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72 MEDICINAL CANNABIS FROM PAGE 71 pharmacists as much as we can,” he continued. “There’s been a lot of red tape in preceding years for our pharmacists and \\\\\\\\\\\\\\\[it’s been\\\\\\\\\\\\\\\] really hard for them to get past a lot of that. So ... we have released our new platform to try and help our pharmacists out, called CanView.” To help pharmacists upskill, courses and platforms such as CanView are becoming available. Dr Jansen adds that through CanView, an educational platform will be released that pharmacists can access for further training around medicinal cannabis. Dr Jansen says this will be a free platform for pharmacists and doctors to access and learn about medicinal cannabis – when to dispense and what dosing is appropriate. He says pharmacists, when discussing medicinal cannabis with their customers, need to be especially aware of the legalities around driving. “There’s no legal lower limit for THC to drive ... For CBD \\\\\\\\\\\\\\\[there are no driving restrictions\\\\\\\\\\\\\\\] – most CBD products don’t have any trace of THC in them, but some do and ... you need to make the patient aware that there could be trace THC in their product,” he said. “\\\\\\\\\\\\\\\[From\\\\\\\\\\\\\\\] the THC side of things, there is that restriction and you can’t give an answer on how long it’ll take someone to metabolise it completely from their body. We try to give that information out to pharmacists ... through the CanView website – we have a document there that shows any trace amounts in certain products.” Mr Sclavos added: “THC has psychoactive effects such as euphoria or feeling relaxed or sleepy ... Pharmacists, as a baseline, \\\\\\\\\\\\\\\[need to know that\\\\\\\\\\\\\\\] if any patients are taking these products, whether illicitly or through prescription, they’re going to fail drive drug tests.” Therefore, he adds, “pharmacists not only have to be aware of clinical issues, they also need to be aware of these legislative issues”. In addition to the option of the CanView platform, on July 1 2020 NPS MedicineWise released a new portal to “help health professionals and consumers navigate evidence-based information about medicinal cannabis”. “Medicinal cannabis is a medicine that Australians want to know more about,” NPS MedicineWise CEO Adjunct Associate Professor Steve Morris said. “Accessing clear, accurate and up-to-date information about medicinal cannabis can be challenging ... because there are many groups with an interest in this area, and a complex regulatory environment.” Further supporting the argument for additional education, Mr Sinclair added: “I think it’s fair to say that most healthcare professionals, be they pharmacists, nurses or doctors, had very little training in the endocannabinoid system or the therapeutic effects of cannabis in their undergraduate courses. “Most medical professionals I speak to say they only learned about the harms associated with cannabis, which is why education plays such a vital role in overcoming the stigma of this now legal medicine. “Training programs exist in Australia that focus on medicinal cannabis prescribing and really should be considered essential for anyone wanting to work in this evolving space, as I suspect medicinal cannabis will continue to grow in use by the Australian public as time goes on.” In summary Delving into the medicinal cannabis arena, it’s fair to say that this a complex topic – one that pharmacists cannot shy away from, particularly given the fact that low-dose CBD may soon be downgraded to a Schedule 3 medicine. “Currently a delegate-initiated proposal is before the Joint Advisory Committee on Medicines and Chemicals Scheduling to downschedule CBD to Schedule 3 in the Standard for the Uniform Scheduling of Medicines and Poisons, with a ruling expected later this year,” Mr Sinclair said. Times are changing, and pharmacists need to change with them, because their role has never been seen to be more important than in the space of medicinal cannabis, and as Mr Sclavos says, the biggest role of pharmacists in this space is “titration, dosing and proper dispensing”, along with advising “on \\\\\\\\\\\\\\\[the\\\\\\\\\\\\\\\] maintenance dose of \\\\\\\\\\\\\\\[the\\\\\\\\\\\\\\\] medication”. References 1. Guidancefortheuseofmedicinalcannabis in Australia: Patient information, tga.gov.au/ publications/guidance-use-medicinal-cannabis- australia-patient-information \\\\\\\\\\\\\\\[Accessed 1.7.2020\\\\\\\\\\\\\\\]. 2. Australian Government Department Health TGA, ‘Safety of low dose cannabidiol’, Version 1.0, April 2020. 3. Australian Government Department Health TGA, ‘Safety of low dose cannabidiol’, Version 1.0, April 2020. 4. Australian Government Department Health TGA, ‘Safety of low dose cannabidiol’, Version 1.0, April 2020. 5. Review on the safety of low dose cannabidiol, tga.gov.au/alert/review-safety-low-dose- cannabidiol \\\\\\\\\\\\\\\[Accessed 2/7/20\\\\\\\\\\\\\\\] 6. Guidance for the use of medicinal cannabis in Australia: Patient information, tga.gov.au/ publications/guidance-use-medicinal-cannabis- australia-patient-information \\\\\\\\\\\\\\\[Accessed 1/7/20\\\\\\\\\\\\\\\]. 7. NIH, Research Report, Marijuana Research Report, ‘Is marijuana safe and effective as medicine?’ drugadbuse.gov/publications/research- reports/marijuana-safe-effective-medicine \\\\\\\\\\\\\\\[Accessed 1/7/20\\\\\\\\\\\\\\\] 8. NIH,ResearchReport,MarijuanaResearch Report, ‘Is marijuana safe and effective as medicine?’ drugadbuse.gov/publications/research- reports/marijuana-safe-effective-medicine RETAIL PHARMACY • AUG 2020 Platforms to access further information CanView: canview.com.au/ NSP MedicineWise: nps.org.au/ professionals/medicinal-cannabis- what-you-need-to-know