Since the Australian Federal Government first legalised access to medicinal cannabis back in 2016, hundreds of cannabis products have become available.
The supply of medicinal cannabis within Australia is regulated by the Therapeutic Goods Administration (TGA). With most medical cannabis products falling under the ‘unregistered drugs’ category, prescription requires approval under the TGA Special Access Scheme (SAS), or as an Authorised Prescriber (AP).
Medicinal cannabis can be prescribed by any medical doctor in Australia, provided that it is clinically appropriate, and that there is evidence supporting the use of medicinal cannabis for the patient’s treatment. Nurse Practitioners are also able to prescribe medicinal cannabis in certain states or territories.
Although medicinal cannabis can be prescribed by any doctor, it is important that you find a doctor who not only understands it in depth, but has also undergone additional training specifically for medicinal cannabis.
Authorisation Pathways For Prescribing Cannabis
Should a practitioner wish to prescribe a medicinal cannabis product that is not registered on the ARTG, they will need to gain approval from the TGA in one of two ways:
- Special Access Scheme
- Authorised Prescriber Scheme
Special Access Scheme
The Special Access Scheme gives a practitioner the opportunity to apply for the ability to prescribe unapproved medicinal cannabis products to a single patient. When applying for the Special Access Scheme, the practitioner must outline the following:
- Who the patient is and what their condition is.
- How prescribing the unapproved product will improve the patient’s condition.
- How the practitioner will assess the patient’s response to the treatment.
There are 3 categories that determine how a practitioner can prescribe an unapproved medicinal cannabis product for a patient:
- Category A
- Category B
- Category C
Special Access Scheme: Category A
An unapproved therapeutic good can be prescribed for a patient who is classified as seriously ill. TGA defines seriously ill as a condition from which death is reasonably likely to occur within a matter of months, or from which premature death is reasonably likely to occur in the absence of early treatment1.
In order to prescribe a patient with medicinal cannabis under Category A, the prescriber must be a medical practitioner.
Special Access Scheme: Category B
This pathway, also known as the SAS-B pathway, allows practitioners to submit an application using clinical justification for the use of medicinal cannabis and the benefits for a particular patient2. If a practitioner doesn’t have experience with a specific unapproved therapeutic good or a condition, they must receive a letter of support from an appropriate specialist. The goods a practitioner can prescribe will depend on a few factors, including:
- The condition being treated.
- Requirements of the state/territory they practise in.
- Scope of the practitioner’s practice.
- The provision of a brief clinical justification that supports the use of the prescribed product for the patient’s condition.
Authorised Prescriber Scheme (AP)
The Authorised Prescriber Scheme gives a practitioner the opportunity to apply for the ability to prescribe an unapproved medicinal cannabis product to multiple patients3. Any Australian registered medical practitioner can apply to become an AP, however this pathway is not available to Nurse Practitioners.
Authorised Prescribers can prescribe unapproved products and will not need to seek approval for each individual patient they are prescribing the medication to. An Authorised Prescriber is required to report on:
- Suspected product defects.
- Any undesired effects caused by the products.
- The total amount of patients they have treated every 6 months in a calendar year.
Applications are generally approved in 10 business days, and once a practitioner has been approved to be an Authorised Prescriber, they may prescribe the unapproved product to patients in their care.
Regulations Around Prescribing MedicinalCannabis
The cannabis plant can contain anywhere between 80 and 100 cannabinoids, the most common being major cannabinoids, Tetrahydrocannabinol (THC) and Cannabidiol (CBD). Learn more about cannabinoids here.
CBD is generally a non-impairing, well-tolerated cannabinoid – even at high doses4. Products that contain only CBD are classified as Schedule 4 medicines and do not require approval from a state or territory health department.
Products containing THC are classified as Schedule 8 controlled drugs – regardless of the amount of THC present. Like other Schedule 8 medications, prescriptions for THC-containing products must be approved by a state or territory health department.
With such a high number of medicinal cannabis products now available, a large percentage of them have not yet been assessed for safety by the Therapeutic Goods Association (TGA). As a result, products that are yet to be assessed are not eligible to be registered on the Australian Register of Therapeutic Goods (ARTG)5.
The ARTG is a public database outlining the therapeutic goods available to us in Australia, as well as ensuring their safety, effectiveness, and quality. To prescribe medicinal cannabis products that are not listed on the ARTG, practitioners are required to gain approval from the TGA.
State Specific Regulations
Each state has different rules and regulations pertaining to who can prescribe medicinal cannabis to patients.
To find out the specific regulations within your state, read on.
Who can prescribe medicinal cannabis in Western Australia?
All medical practitioners within WA are able to prescribe medicinal cannabis products. However, prior to prescribing any medical cannabis products that aren’t registered with the TGA, prescribers must obtain approval from the TGA.
State approval is not necessary for the prescription of medicinal cannabis products containing cannabidiol (CBD) only, as they are classified as a Schedule 4 medicine.
Learn more about medical cannabis access in Western Australia.
Who can prescribe medicinal cannabis in the Northern Territory?
In the Northern Territory, only an NT-based doctor is able to prescribe medicinal cannabis products. Before prescribing medicinal cannabis, the practitioner must first receive authorisation under the Authorised Prescriber Scheme or the Special Access Scheme.
A practitioner does not need to seek NT authorisation to prescribe Schedule 4 (CBD-only) products.
Learn more about medicinal cannabis access in the Northern Territory.
Who can prescribe medicinal cannabis in South Australia?
Medical practitioners within SA can apply to prescribe unapproved medicinal cannabis products through the TGA. Medical practitioners must fulfill both Commonwealth and South Australian Controlled Substances legislative requirements in order to be deemed eligible to prescribe medicinal cannabis.
If the medical practitioner is prescribing medicinal cannabis for a patient displaying a condition that they are not an expert in, depending on the circumstances, the practitioner may be required to seek a report from a specialist commenting on the effectiveness and suitability of medicinal cannabis in the patient’s treatment.
While no state-based approval is necessary for a practitioner to prescribe Schedule 4 products, a Section18A authority is required when a practitioner wishes to prescribe a Schedule 8 medication to a patient under the following conditions:
- The product is being prescribed for longer than 2 months.
- The patient has already been prescribed a Schedule 8 drug for a period longer than 2 months.
- The prescriber has reason to believe that the patient has a dependency on drugs.
Learn more about medicinal cannabis access in South Australia.
Who can prescribe medicinal cannabis in Queensland?
Both Queensland medical practitioners and medical practitioners based in other states that are prescribing to Queensland-based patients are eligible to prescribe medicinal cannabis, provided that they hold TGA approval. Queensland doctors can prescribe Schedule 4 and Schedule 8 products without a Queensland State approval6.
Learn more about medicinal cannabis access in Queensland.
Who can prescribe medicinal cannabis in New South Wales?
Any registered medical practitioner within NSW is eligible to legally prescribe medicinal cannabis if they believe it is a suitable treatment for their patient, and if they receive approval from the TGA.
The prescription of Schedule 4 medications do not require approval from the TGA, however approval from the TGA is required before a practitioner can prescribe a Schedule 8 cannabis medicine.
As of September 2019, a practitioner must submit an application to NSW Health for the prescription of a Schedule 8 cannabis medication where it is required for:
- A person with a drug dependency.
- A clinical trial.
- A child under the age of 16.
Learn more about medicinal cannabis access in New South Wales.
Who can prescribe medicinal cannabis in the ACT?
To be eligible to prescribe medicinal cannabis in the ACT, practitioners are required to receive approval from both the TGA and the Chief Health Officer of the ACT. They must also obtain Special Access Scheme approval before prescribing medicinal cannabis to any patients.
Under the ACT Controlled Medicines Prescribing Standards, medicinal cannabis can be approved for the following conditions and symptoms:
- Spasticity as a result of multiple sclerosis (MS).
- Nausea and vomiting caused by chemotherapy.
- Anxiety and pain from a life-limiting disease with a prognosis of 12 months or less.
- Refractory paediatric epilepsy.
Applications for other conditions will be reviewed on a case-by-case basis, and may be referred to the Medicinal Cannabis Medical Advisory Panel for further advice.
Learn more about medicinal cannabis access in the ACT.
Who can prescribe medicinal cannabis in Victoria?
Any medical practitioner is able to prescribe medicinal cannabis to any patient with any condition, provided that they have obtained the required TGA and state approvals, and they believe it is a clinically appropriate treatment option7.
If a medical practitioner wishes to prescribe an unapproved medicinal cannabis product to one patient, they can apply to do so under the Special Access Scheme. If they wish to prescribe one medicinal cannabis product to patients with the same condition, they can apply to become an Authorised Prescriber of the product through the TGA.
If the patient receiving treatment has a drug dependency, the prescriber is required to obtain a Schedule 8 Treatment Permit under the Victorian Drugs Poisons and Controlled Substances Act.
Learn more about medicinal cannabis access in Victoria.
Who can prescribe medicinal cannabis in Tasmania?
In the event that conventional treatments and medications have failed, the Tasmanian Government has acknowledged that it is appropriate for a registered medical practitioner to prescribe a trial of an unregistered medicinal cannabis product.
Under the Tasmanian Government’s Controlled Access Scheme (CAS)8, relevant medical practitioners are authorised to prescribe medicinal cannabis. Through this scheme, medical cannabis can only be prescribed under limited circumstances where conventional treatments have otherwise been unsuccessful in treating the patient’s condition.
Learn more about medicinal cannabis access in Tasmania.
Forms of Cannabis Clinicians Can Prescribe
There are a range of different products clinicians may choose to prescribe to their patients, with some of the most popular being:
- Dried flower products
Your prescribing practitioner will determine which method will be most effective in treating your symptoms. It is also important to note that each product will have a different onset, effect, and duration of action on each person.
Learn more about the different ways you can consume medical cannabis by visiting our ‘How Medicinal Cannabis Can Be Consumed’ article.
- Goods T. Unapproved products for individual patients (Special Access Scheme). Therapeutic Goods Administration (TGA). Published December 14, 2022. Accessed June 21, 2023. https://www.tga.gov.au/products/unapproved-therapeutic-goods/special-access-scheme-sas-and-authorised-prescriber/prescribe-unapproved-therapeutic-good/unapproved-products-individual-patients-special-access-scheme
- Arnold JC, Nation T, McGregor IS. Prescribing medicinal cannabis. Aust Prescr. 2020 Oct;43(5):152-159. doi: 10.18773/austprescr.2020.052. Epub 2020 Sep 29. Erratum in: Aust Prescr. 2020 Dec;43(6):225. PMID: 33093741; PMCID: PMC7572192.
- Donovan P. Access to unregistered drugs in Australia. Aust Prescr. 2017 Oct;40(5):194-196. doi: 10.18773/austprescr.2017.062. Epub 2017 Aug 15. PMID: 29109604; PMCID: PMC5662438
- Cannabidiol in cannabis does not impair driving, landmark study shows. The University of Sydney. https://www.sydney.edu.au/news-opinion/news/2020/12/02/Cannabidiol-CBD-in-cannabis-does-not-impair-driving-landmark-study-shows.html
- Australian Register of Therapeutic Goods (ARTG). Therapeutic Goods Administration (TGA). Published December 18, 2021. https://www.tga.gov.au/resources/artg
- Prescribing medicinal cannabis in Queensland | Queensland Health. Qld.gov.au. Published 2017. https://www.health.qld.gov.au/public-health/topics/medicinal-cannabis/prescribing
- Australia V. Medicinal cannabis. Vic.gov.au. Published 2022. https://www.health.vic.gov.au/drugs-and-poisons/medicinal-cannabis
- Department of Premier and Cabinet. www.dpac.tas.gov.au. Accessed June 21, 2023. https://www.dpac.tas.gov.au/divisions/policy/medicinal_cannabis
The information on this website is provided for educational and informational purposes only and not intended for use as medical advice. Polln is not promoting the use of medicinal cannabis. Medicinal cannabis in Australia is scheduled medication and regulated by the Therapeutic Goods Administration (TGA). Details about medicinal cannabis as a scheduled drug can be found on their website. If you would like to explore medicinal cannabis for your chronic condition, please consult with a doctor.
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