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:

• Special Access Scheme (SAS)

• Authorised Prescriber Scheme (AP)

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.

Clinical evidence

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.

https://www.health.qld.gov.au/public-health/topics/medicinal-cannabis/prescribing