CBD Dosage Guidelines for Medical Professionals

CBD Dosage Guidelines for Medical Professionals

 

Are you a healthcare professional that’s interested in expanding your patients’ therapeutic options through personalised CBD dosages? Do you want to learn more about the prescribing guidelines for medical cannabis in Australia? This article will answer all your burning questions.

 

CBD is a naturally occurring cannabis compound that displays a wealth of beneficial properties. Its non-psychoactive nature minimises the risk of unwanted effects.

 

The diverse therapeutic potential of CBD makes it a subject of interest for medical practitioners, as it offers a holistic approach to healthcare. Incorporating CBD into treatment plans can provide alternatives, especially for conditions where traditional medications may fall short.

 

Evidence-based prescription guidelines provide the foundation for informed decision-making. Rigorous research and clinical studies are paramount to ensuring CBD prescriptions are grounded in scientific validity.

 

Another crucial aspect is prioritising patient well-being. Doctors must have a thorough understanding of the patient’s medical history, CBD dosages for specific needs, and how to maintain open communication.

 

Ready to learn more? Keep reading for a comprehensive overview of CBD prescribing guidelines for medical practitioners.

 

Understanding CBD as a medical practitioner

 

Any cannabis product prescribed by a doctor to relieve the symptoms of a medical condition is defined as medical cannabis.¹

 

Australia legalised the medicinal use of cannabis in 2016. Patients can access it with a prescription from a health professional. Recreational use is illegal in all regions, except in the Australian Capital Territory (ACT).

 

The regulation of cannabis and its derivatives involves multiple agencies, including the Therapeutic Goods Administration (TGA), the Office of Drug Control (ODC), and regional health departments.

 

Over-the-counter CBD oil products are not yet available in Australia, as none have met the relevant criteria for TGA approval. However, the future looks promising.

 

The TGA down-scheduled low dose CBD in February 2021, and CBD-infused products could soon become available without a prescription.² For now, patients will need a script from their physician to get CBD oil products.

 

CBD vs. THC

 

Cannabidiol (CBD) and tetrahydrocannabinol (THC) are two of the many cannabinoids found in the cannabis plant. Although they share many similarities, they’re also different compounds with some contrasting properties.

 

CBD is a non-psychoactive compound. It influences the endocannabinoid system (ECS) in your body, which has a part in regulating several physiological processes.

 

Unlike THC, CBD doesn’t produce the typical euphoric effects associated with cannabis. It’s also shown to offset the psychoactive sensations of THC by inhibiting CB1 receptor signaling.

 

Cannabidiol is often used for medicinal purposes, as it’s said to have anti-inflammatory, analgesic, anti-anxiety, and neuroprotective effects.

 

THC is the primary psychoactive compound responsible for the intoxicating effects linked with cannabis use. It binds to cannabinoid receptors in the brain and nervous system, leading to alterations in perception, mood, and consciousness.

 

Tetrahydrocannabinol also has medicinal properties, including pain relief and anti-nausea effects. However, its psychoactive nature limits its use.

 

Below are the main differences between THC and CBD:

 

  • Psychoactive effects: THC produces a euphoric high, while CBD doesn’t have any intoxicating effects.

 

  • Legal status: The legal status of CBD and THC varies significantly from one jurisdiction to another. Low doses of CBD are legal in many places. THC is often subject to stricter regulations.

 

  • Medical applications: Both CBD and THC have medicinal properties, but their applications differ.

 

  • Side effects: THC is known to cause side effects like anxiety, paranoia, and impaired cognitive function, especially in higher doses. CBD tends to have a better side effect profile.

 

The therapeutic properties of CBD

 

CBD has gained attention for its potential therapeutic properties. While research is still ongoing, there’s plenty of evidence suggesting it has a range of beneficial effects:³

 

  • Anti-inflammatory properties
  • Analgesic effects
  • Anti-anxiety and anti-depressant effects
  • Neuroprotective properties 
  • Antipsychotic effects
  • Anti-seizure effects
  • Anti-nausea and antiemetic effects
  • Skin conditions 
  • Cardioprotective effects

 

The side effects of CBD

Many people use CBD without experiencing significant side effects, but individual responses can vary. Below are some potential side effects of CBD to keep in mind:

 

  • Dry mouth
  • Appetite changes
  • Fatigue
  • Weight changes
  • Diarrhoea 
  • Low blood pressure
  • Lightheadedness

 

The science behind CBD dosages

 

Individual responses to CBD can vary, and determining the appropriate dosage involves various factors. Here are some key elements that influence CBD dosage recommendations.

 

  • Age: Age impacts how the body metabolises substances. Consider whether the individual is a child, adult, or elderly.

 

  • Weight: Body weight can affect the distribution and metabolism of CBD. Those with higher body weight tend to require a larger dosage.

 

  • Health status: General health, pre-existing conditions, or medications can influence how the body processes CBD.

 

  • Severity of the medical condition: The severity of the medical condition being treated plays a role in determining the appropriate CBD dosage.

 

  • Desired results: The patient’s therapeutic goals influence the optimal dosage.

 

  • Individual sensitivity: Sensitivity to substances can vary between individuals.

 

  • Delivery method: The method of CBD administration can affect how quickly the body absorbs and metabolises CBD.

 

  • Type of CBD product: Full-spectrum CBD products contain a range of cannabinoids, which may enhance the overall therapeutic effect. CBD isolate products contain only pure CBD.

 

  • Tolerance and duration of use: Individual tolerance to CBD may develop over time. Additionally, the duration of CBD use can influence the body’s response.

 

Always advise your patient to start with lower doses, gradually increasing as needed while monitoring for any adverse effects.

 

 

 

Dosing methods and delivery systems

 

Selecting the appropriate dosing method and delivery system promotes optimal therapeutic outcomes. When choosing between sublingual and oral administration, consider patient preferences, the condition being treated, and the desired results.

 

Let’s explore the dosing methods for medical cannabis.

 

Tinctures

Tinctures are liquid extracts of CBD that are administered sublingually or added to food and beverages.

 

Sublingual administration involves placing a few drops under the tongue. It allows for rapid absorption, as CBD bypasses the digestive system and enters the bloodstream directly. This method is preferred by many patients due to its fast onset of effects.

 

Sublingual administration also enables precise control over the dosage, making it easier for practitioners to tailor treatment plans.

 

Capsules

CBD capsules provide a convenient and discreet way to administer a controlled oral dosage. They’re popular among patients who prefer a pre-measured amount and a tasteless option.

 

The onset of effects may be slower compared to tinctures, as capsules need to be broken down in the digestive system. However, oral ingestion often results in a longer duration of effects.

 

Practitioners should consider the patient’s gastrointestinal health, as factors like digestion and absorption may vary among individuals.

 

Topical applications

Topical CBD applications include creams, balms, and patches that are applied directly to the skin for localised relief.

 

Topicals don’t enter the bloodstream, but they can still interact with cannabinoid receptors in the skin.

 

Personalising CBD prescriptions

 

CBD may interact with certain medications or exacerbate pre-existing conditions.⁴

 

It’s crucial to identify contraindications and potential interactions to make informed decisions about the suitability of CBD for the patient.

 

A thorough examination of the patient’s medical history is essential before embarking on a personalised CBD prescription plan. Consider pre-existing conditions, past treatments, and any medications currently being taken.

 

Understanding the patient’s medical history aids in tailoring the dosage and selecting the most suitable product. It also minimises the risk of adverse effects and ensures the safe integration of CBD into the healthcare regimen.

 

Engaging in open and transparent communication with the patient is helpful during this assessment. Encourage them to share concerns, previous experiences, or potential side effects.

 

Consultation and collaboration with other healthcare professionals

 

CBD prescriptions shouldn’t exist in isolation, but rather as part of an integrated approach that addresses the patient’s broader health needs.

 

Collaborating with other healthcare teams involved in the patient’s care enables the exchange of valuable insights and a coordinated treatment plan.

 

It also ensures that potential contraindications or interactions with other treatments are identified and addressed promptly.

 

Monitoring and adjusting CBD treatment plans

 

The success of a CBD treatment plan extends beyond the initial prescription. Regular follow-ups, patient monitoring, and dosage adjustments may be required based on individual responses.

 

Regular patient follow-ups

 

Regular follow-up appointments are instrumental in gauging the effectiveness and safety of a CBD treatment plan.

 

These appointments provide an opportunity to assess the patient’s response, address any concerns or questions, and make adjustments. They allow practitioners to track the patient’s progress over time for a refined treatment approach.

 

A consistent follow-up schedule also fosters a long-term relationship between the patient and healthcare practitioner.

 

Patient monitoring

 

While CBD is generally well-tolerated, CBD treatment monitoring for potential adverse effects is crucial.

 

Stay attuned to any signs of discomfort, changes in mood, or unexpected reactions from your patient. Prompt identification of adverse effects allows for timely intervention and adjustments to the treatment plan.

 

Evaluate the effectiveness of the CBD treatment in addressing the targeted symptoms or conditions. Use this data to make informed decisions on the continuation, modification, or cessation of the CBD prescription.

 

Adjusting dosage based on patient response

 

No two people are alike, so their response to CBD may vary. Based on the observed effects and the patient’s feedback, be prepared to adjust the CBD dosage.

 

Fine-tuning the CBD dosage ensures patients receive the right amount for their needs and minimises the risk of side effects.

 

Include patients in the decision-making process when adjusting dosages. Discuss their experiences, address any concerns, and decide on the most appropriate course of action.

 

Educating patients on CBD usage

 

Empowering patients with knowledge about CBD is a fundamental aspect of promoting informed decision-making and ensuring a positive therapeutic experience.

 

Provide patient education on CBD by explaining what it is and how it interacts with the body. Clarify that CBD is distinct from THC, emphasising its non-psychoactive nature and legal status.

 

Educate patients on the various methods of CBD administration. Discuss the nuances of each method, helping them make informed choices based on preferences and medical needs.

 

Provide clear and concise information on dosing guidelines. Emphasise the importance of adhering to the prescribed dosage and the potential impact of self-adjusting. Encourage patients to reach out with concerns.

 

Address common concerns and misconceptions

 

Address CBD misconceptions and concerns. Share insights on the variability of individual responses and highlight the importance of consistency in following the treatment plan.

 

Transparently discuss the safety profile of CBD while acknowledging the potential for side effects. Reinforce that while adverse reactions are rare, prompt communication is essential for tailored adjustments to the treatment plan.

 

Educate patients about potential drug interactions, emphasising the significance of disclosing all medications and supplements. This transparency ensures the formulation of a safe and effective CBD treatment plan.

 

Encourage open communication between practitioners and patients

 

Establishing trust is pivotal for a successful patient-practitioner relationship. Foster an open and supportive atmosphere where patients feel comfortable. Encourage patients to communicate regularly, especially during the initial stages of CBD treatment.

 

Equip patients with additional resources, like pamphlets, articles, or reputable websites, to facilitate self-education. This reinforces the information provided during consultations and also encourages patients to take an active role in their well-being.

 

 

Navigating legal and ethical considerations

 

Medicinal cannabis in Australia is accessible to patients through various health professionals. Doctors, specialists, and some nurse practitioners can prescribe it, but there are legal considerations for prescribing CBD.⁵

 

Prescribers can follow two main pathways: the Special Access Scheme (SAS) or as an Authorised Prescriber (AP).

 

Medical practitioners must apply for approval to prescribe a category of products via the Therapeutic Goods Administration portal. State and territory variations exist in regulations, such as THC limitations and specialist endorsements.

 

Despite misconceptions about the complexity and time-consuming nature of applications, becoming a medicinal cannabis prescriber is straightforward. With the right information and experience, you can integrate it into your toolkit and provide additional options for care.

 

Here are some useful resources for legal updates about medical cannabis:

 

 

 

Apart from legalities, medical practitioners must also navigate ethical considerations to ensure responsible and compassionate patient care.

 

  • Transparency and informed consent: It’s crucial to openly discuss potential risks, benefits, and uncertainties associated with CBD treatment to allow patients to make well-informed decisions.

 

  • Respect for patient autonomy: Respect your patient’s autonomy by including them in the decision-making process, understanding their preferences, and considering their values.

 

Ethical CBD prescribing involves maintaining confidentiality, protecting patient privacy, and promoting a therapeutic relationship built on trust.

 

The diverse applications of CBD for different patient demographics

 

CBD demonstrates diverse applications across various patient demographics, showcasing versatility in addressing a range of health concerns.

 

Let’s look at some real-life CBD cases and studies below:

 

Paediatric patients

  • Epilepsy: CBD has shown promise in reducing seizures in children with rare forms of epilepsy. Beyond paediatric cases, adults with epilepsy may also find relief from seizures through CBD treatment.

 

 

Adults

  • Chronic pain management: CBD is recognised for its analgesic properties, offering relief for individuals with chronic pain conditions like arthritis, fibromyalgia, and migraines.

 

 

 

Senior citizens

 

  • Neuroprotection: Studies suggest that CBD’s neuroprotective qualities could be relevant in managing neurodegenerative diseases like Alzheimer’s and Parkinson’s.

 

Cancer patients

 

  • Appetite stimulation: Many CBD success stories claim it helps stimulate appetite, addressing weight loss and lack of appetite associated with cancer treatments.

 

Patients with psychiatric conditions

 

 

Other applications

  • General wellness: CBD is increasingly used by holistic enthusiasts seeking overall wellness, stress reduction, and balance in their daily lives.

 

  • Skin conditions: Topical CBD products are often explored for their potential to manage skin conditions like eczema, psoriasis, and acne.

 

 

Continuous learning is key

 

Medical cannabis is growing in popularity, and CBD is at the forefront of this revolution. As a healthcare practitioner, it’s vital to adhere to CBD prescribing best practices for optimal results.

 

Thorough patient assessments, dosage considerations, and ongoing monitoring are the cornerstones of successful treatment plans. It’s also important to educate your patients about the benefits and risks of CBD, along with expected outcomes.

 

Remember to stay informed on local and national regulations as well as changes in legislation. Collaborate with other medical professionals to ensure a holistic, well-rounded approach.

 

Continuing education for medical practitioners is key. Stay updated on the latest research on CBD to promote a culture of evidence-based decision-making. Actively seek opportunities for professional development and engage with peers to share insights.

 

At PlantEd, we believe in the power of ongoing education. We offer a range of accredited courses designed by experts for registered healthcare practitioners to enhance their knowledge of medicinal cannabis.

 

Ready to embark on a nurturing learning journey? Sign up for a course today and expand your knowledge of medical cannabis. You can also join our PlantEd community and get access to events, conversations, and a rich learning hub.

 

 

References

  1. Medical Cannabis (Marijuana) and Legalities In Australia [Internet]. honahlee. [cited 2024 Feb 28]. Available from: https://honahlee.com.au/articles/medical-cannabis-legal-australia/#:~:text=of%20medical%20cannabis-

 

  1. Over-the-counter access to low dose cannabidiol. (2023, December 24). Therapeutic Goods Administration (TGA). https://www.tga.gov.au/news/media-releases/over-counter-access-low-dose-cannabidiol

 

  1. National Academies of Sciences, Engineering, and Medicine. Therapeutic Effects of Cannabis and Cannabinoids [Internet]. Nih.gov. National Academies Press (US); 2017. [cited 2024 Feb 28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425767/

 

  1. ScD KB PharmD. CBD and other medications: Proceed with caution [Internet]. Harvard Health Blog. 2021. [cited 2024 Feb 28]. Available from: https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743

 

  1. Goods T. Accessing medicinal cannabis for a patient [Internet]. Therapeutic Goods Administration (TGA). 2022. [cited 2024 Feb 28]. Available from: https://www.tga.gov.au/accessing-medicinal-cannabis-patient
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