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

Since first becoming legal in 2016, more than 370,000 prescriptions have been filled for medical marijuana in Brisbane, Queensland and all over Australia.

Known as the Sunshine State due to its glorious weather, Queensland is also home to Australia’s most widespread medical cannabis community – more than 50% of all medical cannabis prescriptions in Australia have been made for patients in Queensland.

Despite this, there’s still a lot of confusion as to how medical marijuana prescriptions work, who might be eligible, when and how it can be used to treat chronic conditions and even whether weed is legal in Queensland. If you live in Brisbane or any other part of Queensland and want to know more about how medical cannabis works, this post should help you get informed.‍

Who Can Be Prescribed Medical Cannabis in Brisbane & Queensland?

In Queensland, there are more than 130 medical conditions that people can be prescribed medical cannabis for, including anxiety, PTSD, pain, insomnia, epilepsy, multiple sclerosis, autism, fibromyalgia, ADHD and more. Whatever the condition, it needs to have lasted for longer than three months and proven resistant to conventional treatment methods.

According to the TGA’s regulations, cannabis remains an “alternative” treatment, essentially meaning that it can’t be the first treatment offered to patients. You don’t need to have tried every available treatment, you simply need to have tried either pharmaceutical or non-pharmaceutical interventions and found that they didn’t work or caused unacceptable side effects. ‍

How Do Medical Cannabis Prescriptions Work?

Medical cannabis prescriptions work slightly differently to regular prescriptions. Prescription medicines are regulated by a government body called the Therapeutic Goods Administration (TGA). Essentially, the TGA assesses the available evidence for a given medicine and then determines if they should be considered approved or unapproved.

Approved medicines are those that have a significant body of research and clinical use behind them and can make definitive claims as to their efficacy and safety i.e. antibiotics are an effective treatment for bacterial infections. The TGA then registers these medicines for very specific purposes.

As it stands, the TGA has only approved two medical cannabinoids in Queensland:

• CBD oil for the treatment of seizures associated with the Lennox-Gastaut and Dravet forms of epilepsy.
• A combination of THC and CBD oil for the treatment of multiple sclerosis.
  

The Difference Between Approved and Unapproved Medicines

Unapproved medicines are those that are considered safe and potentially effective but have yet to muster the clinical evidence required to be fully approved. This doesn’t necessarily mean that cannabis is an ineffective medicine, simply that – thanks to decades of illegality and demonisation – high-level medical research into THC, CBD and other cannabinoids is only now being undertaken.

The TGA lets doctors prescribe unapproved medicines under two schemes:

• Authorised Prescriber Scheme: doctors apply to the TGA to become Authorised Prescribers of specific unapproved medicines for a particular class of patients.
• Special Access Scheme: the SAS allows doctors to prescribe an unregistered medicine to a patient if they think it might help their condition.

More than 90% of the cannabis prescriptions in Queensland are completed through the SAS. If you’re curious as to who’s being prescribed medical cannabis and what conditions it’s being prescribed for, the TGA makes the prescribing data publicly available.

Queensland also has an additional precaution before issuing a prescription. As they state, "You will need to give informed consent and sign that you understand that you cannot drive or operate heavy machinery if the medicinal cannabis contains tetrahydrocannabinol (THC)."

How Long Does a Medical Cannabis Approval Take in Queensland?

Patients who are interested in obtaining a cannabis prescription in Queensland must first speak to their healthcare provider about their eligibility. (Medical cannabis is sometimes referred to as medical marijuana or medical cannabinoids in Queensland.) If their healthcare provider believes that medical cannabis may be a suitable treatment option, they can apply for access through the SAS or APS.

To apply for access through the SAS, patients must have their healthcare provider submit an application on their behalf. The application must include information about the patient's medical condition, the proposed medical cannabis product and the dosing regimen. Once the application is approved, patients can access the prescribed medical cannabis product through an approved supplier.

The time it takes to complete this process will depend on how familiar your healthcare professional is with the SAS cannabis prescription pathway, but shouldn't take longer than a day or two. (Dedicated cannabis clinics have streamlined the process so that it can be completed almost instantly.)

How Can I Consume Medical Cannabis in Queensland?

Your doctor will talk to you about your preferred method of administration. Cannabis can be prescribed in many forms – including lozenges, capsules and ointments – but by far the most commonly prescribed are flowers and oils. (Despite their popularity overseas, cannabis edibles are not a readily available prescription option in Australia.)

Cannabis flowers are the dried plants you probably picture when you think about marijuana. Flowers are ground up using a grinder and then added to a vaporiser, which makes it easy for the patient to control their dosage. It’s important to note that under TGA guidelines, cannabis flower can only be vaporised. Smoking cannabis is not an approved method of ingestion due to issues with regulating dosage and the adverse health effects of smoke inhalation.

Oils are highly concentrated extracts of CBD and THC (along with various terpenes, flavonoids and cannabinoids) that allow for the delivery of tailored cannabis medicines. This is particularly the case with CBD oils, which can offer therapeutic benefits without the psychoactive effects of the cannabis flower. Oils allow for very precise dosing and can be consumed in a wide variety of ways, from drops under the tongue (sublingual) to vape cartridges, capsules, ointments and more.

What’s the Difference Between CBD and THC?

One of the biggest decisions a doctor will make when issuing a prescription is the balance between cannabidiol (CBD), tetrahydrocannabinol (THC) and other medicinal cannabinoids, terpenes and flavonoids. CBD and THC are the two major cannabinoids in cannabis and the two compounds that have had the most research directed their way.

CBD has no psychoactive properties, but still appears to offer some potential therapeutic benefit through its effects on the endocannabinoid system. THC, on the other hand, is the compound that makes you feel “affected” when you consume cannabis. Treatment for certain illnesses may rely on THC’s psychoactive properties – for instance, appetite stimulation for cancer patients. However, patients may not want to, or be able to feel those effects. (For instance, it’s illegal to drive in Queensland with any amount of THC in your system.)

You’ll often see cannabis oils and dried flowers discussed in terms of their THC and CBD content. Flowers tend to be primarily THC – varying in content from around 19% to 32% – with limited naturally occurring CBD. Oils allow producers to more specifically set the CBD and THC levels. With cannabis oils, you can create pure CBD and pure THC oils, or any ratio in between, along with isolates (only CBD or only THC) and full-spectrum (CBD, THC and the rest of the cannabinoids, terpenes and flavonoids).

Is CBD Oil Legal in Queensland?

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

In 2021, the TGA announced that low-dose CBD oils would now be available to buy over the counter at your local pharmacy. However, you’re still unlikely to find any pharmacy CBD oil products because no CBD oil products have yet been fully registered with the Australian Register of Therapeutic Goods (ARTG).

Registrations is an involved and expensive process that requires clinical trials and formal approvals and which can take up to 2 years. Given the change only came into effect in 2021, it will probably take until late 2023 before the first products arrive in pharmacies. In the meantime, you can still get CBD oil in Brisbane and Queensland through your doctor.

How Much Does Medical Marijuana Cost in Queensland?

As a general rule, your medical cannabis prescription won’t be covered by the PBS. This means that you’ll have to pay for your medication out-of-pocket i.e. at full price.

The price of medical cannabis will vary depending on the form and dosage you’ve been prescribed. The average cost for patients is around $250-$300 per month, not including the cost of your appointment with the prescribing doctor which tends to be between $80-$150.

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

One of the biggest barriers for people who might be eligible to access medical marijuana in Queensland is access itself. It’s estimated that only 5% of Australian doctors are currently prescribing medical cannabis and it can be difficult and uncomfortable for patients to have open conversations about cannabis care with their GP.

Dedicated cannabis clinics offer confidential consultations with doctors who understand the potential benefits and risks of medical cannabis. They’ll ask you questions about your condition and treatment history and – if they assess that you might benefit from a prescription – they’ll help you navigate towards a formula and type of cannabis product that best suits your symptoms and level of comfort.

If you are eligible for a medical cannabis prescription, you can typically purchase your medicine and have it delivered to your door, packaged in a discreet box. All medical cannabis products must pass exhaustive checks with the TGA before being offered to patients, so you can be confident that what you’re buying is exactly what you’re getting. And if the treatment isn’t what you expected, you can set up a follow-up appointment with a cannabis clinician to discuss what is and isn’t working.