A 2016 survey of Australian cannabis users found that a majority of respondents were utilising illicit cannabis for medicinal properties. Soon after the survey was carried out, Australia’s government passed legislation that enabled patients to access medical cannabis products through prescription from a medical provider.

A more recent survey, carried out in 2018-19, aimed to examine patterns of medical cannabis use, two years after the legislation change. The Cannabis as Medicine Survey (CAMS-18) collected data from 1388 participants, who were aged 18 or over, lived in Australia, and had used a cannabis product for medicinal purposes in the last year. The majority of participants were recruited through online media between September 2018 and March 2019.

Medical Cannabis in Australia

Following the effective legalisation of medical cannabis in Australia, the Australian Therapeutic Goods Administration published its clinical guidance in December 2016. This guidance allowed the prescription of a large range of unregistered medical cannabis products for a variety of conditions.

Since the 2016 legislation change until 30th June 2020, the Therapeutic Goods Administration has reportedly approved over 50,000 SAS Category B applications for medical cannabis products. Although access is becoming increasingly easier for patients in Australia, unregistered medical products, such as medicinal cannabis, are not subsidised by the government or health insurance schemes. This means that patients must bear the cost of prescription charges.

In some cases, the cost of medications can be prohibitive. However, the price typically ranges from $5-$15 per day and costs are continuously declining.

Changes in Medical Cannabis Use Following Legalisation

The Cannabis as Medicine Survey 2016 (CAMS-16) revealed that the vast majority of respondents who used cannabis for medicinal purposes sourced the products illicitly. In fact, only one participant accessed cannabis on prescription. Respondents generally reported high levels of efficacy using cannabis products for a range of conditions (mainly chronic pain, mental health, and sleep conditions). Respondents also reported significantly high occurrences of side effects, though these were mostly minor.

Cannabis as Medicine Survey 2018-19 Findings

Two years after the publication of the 2016 survey, the same researchers conducted a follow-up survey, CAMS-18. Again, the majority of respondents reported using cannabis as a treatment for pain (36.4%), mental health (32.8%), and sleep (9.2%).

Despite access to medical cannabis products improving significantly in the period following the publication of the CAMS-16, few respondents – only 2.7% – reported accessing products through legal prescriptions. The remaining respondents reported sourcing illicit cannabis products for medicinal purposes. The greatest perceived barriers to accessing legal medical cannabis were reported to be “cost, disinterest from the medical profession and stigma regarding cannabis use.”

Findings from the CAMS-18 found that a significant proportion of respondents did not know the composition of their cannabis (25.8%), or that the composition varied significantly between batches (23.9%). These findings highlight the inconsistency of cannabis products sourced from the black market.

Of the remaining respondents, a majority (21.3%) reported that their cannabis contained higher proportions of tetrahydrocannabinol (THC) – the psychoactive cannabinoid which causes the euphoria associated with recreational cannabis use. In addition, most of the participants reported that they were concerned about the possible presence of contaminants in non-prescribed cannabis products.

Accessing Medicinal Cannabis Products

When asked how they accessed their cannabis products, 46.2% of respondents indicated that they sourced the products from ‘recreational dealers’. Of the remaining respondents, 25.3% sourced cannabis from friends or family; 11.6% by growing their own; 7.2% from illicit medical cannabis suppliers; 5.1% from online suppliers; and 4.7% from ‘other’ sources.

A majority of respondents (47.8%) stated that they hadn’t sourced legal medical cannabis because they didn’t know any medical practitioners that were willing to prescribe. Interestingly, a significant proportion (32%) were not aware that they could legally access medical cannabis in Australia.

A further 21.2% indicated that legal medical cannabis was too expensive; 18.4% believed that their medical practitioner was not interested or unwilling to prescribe medical cannabis, and 12.7% indicated that they wished their cannabis use to remain confidential from their healthcare providers.

Conclusions

These findings indicate that, despite an increase in active medical cannabis patients, in some respects, little has changed for medicinal cannabis in Australia between 2016 and 2018. Many would-be patients are still accessing illicit cannabis as opposed to legal medical cannabis products, and the same barriers to legal cannabis are also still widely quoted.

Data collected in the CAMS-18 study revealed that consumers would prefer to administer medical cannabis orally or through vaporisation. This is a move away from the traditional method of smoking. Nevertheless, smoking cannabis, both for recreational and medical purposes, remains the most common route of administration. Nevertheless, this change represents a positive move away from more harmful administration methods.

The researchers conclude that the findings indicate that the uptake of legal medical cannabis in the first two years of legalisation has been minimal. These findings paint a worrying picture of Australians continuing to obtain questionable quality products from non-approved and illicit sources.

However, the number of active medical cannabis patients in Australia is continuing to rise – up from 1,606 in January 2019 to 10,595 in December 2019 (an increase of 658%). In addition, the cost of medical cannabis products has also seen a significant decrease – down 17.4% between the start of 2020 and the latter half of 2019.