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[5 min read] Management of cannabidiol (CBD) in primary care

Curious about Medicinal Cannabis?

Cannabidiol (CBD) is one of the two dominant cannabinoids in the cannabis species. Since its discovery in 1940 CBD has been subject to investigation for its potential to treat a wide range of symptoms and diseases. Unlike its counterpart THC, CBD lacks intoxicating effects which allows for a broader capacity to prescribe in varied patient demographics.

CBD does not interact with the endocannabinoid system (ECS) in the same fashion as other cannabinoids. Its influence on cannabinoid receptor 1 is established yet many of its therapeutic effects may potentially occur via different mechanisms. CBD is also thought to induce possible therapeutic effects by modulating ion channels, neurotransmitters and a number of other processes in the immune and central nervous systems.

Safety of CBD

Numerous clinical trials from around the world have assessed the safety of CBD at varying doses in a range of settings and diseases. While some mild side effects have been routinely reported, CBD has largely been shown to be a safe compound. In 2018 the World Health Organisation’s Expert Committee on Drug Dependence (ECDD) released a critical review on the safety and efficacy of CBD. This was the first time a cannabis-derived substance has been reassessed in this manner since it was restricted under the 1961 Single Convention on Narcotic Drugs.

“The Committee recommended that a footnote be added to Schedule 1 of the 1961 Single Convention on Narcotic Drugs to read: ‘Preparations containing predominantly cannabidiol and not more than 0.2% of delta-9-tetrahydrocannabinol are not under international control.’”
– Excerpt from Expert Committee on Drug Dependence recommendations

Simply put, this review showed CBD is widely well tolerated with a good safety profile and significant potential therapeutic benefits across a number of indications. Its tendency to few and mild side effects was also noted by the committee.

Low-dose CBD given the greenlight for over-the-counter sales

The good safety profile of CBD is one of the key reasons why the Australian Department of Health’s Therapeutic Goods Administration made the final decision to legalise low dose CBD formulations to be sold as an over-the-counter (OTC) medicine in Australian pharmacies, technically from February 2021.

What does down-scheduling of CBD mean in practice?

The decision by the TGA to down-schedule CBD from a Schedule 4 (S4) to a Schedule 3 (S3) drug opens the door for the sale of registered CBD products (with 2% or less other cannabinoids, but only <1% THC) to adults in packets containing up to 4,500mg of CBD, amounting to 30 days supply of the recommended maximum daily dose of 150mg.

In order for a product to be available for sale over-the-counter in Australian pharmacies, medicinal cannabis product companies need first to apply for ARTG registration for these S3 products, which can be lengthy. The products need to be demonstrated to be safe, of pharmaceutical grade quality manufactured in a GMP facility, and effective.

It’s therefore important for consumers to understand that most S3 products may not be available for sale in Australian pharmacies until 2022.

There’s more to this article

Read the full blog over on the HealthCert Community at this post. If you aren’t already a member, we invite you to join for free!

What’s covered:

  • What it can be used as a treatment for
  • What product is on the Australian Pharmaceutical Benefits Scheme
  • Dosage
  • Interactions and side effects
  • Future investigations
  • Research

Learn more about medicinal cannabis in primary care with HealthCert’s NEW online Professional Diploma of Medicinal Cannabis program.

This article has been provided by our partner, Southern Cannabis Holdings. Southern Cannabis Holdings builds, integrates and operates high-value brands across the cannabis value chain, including FreshLeaf AnalyticsCannabis Access Clinics and Applied Cannabis Research. HealthCert and Southern Cross Holdings have partnered up to bridge gaps in patient and clinician knowledge on medicinal cannabis.


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