Please reach us at reception@cannabisdoctorstasmania.com.au if you cannot find an answer to your question.
We provide a comprehensive service that includes an assessment, a discussion of suitable options, detailed education of the medication to ensure you are comfortable with how to use the medication, assistance with pharmacy matters and regular follow up to provide opportunities to adjust medications as needed. It is important to note that not all patients will gain benefit from the therapy, and as such we will provide you recommendation on when to cease your trial and what other related treatment options are available to you.
We know that new things can be confusing and overwhelming. That is why we aim to make things as easy as possible. Here are the steps from start to finish for your journey with Cannabis Doctors Tasmania.
1. MAKE AN INITIAL APPOINTMENT
You can do this directly through the links found on the our website or by clicking here or search for our clinic on the HotDoc booking platform.
You can also contact reception by phone and book in directly that way.
Once you book in you will get 3 forms to complete from HotDoc which are very easy to do on your phone or laptop. The link for these will come via SMS or email, usually within a couple of hours of the appointment having been made.
i - New patient registration form - which covers basic administrative questions as well as questions about your medications and medical history. Please be as accurate as possible.
ii - Payment preauthorisation request - HotDoc will ensure that your card details are stored securely and credit card details are not taken over the phone. Your card will not be billed until after your consultation with the doctor.
iii - Patient consent form - Because medicinal cannabis is an unregistered and experimental treatment option in Australia, we are required to obtain a signed consent form from every patient.
2. THE DOCTOR WILL CALL YOU AT THE APPOINTMENT TIME
You will be contacted either via phone or video depending on you chosen preference when you booked in.
The doctor will discuss aspects of your history, the impacts the symptoms have on your life, the endocannabinoid system and your therapy options, the process of obtaining your medication and the follow up requirements, among other things.
Ask all the questions you need at the appointment or follow up with an email in the days after your consultation if you forget anything.
3. HAVE YOUR PRESCRIPTION DISPENSED
Scripts can be filled at any pharmacy outside of Tasmania or Western Australia.
We recommend using dedicated cannabis dispensaries and we can provide a list of recommend pharmacies that you can choose from. But we are also happy to send you scripts to any pharmacy that you prefer.
Your medication will then be posted to you through a courier like StarTrack.
4. FOLLOW UP
Follow up is required a short time after starting the medication due to the experimental nature of the treatment and to ensure you are benefiting from the medication.
After the first follow up appointment, if everything is working well and you are benefiting from the treatment, the follow up period can be lengthened. In the longer term, the aim for stable benefiting patients, is for reviews to occur every 3-6 months for monitoring and prescriptions.
Yes you can! Feel free to see any of our doctors for your follow up appointments if their schedule is better suited to your availability. You will typically do better if you follow up with the same doctor, so we try to encourage that when possible, but we understand that sometimes our doctors don't have availability that suits you.
Broadly speaking, you will be eligible if you have had a chronic condition for over 3 months and 2 conventional treatments have failed to adequately manage the condition (this can include over the counter medications or allied health treatments like psychology or physiotherapy).
If you wonder whether you may benefit or whether you are eligible, get in touch with us. We love questions!
How sad for you. But nonetheless, interstate patients are more than welcome to take advantage of our services. We treat patients from all around Australia and we are happy to provide answers to any of your questions. So get in touch.
No, in most circumstances a referral is not necessary for a consultation. You can make an appointment without a referral but it can be very useful if you are able to get one. Your lovely GP will often have lots of useful little details for us about your medical history.
For patients over 18 years of age, we understand that it is not always possible to get a referral before your appointment. Our doctors will take the time to understand your medical history and a collaborative approach is used to formulate a treatment plan and we can communicate this with your regular GP and other members of your healthcare team after your consultation. However, if you do not wish for your doctor to discuss your treatment with other healthcare providers we are also happy to respect that request.
The only exception to this is with patients under 18 years of age. Anyone under 18 years of age requires at least a GP referral to be consider for treatment, and sometimes they will also need a non GP specialist referral (from a paediatrician or a neurologist etc).
Whether you called reception, or went directly to the booking website, you will inevitably end up using the HotDoc booking platform website to see our doctors.
If you use HotDoc already you can probably stop reading here.
For those who are wondering who is this 'HotDoc' and how do I get an appointment with them? HotDoc is an online booking platform for health professionals and they are great at it. They are a thoroughly trusted and convenient platform that will increase your control over your journey with us.
If your are new to our clinic or new to the HotDoc booking platform, you will possibly receive three text messages from HotDoc. These will typically come within an hour of the booking having been made. Both text messages will have a brief explanation of their purpose and a weblink to click which will open:
1. New patient registration form - which covers basic administrative questions as well as questions about your medications and medical history. Please be as accurate as possible.
2. Payment preauthorisation request - HotDoc will ensure that your card details are stored securely and credit card details are not taken over the phone. Your card will not be billed until after your consultation with the doctor.
3. Patient consent form. Because some of the medications we use are considered unregistered and experimental treatment options in Australia, we are required to obtain a signed consent form from every patient.
The entire platform provides a seamless booking, appointment and payments process for your journey with us.
Your initial consult can take between 30-45 minutes and costs $139. Follow up appointments for monitoring, support, dose titrations and for scripts are charged at $89 and typically take 15 minutes.
Payment is processed via the HotDoc booking platform after the consultation.
Unfortunately patients will not be eligible for a Medicare rebate as the rules around telehealth eligibility have changed with reducing COVID-19 restrictions.
Medication costs vary depending on the condition or conditions being treated. Medication costs can range from a couple of dollars per day up to a $20/day depending on how many medications you require and how frequently you are using them. The doctor will be able to give you an estimate on the costs of the medications at the time of prescribing them.
If you have any other questions about our fees or processes please don't hesitate to contact us. We love providing answers to your questions.
Great question! We would love to know as well. Unfortunately with reducing COVID-19 restrictions, the Commonwealth government opted to restrict Medicare/DVA funding for telehealth consultations to your regular GP practice if you have seen them face to face in the last 12 months. We don't know why they made this decision.
If you feel that you have exhausted the available treatments for your condition, it would be worthwhile talking to one of our doctors regarding a trial of natural medications to see if you might benefit. It is important to remember that some natural medicines are considered to be an experimental treatment and the evidence for its benefit for many conditions is lacking. In Australia, medicinal cannabis is an unapproved medicine and considered experimental. This is mostly due to insufficient evidence of benefits versus harms. Medicinal cannabis products are not in the Australian Register of Therapeutic Goods and has not been evaluated for quality, safety and efficacy in the Australian context.
You may find that during your trial of medication that you do not gain any benefits or that any benefits are overwhelmed by side effects. In which case your trial will be stopped and our doctor will offer you other treatment suggestions.
The following is a fantastic summary of both possible short and long term side effects from a paper published in the Australian Journal of General Practice
Cannabis is a relatively safe drug, and it is not associated with fatal overdoses. On the basis of animal lethal dosing studies, the human lethal dose of THC has been extrapolated to be >15,000 mg. This highlights that THC has a very wide safety margin, as this lethal dose is 750 times greater than a typical intoxicating dose of 20 mg. Unlike the opioids, cannabis does not cause respiratory depression because of a paucity of cannabinoid receptor expression in the brainstem.
A major issue with acute dosing of medicinal cannabis products that contain THC is intoxication. A typical intoxicating dose of THC in a person who has never used cannabis previously is approximately 10 mg, although caution is warranted as some patients may be more sensitive. When intoxicated, patients may experience euphoria and anxiolysis as well as enhanced sensory perceptions. Higher doses of THC are associated with anxiety, panic and disorientation in some individuals. Subtle cognitive deficits such as impaired attention and short-term memory impairment may be experienced. THC-containing cannabis may impair driving performance. THC in medicinal cannabis may also cause the classic ‘munchies’ effect by enhancing appetite. Dry mouth and dizziness are common side effects. Cannabis may also cause nausea and vomiting.
Cannabis may provoke a transient psychosis in some healthy participants because of its THC content, although these reactions are rare. In a study that examined emergency hospital admissions across 14 European countries over a six-month period, only seven cases of cannabis-induced psychosis were found when cannabis was the only drug used. CBD-dominant cannabis products may also contain THC, and so it is important that doctors consider the THC content in their dosing recommendations to avoid THC-related intoxication.
CBD administered as a highly purified substance is very safe and not intoxicating. Phase 1 studies demonstrate that it is well tolerated even at very high doses (up to 6000 mg). The most common side effect of CBD is diarrhoea. The main area of concern related to CBD’s safety is the potential for drug–drug interactions that might occur when CBD is administered with conventional pharmacotherapies. CBD is an inhibitor of cytochrome P450 (CYP450) enzymes such as CYP3A4 and CYP2C19, and high doses of CBD used to treat childhood epilepsies increase plasma concentrations of anticonvulsant medications, particularly clobazam, which can lead to increased sedation. Co-administration of CBD with valproate is suspected to cause an elevation of liver transaminases. CBD has also been observed to cause clinically significant pharmacokinetic interactions with warfarin, tacrolimas and methadone by magnifying the adverse effects of these medications. Accordingly, careful upwards dose titration of CBD-dominant products is best practice, especially in patients taking other medications. It is important that doctors carefully monitor patients for any side effects of their concomitant medications when commencing medicinal cannabis products.
There is a need for more safety and pharmacovigilance studies with medicinal cannabis products. Most evidence on the potential long-term adverse effects of cannabis derives from its recreational use, which may not readily apply to medicinal cannabis use. Recreational cannabis is unregulated and contains high concentrations of THC, which is exploited for the specific purpose of intoxication. However, medicinal cannabis is regulated by specific manufacturing standards and is prescribed under medical supervision using strict dosing regimens. Further, studies on the adverse effects of recreational cannabis involved smoking as the dominant route of administration, which is not recommended in a medicinal cannabis setting. Cannabis smoking also encompasses mixing cannabis flower with tobacco, which further complicates interpretation of studies on the harms of recreational cannabis. It must also be recognised that most of the evidence on the adverse effects of recreational cannabis use relies on observational, population-based studies, which may include multiple confounders and cannot unequivocally infer causation. All these limitations must be kept in mind when evaluating the existing evidence. In time there will be better evidence for any long-term health impacts of medicinal cannabis more specifically, which is likely to be safer than recreational cannabis.
An excellent evaluation of the long-term toxicity of THC comes from a placebo-controlled randomised controlled trial (RCT) in 329 patients with multiple sclerosis in which THC was administered daily to participants for three years (up to 28 mg/day). This trial concluded that THC has an acceptable safety profile with low-to-moderate toxicity and a low incidence of serious adverse events; there was no difference in the total number of adverse events in the placebo group versus the THC group. The most common adverse effects of THC when compared with placebo were dizziness and light-headedness, and dissociative thinking or perception disorders. More research is needed to address the long-term effects of CBD. Long-term adverse effects of CBD were reported in patients with childhood epilepsy receiving Epidyolex under an expanded access program for up to 144 weeks. The adverse effects were similar to those reported in shorter-term trials, with the most common adverse effects being somnolence (30%) and diarrhoea (24%).
Acute use of cannabis containing THC may impair cognitive and memory function, especially when intoxicating doses of THC are administered. However, evidence for long-term and enduring cognitive and memory dysfunction is highly contentious. A systematic review and meta-analysis of 69 cross-sectional studies in a recreational context found only a small effect size for reduced cognitive functioning in people who used cannabis frequently at high doses for an extended period. The study’s authors questioned the clinical significance of the cognitive impairments for most people who use cannabis. There was no association between cannabis use and reduced cognitive function in studies in which the participants were drug-free for >72 hours, thus suggesting any cognitive impairing effects were reversible.
Some small-scale studies have reported structural abnormalities in the brains of people who used cannabis heavily over a long period of time in a recreational setting. However, these effects were not replicated in larger studies that controlled for confounding variables (eg alcohol use, tobacco use). A high-profile article reported that long-term cannabis use commencing in adolescence reduced IQ. However, there were no reductions in IQ in those who commenced use in adulthood and had been abstinent for a year, suggesting adult use does not have any residual effects on cognitive function. Notably, the same authors more recently revised their conclusions, stating that adolescent cannabis use was not responsible for the reductions in IQ, but rather it was explained by familial factors.
In conclusion, the prescription of medicinal cannabis for adults is unlikely to have irreversible adverse effects on cognitive function. Patients should be monitored for acute impairing effects on cognition that might arise with medicinal cannabis containing THC. The effects of CBD products that do not contain THC would be of less concern, as CBD does not appear to affect cognitive function.
Repeated recreational use of street cannabis for the sole purpose of intoxication may lead to cannabis dependence. People who use cannabis recreationally may seek out professional treatment to assist with drug abstinence. Thirteen per cent of people who have used cannabis as a recreational drug will become cannabis dependent. Individuals with cannabis dependence crave the drug, lose control of their drug use and use cannabis for longer periods than intended. Individuals with dependence may also experience a cannabis withdrawal syndrome when they abstain from cannabis use, although this is mild when compared with syndromes associated with alcohol, benzodiazepines or heroin. Cannabis withdrawal promotes symptoms of insomnia, depression, anxiety and gastrointestinal disturbance that may last 48–72 hours. Overall, cannabis has mild-to-moderate addictive liability. The issue of cannabis dependence in those using it purely for medicinal purposes has yet to be adequately studied. It may be that medicinal use of cannabis, where intoxication is not the primary aim, may be less susceptible to any habit-forming effects of THC. CBD is not habit-forming.
Acute cannabis-induced psychosis has been documented but is rare. Of more concern is the link between cannabis use and schizophrenia. Human population studies suggest that there is a dose-dependent increase in the risk of developing schizophrenia in those who commence cannabis use during adolescence as a recreational drug. Some argue against the view that cannabis causes schizophrenia by citing that the rapid increase in global cannabis use in recent decades has not translated into an increased incidence of schizophrenia. Most agree that cannabis does not directly cause schizophrenia, but rather cannabis may be permissive to schizophrenia in individuals who are already vulnerable.
It must be emphasised that the vast majority of people who use cannabis will never develop a psychotic disorder. It has been estimated that 4700 young people would need to be dissuaded from cannabis use to prevent a single case of schizophrenia. In any case, doctors should not prescribe medicinal cannabis with THC content to patients who have a known sensitivity to cannabis or to those who have a personal or family history of schizophrenia or psychotic disorders. Interestingly, purified CBD has antipsychotic properties in humans.
There are rare case reports of long-term, heavy recreational cannabis use promoting severe nausea and vomiting, which is known as the cannabis hyperemesis syndrome. The syndrome is associated with compulsive bathing behaviour and resolves on cessation of cannabis use. Cannabis hyperemesis syndrome appears to be mediated by THC, and there is no evidence of CBD causing the syndrome. There have been no reports of cannabis hyperemesis occurring in patients taking medicinal cannabis, which may be due to lower doses of THC being prescribed.
There is currently over 800 natural medicine products available in Australia and Tasmania. We do not have any financial relationships with medication producers, nor are we trying to push our own range of cannabis medications. This means that every single medication available will be considered when formulating a treatment plan for you, without any financial incentives influencing our prescribing decisions.
In Tasmania, for a pharmacy to be able fill a cannabis prescription they require the prescribing doctor to obtain a Commonwealth approval and State authorisation. Additionally, the prescriber needs to be present and practising in Tasmania when issuing the prescription for Schedule 8 products. In Victoria, in the majority of cases, only a commonwealth approval is required. Due to these differences in legislation it made more sense to base the clinic in Melbourne. This way the clinic doesn't have to close down every time Dr Tom travels interstate. In the future we are hopeful that enough patients value and benefit from this service that we can open a physical site in Tasmania with another doctor to enable us to cover interstate leave. Or hopefully the legislation changes.
The other issue in Tasmania is we lack a dedicated pharmacy/dispensary. These are available interstate and they offer a wealth of knowledge and expertise to assist patients to get the most out of their medication. For the time being, it is safer and more practical to run our services utilising interstate options. But hopefully in the not too distant future things will change!
If your medication only contains CBD (and has no THC) you can drive in any State or Territory in Australia.
If your medication contains any amount of THC it is recommended that you do not drive. In Australia, driving with a detectable level of THC may lead to fines, convictions or loss of licence.
Patient interested in changing these laws should visit Drive Change
Yes. In Australia you are free to travel with your prescribed medications and to use them as prescribed anywhere in Australia. We suggest keeping your medications in the original packaging that it comes in from the chemist, and to ensure that the pharmacy label is clearly visible on the packaging still.
No. Do not under any circumstance take your medication overseas. You will be subject to the laws and customs of the country you fly to and the vast majority of countries have significant consequences for importing medications into their country. Your medication is only legal to use in Australia.
We understand that sometimes things come up unexpectedly. Therefore you can cancel up to 1 hour before your appointment via HotDoc or just call reception to let us know you won't be able to make it.
If you are not contactable during your appointment time, and you have not cancelled your appointment, your will be charged the full fee of either $139 for an initial consult or $89 for a follow up consultation.
You will then be free to book another appointment which will also attract the normal consultation fee.
If you are not contactable during your appointment time, and you have not cancelled your appointment, you will be charged the full fee of either $139 for an initial consult or $89 for a follow up consultation. Our doctors will try at least 3 separate times to call you during your appointment time and will leave messages where possible.
You can cancel your appointment via HotDocs or you can call us. If we don't answer the phone just leave a voice message advising us of your cancellation.
You will then be free to book another appointment which will attract the normal consultation fee.
Patients have questions, we have answers. We will display the most frequently asked questions, so everybody benefits.
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