Amidst growing global acceptance of medicinal cannabinoids as a potential therapeutic interest in cannabidiol (CBD) is increasing. In Australia in 2020, a government inquiry examined the barriers that the public are experiencing in accessing medicinal cannabis. A number of recommendations to improve access were made. In response to these recommendations, the Australian therapeutics regulatory authority down-scheduled CBD from Prescription Only (Schedule 4) to Pharmacist Only (Schedule 3). As a group of early to mid-career researchers of the Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), we propose some considerations in relation to over-the-counter availability of CBD and opportunities to improve knowledge about its potential therapeutic benefits alongside its increased uptake.
AnDPeigneurSHendrickxLA, et al. (2020) Targeting cannabinoid receptors: Current status and prospects of natural products. Int J Mol Sci21: 5064.
3.
AtakanZ (2012) Cannabis, a complex plant: Different compounds and different effects on individuals. Ther Adv Psychopharmacol2: 241–254.
4.
BahjiAMeyyappanACHawkenER (2019) Cannabinoids for the neuropsychiatric symptoms of dementia: A systematic review and meta-analysis. Can J Psychiatry65: 365–376.
5.
BalachandranPElsohlyMHillKP (2021) Cannabidiol interactions with medications, illicit substances, and alcohol: A comprehensive review. J Gen Intern Med. Epub ahead of print 29 January 2021. DOI: 10.1007/s11606-020-06504-8.
6.
BergmannKRBroekhuizenKGroeneveldGJ (2020) Clinical trial simulations of the interaction between cannabidiol and clobazam and effect on drop-seizure frequency. Br J Clin Pharmacol86: 380–385.
7.
CasiraghiAMusazziUMCentinG, et al. (2020) Topical administration of cannabidiol: Influence of vehicle-related aspects on skin permeation process. Pharmaceuticals (Basel)13: 337.
8.
CharernboonTLerthattasilpTSupasitthumrongT (2021) Effectiveness of cannabinoids for treatment of dementia: A systematic review of randomized controlled trials. Clin Gerontol44: 16–24.
9.
CharlesLReynoldsTCameronM, et al. (2015) Using social media for actionable disease surveillance and outbreak management: A systematic literature review. PLoS One10: e0139701.
10.
ChenK-AFarrarMCardamoneM, et al. (2018) Cannabidiol for treating drug-resistant epilepsy in children: The New South Wales experience. Med J Aust209: 217–221.
11.
ChesneyEOliverDGreenA, et al. (2020) Adverse effects of cannabidiol: A systematic review and meta-analysis of randomized clinical trials. Neuropsychopharmacology45: 1799–1806.
12.
Commonwealth of Australia (2020) Current barriers to patient access to medicinal cannabis in Australia. In: TSCAR Committee (ed.) Senate Printing Unit. Canberra: Parliament House.
13.
CPASS (2021) Cannabis patient advocacy & support service: Collaboration. Advocacy. Research. Education. Available at: http://www.cannpass.org (accessed 1 June 2020).
14.
DevinskyOCrossJHLauxL, et al. (2017) Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med376: 2011–2020.
15.
DevinskyOMarshEFriedmanD, et al. (2016) Cannabidiol in patients with treatment-resistant epilepsy: An open-label interventional trial. Lancet Neurol15: 270–278.
16.
DoranTKontopantelisEValderasJM, et al. (2011) Effect of financial incentives on incentivised and non-incentivised clinical activities: Longitudinal analysis of data from the UK Quality and Outcomes Framework. BMJ342: d3590.
17.
Dos SantosRGGuimarãesFSCrippaJAS, et al. (2020) Serious adverse effects of cannabidiol (CBD): A review of randomized controlled trials. Expert Opin Drug Metab Toxicol16: 517–526.
EfronDTaylorKPayneJM, et al. (2020) Does cannabidiol reduce severe behavioural problems in children with intellectual disability? Study protocol for a pilot single-site phase I/II randomised placebo controlled trial. Br Med J Open10: e034362.
20.
FreemanTPHindochaCBaioG, et al. (2020) Cannabidiol for the treatment of cannabis use disorder: A phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. Lancet Psychiatry7: 865–874.
21.
FreemanTPLorenzettiV (2020) ‘Standard THC units’: A proposal to standardize dose across all cannabis products and methods of administration. Addiction115: 1207–1216.
22.
GrantKSPetroffRIsoherranenN, et al. (2018) Cannabis use during pregnancy: Pharmacokinetics and effects on child development. Pharmacol Ther182: 133–151.
23.
HillenJBSoulsbyNAldermanC, et al. (2019) Safety and effectiveness of cannabinoids for the treatment of neuropsychiatric symptoms in dementia: A systematic review. Ther Adv Drug Saf10: 2042098619846993.
24.
HuestisMASoliminiRPichiniS, et al. (2019) Cannabidiol adverse effects and toxicity. Curr Neuropharmacol17: 974–989.
25.
IfflandKGrotenhermenF (2017) An update on safety and side effects of cannabidiol: A review of clinical data and relevant animal studies. Cannabis Cannabinoid Res2: 139–154.
26.
Innovative Medicines Initiative (2021) Europe’s partnership for health. Available at: https://www.imi.europa.eu/ (accessed 11 February 2021).
27.
KnaubKSartoriusTDharsonoT, et al. (2019) A novel self-emulsifying drug delivery system (SEDDS) based on VESIsorb® formulation technology improving the oral bioavailability of cannabidiol in healthy subjects. Molecules24: 2967.
28.
LaprairieRBBagherAMKellyME, et al. (2015) Cannabidiol is a negative allosteric modulator of the cannabinoid CB1 receptor. Br J Pharmacol172: 4790–4805.
29.
LiuFJagannathaAYuH (2019) Towards drug safety surveillance and pharmacovigilance: Current progress in detecting medication and adverse drug events from electronic health records. Drug Saf42: 95–97.
30.
McGregorISCairnsEAAbelevS, et al. (2020) Access to cannabidiol without a prescription: A cross-country comparison and analysis. Int J Drug Policy85: 102935.
31.
MillarSAMaguireRFYatesAS, et al. (2020) Towards better delivery of cannabidiol (CBD). Pharmaceuticals (Basel)13: 219.
32.
MontoyaZConroyMVanden HeuvelBD, et al. (2020) Cannabis contaminants limit pharmacological use of cannabidiol. Front Pharmacol11: 571832.
33.
PariharVRogersABlainAM, et al. (2020) Reduction in tamoxifen metabolites endoxifen and N-desmethyltamoxifen with chronic administration of low dose cannabidiol: A CYP3A4 and CYP2D6 drug interaction. J Pharm Pract. Epub ahead of print 15 November 2020. DOI: 10.1177/0897190020972208.
34.
PertweeRG (1997) Pharmacology of cannabinoid CB1 and CB2 receptors. Pharmacol Ther74: 129–180.
35.
PertweeRG (2008) The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: Delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. Br J Pharmacol153: 199–215.
36.
PeruccaEBialerM (2020) Critical aspects affecting cannabidiol oral bioavailability and metabolic elimination, and related clinical implications. CNS Drugs34: 795–800.
37.
PierceCEDe VriesSTBodin-ParssinenS, et al. (2019) Recommendations on the use of mobile applications for the collection and communication of pharmaceutical product safety information: Lessons from IMI WEB-RADR. Drug Saf42: 477–489.
RussoEBBurnettAHallB, et al. (2005) Agonistic properties of cannabidiol at 5-HT1a receptors. Neurochem Res30: 1037–1043.
40.
RybergELarssonNSjögrenS, et al. (2007) The orphan receptor GPR55 is a novel cannabinoid receptor. Br J Pharmacol152: 1092–1101.
41.
SarrafpourSUritsIPowellJ, et al. (2020) Considerations and implications of cannabidiol use during pregnancy. Curr Pain Headache Rep24: 38.
42.
SarrisJSinclairJKaramacoskaD, et al. (2020) Medicinal cannabis for psychiatric disorders: A clinically-focused systematic review. BMC Psychiatry20: 24.
43.
SolowijNBroydSGreenwoodLM, et al. (2019) A randomised controlled trial of vaporised Δ(9)-tetrahydrocannabinol and cannabidiol alone and in combination in frequent and infrequent cannabis users: Acute intoxication effects. Eur Arch Psychiatry Clin Neurosci269: 17–35.
ThieleEMarshEMazurkiewicz-BeldzinskaM, et al. (2019) Cannabidiol in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension study. Epilepsia60: 419–428.
48.
WattGKarlT (2017) In vivo evidence for therapeutic properties of cannabidiol (CBD) for Alzheimer’s disease. Front Pharmacol8: 20.
49.
WhyteLSRybergESimsNA, et al. (2009) The putative cannabinoid receptor GPR55 affects osteoclast function in vitro and bone mass in vivo. Proc Natl Acad Sci U S A106: 16511–16516.
