Aussie Doctors Don't Know How To Prescribe Medical Cannabis
Claims the "stunningly cumbersome" system is fuelling black market
Despite being legalised in Australia more than two years ago, the vast majority of Australian doctors simply don't understand the legal hoops they have to jump through to prescribe medical cannabis to their patients.
Drug reform advocates say the "insane" system is fuelling a thriving black market in medical cannabis, with patients finding it "impossible" to legally access the therapeutic product.
"The framework is stunningly cumbersome. This research makes a lie of the suggestion that [the system] easy and fine, or that GPs don't want to prescribe," said emergency physician Dr David Caldicott, of the Australian National University.
A study of attitudes to medical cannabis from 640 general practitioners nationwide -- said to be the first of its kind in Australia -- was published in the British Medical Journal Open on Wednesday.
The study, from the University of Sydney's Lambert Initiative for Cannabinoid Therapeutics, found 56 percent of doctors supported prescribing medical cannabis to patients, but only 29 percent felt comfortable talking about the drug with their patients.
Nearly 83 percent said they did not know how to help patients access cannabis, 79 percent did not understand the current regulatory process, and nearly 70 percent said they were not aware of the different types of cannabis products available.
"Our results highlight the need for improved training of GPs around medicinal cannabis, and the discrepancy between GP-preferred models of access and the current specialist-led models," the study's authors wrote.
Caldicott is part of the Australian National University medical school, as well as an emergency physician and founding member of the Australian Medical Cannabis Observatory. He also runs education courses for doctors interested in learning about medical cannabis and how to prescribe it, due -- he said -- to the lack of information available to interested doctors.
"We were flabbergasted medical cannabis was rolled out in Australia without any education process," he told ten daily.
"The vast majority of doctors, when thinking of cannabis, think of smoking joints for recreational purposes. Every time we have a course, it's oversubscribed."
"Lots of doctors do want to know more."
Jenny Hallam is a South Australian woman who has faced legal action over growing and supplying medical cannabis products to people frustrated at the lack of legal access. She speaks to people nationwide about their problems in accessing cannabis through appropriate channels, and said the current framework was unworkable.
"It's almost impossible. The lengths people have to go to is insane. People aren't getting it because it's so ridiculous," she told ten daily.
The Lambert Initiative study also reported doctors' attitudes to prescribing cannabis for different conditions. Nearly 80 percent supported palliative care patients having access to the drug, more than 80 percent supported the drug's use for chronic cancer pain, and 70 percent for epilepsy.
However, just nine percent backed the drug for depression, 13 percent for anxiety, and 19 percent for post-traumatic stress disorder.
"It's really putting GPs in quite an uncomfortable position because no one has stepped up to train GPs about this issue properly," Professor Iain McGregor from The Lambert Initiative told ABC News.
"The TGA has information on their website but I think some GPs look at that website, look at the application process, and just say 'I'm far too busy to deal with that'."
Caldicott said he did not support medical cannabis being made available for anyone who simply wanted it -- the same as how valium is not prescribed for those who simply ask for it -- but said a lack of education meant health professionals did not know what type of patients could benefit from the drug.
"Doctors are crying out for this. A lot of time, patients wanting it won't be appropriate, but doctors haven't been given the info on why it might not be appropriate for them. Our argument is, you're as likely after a good education to not prescribe medical cannabis as you are to prescribe it," he said.
Hallam claimed many patients were "at their wit's end." She slammed the protracted process many people had to go through. Caldicott estimated only a few hundred people in Australia had access to the drug, and Hallam claimed the government was "teasing" sick people.
"People are accessing it on the black market. People wouldn't be risking prosecution for this, unless they were absolutely desperate. People do try to get it legally first," Hallam said.
"We’re getting hundreds of people across the country trying to access it, most are being turned away. They cant even get it on the black market now."
"The government has teased people, saying it was legalised in 2016, and got people's hopes up thinking it would be available."
Caldicott, too, criticised the fact that the drug has been legalised but access remained difficult.
"It's extraordinary that you'd introduce something like medical cannabis, but at no level to offer an opportunity for any doctor to educate themselves about it. It's completely ludicrous," he said.
"The way it was introduced was an absolute train crash. People think it was designed to be confusing."
Hallam had a more blunt assessment.
"If they wanted to do it properly, they'd start an education program for doctors immediately, then make the process easier. They need a federal framework, because they've put it in the hands of each individual state and nobody knows what to do," she said.
"They're slowing it down deliberately."