Introduction to Medicinal Cannabis: A Practical Guide for Health Professionals and Patients

By Dr Teresa Towpik

This book is designed to be a comprehensive introduction to medicinal cannabis for health professionals as well as patients wanting to discover the therapeutical benefits of the cannabis plant.

With this book you'll learn:

• Dr Towpik's personal experience in prescribing medicinal cannabis
• Cannabis

• Language: English
• Publisher: Medihuanna Pty Ltd
• Release date: Nov 1, 2020
• ISBN: 9780646832692

Dr Teresa Towpik

Dr Teresa Towpik is a cannabis clinician in Australia since October 2018. Before that, she was a GP since 1993, originally from Poland, where she studied medicine from 1978 to 1984. As a conventional doctor she used to practise evidence-based medicine and followed the guidelines diligently. At the same time, she has always felt there is much more to healing than simply prescribing pills. As well as wanting to go deeper into why we get sick in first place, she felt a need to learn more about plants and herbs and practise more holistically. She researched and learnt about various methods. He motto is that that healing can occur on multiple levels: physical, emotional, mental and spiritual. She believes the healing process is personal and unique for each person. As a traditional GP, she used to hold biased and limited views regarding cannabis. She felt it was illegal for valid reasons, being highly addictive, harmful and a gateway to heavier drugs such as heroin. She had not been aware of therapeutic properties of cannabis until January 2016 when she heard that the nation's laws were going to be amended legalising it for medicinal use. This news came as a revelation to her. She felt perhaps it could be the answer to her hopes of introducing a more holistic and natural approach to her practice. As she began researching cannabis, she quickly realised how mistaken she had been in her attitude, which had lacked any base of knowledge and understanding. While studying the plant and its history, she heard people talking about their experiences with medicinal cannabis and was touched and inspired by their stories. Perhaps the most amazing were the stories of children suffering from intractable epilepsy, who were going through 50-100 seizures per day. They were not responding to conventional drugs and they were experiencing many adverse effects. For many of them cannabis brought life-changing improvements. She decided to get actively involved in promoting cannabis treatments and educating the general public - and to hopefully interest other GPs who may be sceptical and dismissive of it, as she once was. In researching cannabis and its therapeutic properties, her initial learning experience was chaotic and frustrating. She struggled with so much information online and was searching for more structured education for busy doctors. With that in mind she funded MediHuanna in October 2016. MediHuanna is devoted to educating health professionals about the science of medicinal cannabis and equipping them with the practical skills necessary to treat and prescribe for patients who would benefit from its use. MediHuanna's online and face-to-face courses have received accreditation from the Royal College of General Practitioners (RACGP), the professional body of GPs responsible for maintaining the standards of GP education. She has been prescribing cannabis since March 2018 and feels extremely privileged to witness many life-changing experiences among her patients. Being able to guide them and see them getting better has been very rewarding. She is now actively involved in educating and mentoring fellow doctors, hoping to inspire them to learn about the remarkable properties of this plant and to embrace it as an important therapeutic agent that will widen and enhance their treatment options.

Book preview

Copyright © 2019 by Medihuanna PTY LTD Second Edition

Published by Medihuanna

Introduction to Medicinal Cannabis: A Practical Guide for Health Professionals & Patients

Written by Dr Teresa Towpik

Design by Mariusz Krzeszewski

Printed by Medihuanna

All rights reserved. Without limiting the rights under copyright reserved above, no part of this publica-tion may be reproduced, stored in or introduced into a database and retrieval system or transmitted in any form or any means (electronic, mechanical, photocopying, recording or otherwise) without the prior written permission of both the owner of copyright and above publisher.

For permissions contact:

Email: [e-mail]

URL: www.medihuanna.com

ISBN 978-0-646-80227-5

ISBN 978-0-646-83269-2 (e-book)

Table of Contents

Acknowledgements

Preface

My personal experience in prescribing cannabis in Australia

Section 1 | The Basics

The History of Cannabis

The Cannabis Plant

Endocannabinoid System (ECS)

Cannabinoid Receptors

Endogenous Cannabinoids

Key and Lock Analogy

Allosteric and Orthosteric receptor binding site

The Endocannabinoid System in Action

Section 2 | Pharmacology

Delta 9-Tetrahydrocannabinol (THC)

Cannabidiol (CBD)

Other Cannabinoids

Terpenes and Flavonoids

Cannabinoid Deficiency Syndromes

Cannabis Pharmacology

Whole Plant Medicine & The Entourage Effect

Section 3 | Clinical Applications

Chronic Pain

Drug Addictions and Opioid Epidemic

Cancer

Chemotherapy Induced Nausea and Vomiting

Palliative Care

Epilepsy

Multiple Sclerosis

Neurodegenerative Diseases

Diabetes

Inflammatory Disorders

Anxiety, Depression & Schizophrenia

PTSD

Osteoporosis

Antibacterial & Antioxidant

Section 4 | Safety Considerations

Acute Toxicity and Safety Ratio of Cannabis

Acute Lethal Toxicity - Psychoactive Substances

Physical Dependence

Drug Induced & Causes of Death in Australia 2012

Short-term and Long-term effects of cannabis

Potential Drug Interactions

Contraindications and Precautions

Section 5 | Patient Care

Determining Suitability for Cannabis Treatment

Treatment Considerations

Biphasic Effect

Bi-directional effect of cannabis

Balanced Cannabinoid Ratios

Pharmacokinetic Considerations

Chemovar Considerations

Patient Centred Considerations

Dosing & Titration

Section 6 | Delivery Methods

Delivery methods

Inhalation Methods

Oral Methods

Topical Methods

Rectal Methods

Vaginal method

Cannabis Juicing

Conclusion

References

"

Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care.

Francis Young

US Drug Enforcement Administration Chief Administrative Law Judge – 1988

Acknowledgements

I would like to acknowledge the key people who played criti-cal roles in the production of this book. Thank you to Mariusz Krzeszewski, Pavel Bulkiewicz, Luka Bankovic as well as Warwick Stanley for their help with editing and attention to detail.

I would also like to acknowledge all of the people who kindly agreed to read this book and provided me with constructive and valuable feedback.

Preface

Welcome to the second edition of Introduction to Medicinal Cannabis.

It has been quite the journey since the first edition in December 2017.

As my learning process continues and my fascination with the cannabis plant grows, I am witness to the many gifts it has to offer to my patients.

To my new readers, I will introduce myself as a GP who studied medicine in Poland, my country of birth, before beginning my career in Australia in 1993.

As a conventional doctor I have practised evidence-based medicine and followed the guidelines diligently. I still do.

At the same time, I’ve always felt there is much more to healing than simply prescribing pills. As well as wanting to go deeper into why we get sick in first place, I felt a need to learn more about plants and herbs and practise more holistically.

I researched and learnt about various methods. My experience with breast cancer in 2001 showed me that healing can occur on multiple levels: physical, emotional, mental and spiritual. I believe the healing process is personal and unique for each person.

As a traditional GP, I held biased and limited views regarding cannabis. I felt it was illegal for valid reasons, being highly addictive, harmful and a gateway to heavier drugs such as heroin.

I had not been aware of therapeutic properties of cannabis until January 2016 when I heard that the nation’s laws were going to be amended legalising it for medicinal use.

This news came as a revelation to me. I felt perhaps it could be the answer to my hopes of introducing a more holistic and natural approach to my practice.

As I began researching cannabis, I quickly realised how mistaken I had been in my attitude, which had lacked any base of knowledge and understanding.

While studying the plant and its history, I heard people talking about their experiences with medicinal cannabis and was touched and inspired by their stories.

Perhaps the most amazing were the stories of children suffering from intractable epilepsy, who were going through 50-100 seizures per day. They were not responding to conventional drugs and they were experiencing many adverse effects. For many of them cannabis brought life-changing improvements.

I decided to get actively involved in promoting cannabis treatments and educating the general public – and to hopefully interest other GPs who may be sceptical and dismissive of it, as I once was.

In researching cannabis and its therapeutic properties, my initial learning experience was chaotic and frustrating. I struggled with so much information online and was searching for more structured education for busy doctors. With that in mind I funded MediHuanna in October 2016.

MediHuanna is devoted to educating health professionals about the science of medicinal cannabis and equipping them with the practical skills necessary to treat and prescribe for patients who would benefit from its use.

Our online and face-to-face courses have received accreditation from the Royal College of General Practitioners (RACGP), the professional body of GPs responsible for maintaining the standards of GP education.

I have been prescribing cannabis since March 2018. I feel extremely privileged to witness many life-changing experiences among my patients. Being able to guide them and see them getting better is very rewarding.

To those who had not yet read or heard of this book’s first edi-tion, this its extended version, adding testimonials from grateful patients and including full referencing of the book’s information.

In this edition, I share some of my clinical experience in using medicinal cannabis in general practice. I have also added chapters on patient care, dosing, management and monitoring.

It is a comprehensive, practical introduction to cannabis medi-cine for health professionals and could also be useful for patients wanting to learn about it.

I hope to inspire my fellow doctors to learn about the remarkable properties of this plant and to embrace it as an important therapeutic agent that will widen their treatment options.

My personal experience in prescribing cannabis in Australia

Cannabis was legalised in Australia for medicinal use in January 2016 but at that time