Medical cannabis advocate hopes to define ‘good care’ for patients
The newly appointed ambassador for medical cannabis is promising to put patients first, but was employed by corporate executives facing allegations of false advertising and faces a sector riddled with noncompliance.
Lisa Penlington, the first chief executive of the advocacy group Cannabis Council Australia, has few illusions about the task she faces to repair the credibility of an industry under attack and still marginalised – some say for good reason.
The former Royal Australasian College of Physicians executive general manager, Ms Penlington is pitching herself as the interpreter between medical authorities and the increasing number of patients who use medical cannabis.
The drug was used legally by an estimated 700,000 Australians in the 12 months to February last year and has grown into a near-$1bn industry since its medical legalisation in 2016. But many doctors have raised concerns over the rise in foreign importing, tick-and-flick prescribers, spotty regulation and the potency of THC, the main psychoactive constituent of cannabis.
Ms Penlington argued that a coalition of stakeholders had to explain how patients could be placed at the centre of the industry’s future, with regulation built from there.
“Our aim is to essentially establish an advisory body of experts, and it will represent the participants in the sector, but it will also involve people who are part of mainstream medicine; it’s actually integrating the two,” Ms Penlington told The Australian.
“This is a sector that is providing healthcare to Australian patients, and what’s missing at the moment is clarity and some clear communication about what good healthcare looks like when medicinal cannabis is involved.
“In the absence of something that’s clearly defined, we’re left with discourse … There’s a stigma attached to it, because there is a gap at the moment in the definition of what ‘good’ looks like.
“We are reaching out to the government, to regulators, to a number of stakeholders in healthcare, as well as in the sector itself. It really will be about bringing people together to reach consensus, to identify where there may be concerns around quality and safety and how we were operating.”
Cannabis Council Australia, which was established last year, does not have enforcement power over growers or operators. Ms Penlington is relying on advocacy to pull the sector into prominence and credibility.
“(We should be) recognising that when medicinal cannabis was originally regulated … there was an expectation that patients would access that treatment by exception, and that’s not what’s actually transpired,” she said.
“It has significant regulation because it is healthcare that’s accessed by exception, and that creates some uncertainty as to what doctors are allowed and not allowed to do … (they don’t) know what good, safe, responsible consultation looks like. Once you start being very clear about that, if there are bad actors out there who are not conducting themselves according to best practice, then that will come out.
“I’m not going to suggest that tomorrow I can have everything in place, I’m 10 days into the job, but I have a plan for how we can actually set about doing that.
“My appointment … (shows) we can actually integrate medicinal cannabis with the health system, rather than seeing it as something that is operating on the margins.”
While the council bills itself as an independent representative, records lodged with the Australian Securities and Investments Commission show its three directors are all executives at alternative medicine conglomerate Montu: founder Christopher Strauch, chief financial officer Edward Lonergan and executive director Rhys Stanley.
Montu and Mr Strauch were taken to court by the Therapeutic Goods Administration in April last year for alleged unlawful advertising of medicinal cannabis. The two parties have entered mediation in an effort to settle outside of court, with a mediator to be appointed by August 1 and agreement reached by November 14
“Cannabis Council Australia was established by Montu to help drive responsible, sector-wide reform and better integrate medicinal cannabis with the broader healthcare system. As seen in many peak bodies in the health sector, it is normal for a founding organisation to play a larger role in early governance,” a Montu representative said.
“As membership grows, so too will the diversity of its leadership. Lisa has communicated that her focus is on building a credible, independent industry voice that represents responsible participants within the medical cannabis ecosystem. She welcomes to the table all who share that vision.”
An investigation by The Australian last month found the credibility of the sector – upon which farmers and regional communities are becoming increasingly financially reliant – was being driven to the wall by legalised “drug rackets”, where telehealth clinics rushed out mountains of high-potency prescriptions with little due process.
About 65 per cent of medical cannabis scripts issued are for pain; 25 per cent for anxiety; and 10 per cent for insomnia.
Doctors raised concerns no regulator had sufficient oversight, due to the way the industry had developed, outside the normal pharmaceutical evaluation and approval system.
Only one medicinal cannabis product is approved for supply in Australia, but the TGA has several schemes allowing doctors to access about 500 unapproved products for patients outside the Pharmaceutical Benefits Scheme.
Because these products are unapproved, the onus falls on doctors to take responsibility for their prescribing.
The Office of Drug Control lists more than 40 companies licensed to grow, produce or manufacture medical cannabis in Australia.
Cannabis Council Australia is the emerging stakeholder body for Australia’s medical cannabis industry, spanning beyond the existing Medical Cannabis Industry Association by drawing in patient and doctor perspectives.
“I look forward to meeting with Lisa Penlington to discuss the objectives of the CCA and how we can collaborate to facilitate and promote the growth and development of the medicinal cannabis industry,” said MCIA executive officer Patty Holmes.
“(Stakeholder engagement has grown) significantly and at great expense as navigating the evolving regulatory and legislative requirements for unregistered medicines is complex, with significant challenges.
“Industry supports the ongoing sophistication of the regulatory environment ensuring products are fit for purpose.”
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