Australia’s health practitioner watchdog has launched a significant crackdown on medicinal cannabis prescribing, taking action against 57 medical practitioners, pharmacists, and nurses over concerning prescribing practices. Furthermore, the Australian Health Practitioner Regulation Agency (AHPRA) announced it is investigating an additional 60 practitioners amid growing concerns about patient safety.

Surge in Prescriptions Raises Alarm

AHPRA chief executive Justin Untersteiner revealed that the regulator has serious concerns about medicinal cannabis prescribing practices that are leading to “significant” patient harm. Moreover, the agency has discovered that some practitioners issued more than 10,000 scripts in a six-month period, with one practitioner issuing over 17,000 prescriptions.

“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,” Untersteiner said.

Additionally, the regulator highlighted concerns about excessive quantities being prescribed and multiple different prescriptions being issued to single patients so they could “try which one suits them.”

Industry Practices Under Scrutiny

The crackdown follows ABC investigations that revealed patients with histories of psychosis had been hospitalised after receiving medicinal cannabis prescriptions. Tragically, one patient died following inappropriate medicinal cannabis prescribing practices.

Subsequently, concerns emerged from doctors who reported being treated like drug dealers and pressured by telehealth companies to write medicinal cannabis scripts. Indeed, some businesses were using “aggressive and sometimes misleading advertising that targets vulnerable people” and online questionnaires that coached patients to provide responses justifying prescriptions.

New Guidelines Issued

Consequently, AHPRA has released new guidelines urging prescribers to prioritise patient wellbeing above profits. The guidelines explicitly state that except for childhood epilepsy, muscle spasms and pain associated with multiple sclerosis, cancer, and chemotherapy-induced nausea and vomiting, “there is little evidence to support the use of medicinal cannabis.”

Nevertheless, according to Therapeutic Goods Administration (TGA) data, the main conditions for which medicinal cannabis prescribing occurs include insomnia, chronic pain, and anxiety.

Prescribing Requirements

The new guidelines establish that medicinal cannabis should not be prescribed as a first-line treatment. Instead, it should only be used when there is an evidence-supported clinical indication and when other treatments have failed.

Furthermore, the guidelines require that patients be thoroughly assessed, proper medical records be taken, and an exit strategy developed to help patients discontinue the medication if treatment proves ineffective.

Unapproved Products Dominate Market

Most medicinal cannabis products prescribed in Australia are unapproved, meaning they have not been assessed by the TGA for safety, quality, performance, or effectiveness. Therefore, patients must now be informed of this during consultations under the new guidelines.

Similarly, the majority of cannabis products prescribed in Australia contain THC, which causes psychoactive effects. As a result, these products are classified as Schedule 8 medicines due to risks of misuse, abuse, and potentially addictive properties.

Medical Board Response

“We don’t prescribe opioids to every patient who asks for them and medicinal cannabis prescribing is no different. Patient demand is no indicator of clinical need,” said Medical Board of Australia Chair, Dr Susan O’Dwyer.

Additionally, AHPRA and the Medical and Nursing and Midwifery Boards announced they are working with other regulators like the TGA. Moreover, they may investigate practitioners with high rates of medicinal cannabis prescribing even without receiving formal complaints.

Telehealth Company Concerns

The surge in prescriptions has been driven largely by telehealth companies providing what they market as a “one-stop shop” for quick access to medicinal cannabis. However, these practices have raised significant concerns about appropriate patient assessment and follow-up care.

Consequently, the new guidelines aim to address these concerns by establishing clearer standards for medicinal cannabis prescribing practices across all healthcare settings, including telehealth services.

Patient Safety Focus

Ultimately, the regulatory action reflects growing concerns about the rapid expansion of medicinal cannabis prescribing without adequate safeguards. Therefore, AHPRA’s intervention aims to ensure that patient safety remains the primary consideration in all prescribing decisions.

Finally, patients and doctors are encouraged to report unsafe practices to help protect others by calling the AHPRA Notifications Hotline on 1300 361 041. The regulator continues to monitor prescribing patterns and will take further action where necessary to protect public health.

Source: ABC