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

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

One of the country’s most forward-thinking states, it’s little surprise that Victoria has been at the forefront of medical cannabis activism, research and clinical use.

However, people still don’t always understand exactly how medical marijuana prescriptions work, who might be eligible, how cannabis is used to treat chronic conditions, and the legality of cannabis use in Victoria. If you live in Melbourne or any other part of Victoria and are interested in learning about how the medical cannabis system works, this blog contains all the essential information.

Who Can Be Prescribed Medical Cannabis?

In Australia medical cannabis has been prescribed for more than 130 conditions, from anxiety to PTSD, pain, insomnia, epilepsy, multiple sclerosis, autism, fibromyalgia, ADHD and many more. If the condition has persisted for more than three months and has proven resistant to conventional treatment methods, you can talk to your doctor about whether it might benefit from cannabis care.

It’s important to note that cannabis is still considered an “alternative” treatment. This basically means that it can’t be the first treatment offered to patients. Under this rule you don’t need to have tried every other available treatment – you simply need to have tried other therapies, whether they’re pharmaceutical or non-pharmaceutical, and found that they either didn’t work or caused unacceptable side-effects.

How Do Medical Cannabis Prescriptions in Victoria Work?

Like all other prescription medicines, you need to talk to a doctor if you want to get access to medicinal marijuana in Victoria. However, 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 registered or unregistered.

Registered 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 only recognises two medical cannabinoids in Victoria:

• 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.

Unregistered medicines are those that are considered safe and potentially effective but have yet to muster the clinical evidence required to be fully registered. This doesn’t necessarily mean that cannabis is an ineffective medicine, simply that the sort of medical research required to become registered with the TGA is only now being undertaken.

When Can Patients Be Prescribed Medical Cannabis?

The TGA lets doctors prescribe unregistered medicines under two schemes:

• Authorised Prescriber Scheme: the APS lets doctors apply to the TGA to become Authorised Prescribers of specific unregistered 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. SAS prescriptions are approved by the TGA on a case-by-case basis.

More than 90% of the cannabis prescriptions in Victoria 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.

How Can You Consume Medical Cannabis in Victoria?

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.)

When we talk about cannabis flowers, we’re talking about 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.

A more recent innovation, 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 THC and CBD?

Cannabis can be prescribed in a wide variety of forms, cultivars and THC concentrations. When issuing a prescription, doctors will evaluate your medical history, symptoms and any previous cannabis experience before deciding what the best format might be.

One of the biggest decisions 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 Victoria 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 Victoria?

The TGA separates cannabis products into 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, it is still almost impossible to access pure CBD oil without a prescription due to the way that medical products are regulated in Australia.

In order to be sold through pharmacies, products need to be registered with the Australian Register of Therapeutic Goods (ARTG). This 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 later in 2023 before the first products arrive in pharmacies.

In the meantime, you can still get a CBD prescription in Victoria through your doctor.‍

Can You Fly With Medical Marijuana in Victoria?

If you have a medical cannabis prescription, you are entitled to carry and use your prescribed products anywhere that you would be able to carry and use other prescription medicines – basically, everywhere. While you won’t be allowed to vape on a plane, as long as you have the original prescription document and product packaging you can bring your medical cannabis with you wherever you travel in Australia.

Note that this does not cover international travel. Once you leave Australia you’re subject to the laws of whatever country you travel through, so make sure you do your research before getting on an international flight with your medical cannabis prescription in your luggage.‍

How Much Does Medical Marijuana in Victoria Cost?

Unfortunately, most medical cannabis prescriptions aren’t covered by the Pharmaceutical Benefits Scheme (PBS), so you’ll generally have to pay your medication costs out-of-pocket.

The price of your 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 typically costs 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 Victoria 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.