Understanding prescription cannabis access barriers offers valuable insights into how health services are meeting the needs of two key groups of Australians who regularly use drugs. This post draws on the latest 2024 national data from the Ecstasy and Related Drugs Reporting System (EDRS) and Illicit Drug Reporting System (IDRS), both coordinated by the National Drug and Alcohol Research Centre (NDARC). We explore the rise in prescribed cannabis use, the main barriers faced, and how these trends are shaping public health and policy.

Introduction

There has been a rapid increase in awareness and use of prescribed cannabis in Australia, particularly among people who inject drugs and those who regularly use ecstasy and stimulants. But as legal access expands, it’s crucial to understand both the opportunities and the persistent barriers preventing equitable access. This blog will uncover key findings from two major national monitoring systems, spotlighting trends in access, cost, and comparisons with illicit sources. We’ll also examine how these “barriers to prescription cannabis” impact health outcomes and what needs to change moving forward.

About the Study and the Populations

The Drug Trends program, including the IDRS and EDRS, takes a close look at patterns among people who frequently use drugs. For the 2024 report, researchers interviewed:

• 884 people who regularly inject drugs (PWID) through the IDRS
• 771 people who use ecstasy and similar stimulants via the EDRS

Their responses shed light on prescription cannabis access barriers and reveal how these issues affect everyday lives.

Key Findings on Prescription Cannabis Access Barriers

Awareness and Knowledge of Prescribed Cannabis

• IDRS group: 85% knew cannabis could be legally prescribed in Australia.
• EDRS group: 93% were aware.

Awareness has grown, but knowing about prescribed cannabis does not guarantee successful access, highlighting persistent barriers to prescription cannabis.

Lifetime and Current Use of Prescribed Cannabis

• Lifetime prescribed use: Doubled since 2021 in both groups
  • 17% of IDRS participants
  • 25% of EDRS participants
• Current use:
  • 7% of IDRS
  • 11% of EDRS

Despite rising lifetime use, most within these populations are not currently using prescribed products.

Barriers to Prescription Cannabis by Source and Cost

How Are People Accessing Prescribed Cannabis?

Among current prescribed cannabis users:

• IDRS: 58% received prescriptions via telehealth, 25% via General Practitioners (GPs), 8% from cannabis clinics.
• EDRS: 54% via telehealth, 26% through cannabis clinics, 10% via GPs.

The popularity of telehealth reflects both greater convenience and possible difficulties attending in-person appointments.

Financial Barriers to Prescription Cannabis

Median monthly spend on prescribed cannabis:

• $300 AUD (IDRS)
• $350 AUD (EDRS)

More than half said prescribed cannabis was too expensive:

• 54% of IDRS
• 61% of EDRS

Cost remains a consistent and significant barrier to prescription cannabis, especially for those with lower incomes.

Other Challenges

Only about one-third believed prescribed cannabis was easier to access than illicit varieties:

• 33% (IDRS)
• 36% (EDRS)

Despite growing availability and telehealth, many still face obstacles and sometimes revert to illicit markets.

Comparison with Illicit Cannabis

Among participants who used both legal and illegal cannabis, experiences varied:

• Effectiveness: 40% of IDRS and 37% of EDRS believed prescribed cannabis was more effective.
• Safety: 52% of IDRS and 49% of EDRS said prescribed cannabis was safer.
• Ease of access: Only around one-third found legal products easier to access.

While prescribed cannabis is often judged safer and sometimes more effective, cost and access issues often tilt preference back to illicit sources.

Trends in Forms of Prescribed Cannabis

Preferred forms differ between groups:

• IDRS: 81% used oral oils/capsules, 27% preferred vaporised flower.
• EDRS: 64% used oral oils/capsules, 59% vaporised flower.

This may reflect differences in habits, medical needs, or provider choices.

Observations and Wider Implications

Rapid Uptake with Persistent Access Barriers

Both samples show a rapid doubling in prescribed cannabis use compared to previous years. This rise signals progress in awareness and acceptance, especially through telehealth and GP engagement. However, the central prescription cannabis access barrier remains affordability, with a significant portion of participants reporting cost as prohibitive.

Telehealth Dominates, but Not Enough

Telehealth has revolutionised access, especially for those facing social or logistical barriers, yet some still face challenges such as digital literacy, reliable internet access, or unwillingness from providers.

Illicit Cannabis Remains Competitive

Legal reforms have boosted uptake, but many still rely on illicit supplies. Reasons include cost, ease, or perceptions about effectiveness and safety.

Source: UNSW