These people face excruciating pain daily, but medicinal cannabis makes life bearable

By national medical reporter Sophie Scott and the Specialist Reporting Team's Mary Lloyd

Christian Read has taken everything from period pain pills to heavy opioid-based medication to manage the severe pain he suffers from multiple sclerosis (MS).

"I have actually sat there and watched as my foot completely deformed in shape," he said.

Mr Read has pain "quite literally from head to toe".

As well as spasms that contort different parts of his body, he experiences vision problems when his optic nerve swells, he is constantly battling exhaustion and is forced to deal with the side effects of being on the "opioid treadmill".

"When you are dealing with chronic pain, when it's every day for years and it's not going to get better, you begin to develop particularly dark and unpleasant moods," he said.

After years of unrelenting pain, Mr Read approached a local GP about possible treatment with medicinal cannabis and was offered a low dose.

He said "within a week" he realised it was making a difference.

"It's been remarkable how quickly it transformed my day-to-day living," Mr Read said.

For patients like Mr Read, accessing alternatives such as medicinal cannabis had been difficult until the Federal Government relaxed restrictions in March 2018.

New data obtained by the ABC revealed just how popular the controversial treatment had become, with more than 3,100 medicinal cannabis scripts approved by the Therapeutic Goods Administration (TGA) from March to January 2019.

Those patients had a range of conditions, including nerve pain, anorexia, chemotherapy-induced nausea and vomiting and palliative care.

Health authorities said, so far, no requests had been rejected.

Mr Read said he was not totally off his traditional medication, but instead of a daily dose he was now more likely to be reaching for them once a month.

He said the medicinal cannabis had helped him "reset to normal".

"My body itself stops becoming a locus of malfunction and I feel like I did before the symptoms became particularly damaging and painful," Mr Read said.

"It helps my brain deal with the pain as it exists, rather than treatment for the pain itself."

One notable difference he said, was sleep.

"The effect on my quality of life is not to be underestimated," Mr Read said.

"I sleep better, I manage my pain symptoms more easily [and] I have more energy because of that. I have a more positive outlook."

'From the very first night, I was nervous'

Beth McDougall had never touched pot in her life.

But when the 56-year-old was diagnosed with advanced lung cancer, she experienced excruciating pain in her chest, so her oncologist wrote her a prescription for medicinal cannabis oil.

"From the very first night, I was nervous. I thought 'what's this going to be like?'" Ms McDougall said.

"I have never used cannabis [or] smoked drugs in my life, so I had no idea what the reaction would be.

"Within 15 minutes, I just fell asleep."

Before using cannabis oil, Ms McDougall was waking every two hours to take strong painkillers such as oxycodone.

She now says she can sleep for up to six hours if she adds cannabis oil to her cocktail of medications.

"If you have a good sleep and you are not in pain, you will meet friends for lunch, or take the dog for a walk, or go for a swim, but if you are tired and cranky, you will say 'not today'," she said.

"It hasn't been this 'wow' miracle cure. It's just made my life better."

Dr Judith Lacey, from the Chris O'Brien Lifehouse, prescribed very low doses of medicinal cannabis to many of her cancer patients.

"I think the perception is that people would be feeling stoned and that their life with cancer would be walking around in a haze, but actually people are functioning very highly and feeling better control of their symptoms," she said.

Sydney GP Dr Teresa Towpik was initially sceptical about the usefulness of medicinal cannabis.

"I was quite ignorant and arrogant as well. I saw it as a drug of addiction, a gateway drug," she said.

But since researching the benefits and prescribing it to her chronic pain patients, she has become an advocate.

"At least half of my patients have been able to reduce their pain medication or some of them even stop it," she said.

How do patients gain access?

GPs can apply to the TGA for approval for a script for individual patients or apply to become an authorised prescriber.

So far, there are 54 authorised prescribers such as GPs and oncologists across Australia.

Patients get a script from the doctor, which has to be approved by the TGA.

The patient takes it to a pharmacy, which orders the drug directly from the cannabis supplier.

Once the medicinal cannabis arrives at the chemist, the patient can pick it up.

Beth said she didn't feel high or tired when she used it.

"You don't feel anything. It just reduces the pain so I can get to sleep," she said.

Dr Towpik said none of her patients had asked to increase the dose of medicinal cannabis they were taking.

"They are not asking for more, or exhibiting any drug-seeking behaviour," she said.

Mr Read said he still felt embarrassment and concern about a stigma that this was a "low drug for hippies".

"This is not a doctor handing you a joint in the back of a Combi," he said.

"This is an effective drug, an effective medicine. Destigmatising it is important."

Advice from experts is to try other drugs first

Director of the Australian Centre for Cannabinoid Clinical and Research Excellence Professor Jennifer Martin said when it came to the scientific evidence behind medicinal cannabis, the picture was mixed.

"The evidence of non-cancer pain is actually not that strong. There was a big review in the US a few years ago which suggested there would be some benefit for some patients," she said.

"But when the Australian team updated the information, they found we would have to treat 24 patients with this particular cannabinoid for one of them to get a reduction in their pain symptoms.

"Certainly some people that have taken cannabinoids do say they have had a lot of benefit, but we have also seen older patients who have had side effects."

She said it was better for patients to use drugs that had been registered by the TGA first, before trialling medicinal cannabis.

Professor Martin said the scientific evidence of benefits was stronger for treating conditions such as kids with epilepsy who had not responded to medication.

Not a miracle cure, but a way to 'engage in the world'

For patients like Mr Read and Ms McDougall, adding medicinal cannabis to their regime has improved their lives.

"It has been beneficial to my work because I'm not taking a huge amount of opioid medicine ... I just feel better, I feel more effective, I write more, I write more easily," Mr Read said.

"The actual drug itself hasn't miraculously granted me health ... it just granted me the ability to engage in the world in a pain-free manner."

Ms McDougall said medicinal cannabis had given her some quality of life as she deals with advanced cancer.

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