The Pharmacy Guild of Australia and the Australian Medical Association (AMA) have called for the urgent reform of medicinal cannabis prescribing and dispensing, warning that the current system is being “exploited” and poses a risk to patient safety.
“We are seeing a system that is being exploited, with prescriptions issued without proper clinical oversight and patients bypassing their regular GP and pharmacist,” says Pharmacy Guild of Australia National President Professor Trent Twomey.
Medicinal cannabis prescribing and dispensing largely unregulated
In a joint letter to Health Minister Mark Butler, the Guild and the AMA have raised concerns over the largely unregulated growth in medicinal cannabis prescribing and dispensing, particularly through clinics operating outside typical care pathways.
The organisations have also raised concerns that long-term reliance on the Therapeutic Goods Administration’s (TGA) special access schemes (SAS) has led to excessive and poorly regulated prescribing practices, with reports of coercive practices by cannabis companies and adverse health outcomes, particularly among vulnerable patients.
“We are seeing the use of medicinal cannabis for conditions where it is contraindicated or where it’s use should be under strict and/or ongoing supervision, and our members are increasingly reporting serious adverse outcomes for patients,” says national AMA President Dr Danielle McMullen.
“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.
“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.”
Urgent action needed to protect patients
The Guild and AMA are calling for stronger clinical governance, tighter prescribing and dispensing regulations, and the reformation of the SAS to restrict its use to genuine, exceptional cases under supervision.
“What began as a special pathway for medication has now become the norm with thousands of products prescribed without safety, quality or efficacy controls,” says Professor Twomey.
“We need stronger governance and regulation to protect patients.”
They also urge sponsors to register all medicinal cannabis products used beyond exceptional access on the Australian Register of Therapeutic Goods (ARTG) for evidence-based indications within the next 2 years.
Additionally, the organisations call for the immediate suspension of Category 5 products containing THC (tetrahydrocannabinol) concentrations above 98% during the review, and support tighter controls on prescribing and dispensing, including volume thresholds for ARTG registration, dispensing limits for high-THC products, and specialist-only prescribing for higher-risk categories.
The AMA and Guild have requested a meeting with Minister Butler to discuss the issue.
“We welcome the action taken to date by regulators including updated prescribing guidance, but urgent action is needed to ensure medicinal cannabis is prescribed, dispensed and regulated in the same manner as other registered drugs of dependence, says Dr McMullen.
