Medical cannabis is a broad term for cannabis-based medicine that is used to relieve symptoms of certain conditions. The cannabis plant contains more than 100 different chemicals named cannabinoids, with each one producing a different effect on the endocannabinoid system in the body. Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two main cannabinoids used in medicinal cannabis in Ireland.
How is Cannabis used Medically?
There is evidence to suggest medical cannabis can be helpful in the management of chronic pain, including neuropathic pain; spasticity; nausea and vomiting, particularly in the context of chemotherapy; and in the management of anxiety.
Further evidence also moderates evidence that medical cannabis can be beneficial in treating sleep disorders; appetite stimulation in the context of chemotherapy; fibromyalgia; post-traumatic stress disorder; and for some symptoms of Parkinson’s disease.
How does it help?
Medical cannabis treatment may help in several areas:
- Ease pain.
- Control nausea and vomiting caused by chemotherapy for cancer.
- Multiple sclerosis
Medical Cannabis Access Programme
In June 2019 the Minister for Health launched the Medical Cannabis Access Programme to be operational on a pilot basis for five years. The programme will help facilitate access to medicinal cannabis for suitable candidates.
The programme makes it possible for a consultant to prescribe medicinal cannabis for a number of conditions, where a patient has failed to respond to traditional pharmaceutical treatments.
Currently, three conditions qualify under the Medicinal Cannabis Access Programme.
- Spasticity associated with multiple sclerosis
- Intractable nausea and vomiting associated with chemotherapy
- Severe, refractory (treatment-resistant) epilepsy
The Medicinal Cannabis Access Programme is currently under review by the Department of Health.
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Difference between Marijuana and Medical Cannabis
Medical cannabis is prescribed by a consultant doctor who understands which product would be most medically beneficial for their patient. Marijuana or cannabis bought from unlicensed sources without a prescription is currently illegal in Ireland.
Hemp Vs. Marijuana Vs. CBD
Hemp , Marijuana and CBD all come from the same species, the Cannabis Sativa plant although variations can exist. The defining difference is their THC content. Hemp has a low THC volume, commonly below 0.3% THC meaning it does not produce the same psychoactive effect.
Hemp is ordinarily used for industrial purposes such as textiles but also produce CBD. Marijuana on the other hand is a high-THC variation of the Cannabis Sativa plant.
What are the common uses of Medical Cannabis?
The most common uses of medical cannabis in Ireland are limited to the three conditions listed above. Namely, Epilepsy, Multiple Sclerosis and nausea and vomiting due to chemotherapy.
Intractable nausea and vomiting associated with chemotherapy
Nausea and vomiting due to chemotherapy are common side effects of treatment. Medical cannabis for cancer patients has been shown to alleviate these symptoms. Considerable evidence demonstrates that manipulation of the endocannabinoid system regulates nausea and vomiting in humans. According to randomised research, medicinal cannabis is more effective than traditional medication for treating nausea and vomiting due to chemotherapy.
Severe, refractory (treatment-resistant) epilepsy.
Approximately one-third of patients with epilepsy have seizures that are resistant to antiepileptic medications. Traditionally CBD was seen as the most effective cannabinoid for drug-resistant epilepsy, although recent studies have found that for medical cannabis treatment for epilepsy “whole-plant medical cannabis products are superior to isolated CBD products in patients” and can result in a reduction in the frequency of seizures.
Spasticity associated with multiple sclerosis
60-84% of multiple sclerosis patients experience spasticity. When severe, it can be extremely challenging in terms of mobility. Studies have shown that cannabis treatment for multiple sclerosis can show an improvement in spasticity measures in over half of the patients treated. Research conducted with 279 people with MS in the UK showed the relief from muscle stiffness for those people taking the medical cannabis extract was “almost twice as high than with placebo.
Can I get a prescription for Medicinal Cannabis in Ireland?
Medical cannabis prescriptions are available in Ireland. To obtain a prescription, under the Medical Cannabis Access Programme, a consultant with specialist training in a specified medical condition may prescribe medicinal cannabis to their patient. Cannabis for medical use will only be prescribed once other treatments have failed. The Health Service has issued clinical guidelines to inform consultants.
How do I get a medical cannabis card?
Oleo launched its Medical Cannabis Card in November 2022. The Oleo Medical Cannabis Card will be the same size as other cards in your wallet. It will contain your photo and the details of your medical cannabis prescription including your Cannabis for Medical Use Register (CMUR) number. You can find all the details about the card and how to apply here.
How much Medical Cannabis will I be provided?
We cannot determine how much medicinal cannabis will be provided to the patient. This will be dependent on the patient’s condition and the severity of their symptoms. This aspect is best discussed with your consultant.
Different methods to consume Medical Marijuana
Depending on the medical marijuana product you are prescribed there are multiple ways to administer medicinal cannabis.
- Inhalation: Inhaled cannabis may be the most well-known method of administration for medical cannabis flowers. The main benefit of inhaled cannabis is that the onset of action is practically quick, making it simple for a patient to titrate the dosage for maximal benefit. At Oleo we have developed our Panacea Inhaler which is available to patients prescribed medical cannabis under the Medical Cannabis Access Programme and is also available to buy on Amazon.
- Sublingual: Sublingual delivery is another option for the administration of oil-based medical cannabis. Medical cannabis oil can have a rapid onset of action by being administered under the tongue or in the oral cavity. The patient feels the effects after a few minute. Other cannabis products may come in a spray bottle that can be sprayed directly into the mouth.
- Tablet/ Pill format: Cannabinoids are soluble in fat, their absorption through the gut is slower and less predictable, depending on both the metabolism of the individual and the contents of the stomach. Determining an effective dose is more challenging, especially for the inexperienced patient, because the onset of the effect may take up to an hour to occur.
What will be the effects of Medical Cannabis?
Medical cannabis may aid with pain relief, nausea and vomiting control, inflammation reduction, and inflammation depending on the condition you are trying to treat. Medical cannabis may also interact with other treatments. It is best to discuss this with your Consultant.
Are there any side effects of Medical Cannabis?
Medical cannabis, like all medications, poses a risk of side effects. The type of medical cannabis product, the active chemicals (such as CBD, THC, or a combination), and individual differences can all have a significant impact on side effects. THC-containing products can impair driving and cognitive performance and produce sedation, anxiety, dizziness, appetite stimulation, and other symptoms. Although CBD rarely has significant negative effects on its own, it can change the effects of other prescribed drugs.
Will it Make me feel high?
In many cases, the answer to this is: only if you want to unless the dosage you need is quite high. The doses needed for medical purposes are often significantly lower than what is used recreationally. The most commonly reported adverse reactions in the first four weeks of exposure were dizziness, which occurs mainly during the initial period, and fatigue.
These reactions are usually mild to moderate and resolve within a few days even if treatment is continued.
What is THC? And how is it different from CBD?
THC, known by its scientific name, Tetrahydrocannabinol is the principal psychoactive constituent of cannabis and one of at least 113 total cannabinoids identified on the plant.
CBD, also known as Cannabidiol, is the second most common cannabinoid found in the cannabis plant. CBD does not produce any psychoactive effect.
Both CBD and THC are chemically similar to your body’s endocannabinoids. This allows them to interact with your cannabinoid receptors. Although CBD and THC have similar chemical structures, they don’t both have the same psychoactive properties. While CBD is psychotropic, it does so differently than THC. It doesn’t result in a THC-related high. The brain’s cannabinoid 1 (CB1) receptors bind with THC. It results in a high or euphoric feeling. According to research, this high can be more intense if the THC is inhaled as opposed to consuming.
Is Using Medical Cannabis Legal in Ireland?
Prescribed medical cannabis is legal in Ireland. Cannabis obtained without a valid prescription will fall under the Misuse of Drugs Act 1977 and will be deemed illegal. You can view a breakdown of the laws relating to illegal cannabis here.
Read our similar blog on: Is Medical Cannabis Legal in Ireland
Medical Cannabis Ireland
The availability of medical cannabis prescriptions is relatively new in Ireland. Nonetheless even in its infancy medical cannabis and related research have shown the potential benefits of medical cannabis for alleviating patients’ symptoms across a range of conditions.
The Medical Cannabis Access Programme is currently under review by the Department of Health. The Department of Health has commissioned an evidence review to access scientific research on the efficiency and safety of cannabis-based treatments for a range of conditions The initial stage of the review has been completed. A clinical group will now be convened to access this evidence and provide guidance on any amendments to the Medical Cannabis Access Programme. This is expected early in the new year.