The Who, What, How & Why of Medical Cannabis in Australia

Since first becoming legal in 2016, more than 390,000 prescriptions have been filled for medical cannabis in Australia. Most medical cannabis prescriptions are filled in Queensland, followed by Victoria and then New South Wales. There have been significantly fewer prescriptions in other regions of Australia, but medical cannabis is available equally nation-wide.

Medical cannabis is a new frontier of medicine in Australia, but as with all new treatments there can be some confusion around how to access them and what they are used for. Read on to get informed about medical cannabis in Australia and how it might benefit you. ‍

Who Can Be Prescribed Medical Cannabis In Australia?

Medical cannabis has been prescribed for over 130 medical conditions in Australia, including anxiety, PTSD, insomnia, multiple sclerosis, epilepsy, chronic pain, fibromyalgia and autism.  

However, medical cannabis is still considered an alternative treatment meaning that you can only receive a medical cannabis prescription if you’ve already tried conventional treatments and have found them to be ineffective or you experienced unacceptable side effects.

Don’t worry – you don’t need to exhaust every therapeutic option before considering medical cannabis, you just need to demonstrate that you’ve tried some conventional treatments first and that they didn’t fully resolve your condition. ‍

How Do Medical Cannabis Prescriptions Work?

Medical cannabis prescriptions aren’t quite as simple as more traditional prescription medications. All prescription medications are regulated by the TGA, an independent government body. A medication can either be approved or unapproved, depending on the TGA’s assessment of the scientific evidence for that medication’s effectiveness and safety.

To get approval from the TGA, a medication typically needs to be backed up by an extensive body of research and clinical use and proven to be safe and effective. A well-known example of an approved medication are the various types of antibiotics available for treating bacterial infections. The TGA will register a medication for a specific purpose once they have approved it.

So far, only two medical cannabis products have been approved by the TGA:

• Sativex: a combined THC and CBD mouth spray that may help manage multiple sclerosis.
• Epidyolex: a CBD oil specially designed for managing seizures from the rare childhood epilepsy conditions Lennox-Gastaut syndrome and Dravet syndrome.

The Difference Between Approved and Unapproved Medications

Despite the name, unapproved medications can still be prescribed and offer potential medical benefits – being unapproved just means that their effectiveness is still being gauged. Getting a medication approved is a difficult process and many emerging medications are yet to gain approval from the TGA.

In the case of medical cannabis, high-quality research on THC, CBD and other cannabinoids is only just beginning, despite cannabis’s long history of medical use. This is because of decades of stigma and demonisation stalled the research into cannabis’s medical applications.

Two schemes created by the TGA allow doctors to prescribe unapproved medicines:

• Special Access Scheme: if they think an unapproved medicine may help a patient’s condition, doctors can prescribe that medicine via the Special Access Scheme (SAS).
• Authorised Prescriber Scheme: doctors can apply to the TGA to become authorised prescribers of specific unapproved medicines for a particular class of patients.

Over 90% of medical cannabis prescriptions in Australia are completed through the SAS. If you’re curious about who and what medical cannabis is prescribed for, the TGA has the data publicly available on their website. ‍

How Long Does a Medical Cannabis Approval Take in Australia?

If you think medical cannabis might be able to help manage your chronic condition, you can book a consultation with a medical cannabis clinic or your regular GP to discuss your eligibility. Your GP or medical cannabis doctor can apply for access on your behalf through the SAS or APS if they believe you would benefit from it.

If your doctor prescribes through the SAS, they’ll submit an application with details about your condition, the proposed medical cannabis product and dosing regimen. You’ll be able to access your medical cannabis through an approved supplier if your application is successful. The application typically takes around one to two days to process, although can be faster through a dedicated medical cannabis clinic, where the process is more automated.‍

How Can You Consume Medical Cannabis in Australia?

Medical cannabis is most commonly prescribed in its dried flower form or as a concentrated oil. Medical cannabis is also available in capsule or lozenge form, or as topical ointments and creams. Cannabis edibles, while a popular overseas option, aren't readily available for prescription in Australia. When you have your initial consultation, you’ll discuss these options and decide with your doctor which is best for you.

Dried flower is the most well-known form of medical cannabis. These dried flowers are ground up and added to a vaporiser such as the Mighty Medic, where you can easily control your dosage.

Smoking isn't approved by the TGA as a way of consuming medical cannabis. Smoke inhalation can be harmful, and it’s difficult to regulate your dosage through smoking medical cannabis. Vaping the dried cannabis flower is a safer, more efficient alternative.

Cannabis oil is another prescription option. Different cannabis oils have varying amounts of THC, CBD, terpenes, flavonoids and other cannabinoids. If you can’t or would prefer not to consume THC because of its psychoactive effects, isolate CBD oil can be a good choice. You can also precisely control your dosage with oils by using a measured dropper, which you use to place the oil under your tongue. Other ways of consuming CBD oil include capsules and ointments. ‍

What’s the Difference Between CBD and THC?

Different cannabinoids are used to treat different conditions, so your doctor will carefully assess you and decide whether a THC- or CBD-dominant product will be the most beneficial. ‍

CBD and THC are the two most researched cannabinoids, but your doctor will also consider the balance of terpenes, flavonoids and other minor cannabinoids when issuing a medical cannabis prescription.

CBD may have some therapeutic benefits through its effect on the endocannabinoid system, despite being non-psychoactive. THC is the compound in medical cannabis that causes a “high.” Certain conditions may benefit from THC’s psychoactive effects – for instance, it may help stimulate a cancer patient's appetite.

Dried cannabis flowers tend to contain around 19% to 32% THC, and limited amounts of naturally occurring CBD. Cannabis oils allow producers to set any specific ratio of THC and CBD.

Cannabis oils have three different groupings: isolate, broad-spectrum and full-spectrum. Isolate cannabis oils contain only CBD or THC, broad-spectrum oils contain no THC but do contain CBD, terpenes, flavonoids and other minor cannabinoids such as CBN. Full-spectrum cannabis oils are extracted from the whole cannabis plant, meaning they contain all cannabinoids, terpenes and flavonoids, including varying amounts of THC. ‍

Can I Drive While Taking Medical Cannabis in Australia?

It’s illegal to drive with any amount of THC in your system in all Australian states except Tasmania. In Tasmania, you may drive with small amounts of THC in your system, provided you aren’t under THC’s intoxicating effects and have a valid medical cannabis prescription.

Otherwise, it's best to play it very safe with THC products, as THC can remain in your system for a long time after using medical cannabis. ‍

Is CBD Oil Legal in Australia?

Under the TGA’s guidelines, cannabis products are placed in five categories: pure CBD (>98% CBD), CBD dominant, balanced, THC dominant and pure THC (>98% THC).

Pure CBD oil, while technically legal to buy over the counter since 2021, is still only accessible via prescription. This is because no CBD oil products have yet been fully registered with the Australian Register of Therapeutic Goods (ARTG).

This registration process can take up to 2 years and involves clinical trials and formal approvals. Late 2023 is likely the earliest we may see CBD products in Australian pharmacies.‍

How Much Does Medical Cannabis Cost in Australia?

Unfortunately, medical cannabis isn’t covered by the Pharmaceutical Benefits Scheme (PBS), meaning you’ll have to pay for it out of pocket.

Medical cannabis costs on average around $250 to $300 per month, and will depend on the dosage and form you've been prescribed. This doesn’t include your initial consultation with a prescribing doctor, which tends to be between $80 and $150. ‍

What's the Difference Between a Medical Cannabis Clinic and a GP?

Since medical cannabis is an emerging treatment, some doctors might be hesitant to prescribe it. It’s estimated that only 5% of Australian doctors prescribe medical cannabis, and it can be hard or uncomfortable for patients to have open conversations about cannabis care with their GP.

Doctors in dedicated cannabis clinics know the potential risks and benefits of medical cannabis. You can book a confidential telehealth consultation with a dedicated cannabis clinic, where a doctor will ask you about your condition and treatment history. If they think you might benefit from it, they’ll discuss which form of medical cannabis might be most suitable for you and your comfort level.

If you receive a medical cannabis prescription, you can purchase your medication and have it delivered to your door. You can be confident that what you buy will be the same high-quality product you ordered, as all medical cannabis products must pass extensive checks with the TGA before being offered to patients.

If you do have issues or the treatment isn’t what you expected, arrange a follow-up appointment with your GP or cannabis clinician to discuss any concerns you have.