Major crackdown on medicinal cannabis, doctor writes 17k scripts
The nation’s health watchdog fears profits were being put ahead of patient safety as the medicinal cannabis industry explodes.
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Some practitioners have issued more than 10,000 medicinal cannabis prescriptions in just six months, it can be revealed as Australia’s health watchdog announces a major crackdown.
Authorities have become concerned at “poor practice” in the burgeoning industry, saying it has led to underage patients receiving scripts and reports of medicinal cannabis-induced psychosis.
The Australian Health Practitioner Regulation Agency (Ahpra) and National Boards on Wednesday announced the first official guidelines for prescribing the drug.
“We don’t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different,” Medical Board of Australia Chair Dr Susan O’Dwyer said.
“Patient demand is no indicator of clinical need.”
The regulators said a lax system had led to fears of profits “over patient safety”, citing reports of “serious adverse outcomes such as psychotic episodes” for patients whose medical history was not properly considered.
One practitioner is believed to have written 17,000 scripts in half a year, while seven others issued more than 10,000 each.
Some consultations are lasting “a few seconds”, according to Aphra, and cannabis was being prescribed simply because patients were requesting it.
The new guidelines include thorough assessment of patients, taking their medical history into account, creating management plans and continuity of care, maintaining medical records and offering different treatment options.
Ahpra chief executive Justin Untersteiner warned practitioners of the inherent conflict of interest for working in an organisation that only prescribes and dispenses a single medicine.
“Some business models that have emerged in this area rely on prescribing a single product or class of drug and use online questionnaires that coach patients to say ‘the right thing’ to justify prescribing medicinal cannabis,” Mr Untersteiner said.
“This raises the very real concern that some practitioners may be putting profits over patient welfare.”
Ahpra has taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices and is investigating 60 more.
Mr Untersteiner added Ahpra “will investigate practitioners with high rates of prescribing any scheduled medicine, including medicinal cannabis, even if we have not received a complaint”.
GPs and qualified nurses have been able to prescribe medicinal cannabis for patients under a legal access scheme since 2016.
Under the laws they must only make the prescription after identifying a therapeutic need and undertaking a thorough patient assessment.
Data from the Penington Institute showed in November that Australians spent $400 million on medicinal cannabis in the first six months of 2024.
That was up on the $234 million for the whole of 2022.
Ahpra estimated last February that the number of unregistered users of medicinal cannabis products had “spiralled” from 18,000 in 2019 to more than one million by January 2024.
Wayne Hall, a professor at the National Centre for Research on Youth Substance Use Research at the University of Queensland, told The Guardian last year he expected Australia’s market to follow a trajectory seen in Canada and the US.
“When you create a medical cannabis program … the pressure is often brought to bear to expand it so it merges into a de facto legal cannabis market for adults,” Prof Hall said.
In a statement the Therapeutic Goods Administration welcomed the new guidelines, saying it was working closely with regulators to ensure safe prescription of medicines.
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