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One script every five minutes on average — that’s how fast a single doctor was prescribing medicinal cannabis, raising concerns from Australia’s health regulator.
According to the Australian Health Practitioner Regulation Agency (AHPRA), over a six-month period, some practitioners have written over 10,000 prescriptions for medicinal cannabis, with one issuing more than 17,000.
AHPRA said that as of 31 December last year, 57 practitioners (medical practitioners, pharmacists and nurses) had action taken against them by a medical board over prescribing medicinal cannabis.
“Current prescribing data raises red flags that some practitioners are not meeting their professional obligations,” AHPRA stated.
APHRA has issued new guidelines to help practitioners who prescribe medicinal cannabis, addressing concerns that “poor practice” may cause “significant patient harm”.
Some experts have welcomed these guidelines.
“I think it’s timely for the regulator for medical practice to be putting out some clear statements on the inappropriateness of some of the prescribing,” emeritus professor Wayne Hall, from the National Centre for Youth Substance Use Research at the University of Queensland, told SBS News.
On the other hand, some advocates say that patients still face difficulties in obtaining them through their GPs, pointing out a “lack of education” among the doctors, which may account for high prescribing rates among some practitioners.
APHRA noted “in relation to the vast majority of notifications received by APHRA in this area, practitioners often respond to our involvement by modifying their practices without the need for further regulatory action”.
A ‘stigma’ amongst GPs
Since then, prescriptions increased from about 17,000 in 2020 to over 800,000 in 2024, according to the Department of Health. As patients may receive multiple prescriptions, this data doesn’t show how many individuals access medicinal cannabis.
On Wednesday, APHRA warned: “poor medicinal cannabis prescribing practices and surging patient demand are leading to significant patient harm”.
It also raised its concerns by “patients presenting to emergency departments with medicinal cannabis induced psychosis”.
Hall said the “major driver” for the rise in prescriptions is “profit”.
“A lot of these medical cannabis clinics that have been set up, they only prescribe cannabis, and they do it from their point of view, at a high volume of prescriptions is the way to generate a good profit margin,” he said.
“That’s what they seem to be doing without a great deal of care taken in assessing the appropriateness of prescriptions for patients.”
But some supporters of the Australian medicinal cannabis industry argue that those seeking a prescription mostly approach doctors remotely, as there is a “stigma” among doctors.
“The problem is that mainstream general practice practitioners are generally reluctant to prescribe medicinal cannabis,” Teresa Nicolleti, chair of the Australian Medicinal Cannabis Association, told SBS News.
“They don’t know enough about medicinal cannabis. There’s a historical concern around the prohibition before it was legalised, and whether they should be prescribing it.
“There are now hundreds of thousands of scripts being issued, but they’re being issued by telehealth clinics rather than GPs. There’s only a very, very small proportion of GPS who will prescribe medicinal cannabis.”
Virtual care, or Telehealth clinics, are a type of service that provides healthcare services remotely, typically through video or phone consultations
Lack of ‘education’, or lack of ‘evidence’?
Nicolleti said one of the reasons behind this stigma is that there is “not enough education” among doctors about the benefits of medicinal cannabis.
“The problem is if the colleges, the peak bodies, aren’t supporting it, then it’s very difficult for GPs to become comfortable with it. And so until that position changes, I don’t think we’re going to address this,” she said.
Most medicinal cannabis products are considered unregistered medicines by Australia’s Therapeutic Goods Administration (TGA), which means they haven’t undergone the same rigorous assessment for safety and efficacy as registered medicines.
As a result, practitioners need the TGA’s approval to prescribe medicinal cannabis products.
Hall said: “The problem is that we have these drugs being prescribed for unapproved purposes, that is to treat conditions for which these drugs are not approved by the regulatory body [TGA].”
Doctors need the medicines watchdog’s approval to prescribe medicinal cannabis products. Source: Getty / FG Trade
He said that, alongside education, “lack of evidence” about some medicinal use of cannabis is also one of the reasons GPs are reluctant to prescribe.
“The great majority of prescriptions under the medical cannabis program are for things like chronic pain, sleep disorders, anxiety, and distress.
“The problem is that when the use becomes regular and people are using regularly over long periods … They put themselves at risk of developing dependence, and the evidence for long-term effectiveness and safety is, is really not there.
“In those cases, the evidence for efficacy and safety is, is much more marginal or very lacking in the case of [conditions like] anxiety and depression.
“I think part of the reason for scepticism about medical use is that the evidence isn’t there for a lot of the reasons, the medical conditions for which people seek prescriptions.”
