Information for Doctors

Various elements of the Cannabis plant may interact with prescribed, licensed medications. If you want EMIS web to highlight these interactions to you, add Sativex to your patient’s medication list. Sativex is a combination of cannabidiol and dronabinol. The former is available as a food supplement without a prescription, so when considering contraceptives, always consider these potential interactions and ask if your patient takes either of these. If your patient is taking OTC CBD then consider adding Epidyolex to their prescription list to get interaction alerts.

Some patients will start with an oil and some will start with vaped flos. If they go straight in with an oral/sublingual treatment, this is akin to treating pain with modified release morphine and then adding immediate release oral morphine for breakthrough at a later date. If they start with vaped flos, it will treat the acute element and give an indication of how much oil they are likely to need.

The Medical Cannabis Clinicians Society is a good source of information if you want to learn more.

Overdose is almost impossible as the LD50 for THC is around 500-600mg/kg, although inadvertent overconsumption is likely to result in nausea, tachycardia and hypotension. Toxbase has useful information if you see patients in the Emergency Department. Unheated flower will contain the acids of CBD and THC in their carboxylated state which have no psychoactive effects, hence unheated, ingested flos is unlikely to cause any adverse symptoms. If somebody has symptoms of stroke it is important to decide if they’re having a stroke or they have symptoms from cannabis which will wear off as they clear the cannabis from their blood. The former requires immediate active treatment and the latter can be managed conservatively.

More information about cannabis products can be found on the producer websites: Bedrocan, Spectrum Therapeutics, Breath of Life and Althea. Althea operate the concierge system for doctors who want to know more, but they seem to have a bias towards oil based products.

DVS have rescinded their previously issued advice and defer to DVLA guidance which is available online.