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Medicinal cannabis is a regulated medicinal product derived from the cannabis plant used to treat symptoms or diseases. Medicinal cannabis has been legal since 2016 in Australia, and most health professionals Australia-wide can prescribe medicinal cannabis products. However, there are some requirements and restrictions around the types of health professionals that can prescribe in different States and Territories.
In this article, you’ll learn who can prescribe medicinal cannabis in your local jurisdiction, why cannabis clinics exist and how they may be helpful to you as a health professional and get an overview of the prescriber pathways. Here are the topics covered in the article:
Who can prescribe medicinal cannabis in Australia?
While most patients and health practitioners think that a doctor must be specialised, needs to have done special training or have a permit to prescribe, that is not the case. Any doctor, specialist and most nurse practitioners can prescribe medicinal cannabis in Australia. First, however, you need to understand the application process.
There are also specialised cannabis clinics that have increased knowledge of applying medicinal cannabis to certain conditions and specialities. Cannabis clinics may have health professionals who focus on specialist areas like psychiatry, palliative care, oncology, pain management, rheumatology and neurology; however, many clinics have GPs who prescribe.
While hospital doctors can prescribe medicinal cannabis, it’s not common practice. And it is important to note that nurse practitioners cannot prescribe in all jurisdictions in Australia, and rules may vary by location. Nurse practitioners should speak with their local nursing and midwifery board to get detailed information about their eligibility requirements.
State vs federal requirements may differ
The federal requirements for prescribing cannabis are the same across all states and territories. That means that health practitioners can apply to the TGA via the SAS or AP pathways. However, each state has its adjunctive applications that may need completion for certain populations.
For example, some jurisdictions have a limitation on the amount of THC that can be prescribed in a 24 hour period. WA and SA have a cap of 20% on the strength of the inhaled flower products. Some states require specialist endorsement or state approval for certain populations like the pediatric patients or those with a history of drug or alcohol abuse. These are extra safety precautions that the particular state feels are necessary to maintain the health of its citizens.
It’s important to remember that these rules apply to the location of the prescriber, not the patient.
The cannabis clinic’s role in medicinal cannabis
These clinics have risen out of necessity for patients. A large portion of the medical community still lacks an understanding of the endocannabinoid system and how cannabis can be utilised as a valuable therapeutic tool within their toolkit. It’s not something we learned in our university training and pathways
Dr Jim Connell
Medicinal cannabis clinics are specialist clinics where the medical team is knowledgeable about treating various conditions with cannabis. These clinics do not take over the primary care of that patient. And most of these clinics will communicate back and forth with the primary caregivers so they understand the treatment and outcomes. It’s essential for a patient’s primary caregiver to monitor side effects, benefits, and interactions with the patient’s current medical regime.
If you’re interested in prescribing medicinal cannabis, you must have some knowledge about the medicine. You can get this information from various self-teaching courses or formal online and in-person courses across the country. If you’d like to trial a patient on medicinal cannabis, you may want to start by referring a patient to a clinic.
Pathways for prescribing medicinal cannabis
There are two main pathways for prescribing medicinal cannabis – the Special Access Scheme B (SAS B) and the Authorised Prescriber Scheme (AP) pathways.
The Special Access Scheme was set up for medical practitioners to prescribe unapproved medicines that aren’t on the PBS. It has been used for various medicines and medical devices for years, but now has mostly become a pathway for servicing cannabis prescribers.
When doing an SAS application you apply via the Therapeutic Goods Administration portal and apply to prescribe a category of products to a patient. After the category approval you write a script specifically for a product in that category.
The Authorised Prescriber Scheme is for health professionals who have experience prescribing. To become an AP, you must apply to the TGA and, in some cases, get ethics approval. If approved as an AP, you will be approved for certain categories of products for specific conditions. As an AP, you no longer need to apply to the TGA for each patient. However, there are various reporting requirements on a bi-annual basis.
TGA application turnaround time
One misconception is that the SAS application takes a very long time. While it may take you a while on the first submission, after a few patients, the process should take you no more than 5-10 minutes on average. It’s important to note that the TGA doesn’t ever outright reject an application. If they kick an application back, they require more information or justification for the application.
The time that it takes for the TGA to approve an application varies. Most applications are approved within a week, and many are approved within 72 hours. It depends on the demand the TGA is under at the time of your submission.
Conclusion
The important thing to know is that becoming a medicinal cannabis prescriber is not as complicated as health professionals often think. There is no special license or education you need to prescribe, and any doctor, specialist and most nurse practitioners can prescribe.
If you have a patient that cannabis might help but you aren’t comfortable prescribing, referring your patient to a clinic is a possible solution. However, if you find your patient benefits from cannabis, it’s a good idea to do some research and begin prescribing yourself. Not only will you be able to better manage your patients who want or need medicinal cannabis, but you’ll also have another important tool in your medical toolkit.
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