Frequently asked questions about medicinal cannabis

In Australia, medicinal cannabis refers to a range of quality assured, pharmaceutical cannabis preparations intended for therapeutic use.

Medicinal cannabis products must be prescribed by a doctor to treat the symptoms of a medical condition or, the side effects of a medical treatment (e.g. chemotherapy). Medicinal cannabis preparations include tablets, oils, tinctures and other extracts.

No. Medicinal cannabis can only be legally accessed through your doctor. Growing your own cannabis, or smoking illicit cannabis for medicinal purposes remains illegal in Victoria.

Cannabis that is not prescribed by a doctor is less reliable than a medicinal product, as it has not undergone safety and quality testing and the active ingredients contained within it (cannabinoids such as THC) are inconsistent.

Using cannabis that has not been prescribed by a doctor - in any form - remains illegal in Victoria.

Any patient, with any medical condition can be prescribed medicinal cannabis by their doctor, if they believe it is clinically appropriate.

For patients, the first step is to discuss medicinal cannabis with your doctor.

Legal medicinal cannabis products can only be accessed via prescription from your treating doctor or specialist, where they believe it may be beneficial for your condition.

While any doctor can prescribe medicinal cannabis products, your doctor may need to apply for any relevant Commonwealth and/or State approvals before they can issue a prescription.

For more information about accessing medicinal cannabis, please visit the Better Health Channel.

No. In Victoria, any medical practitioner can prescribe a medicinal cannabis product for their patient, if they believe it is clinically appropriate and have the necessary Commonwealth and/or state approvals.

Medical practitioners do not need to gain accreditation, nor be specialists in a particular field.

Although the evidence base for medicinal use of cannabis is developing quickly, scientific knowledge about how it affects the body is still limited.

The Commonwealth TGA, together with Victoria and other States, has developed guidance documents for doctors and patients that summarise the available evidence to help them determine whether medicinal cannabis may be beneficial for certain conditions, including:

• epilepsy
• multiple sclerosis
• nausea and vomiting
• pain
• palliation.

There are many other potential uses for cannabis-derived treatments, with new applications being investigated in current clinical studies.

Medicinal cannabis is a relatively new treatment and some health professionals may not yet feel sufficiently informed to prescribe it.

Seeking a second opinion for important healthcare decisions from another healthcare professional can give you reassurance about a decision or give you the opportunity to opt for a different choice about a diagnosis or treatment.

The Better Health Channel has some useful information and tools which may assist you in making decisions related to your healthcare:

• Should I get a Second Opinion?
• Getting a Second Opinion
• Healthcare decision making

The Victorian Compassionate Access Scheme provides access to a highly purified medicinal cannabis product (cannabidiol, or CBD) for Victorian children suffering from severe intractable epilepsy.

The number of places available for the scheme remains limited, with strict eligibility criteria in place to ensure this product reaches the most unwell children. Places are allocated by the Victorian hospitals participating in the scheme.

These children are the focus of the Compassionate Access Scheme because of their severe illness and the inability of existing medicines to adequately control their seizures. For some, medicinal cannabis has been able to improve their lives, and the lives of their families by reducing the number of life-threatening seizures they experience.

The costs of medicinal cannabis products can vary substantially from $50 to $1000 per patient per week, depending on the nature of the condition being treated, the particular product required, and the prescribed dose.

Medicinal cannabis products are not currently subsidised by the Commonwealth Government through the Pharmaceutical Benefits Scheme (PBS), meaning that the full cost must be paid by the patient.

Medicinal cannabis may also be accessed through a clinical trial. All clinical trials, including trials of medicinal cannabis, are registered on the Australian New Zealand Clinical Trials Registry (ANZCTR). You can search for relevant clinical trials on the ANZCTR website.

If you are interested in participating in a clinical trial, speak to your doctor.

Medicinal cannabis is a controlled medicine in Australia, and can only be legally obtained when prescribed by a doctor with appropriate approvals.

Products being sold on websites claiming to be 'Medicinal Cannabis' products, cannot be assured of safety and consistency and may contain illegal or toxic substances.

However, it is possible for your doctor to prescribe a medicinal cannabis product not already in Australia, but appropriate import permits from the Office of Drug Control (ODC) will also be required.

The ODC publishes a list of approved importers and manufacturers of medicinal cannabis products on its website, which may assist in identifying suitable quality-assured products available in Australia.

The Better Health Channel has some useful information regarding the risks of self-medication and buying medicines online.

• Health Information and Health Products online
• Complementary medicines - the risks of buying online

There are various medicinal cannabis products available containing different combinations of active ingredients, suitable for different conditions. Many contain Delta - 9 tetrahydrocannabinol (THC), which is the cannabinoid known to have psychoactive properties.

The use of medicinal cannabis products containing THC may decrease a patient's ability to perform some tasks due to its impairing effects on mental alertness and physical coordination.

As there is little evidence or guidance available about the recommended period of time between consuming THC and driving, it is recommended that patients do not drive or perform hazardous tasks, such as operating heavy machinery when taking THC containing medicinal cannabis products.

In addition, it is a criminal offence in Victoria to drive with THC present in your saliva, blood or urine. Patients should discuss the implications for safe and legal driving with their doctor.

Yes. In Victoria, any medical practitioner can prescribe a medicinal cannabis product for their patient, if they believe it is clinically appropriate to do so and they have obtained any necessary Commonwealth and/or state approvals.

More information on what approvals (if any) may be required can be found here.

Medical practitioners do not need to gain accreditation, nor be specialists in a particular field.

Yes. Victorian nurse practitioners are authorised to prescribe any Schedule 2, 3, 4 or 8 medicine within the lawful practice of their profession. Medicinal cannabis products are currently listed in the Poisons Standard as either Schedule 4 (products containing 98% CBD) or Schedule 8 (products containing >2% THC) drugs.

Approval from both the Commonwealth Therapeutic Goods Administration and Victorian Department of Health may be required before a prescription can be issued, depending on the product. More information on approvals can be found here.

No. Any patient with any condition may be prescribed medicinal cannabis if their treating doctor believes it is clinically appropriate and has any required approvals.

Depending on the medicinal cannabis product, approvals may be required from the Commonwealth TGA and/or Victorian Department of Health.

Commonwealth approval is required for any product not listed on the TGA's Australian Register of Therapeutic Goods (ARTG). This can be obtained via the Special Access Scheme (SAS) or Authorised Prescriber authorisation. Only one cannabis product is currently listed on the ARTG.

A Victorian treatment permit is required if a doctor or nurse practitioner intends to prescribe a Schedule 8 medicinal cannabis product (those products containing THC) to a patient with a history of drug dependence. This is a requirement which applies to treatment with any Schedule 8 drug, such as opioids - it is not a specific to medicinal cannabis.

Required approvals are arranged by the prescribing doctor and can be provided in two business days.

More information on what approvals (if any) may be required can be found here.

Therapeutic goods registered on the ARTG have undergone an evaluation for quality, safety and efficacy. There are currently only two medicinal cannabis products entered on the ARTG:

• Nabiximols (Sativex^®), listed on the ARTG as a schedule 8 controlled drug as a 'treatment for symptom improvement in patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication.'
• Cannabidiol (Epidyolex®) listed as a Schedule 4 prescription medicine as an adjunctive therapy of seizures associated with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) for patients 2 years of age and older.

In addition to the two medicinal cannabis products currently approved for use (Sativex and Epidyolex), health professionals are also able to prescribe a variety of unapproved medicinal cannabis products. These products have not undergone the same assessments of safety and efficacy as approved products, but can still be prescribed with approval from the Commonwealth Therapeutic Goods Administration (TGA).

The TGA has published a list of unapproved medicinal cannabis products on their website, organised by category of active ingredient (high THC, low CBD etc.). This list can be used to identify an appropriate product for your patient and can be accessed here.

The Office of Drug Control (ODC) also publishes a list of importers and manufacturers of medicinal cannabis products on its website, which may assist in identifying products available in Australia.

Before prescribing a product, it is recommended that the prescribing doctor contact the supplier to confirm its availability.

No. Regulation 24 of the Drugs, Poisons and Controlled Substances Regulations 2017 requires you to include the ‘full particulars’ of the medicine, which must include:

• The active ingredient(s) (generic name) of the medicine (e.g. THC, CBD ).
• Strength(s) or concentration(s) of the active ingredient(s) (e.g. THC 10mg/mL : CBD 15mg/mL )
• Directions for the precise dose and frequency of administration (e.g. 1mL po tds )
• Quantity to be supplied (written in both words and figures) (e.g. 50mL (Fifty mL) )

While not specified in the regulations, it is strongly recommended that the name of the proprietary product is included in order to minimise uncertainty and the likelihood that a pharmacist will need to contact the prescriber, to seek clarification, before supply can be made to the patient.

Including only the TGA category of the medicinal cannabis product is insufficient and does not comply with the requirement to include the ‘full particulars’ of a medicine.

Regulations 50 and 51 of the Drugs, Poisons and Controlled Substances Regulations 2017 make it an offence for a pharmacist to supply a Schedule 4 or Schedule 8 poison contrary to the instructions written on a prescription - other than in accordance with exceptional circumstances (as indicated in Regulation 53).

Pharmacists are therefore only able to substitute medicinal cannabis products provided the active ingredients, concentration, quantity and any other specifications (i.e. dosage form) are the same, and the prescriber has not indicated that brand substitution is not permitted.

If a substitution is required due to stock issues or other reasons, the pharmacist would need to contact the prescriber to receive a verbal or written instruction from them to dispense a product with different active ingredient ratios, concentrations, etc.

Medicinal cannabis cultivation is regulated by the Federal Government under the Narcotic Drugs Act 1967. For more information on cultivation refer to the Business and Industry section of this website.

Medicinal cannabis manufacture is subject to dual federal-state regulation. The Office of Drug Control is now accepting applications for Commonwealth manufacturing licences and there may be additional Victorian licencing requirements under the Drugs, Poisons and Controlled Substances Act 1981. More information is available on the Business and Industry section of this website.