The medicinal cannabis business risks going up in smoke

If the medicinal cannabis industry isn’t careful, it risks going up in smoke.

A major investigation by Clay Lucas, the first part of which is published in The Sun-Herald and Sunday Age today, has detailed how the nation’s biggest medicinal cannabis company engineered a legally contentious referral scheme as it built a dominant position in the booming industry.

The revelations raise serious concerns about the level of regulation, medical ethics and risks to consumers from an industry that has expanded rapidly since the sale of cannabis was first legalised in 2016. There are nearly 3000 approved providers nationwide and hundreds of online companies materialised during the pandemic that prescribe and sell the drug without patients ever leaving their homes.

Lucas reports that ethical health practitioners have also voiced their concerns that the wider industry must perform better if the drug is to achieve acceptance as a legitimate medicine. He has zeroed in on Montu, using court filings to show how it has become an industry leader and last year processed hundreds of thousands of scripts and doubled its share of the national market for legal supply of the drug.

Among Montu’s products are “its best-selling Circle ‘White Widow’ (57,839 units in the 18 months to December 2023), its Sundaze Sierra Blaze (55,773) and its Upstate Carts Pineapple Express (30,735 units) cannabis flower products”. Legitimate as the medicinal uses of cannabis may be, these products have hardly been given the most serious names.

Montu, through a spokeswoman, says the company was “committed to adhering to all legal and regulatory requirements” and that it worked constructively with regulatory authorities.

There are legitimate reasons cannabis has been legalised for medicinal purposes. As health reporter Angus Thomson has outlined, the TGA has approved two cannabis products to treat specific conditions – one to treat muscle rigidity caused by multiple sclerosis and another to alleviate symptoms of a rare childhood epilepsy.

All other medicinal cannabis products are prescribed off-label, meaning they have not been assessed by the TGA for efficacy, quality or safety. Common off-label uses can include to treat chronic pain, anxiety, and sleep problems: the results of clinical trials have so far been mixed, but there are no doubt patients who are reaping real benefits.

Business is clearly booming, but there are questions about whether the system that was set up to help patients is instead being used as a cynical money-making exercise. The way the business has been promoted is a key concern for regulators. The Therapeutic Goods Administration (TGA) has issued more than 170 infringement notices and fined companies more than $2.4 million in the past five years for breaches of advertising laws around medicinal cannabis.

Perhaps the most damning criticism comes from within the medicinal cannabis industry.

Well-known industry figure, medicinal cannabis advocate and patient figure Clare Barker says people have seized on the opportunity to make money, resulting “in them not putting patient care at the centre of their business operations”.

It seems the lure of green lucre is not worth the risk to people’s health.

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