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Tried everything to treat your chronic pain? 6 questions to ask about legally accessing medicinal cannabis

Federal and State Australian Governments started to decriminalise medicinal cannabis in 2017, but there is still much confusion about how patients can access it, what products are available, and if patients could be charged with drug driving if caught with the products in their system.

Here are six questions you need to ask about legally accessing cannabis.

1. Have I tried all other options?

The Therapeutic Goods Administration (TGA) regulates medicinal cannabis. The TGA’s official policy is that these products should only be prescribed as a last resort. Therefore generally, doctors will not prescribe medicinal cannabis unless you have tried all other possible treatment, and that has failed, or the side effects are too serious.

If you have exhausted all other options before requesting to try medicinal cannabis, you are more likely to be taken seriously.

2. Is it right for my condition?

Some GPs are reluctant to prescribe medicinal cannabis products as they do not know enough about them or are worried about the stigma associated with cannabis. We are aware of one GP authorised to prescribe medicinal cannabis who asks their clients not to advertise their status as a prescriber for fear of an influx of new patients!

While many people have great outcomes, medicinal cannabis is not a miracle cure, and it can’t treat all conditions. It is also not suitable for those who are pregnant, breastfeeding, have a history of unstable cardiovascular disease, or serious psychotic mood or anxiety disorder. For more information on suitable use cases see: Guidance for the use of medicinal cannabis in Australia.

It helps if you can show your GP you have investigated how medicinal cannabis has helped other people with your same condition and are realistic about the possible benefits.

3. Will my Doctor be able to prescribe?

Doctors must apply for and be granted two special TGA permits in order to be able to prescribe medicinal cannabis products. There are only a handful of doctors that have the permits, and many do not want to go through the time consuming and complicated process of being certified to prescribe. Generally, you will also need a specialist to give the prescription the green light, although some GPs can be considered specialists for the purposes of prescribing.

If your treating GP does not have or want to have the permits, you will need to do some research to find a doctor that can assist. A list of medical practitioners who have an interest in, or are authorised to prescribe medicinal cannabis in Victoria, can be found here.

4. What kind of product will help? Are medicinal cannabis products safe and regulated?

There is only one medicinal cannabis product registered on the Australian Register of Therapeutic Goods (ARTG) which allows that medication to be prescribed like other restricted. Other medicinal cannabis products can be prescribed through the TGA’s ‘special access scheme’. Each state and territory has different regulations relating to medicinal cannabis products.

Medicinal cannabis products not on the ARTG vary in strength and purity, as does the method by which they are taken (orally, vaporiser, tincture, or topical applications). None of the medicinal cannabis products are subsidised by the Pharmaceutical Benefits Scheme and we understand most products are quite costly. It’s important to note that products not on the ARTG have not been tested for their quality, safety, efficacy and performance.

5. Could I be charged for drug driving?

The active chemical in medicinal cannabis, THC, is likely to be detected in a roadside drug test. Product disclosure information for medicinal cannabis products states those taking the medication should not drive.

We are not aware of any test case that has dealt with drug-driving when the substance was prescribed medicinal cannabis in Australia. Liability for drug-driving offences are strict, which means if you are found with the drug in your system, you are automatically guilty of the offence.

It will not be a defence that the THC is derived from medicinal cannabis. The consequences of drug driving in Victoria are severe. Therefore, if you need to drive regularly for family or work purposes, medicinal cannabis may not be right for you.

6. Will it be covered by WorkCover or the Transport Accident Commission?

Neither the Victorian WorkCover Authority (VWA), nor the Transport Accident Commission (TAC) have an official, published policy on funding medicinal cannabis products. It is unlikely that the TAC or VWA would fund products not on the ARTG approved list. Ryan Carlisle Thomas is aware of at least one claim for medicinal cannabis product being rejected by a WorkCover insurer and VWA.

‘We are aware of at least one claim for medicinal cannabis product being rejected by a WorkCover insurer and VWA.’

Ryan Carlisle Thomas has previously been informally advised by the VWA that there is no policy in relation to funding for medicinal cannabis. The writer of this blog has contacted the TAC for their official stance but have not had a response.

This blog will be updated if a response is received or an official policy adopted by the TAC/VWA.

Update: 20 January 2020

A South Australian man who is prescribed medicinal cannabis products for Multiple Sclerosis has had a charge of drug driving dismissed by a Magistrate.

Believed to be the first decision of its kind, Magistrate Susan O’Connor found that Brenton Peters was not impaired by THC, the active chemical in marijuana, at the time of driving the car.

Drug driving laws in all states are ‘no fault’ meaning that if the drug is detected in your body, you are guilty of the offence, whether or not your ability to drive is impaired. Medicinal cannabis products do not produce the psychoactive effects of recreational marijuana use.

It is important to note that the decision is not binding on Victorian drivers, or indeed other drivers in South Australia, who would have to satisfy a Magistrate that in their individual circumstances they were not impaired.

However, it has prompted calls for a reform of drug driving laws, given there are now thousands of Australians legally using medicinal cannabis products.

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