Dr Paul Jauncey, as well as Louise Hardy (Manager, RACP Policy and Advocacy) and Ms Joanna Harrison (Senior Adviser, ACRE).

Please visit the RACP website for a transcript embedded with citations. Fellows of the College can claim CPD credits for listening and additional reading.