Prescribing medicinal cannabis
Any registered medical practitioner in Queensland can prescribe medicinal cannabis for any patient with any condition, if they believe it is clinically appropriate and have obtained the required Commonwealth approval.
Medicinal cannabis products are classified as either Schedule 3, Schedule 4 or Schedule 8 controlled substances, most products are not listed on the Australian Register of Therapeutic Goods (ARTG). In circumstances where patients need access to therapeutic goods that are not included in the ARTG, a Therapeutic Goods Administration (TGA) approval is required in order for the medicine to be prescribed.
The Commonwealth Department of Health manages and enables access to:
In Queensland, the Medicines and Poisons (Medicines) Regulation 2021 describes the requirements for prescribing and dispensing S4 and S8 medicines.
Queensland doctors can prescribe Schedule 4 - cannabidiol (CBD) and Schedule 8 - tetrahydrocannabinol (THC) or tetrahydrocannabinol: cannabidiol (THC:CBD) products without a Queensland approval.
Guidance and regulations
- Guidance’s for the use of medicinal cannabis in Australia are a suite of national guidance documents that cover a range of medical conditions, symptoms, and products to be used. The individual documents can be viewed on the TGA's website.
- The Medicines and Poisons (Medicines) Regulation 2021 outlines specific requirements for dealing with regulated substances, including medicinal cannabis, review the Regulation for more information.
- The Medicines and Poisons Act 2019 provides for the development of departmental standards which outline the minimum requirements for safe and effective management of regulated substances, including medicinal cannabis, review the standards for more information.
When making an application to the TGA, you will need to reference clinical evidence that supports using the specific type of medicinal cannabis product proposed (e.g. THC, CBD, or THC and CBD in combination) for your patient's medical condition or symptoms.
More research is being done on the uses of medicinal cannabis. The scientific evidence base is limited but suggests that medicinal cannabis may be suitable for:
- severe muscular spasms and other symptoms of multiple sclerosis
- chemotherapy-induced nausea and vomiting
- some types of epilepsy with severe seizures
- palliative care (cachexia, nausea and vomiting, pain)
- some forms of chronic non-cancer pain.
You may apply for other conditions; however, you will need to supply clinical evidence with your application for this to be considered. There is no evidence that medicinal cannabis is an effective treatment for cancer.
Clinicians should not:
- consider medicinal cannabis as an alternative treatment for cancer.
- defer their standard treatment in favour of using medicinal cannabis.
NSW Cannabis Medicines Advisory Service – (for NSW health practitioners only). However, the Service is also available if:
- You are a medical practitioner in a state or territory outside of NSW but are treating a patient residing in NSW, or
- You are a NSW medical practitioner treating a patient in cross-border areas of NSW.
Commonwealth Department of Health
The Commonwealth Department of Health regulates medicinal cannabis products through the Therapeutic Goods Administration (TGA) and the Office of Drug Control (ODC).
Generally, medicines imported into, supplied in, and exported from Australia must be entered in the Australian Register of Therapeutic Goods (ARTG), which is administered by the TGA. However, there are mechanisms available for access to medicines that are not registered on the ARTG.
As most medicinal cannabis products are currently unregistered medicines, access to these products is through the Commonwealth Special Access or Authorised Prescriber Schemes or through a Clinical Trial.
Your legal obligations
The prescriber must:
- adhere to all conditions as detailed in any TGA import licence or permit, if they are the importing party
- comply with any conditions imposed on a TGA approval relating to the medicinal cannabis product(s) being used, including obtaining informed consent in writing from the patient (or the person with the legal authority to consent to the treatment on behalf of the patient) in relation to the proposed use of the specified medicine
- comply with the Departmental standard – monitored medicines when prescribing S8 medicinal cannabis products for dispensing or giving a treatment dose
- comply with the requirement to check QScript prior to prescribing or giving a treatment dose of a monitored medicine, including S8 medicinal cannabis
- report any adverse events, adverse reactions, serious adverse reactions and unexpected reactions to the TGA.
Find a product
Doctors can apply to prescribe both plant-based products and synthetic products when used for a therapeutic purpose, including:
- tinctures: plant material infused in oil or alcohol
- vapour: dried plant material or concentrated cannabis extract is heated in a vaporiser
- capsules or sprays: generally, oil-based capsules taken orally
- pharmaceutical products such as nabiximols.
Smoking in general is harmful, smoking of cannabis products is not supported.
Products currently used in Australia:
- Office of Drug Control provide a list of manufacturers and suppliers for imported and locally produced medicinal cannabis products currently in use in Australia.
- Nabiximols (Sativex), is listed as an approved medicines on the Australian Register of Therapeutic Goods.
- Sativex is a Schedule 8 medicine and is a plant-derived product. In Queensland medical practitioners can prescribe Sativex without requiring an approval from the state or the TGA.
- Epidyolex is a Schedule 4 medicine used as an adjunct therapy in the treatment of severe forms of epilepsy.