A Call for Caution in Cannabis Prescribing: Viewpoints from a Clinical Naturopath and Herbalist
Article Written by Jessica Kindynis
Read time: 4-5 mins
As a clinical naturopath and herbalist, I have long been captivated by the potential of plant-based therapies. My work centres on applying evidence-based herbal medicine, nutrigenomically active foods, and lifestyle interventions to support health. Alongside, I have been lucky enough to work with some of top thought leaders and medical professionals in the medical cannabis industry in Australia and abroad.
Having witnessed remarkable recoveries or improvements in people's health from manyl forms of plant-based therapies over the years, my respect for the potential botanical medicine runs deep. Yet, when it comes to prescribing medical cannabis, I believe greater caution is warranted.
Plant-based therapy and Alternative Medicine: Reframing an old demon
For centuries, the medical institution has regularly dismissed, discredited, and demonised complementary and alternative medicine, yet now embraces the language of 'plant-based therapy' to suit the advancement of a new golden child. Medical cannabis is hailed as a breakthrough while remaining inaccessible to the very professionals trained in botanical medicine.
I am the first to admit that it can seem like the Wild West in the ‘natural healthcare’ world. So, from a regulatory standpoint, restricting prescribing rights to medical doctors, nurse practitioners, and pharmacists might reflect a commitment to patient safety. This also highlights a paradox: the practitioners (naturopaths and herbalists) with formal training in plant pharmacology are sidelined, while those with little to no background in botanical medicine are tasked with integrating it into patient care.
While I believe the availability of medical cannabis is a huge benefit for many patients, I still have a persistent sense that few within the medical establishment (or the alternative medicine community) would be fully equipped to navigate the complex biochemical interactions that may arise when combining phytochemicals with pharmaceuticals.
The Complexity of Phytochemical Interactions
You’ll be aware by now medical cannabis contains a wide array of bioactive compounds, including cannabinoids, terpenes, and flavonoids. As a Naturopath and Herbalist, these and other phytochemicals are my bread and butter - leveraging traditional and clinical understanding of how these constituents interact with multiple physiological systems to help my patients with their concerns.
Unlike pharmaceuticals with clear doses of active and other constituents, plant-based medicines contain a range of synergistic components that can enhance, modulate, or inhibit the effects of medications. Given how widespread polypharmacy is in our hyper-novel Western society, introducing cannabis into the modern medical equation requires careful assessment.
The effect of cannabinoids on the cytochrome P450 (CYP) enzyme pathways continues to be explored. Commonly, the discourse centres around these enzymes metabolising approximately 60% of prescription drugs and their effects on inhibiting or inducing certain enzymes. Current research on pharmacokinetics and pharmacodynamics clearly warns of medical cannabis applications potentially altering plasma concentrations of medications such as SSRIs, anticoagulants, and benzodiazepines. While this is important information for providers to be up to date on, there are other considerations to be taken into account.
In my opinion, the conversation around medical cannabis prescribing and potential interactions is missing how the complex nature of individual human physiology influences the effects of plant-based therapies. A range of factors can impact metabolism, efficacy, and safety, including:
Lifestyle and habits – Hydration levels, fasting habits, and dietary choices.
Self-medication – Use of OTC medications, nutritional supplements, and herbal products.
Genetic and biochemical individuality – Methylation status, enzyme function, and endocannabinoid system variability.
Environmental influences – Occupational toxin exposure and overall toxic load.
Body composition – Fat distribution affecting cannabinoid storage and release.
The Risks of Overlooking Medication Interactions
Despite the growing body of research highlighting these potential interactions, I have witnessed too many cases where prescribers failed to conduct thorough medication reviews before initiating cannabis treatment. Cases where patients with complex medical histories are given a prescription for medical cannabis without a referral or the prescribing doctor even asking (or cross-checking) current medications for potential contraindications.
The reality that patients take OTC medications, as well as herbal, nutritional and food supplements, without disclosing them to their medical provider is no surprise to healthcare professionals. Yet your average Wednesday afternoon medical cannabis patient is unlikely to be aware that commonly taken medications such as proton pump inhibitors, NSAIDs, and antihistamines may all interact with cannabinoids. Throw in some current online trends like high-dose melatonin, stimulatory amino acids, or whatever parasite cleanse is trending at the moment, and you're likely to encounter a soup of side effects.
The landscape after 2020 has created an environment where many individuals are more invested in their health. They are empowered by endless information at their fingertips and in finding sovereignty in their health choices - yet within this landscape, the need for meticulous pharmacovigilance has never been more present.
The Need for Cross-Disciplinary Collaboration
Far from dismissing medical cannabis, I am hopeful for an approach where cannabis medicines are applied with an intensified awareness of the individual patient and greater interdisciplinary cooperation. I encourage physicians and pharmacists: work collaboratively to ensure medication safety. Take the time in each follow-up consult to ask if patients are taking any new products and leverage pharmacists’ expertise in drug interactions.
I appreciate the added load and logistical challenge these suggestions entail. Yet my experience is that the undercurrent of most people's perception is that plants are safe, in whatever dose you or the unqualified influencer on the internet has told you.
Cross-Checking at Every Step: Regular comprehensive reviews of all patient medications—including OTC drugs and supplements.
Pharmacist Involvement: Pharmacists actively engaged in evaluating potential interactions and providing patient education.
Patient Check-Ins: Encouraging open dialogue with patients about all substances they are taking can prevent avoidable complications.
A Call for Greater Respect for Biochemical Complexity
Often dismissed by conventional medicine as benign, irrelevant or flat-out dangerous, herbalists and naturopaths have long witnessed the potent effects of plant constituents. Now, as this plant-therapy is incorporated into the pharmaceutical landscape the reality that these compounds interact with the human body in profound ways is becoming more apparent..
So, I humbly call prescribers to take a moment of reflection. As professionals entrusted with patient care, I invite you to remember, to deepen your respect the complexity of both human physiology and plant biochemistry.
In the rapidly evolving landscape of medical cannabis, there is a responsibility to tread carefully. I welcome a consistently measured approach that acknowledges the promise and the perils of plant-based medicine, to the benefit of all patients.
Jessica is a Clinical Naturopath specialising in gut ecology, metabolic modulation, and nutritional psychiatry. She has contributed to major medical cannabis conferences in Australia, America and Israel, facilitated local educational events, and developed evidence-based resources for medical cannabis clinics and news outlets. Jessica's collaboration with Australian prescribers has involved crafting professional content that aligns with holistic health perspectives. She is committed to empowering practitioners and individuals with sustainable, nuanced knowledge by exploring the unique narratives of physical, emotional, and mental wellbeing.
Disclaimer: This information is shared with a global readership for educational purposes only and does not constitute medical or business advice. All patient-related information has been de-identified OR fictional to protect privacy. Nothing in this article is intended to promote the use or supply of medical cannabis to members of the public.