Medicinal cannabis being 'exploited' through telehealth

Doctors and pharmacists have raised concerns about medicinal cannabis, alleging excessive and poorly regulated prescribing practices outside of "typical care pathways".

Largely unregulated prescribing and dispensing of medicinal cannabis around the nation needs to be tackled, influential industry groups the Australian Medical Association and Pharmacy Guild of Australia said in a joint letter to Health Minister Mark Butler.

"We are seeing a system that is being exploited — with prescriptions issued without proper clinical oversight and patients bypassing their regular GP and pharmacist," the guild's national president Trent Twomey said.

The number of Australians using medicinal cannabis has passed one million - a significant increase from 18,000 in 2019 - after regulatory changes expanded access.

Politicians and former sporting stars are among the more notable patients.

But doctors are increasingly reporting serious adverse outcomes for patients, with medicinal cannabis being used to treat conditions it may actually contribute to worsening, without adequate oversight.

"We recognise medicinal cannabis can be useful for some patients with specific conditions supported by evidence, such as epilepsy, chemotherapy induced nausea, or muscle spasticity in multiple sclerosis," AMA president Danielle McMullen said.

"However, there is little or no evidence base for many of the conditions for which it is being prescribed, such as anxiety, insomnia or depression."

The groups welcomed prescribing guidance updates from the Australian Health Practitioner Regulation Agency in July.

"But urgent action is needed to ensure medicinal cannabis is prescribed, dispensed and regulated in the same manner as other registered drugs of dependence," Dr McMullen said.

The updated guidance warned poor practices in medicinal cannabis prescription was leading to significant patient harm.

Companies that both prescribe and dispense cannabis, sometimes without in-person consultations, were a particular focus of the AMA's submission to a review by the Therapeutic Goods Administration (TGA).

Schemes originally designed for exceptional access are being exploited as commercial pathways for unapproved products, the AMA said.

But in its own submission, the Penington Institute warned against creating barriers to access.

"The last thing we want is for medicinal cannabis to be so difficult to access that people simply switch to easily available illicit cannabis," the drug policy research organisation's research director Jake Dizard said.

"Ultimately, Australia needs a wholesale realignment of cannabis policy, including the introduction of regulated adult access to cannabis for non-medicinal use."

The TGA is reviewing safety and regulatory oversight over concerns relating to "the rapid growth in the number and type of unapproved medicinal cannabis products being accessed".

Consultation closed earlier in October and the TGA is considering the feedback received.