Under the current legislation, as outlined by the TGA, any and all licenced doctors can prescribe medicinal cannabis to any patient that meets the relevant criteria; the real question, however, is if they will and, if so, what products will they prescribe.

The Current Regulatory Framework

Broadly speaking, a General Practitioner can prescribe medicinal cannabis with an approval from the Therapeutic Goods Administration (TGA), along with the relevant State or Territory’s Health Department.  The Special Access Scheme (SAS) allows certain health practitioners to access ALL medicinal cannabis products that are not included in the Australian Register of Therapeutic Goods (ARTG). Therapeutic goods that are not included in the ARTG (and are not otherwise exempt from being in the ARTG) are described by us as 'unapproved'.  Currently, the overwhelming majority of cannabis products do not appear on the Australian Register of Therapeutic Goods (ARTG), thus deeming them “unapproved products”. 

It's to be noted that “unapproved products” does not mean “non-compliant products”;  In fact, Australia has some of the most stringent and respected standards in the world, required for medicinal cannabis products to be listed on the SAS, which allows certain health practitioners to access therapeutic goods (such as medicines, medical devices or biologicals) that are not included in the Australian Register of Therapeutic Goods (ARTG) for a single patient.  The TGA defines an Unapproved Product as…

Authorised Prescribers

However, doctors who have undertaken the relevant training and have an Established History of use Pathway are eligible to apply for Authorised Prescriber (AP) status.  As described by the TGA, the Authorised Prescriber Scheme allows authorised medical practitioners to supply therapeutic goods (such as medicines, medical devices or biologicals) that are not included in the Australian Register of Therapeutic Goods (ARTG) to a class of patients with a particular medical condition.

An Authorised Prescriber can supply the product directly to specified patients under their immediate care without requiring separate approval for individual patients.

Authorised Prescribers must report the number of patients treated every 6 months. Use of the product must be reported twice yearly covering each period between 1 January to 30 June and 1 July to 31 December.

Further, while the AP traditionally had immediate prescribing rights to products specifically listed on their AP application, the process has evolved since the updated approach by the TGA (as of December 2021) to categorise medicinal cannabis products by active ingredients; meaning doctors with category approvals can access.

Cannabis Categories

  • Category 1: CBD medicinal cannabis product (CBD ≥ 98%)
  • Category 2: CBD dominant medicinal cannabis product (CBD ≥ 60% and < 98%)
  • Category 3: Balanced medicinal cannabis product (CBD <60% and ≥ 40%)
  • Category 4: THC dominant medicinal cannabis product (THC 60% - 98%)
  • Category 5: THC medicinal cannabis product (THC >98%)

So, My Doctor Can Prescribe… But Will They?

This is where things get interesting.  While we now know that, yes, any licenced doctor (i.e. anyone who can legally prescribe up to Schedule 8/Category 5 medicines) in Australia can prescribe the medicines, many still will not.  Generally, this comes down to one of the following reasons:

  • Opposed to Cannabis:  Some doctors are still unaware of the every-growing mound of evidence on the efficacy of medicinal cannabis. As the education standards modernise and an understanding of the endocannabinoid system becomes part of the domestic curriculum, this mindset will continue to dissolve.
  • Unaware/Unsure of Cannabis:  A large portion of general practitioners, while not condoning cannabis, simply do not have the adequate education to effectively prescribe it.  That is to say, they are not opposed to cannabis, they are just not ‘comfortable’ prescribing (and often will not want to go through the longwinded SAS process for a one off).  It is recommended patients request a referral for a clinic such as Canwell from their doctor in this situation.
  • Willing To Prescribe Specific Brands:  Finally, there are doctors (even some at cannabis specific clinics) who will prescribe medicinal cannabis, but only from specific licenced producers (LP).  That is to say, they will provide access to some products but not all (i.e. different LPs offer different whole flower strains, many of which said doctors will not prescribe).  While it is unwise to speculate on why a doctor would choose to limit patient options, it is import to know it is, in fact, their choice to do so.  Further, there are many doctors and clinics, such as Canwell, who are product agnostic, meaning access to every single legal medicinal cannabis product on the Australian market.

Take Away

Cannabis has a multi-generational, global culture than many patients have been integrated with or, at least, very familiar with.  It has had a profound impact on everything from pop culture to our very evolution.  However, the “medicinal” cannabis industry is still in its infancy, specifically here in the great southern land of Australia.  With that in mind, there is much hope to have for 2022 and beyond with access to cannabis trained doctors increasing, a plethora of products available (some high-quality medicines now meeting black market prices) and an open minded populous.  In other words, once you find the right doctor, then “Yes, your doctor can prescribe you cannabis!!”