Medical Marijuana Australia: The VICE Guide on How To Get It

Cannabis is a magical plant for mental, physical and spiritual enhancement. It’s fun, but having been consumed to treat aches and ailments for millennia, medical cannabis or medical marijuana is now legal in Australia and many parts of the world. 

But what is medical marijuana? How did we get here? And why? 

Marijuana, also known as weed, pot, grass, bud, Mary Jane and many other nicknames, is the dried flowers of the Cannabis sativa plant. Native to central and south Asia, the marijuana and cannabis plant as a whole have been used as a psychoactive drug and a medicine or therapy for centuries.

Marijuana’s medicinal effects come from compounds in the plant known as cannabinoids, which bind to naturally-occurring receptors in the human body known as endocannabinoids and are proven to work a litany of wonders on the body. 

Medical marijuana is most commonly prescribed in Australia for chronic pain, followed by anxiety and sleep disorders. There are over 400 medical marijuana products on the market including capsules, gummies, lozenges, wafers and sprays, and oil. 

Most medically available cannabinoids are plant-derived, but can also be synthetically produced. In terms of chemical makeup, the main active ingredients are THC (tetrahydrocannabinol) and CBD (cannabidiol). The shorthand maths has always been that THC gets you blasted into space, while CBD is medicinal in some way.

Lately, there has been political battle over whether CBD impairs your ability to drive,  but around the coffee table on a Saturday night questions always come up over everything from what happens when you mix alcohol and cannabis or whether CBD could interact with prescription medicine. 

Medicinally speaking, there are three categories of products:

-   isolates, meaning they are THC or CBD only

-   full-spectrum, meaning they are high in THC or CBD but also contain lower levels of lesser-known cannabinoids

-   broad-spectrum, meaning they have a range of cannabinoids but without THC

The product differences matter because there can be side effects to medical marijuana. Both CBD and THC products have been recorded to cause fatigue, sedation, vertigo, nausea and vomiting, fever and decreased appetite. Products high in THC have also been associated with more dangerous side effects such as convulsions, confusion, psychosis and cognitive distortion. This is because THC has intoxicating properties, so these THC products are scheduled higher on the TGA registry, meaning they are subject to more control and regulation due to these negative side effects. CBD has a safer and more societally acceptable profile – it doesn’t actually bond with your cannabinoid receptors and scientists believe it slows the breakdown of endocannabinoids already in your body.

Officially speaking, only two medical marijuana products are registered with TGA: one for the treatment of seizures and another for multiple sclerosis. 

But drug harm reduction expert and CEO of the Penington Institute John Ryan told VICE Australia that this was a drop in the ocean. The foreseeable gains to the community, if more medicinal marijuana products were approved by the TGA, are “vast”.

“Making these medications more accessible and more affordable will mean more people can benefit,” Ryan told VICE Australia.

“One example, that is perhaps contrary to our intuition, is that medicinal cannabis presents an untapped opportunity to treat people with cannabis use disorder, placing people with this condition in the care of medical professionals where their use can be monitored and reduced over time.”

Medicinal marijuana is most often prescribed to help relieve anxiety and help people sleep, as well as assist with chronic pain management. But it’s not yet proven to help with actual pain reduction – the way morphine is. It’s also not generally endorsed by professional medical bodies in Australia as a pain management strategy.

Whereas in countries like the US, there’s broader scientific acceptance and support for medical marijuana. One commonly held theory is that because our endocannabinoid systems regulate some of our most critical bodily functions, such as sleep, immune and inflammatory responses and diet, medical marijuana use can supplement an out-of-balance ECS – and therefore play a vital role in maintaining healthy human functioning.

Australian healthcare providers often do a great job of delivering holistic care to our community, and this could be enhanced with greater knowledge and understanding of the benefits and uses of medicinal cannabis, Ryan said.

“We find that many doctors do remain wary about prescribing medicinal cannabis, for a variety of reasons such as a lack of confidence in their own knowledge, and perceptions of efficacy of cannabis as medicine.

“So, equipping medical professionals with information and evidence could improve things markedly, and allow them to better assess the reasonable benefits of medicinal cannabis for each individual patient and their needs.”

Is weed legal in Australia? No, but medical marijuana has been legal in Australia since the Narcotic Drugs Act was changed to legalise its commercial cultivation in 2016.

“Australia was among the first countries to legalise medicinal cannabis at a federal level so, in this way, we’ve been ahead of others,” Ryan told VICE Australia.

“However, there remain several barriers preventing greater patient access to medicinal cannabis, including high medication costs, a lack of education among health professionals about the benefits and uses of medicinal cannabis, and unequal treatment compared to other prescription drugs in the workplace and roadside drug testing regimes.”

Since 2016, there have been legislative and policy changes at national, state and territory levels to legalise and regulate medical marijuana’s manufacture and how it can be prescribed and dispensed, but the barriers can do more damage.

“We know that these obstacles can unwittingly drive people to seek cannabis they intend to use therapeutically through the illicit market, posing new risks to both individuals and the community,” Ryan said.

The cost depends on the form and dosage, and the most common form, CBD oil starts at $0.06/mg. The average cost for patients is said to be $250-$300/month without GP consultation costs.

“What we know is that the cost of medicinal cannabis in Australia can be as low as $50 and as high as $1,000 per patient per week, which is staggeringly high,” Ryan said.

“This high cost is a significant barrier for patients who could receive real benefits from accessing these treatments. If medicinal cannabis were covered by the Pharmaceutical Benefits Scheme, we could see huge benefit for the Australia community, especially for patients for whom medicinal cannabis may be the only medicine that works.”

In most cases, medical marijuana can only be legally accessed through an “Authorised Prescriber”– a doctor or nurse who is approved to prescribe a specific unregistered product, such as CBD oil.

Alternatively, a healthcare practitioner can apply to prescribe medical marijuana to a specific patient through what’s known as special access schemes or SAS. In real terms, most non-seriously ill individuals will go to an authorised prescriber, whereas SAS applies mostly to terminally ill patients. But the rules do vary state to state. 

People in NSW can get medical marijuana through an authorised prescriber, SAS or a clinical trial if you’re strapped for cash. A pharmacist cannot hold stock of an unregistered product unless it has been approved for supply to a particular patient by the Commonwealth, so make sure to ask your prescriber about the most efficient way to get your script. But some dedicated dispensaries exist around the country and Sydney’s first cannabis dispensary isn’t far away.

As of 2020, any doctor in Queensland can prescribe registered medical marijuana products such as Sativex and Epidyolex. For all unregistered products, you’ll have to either go via an Authorised Prescriber or the special access scheme.

Victoria was the first state to legalise medical marijuana. Victoria Health recommends first discussing this with your GP, then any medical practitioner in Victoria can prescribe medicinal marijuana if they believe it’s appropriate and have the necessary Commonwealth and/or state approvals.

All medical practitioners in WA can prescribe medical marijuana, but Schedule 8 – aka THC-dominant – products require Department of Health authorisation for each patient. CBD-only products don’t require authorisation. Any pharmacy in WA can dispense medical marijuana products.

Like other states, you can get a prescription from an authorised prescriber or under the SAS. However, South Australian law requires additional approval be obtained after two months of treatment unless you’re over the age of 70 or in palliative care. 

Tasmanians can get a prescription for unregistered medical marijuana products from an authorised prescriber or under the SAS, and registered products that are Schedule 4, such as CBD oil, can be obtained from any medical practitioner. Medical marijuana in Tasmania can be dispensed at any pharmacy with a valid prescription, however for certain products containing THC, your prescriber must be present and practising in Tasmania at the time of issuing.

But although demand has unsurprisingly spiked since marijuana was legalised for therapeutic purposes in 2016, the majority of Australians who have prescriptions order their products online, where the world is your oyster.

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