Quick Summary – cannabis is legal for medical use through an involved process
Australian law concerning cannabis was revised by the TGA (Therapeutic Goods Administration) in 2017, which changed the legal designation for certain cannabis products. Marijuana is now legal for Medical use in some circumstances.
FACTMarijuana is now legal for Medical use in some circumstances. The process to get hold of it, even for those who deserve it, is convoluted as you will see in the article below.
In essence, wherever you are in Australia, the first step, for those seeking medical marijuana is to discuss the situation with your GP. They may refer you to a specialist who, if they believe your condition will benefit from treatment with cannabis, will prescribe it for you. Some cannabis is then ordered, most likely to a pharmacy which will provide it to you.
There is a difference between what the law currently demands, so that someone can be prescribed legal medical cannabis, and what a ‘normal person’ might think was involved. Typically, in life and for most other circumstances, you have a malady, you see a doctor, you are prescribed a drug and you walk down to the pharmacy and pick it up. For a patient to be prescribed medical cannabis, however, a layer of permission (requiring application through a government procedure if it’s being done for the first time) is required at each step of the process. The Doctor may have to apply to be allowed to prescribe medical cannabis, either on behalf of an individual or a group of individuals with similar symptoms, then an application for import of a cannabis drug which will help has to be obtained (again, by the doctor) then the Pharmacist can order enough to fulfill the prescription. Then it can be provided to the user.
The ‘problem’ created by all of this extra work for medical cannabis stems from the fact that Australia has signed up to the Single Convention On Narcotic Drugs and so has to be able to keep track of production of cannabis.
Cannabis is still not legal for non medicinal use
FACTMarijuana is the most popular drug in Australia with highest rates of usage in the country, some of the highest in the world.
Around the country, Cannabis is categorized by Law enforcement officials as a ‘drug of dependence’. When used for recreational purposes, a small quantity (typically less than 50 grams) is usually dealt with by police with caution. Stricter penalties are applied for larger quantities.
Rules and penalties vary by state and territory for those caught producing or holding the drug.
Before we proceed, please remember, obviously, the information below is not a legal guide. Make sure to get proper legal advice and to consult your Doctor before you risk taking any steps with cannabis which may be illegal.
Key departments involved in Australia’s medical marijuana laws
These departments and theirapply in Victoria, NSW, ACT, SA, WA, The NT and Queensland. Tasmania is slightly different and we cover that state separately, below.
Victoria was the first Australian jurisdiction to legalize cannabis for medical use, in early 2016. Under the Victorian Access to Medical Cannabis act
They key government departments involved are:
- The Commonwealth Department of Health (DOH):
The department of health sets the tone for the National health system and evolves it in light of scientific studies. For example, they issue guidance to Doctors and other medical professionals about medical cannabis.
- The Therapeutic Goods Administration (TGA):
The TGA is part of the health department. It regulates medicines, amongst other things and so has recently reconsidered its position on cannabis.
- The Office of Drug Control (ODC):
The OCD maintains a list of companies which manufacturers and suppliers of medical cannabis .
- State Medical Authorities:
State medical authorities have guidance at a state level on laws which apply in the region and how cannabis can be prescribed, legally, within them.
- Border control:
Border control is involved when cannabis is imported or exported to Australia.
What sort of patient canoes cannabis for medical reasons?
The subtleties of Australian law as it relates to cannabis change over time and vary slightly by state or territory: Generally, the following statements, rules and procedures apply to all states.
Following the legalization of cannabis for medical reasons, all Australian patients are now considered ‘eligible ‘to use cannabis, if they have a relevant medical condition. What is considered a relevant medical condition is determined by a clinical guidance document issued by the Department of Health. They have done their homework on that. It rigorously reviewed the evidence available on cannabis within the health world to provide a framework in which it could be employed constructively in Australia.
Practically, ‘relevant’ conditions at the moment often include patients with Cancer, HIV, Multiple Sclerosis, and, in NSW, those in the final 12 months of a terminal illness. The exact list of what medical cannabis can be used to treat varies by state but often includes those things.
GPs / Doctors and pharmacists can order it
Medical cannabis needs to be prescribed by a Registered Medical Practitioner, most commonly your Doctor (GP) who believes it is required from a clinical perspective to treat a medical complaint you go to them with.
Any drug prescribed in Australia has to be registered with the TGA. Specifically, the drug has to be registered under the Australian Register of Therapeutic Goods (ATRG.). Currently, there is only one cannabis based drug on the TGA list, Nabiximols. Anything else needs to follow the TGA process.
To prescribe unregistered cannabis for a group of patients, the doctor has to apply to become an ‘Authorized Prescriber’ with the TGA. Some medical marijuana drugs are now held in Australia – see below.
Alternatively, doctors can apply to the TGA to import an unregistered cannabis product for a specific patient under the Special Access Scheme.
In either case, the Doctor may need to provide evidence (to the TGA) of the efficacy of the drug which is appropriate to the patient’s condition.
The Doctor also has to make sure they oblige cannabis regulations under their state or territory laws through their health department. This step is easier than it was. The process was revised in April 2018, removing a separate signoff that was required by each state before cannabis could be provided to patients.
They can then order from suppliers / manufacturers, as shown on the ODC website (link above) or obtain a license to import from the ODC. Of course, the Border Control have to be informed of the import request.
Pharmacists wishing to prescribe medical cannabis
Pharmacies fulfilling prescriptions have to be an appropriately qualified pharmacist but no accreditation is required specifically, to dispense medical cannabis .
Pharmacists can’t hold speculative stock of cannabis based medical products. They need to wait until they receive a prescription which has followed the process above and fulfill it at that point.
Medical cannabis can be imported
With a license from the Department of Health. Companies and Doctors can apply to import a non registered cannabis product. The Department Of Health signed off bulk imports of some medical marijuana drugs which mean that those ‘on the list’ are more readily available than they were. For example, stock is held in Australia and does not need to be ordered in. (Under this process.)
What Medical Marijuana products can be prescribed?
Due to the limited information available on the medical benefits of cannabis at the current time, only one cannabis product is registered as a medicine, ‘Nabiximols.’
Other cannabis based products can be provided to patients, but have to be accessed through specific procedures available for unapproved medicines as covered above.
Over time, companies which have conducted / will conduct clinical research in to the efficacy of the drug will be able to submit that evidence to the TGA and the ‘stock’ of medical cannabis products which can be prescribed will grow.
Can private companies apply to import the drug and sell it wholesale?
‘Commercial Sponsors’ can apply to supply under the SAS or AP scheme. But again, as you can see from section 5A (page 174) just as with a pharmacist, the process has to be initiated by a requested from a GP.
Prescribed cannabis comes in a number of forms but is not smoked for medical reasons:
Medical cannabis is provided as an oil, eyedropper, as capsules and a vapor but is not smoked for medical reasons. Smoking has health hazards and can contribute to a lack of clarity about how much of active ingredients have been consumed (‘dosing.)
Distribution in form other than marijuana cigarettes also makes it harder for those who might be inclined to sell the product for recreational rather than medicinal uses.
Tasmania is a bit different:
Tasmania operates under the Medical Cannabis Controlled Access Scheme: Where ‘conventional treatment has been unsuccessful’, a Doctor can prescribe cannabis to their patient. Specialists must apply to the TDHHS (Tasmanian Department of Health and Human Services (as well as applying to / notifying (as appropriate) the TGA and ODC.
Medicine is a science and, quite rightly, Doctors don’t want to prescribe something until they are sure of a sound scientific basis for the decision. Cannabis has been Illegal under Federal, state and Territory laws across the country which means that there is limited evidence available to justify prescribing the drug – a Catch 22 if ever there was one. As of October last year, in total, only 150 or so Australians had been prescribed cannabis.
It’s probably fair to say the National system is currently not easy to follow. Since the requirement for dual signoff – at a state and federal level was removed in April 2017, time taken to provide a prescription has fallen to 48 and in some cases, 24 hours which is an improvement.
Clinical trials of cannabis in a medical context are under way, investigating whether cannabis products assist with epilepsy, for pain relief and as a sleep aid. Over time, as more evidence becomes available to support these propositions, cannabis will also become more readily available.
That can only be a good thing. Australia, like the US, appears to be on the brink of a prescription painkiller ‘epidemic’. In areas of the US where cannabis has been made fully legal, overdoses from prescription painkillers have fallen.