AHPRA is adopting new, strong approaches to regulate the prescription of medicinal cannabis. To date, they’ve enforced against over 50 practitioners who defied these new rules. AHPRA Chief Executive Justin Untersteiner confirmed that the health agency is currently looking into another 60 cases. He emphasized the repeated need for prescribers to comply.
The move comes amid increasing concern around the safety and efficacy of unapproved pharmaceutical cannabis products. These products are the most popular products being sold in Australia today. Yet, most of these products have not been assessed by the Therapeutic Goods Administration (TGA). They have never been evaluated for safety, quality, performance, or effectiveness. AHPRA is committed to ensuring that patients are informed of the unapproved status of these products. Advocates try to focus this knowledge when it matters—in coordinated consultation process.
New Guidelines for Prescribers
AHPRA only acted when the alarm bells started ringing about the rapid increase in medicinal cannabis prescriptions. In response, they recently issued guidelines to limit the prescribing process and use the timing of these products. Much to the contrary, the guidelines explicitly state that medicinal cannabis should not be the initial treatment. The use of it should only be contemplated in that case, when there’s good clinical evidence and after all other treatments have proven ineffective.
Untersteiner noted the gravity of the situation, saying, “There is little evidence to support the use of medicinal cannabis.” He expressed alarm over the prescribing of large quantities of cannabis, or multiple prescriptions for one patient. The concern deepens, particularly given the growing evidence about the harms associated with tetrahydrocannabinol (THC), the psychoactive ingredient in the majority of cannabis products currently prescribed in Australia.
Medicinal cannabis products that contain THC are considered to be Schedule 8 medicines. At the same time, these products carry inherent risks of misuse, abuse, and potential addiction. AHPRA’s new prescribing guidelines aim to reduce these risks by requiring greater oversight over prescribing practices.
Patient Safety and Reporting Mechanisms
AHPRA is calling for patients and clinicians to help identify unsafe and unprofessional practices for writing medicinal cannabis prescriptions. Members of the public are encouraged to contact AHPRA’s Notifications Hotline at 1300 361 041 to raise concerns, or report examples of inappropriate or dangerous prescribing behavior.
Untersteiner pointed to some alarming examples of patients who have come to emergency rooms for complications associated with their use of medicinal cannabis. He stated, “We’ve seen patients present to emergency departments with medicinal-cannabis-induced psychosis, and this can particularly happen where there are patients that have pre-existing mental health conditions or substance abuse or other issues like that.”
Dr. Susan O’ Dwyer, another physician and medical cannabis advocate, voiced the same sentiment about patients heading to doctors demanding prescriptions for the stuff. She remarked, “We don’t prescribe opioids to every patient who asks for them and medicinal cannabis is no different. Patient demand is no indicator of clinical need.”
AHPRA’s Commitment to Compliance
As part of its commitment to ensuring compliance with the new guidelines, AHPRA plans to take a more proactive approach. Untersteiner stated, “We’re currently investigating a further 60 right now as we speak. For those that choose not to meet our requirements, we will be knocking on their door in the near future.”
This rigorous enforcement has the dual effect of protecting patients and reinforcing standards of medical practice with respect to use of medicinal cannabis. Most cannabis products likely to be prescribed in Australia would have THC. AHPRA’s recent actions demonstrate their dedication to upholding patient safety and medical professionalism through their responsible approach to prescribing.
