Queensland hits high for medicinal cannabis prescriptions

Queensland accounts for more than half the medicinal cannabis prescriptions dispensed since it was made legal in 2016, new research shows, but other states are now expected to close the gap.

A major study led by researchers at the University of Sydney has, for the first time, examined all the medicinal cannabis prescriptions issued since 2016, when the national scheme began, to late 2021.

The medicinal cannabis industry in Australia was estimated to be worth $51.8 million in 2021.Credit: Stuart Layt

Senior author Dr Elizabeth Cairns said the rate of prescriptions was slow in the weeks and months after the therapies were legalised, but increased significantly after that.

“It was initially quite slow, but the significant rise in the past few years has been quite astonishing,” she said.

“The data was only on prescriptions, not whether the treatment was effective, but even so, to see these prescribing patterns I think is very informative.”

Almost 250,000 scripts have been approved for Australians since 2016, with 51 per cent of those issued in Queensland.

Study co-author Associate Professor Vicki Kotsirilos, from Western Sydney University, who is also a GP who prescribes medicinal cannabis products, said while the data did not show exactly why Queensland was so far ahead, she could make an educated guess.

“I suspect it could be because of the way the permit system is set up in Queensland. It is easier to prescribe these therapies [there] than in other states,” she said.

“However, in the past two months, Victoria and NSW followed the same permit system as Queensland, so it’s possible we will see the rates of prescriptions in those states also rise.”

The vast majority of medicinal cannabis prescriptions (61 per cent) were for pain management, which Kotsirilos said did not surprise her as the body of evidence on cannabis therapies was strongest for that use compared with other conditions, albeit still with weak evidence overall.

“It’s not a magic bullet. It does take a more holistic approach to treat pain conditions, but for some people, there is enough benefit that it can improve their quality of life,” she said.

“For others, it might be a major benefit, and we never know who those patients might be, it’s just through trial and error.”

Anxiety was the second most common reason for a prescription, at 16 per cent, followed by sleep disorders at 5.7 per cent. A total of 140 conditions were listed as reasons for a script.

Doctors in Australia can prescribe a range of cannabis products, from oils and tablets to cannabis “flowers”, which would be smoked.

Products derived from cannabis contain either the compound CBD, or CBD and THC, which is the chemical that produces a “high” when the drug is used recreationally.

“CBD is a schedule 4 product and THC is schedule 8 [more highly regulated],” Cairns said.

“In general, the S4 prescribing was much lower than the S8 prescribing, but that seems to be because there are more S8 products around, especially given that all the flower products contain THC.”

Before 2020, people aged 45 to 52 had the highest rate of prescriptions, however that later shifted to those aged 20 to 31. The researchers did not know the reason for the shift, but said it was interesting that it coincided with the start of the COVID-19 pandemic.

The efficacy of cannabis products, or cannabis itself, to treat a range of conditions is still very much under review, with researchers around the world gathering data. However, official organisations such as the Australian Faculty of Pain Medicine still do not recommend their use.

Kotsirilos said this research did not look at efficacy but gave a good roadmap to what areas should be the focus of research in future.

The study used data from the Therapeutic Goods Administration, which has kept a record of every medicinal cannabis prescription issued in Australia since 2016.

The research has been published in the journal Frontiers in Pharmacology.