SA patients struggling to access medicinal cannabis as prescriber rates lag behind other states

SA doctors are among the least likely in the nation to prescribe medicinal cannabis to their patients — forcing some to become law-breakers just to seek relief from debilitating pain.

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South Australian doctors are among the least likely in the nation to prescribe medicinal cannabis, new figures reveal.

Advocates say the lack of access is forcing SA patients to seek out illegal alternatives.

Special Access Scheme data shows the Therapeutic Goods Administration granted 206 exemptions to SA doctors to prescribe unregistered medicinal cannabis products to patients from November 2016 to June 30 this year.

This represents just 2 per cent of the nation’s medicinal cannabis prescriptions — one of the lowest rates in Australia since it was legalised in 2016.

Even taking population differences into account, SA doctors remain the least likely to apply for medical cannabis exemptions for patients (excluding the NT and Tasmania) despite State Government support and TGA changes to streamline online applications.

A TGA spokeswoman said cancer pain and symptom management, chronic pain, and seizure management were the main conditions SA doctors were applying for use of medicinal cannabis for patients.

She said there were no restrictions on the conditions for which a medical practitioner might apply to access medicinal cannabis.

For privacy reasons, the TGA would not reveal if any SA doctors have been approved as an “authorised prescriber” of medicinal cannabis products. The Sunday Mail understands there are none in SA.

Federal Health Minister Greg Hunt at Australia’s first operational medical marijuana farm.

SA patients and advocates say the lack of GP support in SA for medicinal cannabis is one of the main factors driving people underground, with good Samaritans risking criminal charges to help sick loved ones.

Inquiries by the Sunday Mail have found SA patients face significant barriers including:

LACK of education and training among “conservative” GPs who have limited research on the patient benefits of medicinal cannabis and are concerned by the stigma of “attracting the wrong type of patient”;

THE TGA application process, which although improved last year, has been described as an “administrative nightmare for time-poor doctors” who are reluctant to waste precious consulting hours on “red-tape”:

Prohibitivecost— approved medicinal cannabis is not subsidised and can be priced anywhere from $150 to $450 each prescription, which can last one week to a month. This excludes GP fees to make the applications and consultations.

Cancer patient Kiwi White at Sleaford Bay. He has been using medicinal cannabis for pain — but has found it impossible to get through legal channels as his GP is not licensed to prescribe it. Picture: Robert Langford

One GP who is licensed and did not want to be named said at least three times the number of patients seeking medicinal cannabis were sourcing it illegally through friends and family due to limited access.

“There are still many barriers to access, unfortunately,” she said.

The GP said there were currently a dozen SA-based specialists — mainly oncologists, neurologists and psychiatrists — supporting medicinal cannabis through the TGA and a handful of GPs.

She said many of her colleagues were reluctant to prescribe medicinal cannabis due to lack of education and stigma.

“The solution is making it easier for GPs to prescribe,” she said.

The doctor, one of the state’s largest medicinal cannabis prescribers, said her patients suffered chronic pain and cancer and had tried conventional high-dose opioids for pain management to no or minimal effect. “For some of them, the medicinal cannabis is an absolute help.”

Australian Medical Association state present Dr Chris Moy said doctors have to weigh up the known benefits of medicinal cannabis “relative to the level of mythology in the community”.

He said there was a lack of research-based evidence proving the benefits of medicinal cannabis, but there were known short and long-term side effects such as confusion, depression and psychosis.

Medicinal cannabis advocate Dianah Walter, from Yorke Peninsula, said she knew of many patients being told by their doctors it was “easier to be prescribed opiates” than investigate medicinal cannabis as a treatment option.

Earlier this year Ms Walter lobbied NGO Primary Health Network for GP education in SA and was told medicinal cannabis was not a priority.

She said the Office of Industrial Hemp and Medicinal Cannabis within the Department for Trade Tourism and Investment Department was keen to explore and support locally grown medicinal cannabis for export only.

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Health Minister Stephen Wade said the State Government supported doctors prescribing medicinal cannabis consistent with evidence. He backed the need for ongoing research, including clinical trials, to better understand the role of medicinal cannabis, and encouraged local establishment of medicinal cannabis and industrial hemp industries.

“There are now a number of SA businesses licensed under the national cultivation, production and manufacture scheme for medicinal cannabis,” he said.

The TGA said uptake of the Special Access Scheme by medical practitioners was increasing and that all states and territories, except Tasmania, were now part of the single-point online application system. It said SA applications to prescribe medicinal cannabis are growing each year — more than 162 so far this year compared to 55 in 2017.