Dr. Andrew Agius is a family doctor with a special interest in obesity, weight-loss, and lifestyle medicine and he has recently set up a pain clinic in Malta. Dr. Agius is well-known in Malta for appearing regularly on national TV and he has been one of the driving forces behind the new medicinal cannabis reform in Malta. Dr. Agius owns a pain clinic in Malta from where he prescribes medicinal cannabis among other things to help his patients. We spoke about medicinal cannabis at Malta:
2:30 - How Dr. Agius discovered cannabis medicine to help patients who did not respond to conventional medicine. He learned about cannabis from a patient who used it illegally and who had studied the endocannabinoid system. He started by using CBD (cannabidiol) in 2016; primarily CBD for chronic pain with inflammation. He has since treated fibromyalgia, hypersensitivity, anxiety, PTSD, and chronic pain among others.
7:40 - The endocannabinoid system is the missing link in the puzzle to why cannabis works so well.
8:40 - Getting medicinal cannabis to Malta; CBD became a novel food and Dr. Agius was told not to recommend CBD and the import was stopped. The campaign for cannabis begun. Dr. Agius started an educational program for cannabis and the ECS but was soon told to stop this as he was reported by his fellow doctors. In 2018 medical cannabis became legal and available in pharmacies in Malta.
14.10 - Public education. Educating patients about the endocannabinoid system and how to use medicinal cannabis. Empowering to manage the dose and side-effects. Providing the tools to self-medicate and manage symptoms.
16:35 - At the beginning of medical cannabis in Malta you needed to have control and follow-up after 15 days. Now the first follow-up is after 1 month. In Malta, the only choice is high THC flos, cannabis flower, which is vaporized. After the second follow-up, the prescription can be extended to 6 months with control every half year.
19:35 - The available products in Malta are only 4 different flower products (flos). Only GMP-certified products are allowed in Malta. There are now production facilities in Malta growing GMP-flowers.
20:55 - Some doctors are afraid to prescribe because of the strict guidelines with all the responsibility being put on the doctor. It can be prescribed for any chronic condition which has not responded to one other approved alternative. Insomnia, sleep disorders, chronic pain, mental health, anxiety,
25.00 - Mental health issues are well treated with medicinal cannabis and chronic pain is often associated with anxiety, depression, and sleep disorders. Dr. Agius is also treating neurological disorders and inflammatory disease. A good tool in the tool kit. Very safe and few side-effects.
27:35: How well does cannabis medicine work? In Dr. Agius's view, the success rate is over 95% when using a pharmaceutical-grade cannabis product which is vaporized and combined with lifestyle changes, supplements, and vitamins.
30:32 What is the best delivery method? Dr. Agius believes full-spectrum or broad-spectrum is the best product. He believes in the entourage effect compared to single-molecule preparations. He also thinks the vaporization is a good way of getting pain relief. Terpenes, flavonoids, and minor cannabinoids like CBG, CBN THCA. Certain strains or chemovars are better for certain indications. It is a good idea to change the chemovar to reduce the risk of tolerance.
37:40 The future of medical cannabis in Malta. Less control and easier access. Give cannabis the same status as opioids/morphine. More research and access to more delivery methods and products from Malta.