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Doctors Warn of Rising Psychosis Linked to Medicinal Cannabis Prescriptions

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Doctors Warn of Rising Psychosis Linked to Medicinal Cannabis Prescriptions

 

Medical experts are raising alarms over a significant increase in hospital admissions due to psychosis linked to medicinal cannabis. This concern comes as “single-issue” cannabis clinics proliferate across Australia, often prescribing the drug via telehealth consultations with minimal oversight.

Brett Emmerson, Queensland chair of the Royal Australian and New Zealand College of Psychiatrists (RANZCP), is calling for stricter regulations on medicinal cannabis products and prescribing practices. “We’re seeing many individuals experiencing their first psychotic episode after being prescribed medicinal cannabis, or those with pre-existing psychotic conditions relapsing,” Emmerson stated.

Emmerson criticised the practices of some cannabis clinics. “These single-issue clinics prescribe cannabis with little to no checks. They often do not communicate with the patient’s primary doctor, leaving other healthcare providers in the dark about their patients’ use of medicinal cannabis.”

Internet Prescriptions and Rising Psychosis Cases

Emmerson highlighted a troubling trend in Queensland’s Metro North Health, the country’s largest public health service. “The Metro North early psychosis service reports that 10% of new cases involve young people aged 16 to 21 who have become psychotic after using medicinal cannabis,” he said. “Medicinal cannabis is causing harm due to its unregulated nature and its widespread use for conditions without sufficient evidence.”

Cannabis Hyperemesis Syndrome

Jennifer Martin, a general physician and clinical pharmacologist based in Newcastle, echoed Emmerson’s concerns. She noted that emergency departments are also seeing cases of cannabis hyperemesis syndrome, a condition where patients experience severe vomiting due to high-potency cannabis. “Some medicinal cannabis products contain significant levels of psychoactive components, leading to adverse effects,” Martin explained. She also highlighted the difficulty in accessing the prescribing doctors, as many prescriptions are done online through telehealth.

Medicinal Cannabis Usage and Regulation

Medicinal cannabis was legalised in Australia in 2016. Some products are based on cannabidiol (CBD), while others contain tetrahydrocannabinol (THC), the psychoactive ingredient in cannabis. Emmerson noted that anxiety and insomnia are the most common reasons for prescribing medicinal cannabis, but he stressed that cognitive behavioural therapy is a more appropriate first-line treatment for these conditions. “Relying on a drug of dependence when non-drug treatments are available is not the right approach,” he said.

Emmerson compared medicinal cannabis companies to alcohol and tobacco retailers, suggesting they profit from dependency. However, he acknowledged the legitimate uses of medicinal cannabis for conditions such as severe childhood epilepsy and chemotherapy-induced nausea.

Calls for Regulation

In March, the RANZCP released a clinical memorandum calling for regulatory changes around medicinal cannabis. “There is insufficient evidence to support medicinal cannabis as a treatment for anxiety and other mental disorders,” the memorandum stated. The RANZCP is particularly concerned about the high rates of cannabis prescribing for anxiety, which may prevent patients from receiving evidence-based treatments.

Emmerson advocates for making medicinal cannabis a regulated medication like other drugs of dependence in Australia. He also believes the Therapeutic Goods Administration (TGA) should ban THC-containing products, except for those used to treat specific conditions like cancer-related nausea and multiple sclerosis spasticity.

Regulatory Responses and Statistics

In February, the Australian Health Practitioner Regulation Agency (AHPRA) held a forum to discuss the safe prescribing and dispensing of medicinal cannabis. According to a communique from the forum, the use of unregistered medicinal cannabis products has skyrocketed, with over one million patients using these products by January 2024, up from around 18,000 in 2019.

Currently, only two medicinal cannabis products have been evaluated for safety, quality, and efficacy by the TGA: Epidyolex for severe childhood epilepsy and Sativex for multiple sclerosis spasticity. Data from the TGA shows an increase in the variety of medicinal cannabis products supplied in Australia, rising from 504 in 2022 to 690 in 2023.

Despite the rise in usage, the TGA was unable to provide comprehensive dispensing data for medicinal cannabis products. “The TGA is not aware of a single source that can provide complete and accurate dispensing data on medicinal cannabis products,” the agency noted.

Conclusion

As the debate over medicinal cannabis continues, medical professionals are urging for stronger regulations to ensure the safety and well-being of patients. By addressing the current gaps in oversight and ensuring evidence-based prescribing practices, Australia can better navigate the complexities of medicinal cannabis use.

 

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Northern Rivers health workers up for awards

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Northern Rivers health workers up for awards

By Tim Howard

Staff from Northern NSW Local Health District have been named as finalists for the 2024 NSW Health Awards for their extraordinary efforts to improve the NSW public health system.

Now in its 26th year, the awards acknowledge the personalised, sustainable, and digitally enabled programs that contribute to the wellbeing of patients and the community.

The Rheumatic Heart Disease Project and the Rural Paediatric Complex Care Coordination Project are among 42 finalists from across the state competing for the Excellence in Aboriginal Healthcare Award and Health Innovation Award, respectively.

The Rheumatic Heart Disease Project  aims to address the significant public health issue of Acute Rheumatic Fever (ARF) and RHD among Aboriginal communities in Northern NSW.

The project was led by Aboriginal Health Nurse Manager Emma-Jane Davies and supported by Robin Auld, Sally Adams and Daniel Ashton, with valuable advice and advocacy from Aboriginal Medical Service partners, in particular Scott Monaghan from Bulgarr Ngaru Medical Aboriginal Corporation.

The Rural Paediatric Complex Care Coordination Project improves care coordination for regional NSW children, reduces family costs and disruptions, and improves outcomes for families in regional NSW.

This is a joint project with Northern NSW, Murrumbidgee, Southern NSW and Western NSW local health districts, together with the Sydney Children’s Hospitals Network.

Rheumatic Heart Disease Project team members, from left, Tracy Bradshaw (Aboriginal Health Worker, Chronic Care for Aboriginal People), Sasha Harrington (Aboriginal Health Engagement and Governance Manage), Daniel Ashton (Aboriginal Health Performance and Project Analyst), Emma-Jane Davies (Nurse Manager Aboriginal Health) and Kirsty Glanville (executive director Aboriginal Health, NNSWLHD).

Northern NSW Local Health District also partnered with Justice Health, the Forensic Mental Health Network, NSW Health Pathology and NSW Health in the NSW Dried Blood Spot Validation Study that has been named a finalist in the Health Innovation Award.

This project is the first of its kind, and aims to make dried blood spot testing a standard diagnostic tool and, if successful, will change how testing is offered for people at risk of hepatitis C.

NNSWLHD chief executive Tracey Maisey praised the achievements of local finalists who have been recognised for their passion and commitment.

“I am thrilled to congratulate our NNSWLHD staff on having their outstanding contributions to our health system recognised,” Ms Maisey said.

NSW Health secretary Susan Pearce AM said it is really exciting to celebrate the people and teams who are enriching health in millions of ways every day.

“These awards are a chance to recognise our incredible healthcare staff and volunteers, across the public health system,” Ms Pearce said.

“I congratulate the finalists, but I also want to acknowledge the work being done across the system every day, by our teams of doctors, nurses, midwives, allied health and support staff.”

NSW Health received 186 nominations across the 12 award categories.

The finalists and winners will be celebrated at the NSW Health Awards ceremony, which will be held on Thursday, October 24 at the International Convention Centre in Sydney.

It will also be livestreamed from 6pm.

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Forty per cent of women from Northern NSW overdue for breast screening

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Forty per cent of women from Northern NSW overdue for breast screening

By Ian Rogers

This Breast Cancer Awareness Month, women aged 50-74 in the Northern NSW Local Health District are being encouraged to schedule a free mammogram, as over 40% (44.7%) of women in the region are overdue for their biannual breast cancer screening.

Patrick Magee, Acting Director of BreastScreen NSW’s North Coast Screening and Assessment Service, emphasized that with around 300 local women expected to be diagnosed with breast cancer this year, now is the time to book a free, potentially life-saving breast screen.

“For women aged 50-74, a breast screen every two years is still the best way to detect breast cancer early – before it can be seen or felt,” Mr Magee said.

“If you’re aged 50 – 74, make breast screening a priority. It only takes 20 minutes and no doctor’s referral is needed.”

This Breast Cancer Awareness Month, BreastScreen NSW is urging women to “Be A Friend, Tell A Friend” about the importance of regular mammograms. The campaign encourages women to spread the word through conversation and social media, reminding friends, family, and colleagues to prioritize breast cancer screenings.

Professor Tracey O’Brien AM, NSW Chief Cancer Officer and CEO of the Cancer Institute NSW, highlighted that early detection is key: when breast cancer is found in its earliest stages, the five-year survival rate is 98 percent. However, this drops to 43.9 percent when the cancer has spread to other organs.

“More than 6500 women in NSW are expected to receive a breast cancer diagnosis this year, and 1,000 women are expected to lose their lives to the disease in 2024, so we need to do everything we can to support women and encourage them to book in a life-saving breast screen,” Professor O’Brien said.

“Early detection not only significantly increases a person’s chance of survival it can also greatly reduce the need for invasive treatment like a mastectomy.

“I know how hard it can be to block out time for yourself. Unfortunately, breast cancer doesn’t wait, so I encourage all eligible women to stop and put themselves first – for themselves and their family.”

Breast cancer is the most common cancer among women, with age and gender being the biggest risk factors—family history is not the primary concern.

Women aged 50-74 are advised to have a breast screen every two years. BreastScreen NSW also recommends that Aboriginal women begin screening at 40, as research indicates they are more likely to be diagnosed at a younger age, with more advanced cancer at diagnosis and poorer survival rates compared to the general female population.

Any woman who notices changes in her breasts, such as a lump, should consult her doctor immediately.

For more information and to make an appointment at a local BreastScreen NSW clinic or mobile van, call 13 20 50 or book online at www.breastscreen.nsw.gov.au.

For more information about the Be A Friend Tell A Friend promotion visit here.

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Breast Cancer Awareness Month

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Breast Cancer Awareness Month

The Honorable Aileen MacDonald has reminded the public that October is Breast Cancer Awareness Month.

Ms. MacDonald emphasised the importance of supporting the National Breast Cancer Foundation during this time, as breast cancer remains the second most commonly diagnosed cancer in Australia, claiming the lives of nine people each day.

“The aim of Breast Cancer Awareness Month is to shine a light on the devastating impact breast cancer has on thousands of Australians each day,” Ms MacDonald said.

“The statistics are alarming. Every year more than 21,000 people in Australia, including around 200 men, will be diagnosed with breast cancer,” she said.

“It saddens me that every year more than 3,300 people in Australia, including 33 men, will die from breast cancer.”

Ms. MacDonald encouraged everyone to undergo screenings, as early detection significantly improves the chances of successful treatment for breast cancer confined to the breast.

“If you experience any symptoms such as lumps, dimples, discharge or discolouration, head to your doctor for further examination,” she said.

For further information Ms MacDonald said visit the National Breast Cancer Foundation website.

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