Australia’s peak medical and pharmacy bodies have issued a stark warning, calling for urgent government reforms to curb what they describe as the “excessive” and poorly regulated prescribing of medical cannabis. The Australian Medical Association (AMA) and the Pharmacy Guild of Australia have raised serious concerns over patient safety, the lack of robust clinical oversight, and the potential exploitation of telehealth models within the rapidly expanding industry.
A Market Under Strain: Rapid Growth and Growing Concerns
Since medical cannabis was legalized in Australia in 2016, the market has experienced exponential growth. Australians are estimated to have spent approximately $500 million on legal cannabis products in 2024 alone, a figure expected to continue rising significantly. This trend has seen patient numbers surge from around 18,000 in 2020 to over a million by early 2024. However, this boom has been accompanied by a surge in prescriptions, often for conditions where the evidence base is limited, raising alarms among healthcare professionals.
Exploitation of Access Schemes and Telehealth
A core concern highlighted in a joint letter to Health Minister Mark Butler is the perceived exploitation of the Therapeutic Goods Administration’s (TGA) Special Access Scheme (SAS) and Authorised Prescriber (AP) pathways. These schemes, originally intended for exceptional access to unapproved medicines, are reportedly being used as commercial avenues for mass prescribing, bypassing traditional GP and pharmacist oversight. The AMA has specifically flagged telehealth models, where consultations can be as brief as 10 minutes, as a particular area of concern. An investigation by The Age newspaper revealed one doctor issued 72,000 prescriptions to 10,000 patients in just two years, underscoring fears of a system driven more by profit than patient need.
Patient Safety and Adverse Effects at the Forefront
Doctors working in emergency departments are reporting an increase in patients presenting with adverse effects from excessive cannabis intake. Concerns are particularly acute regarding cannabis-induced psychosis and its use in individuals with pre-existing psychotic conditions. The AMA noted that the system is being exploited, with prescriptions sometimes issued without proper clinical assessments. Furthermore, there is little or no evidence base for the prescription of medical cannabis for conditions such as anxiety, insomnia, and depression, despite these being common indications. The Australian Health Practitioner Regulation Agency (AHPRA) has also issued guidance, warning that poor prescribing practices are leading to significant patient harm, including psychosis and concerns about high-THC products.
Calls for Urgent Regulatory Reform
In response to these critical issues, the AMA and Pharmacy Guild are advocating for comprehensive reform. Their joint submission to the TGA’s review of unapproved medicinal cannabis products calls for: strengthening clinical governance, supporting regulatory bodies like AHPRA in addressing poor practices, reforming the SAS to restrict its use to genuine exceptional cases, and encouraging the registration of all medicinal cannabis products on the Australian Register of Therapeutic Goods (ARTG) within two years. They also propose the immediate suspension of high-potency THC products (Category 5, over 98% THC) and tighter controls on prescribing volumes and dispensing limits. The organizations emphasize that medicinal cannabis should be prescribed, dispensed, and regulated in the same manner as other registered drugs of dependence.
Navigating a Complex Landscape
The growing trend of medical cannabis use in Australia is complex, with evidence suggesting potential benefits for specific conditions like epilepsy and chemotherapy-induced nausea. However, the widespread and often poorly regulated prescribing for a broader range of ailments, particularly through accessible telehealth channels, has created a public health challenge. As the global market for medical cannabis continues its upward trajectory, Australia faces increasing pressure to strike a balance between patient access and robust regulatory oversight, ensuring that the burgeoning industry prioritizes patient safety and evidence-based medicine. This evolving news cycle highlights a critical juncture for the future of medical cannabis in the country.
