How Weak Medicinal Cannabis Regulation Created a Public Health Problem

Australia’s medicinal cannabis regulation has failed to keep pace with a market few predicted would grow this fast. What started in 2016 as a tightly controlled pathway for seriously ill patients has become a mainstream prescribing industry worth hundreds of millions of dollars a year. Close to one million approvals existed by the end of 2025, according to TGA data. In the first half of 2024 alone, Australians spent more than $400 million on these products.

Yet the TGA has not formally assessed much of what doctors prescribe for safety, quality or effectiveness. These products are legal but officially “unapproved.” Now a regulatory review is under way, and the central question is simple: how did oversight fall so far behind?

A System That Was Not Ready for These Cannabis Prescribing Practices

Australia’s health system was not built for this demand. Doctors raised the alarm as early as 2018. They described a rollout that moved faster than the structures meant to support it.

The problems they identified were serious. Patients sought prescriptions from several practitioners who never communicated with each other. Prescribers received little clear guidance. Nobody built a reliable system to track whether treatments worked or caused harm.

Those problems were never fixed. The market simply grew around them.

Telehealth clinics and online platforms drove most of that growth. Many offer quick consultations with little contact from a patient’s regular GP. The Australian Health Practitioner Regulation Agency (Ahpra) found consultation times of “a few seconds and a few minutes” at some services. One prescriber wrote more than 10,000 scripts in six months. A single pharmacist dispensed 959,000 cannabis products in one year.

From Oils to Flower: A Shift With Real Health Consequences

The products doctors prescribe have also changed. Herbal cannabis, including dried flowers patients smoke or inhale, now overtakes oral oils in prescription rates. This shift carries real clinical risks.

Inhaled cannabis reaches the bloodstream through the lungs within minutes. Oils absorb slowly through the gut and take hours to peak. The standard approach for any new medicine is to start low and monitor carefully. That principle becomes very difficult to follow with a product that acts almost immediately.

THC (tetrahydrocannabinol) approvals are also rising. THC is psychoactive. It can cause impaired cognition, anxiety, and in some people, psychosis. Both THC and CBD interact with other drugs. They alter blood levels and raise the risk of harm in patients who already take antidepressants, sedatives, or opioids.

The result is a system where prescribing happens in one place and monitoring happens somewhere else, or nowhere at all.

What the Evidence Actually Shows About Medicinal Cannabis

The clinical evidence for medicinal cannabis is thin across most conditions doctors prescribe it for. Research reviews find little proof that it reduces anxiety, relieves pain, or helps people sleep. Gaps are equally large for mental health conditions and substance use disorders. These are among the most common reasons Australians receive a prescription.

Without clear measures of benefit or harm, many patients go online. They use social media forums and internet searches to compare products, work out doses, and interpret side effects. Community experience has value, but it is a poor substitute for proper oversight, especially for people on multiple medicines.

Advertising Rules Routinely Ignored

Weak medicinal cannabis regulation also shows up in how these products are marketed. Australian law bans direct-to-consumer advertising of prescription medicines. That covers websites, social media, sports sponsorships, and even euphemisms like “plant medicine.”

Cannabis clinics and suppliers are breaking these rules openly. A 2025 study of 54 Australian medicinal cannabis provider websites found that nearly half violated at least two TGA guidelines. Breaches included unsubstantiated health claims, patient testimonials, and self-assessment tools that coached users on qualifying conditions. One company ran more than 170 social media ads in a single month. Some of those ads reached users as young as 18.

The TGA has issued more than $2.3 million in fines for advertising breaches since 2023. It has started three Federal Court proceedings. None have produced a judgement yet.

In July 2025, Ahpra warned publicly about business models built on “aggressive and sometimes misleading advertising” that targets vulnerable people. By late 2025, organisations representing GPs, doctors, and pharmacists wrote jointly to the NSW health minister. They called for a crackdown on rogue prescribing, vertically integrated clinics, and fast telehealth consultations where the same company prescribes and dispenses the product.

What Needs to Change

The federal government has announced reforms. Medicines prescribed online or via telehealth will appear in My Health Record with clinical context. That gives patients and doctors a fuller picture of what someone is taking.

But visibility alone does not fix the structural failures in cannabis prescribing practices. Researchers and clinicians want nationwide monitoring. This would use secure, linked, de-identified data from electronic medical records across different care settings. It would answer the questions nobody can currently answer: who takes medicinal cannabis, for what conditions, with what effects, and at what cost to their health?

Medicinal cannabis regulation in Australia needs to catch up. The prescriptions are real. The money is significant. The patients deserve the same standards of oversight that apply to every other widely used medicine.

Source: dbrecoveryresources