There are two significant differences between recreational and medicinal cannabis (prescription and over the counter): legality and quality. Recreational cannabis is not subject to quality controls, and its legal status can vary greatly, even within a single nation. Prescription and over the counter medicinal cannabis products are subject to strict quality controls and legally available.
More and more people are turning to medicinal cannabis as a legitimate medicine. In Australia, more than 184,000 patients have been approved by the government to use a medicinal cannabis product.
But with a range of different medicinal cannabis formulations and brands available, it can be hard for doctors and patients to know which one is best for them and their condition. This is compounded by confusion over the differences between recreational, prescription, and over-the-counter cannabis.
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Recreational cannabis
Recreational cannabis includes flower and cannabis extracts that are made by people at home, bought from a cannabis store, or bought illegally from a dealer or website. It does not include products made from hemp.
While recreational cannabis can be legally sold through stores in some countries, it is not permitted in Australia, except for the Australian Capital Territory where it became legal for residents to possess, use, and grow up to two cannabis plants at their home.
Cannabis consumed without a legal prescription, or not bought from a pharmacy, is considered recreational, even if the person taking it is doing so for medical reasons.
The biggest issues with recreational cannabis are its efficacy and safety. The product purchased may not even be cannabis. There are reports of fake cannabis in the media, and we detail products where plant material is not cannabis but instead contains potentially dangerous chemicals that mimic the psychoactive effect of cannabis.
Even real recreational cannabis can contain toxic compounds. When grown in soil, the plant can take up and concentrate heavy metals, including arsenic, cadmium, lead, and mercury.
If the plants have not been grown under appropriate conditions, the cannabis may also be contaminated with fungi, toxins, and bacteria.
The quantity of active cannabinoid ingredients in recreational cannabis can vary significantly. It isn’t subject to testing or controls, so there is no consistent dosage.
Plant growth varies with changes in temperature, sunlight, nutrients, and water, and with that so does the cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), the two main cannabinoids of interest.
This means that the efficacy of the products is constantly changing and may not help with some people’s medical conditions.
Prescription medicinal cannabis
Prescription cannabis was made legal in Australia in 2016 and refers to medicinal products that have been manufactured to a high and consistent standard and are backed by scientific evidence of their efficacy. These include products in familiar pharmaceutical formulations like capsules, creams, and oils, as well as less common forms such as vapes, wafers, and gummies.
To gain access to a prescription medicinal cannabis product this must be approved through a script via the Australian government’s SAS-B scheme, an Authorised Prescriber, or through a clinical trial.
An important distinction between recreational cannabis and prescription cannabis is the role of the doctor in making an informed clinical decision with full knowledge of their patient’s medical history and the other medications they are taking.
When patients self medicate with recreational cannabis, their decision most likely does not take into account potential drug-drug interactions or how cannabis may affect their other medical conditions.
Prescription medicinal cannabis in Australia must be made in a government licensed Good Manufacturing Practice (GMP) facility. A facility that is GMP licensed has been able to demonstrate that they can make a consistent product each and every time. This applies to flower formulations (flos) as well as cannabis extracts.
As well as meeting GMP requirements, prescription cannabis manufactured in Australia must meet the requirements of Therapeutics Goods Order 93 - Standard for medicinal cannabis. One important aspect of TGO93 is that every batch that comes off the assembly line must be tested for quality and safety.
Now all that is about the quality of the cannabis, but what about the actual ingredients?
With prescription cannabis, the quantity and types of cannabinoids have been specifically selected for different conditions. Some conditions require a lot of CBD and no THC, while others may need a balance of both, or some other combination. Some may even include specifically selected, but less common, cannabinoids such as cannabigerol (CBG) or cannabinol (CBN).
When a prescription cannabis product is approved on the Australian Register of Therapeutic Goods (ARTG) the company that sponsors the drug must provide evidence that the quantity and type of cannabinoids in their medicine work for the condition for which it is approved. This data is collected as part of human clinical trials and is analysed by the Therapeutic Goods Administration before they approve it.
A final aspect of prescription cannabis that sets it apart from recreational cannabis is that manufacturers can also potentially control the quantity and types of terpenes in the products. There is growing evidence that terpenes work synergistically with the cannabinoids to exert their beneficial effects on the body.
Over-the-counter medicinal cannabis
In 2020, the Australian government down-scheduled cannabis formulations that contained only CBD from S4 (Prescription-only) to S3 (Pharmacist-only), which is also called over-the-counter. An S3 medicine can be bought in any pharmacy after a short, free consultation with the pharmacist.
In down-scheduling CBD-only cannabis to over-the-counter, the government set specific rules. The video below by the Australian Medicinal Cannabis Association provides an easy-to-understand explanation of those rules.
The products must supply no more than 30 days' worth of CBD at a 150 milligram dose per day in a child proof container. The product must come in an oral (read capsule or oil) or sublingual (under the tongue) formulation. And the CBD must make up at least 98% of the total cannabinoids in the medicine. If there is any THC in the product, it must make up no more than 1% of the total cannabinoids.
Other than those rules, over-the-counter cannabis has the same requirements as prescription cannabis including quality, evidence of efficacy and safety, and approval on the ARTG.
Canngea products
Canngea Pty Ltd is a business-to-business (B2B) Australian government-approved cultivator and manufacturer of prescription and over-the-counter cannabis products. Canngea provides a range of services to our clients, including white labelling of products so they can be sold under other company's brands.
All cannabis products made by Canngea meet European, US, and Australian GMP requirements and are tested against the TGO93 standard.
An additional service we provide to our clients is track and trace so you know the complete history of your product.
