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Medicinal cannabis in Australia: the missing links

Med J Aust 2016; 204 (10): 371-373. || doi: 10.5694/mja16.00234

Cultivation of cannabis for medicinal or scientific purposes needs considered management before it is rolled out as a therapeutic good

Since the publication in the Journal last year of a perspective on cannabis that stated: “Australia is behind the times on the medicinal use of cannabis”,1 there appears to have been a palpable change in community attitudes around cannabis as medicine.2-4 This has occurred alongside anecdotal reports from people with intractable illnesses who have had symptomatic benefit with cannabis.5 Palliative care specialists have acknowledged a potential role for medicinal cannabis in their specialty.6 Internationally, the scene is also changing. For example, the Netherlands Office of Medicinal Cannabis enables dispensation through pharmacies after purchase from a contracted company, which also exports to other European countries.7 In the United States, 23 states and Washington, DC, have legalised marijuana in some form, mostly for medicinal purposes, since June 2015.8

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  • Jennifer H Martin1,2
  • Yvonne A Bonomo3

  • 1 University of Newcastle, Newcastle, NSW
  • 2 Hunter New England Local Health District, Newcastle, NSW
  • 3 St Vincent's Health, Melbourne, VIC


Competing interests:

Jennifer Martin is involved in the NSW Health-funded medicinal cannabis trials and Yvonne Bonomo is leading cannabis research and education programs in Victoria.

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access_time 02:44, 16 June 2016
Matthew McCrone

Dear Editor,
I write to comment, for publication, on the article Medicinal cannabis in Australia: the missing links, MJA 204 (10) 6 June 2016.

One Australian state has already legalised access to medicinal cannabis for people in exceptional circumstances with exactly the kinds of safeguards and support for research proposed by Professor Martin and Associate Professor Bonomo: Victoria.

The Access to Medicinal Cannabis Act 2016 passed the Victorian Parliament with the support of all members of both houses on 12 April 2016. It sets up a scheme under which patients with severe, disabling and life-threatening conditions will be able to access quality-controlled non-smokeable medicinal cannabis products under the supervision and support of their treating specialists and GPs. It will also allow both the medical profession and industry to conduct the kind of research and development advocated in the article.

Our scheme will be compassionate, but it will also be evidence based. It will be guided by an Independent Medical Advisory Committee comprised of experienced clinicians, researchers, pharmacists and others. These experts will mine the best and latest data to inform efficacy, safety, dosing and methods of administration. An important feature of the scheme will be the collection of pharmacovigilance data through a patient register to continue to build the evidence base about the safety and efficacy of medicinal cannabis products. This data together with emerging evidence will be evaluated by the Independent Medical Advisory Committee and will provide the basis for clinical, patient and community education as well as ongoing development of the scheme. As new research is undertaken, we will be able to respond. It is a learning model.

Manufacturers in Victoria will be required to meet stringent quality standards and any product approved for supply will be thoroughly and independently tested and quality assured. Pharmacists will be required to store and dispense medicinal cannabis in accordance with best practice.

The Victorian scheme will tightly regulate prescribing, restricting it to medical practitioners who specialise in the relevant conditions and applying key learnings from our regulation of the other drugs of dependence that pose risks of diversion and misuse. The legislation requires the preparation and dissemination of educational and guidance materials in relation to medicinal cannabis products. This will support the medical profession in its role in prescribing and supplying medicinal cannabis products and will educate patients and families about eligibility requirements for the scheme.

The Victorian Government will also continue to encourage and support Victorian patients' participation in clinical trials.

Competing Interests: The letter to the editor was authored by the Director of the Medicinal Cannabis and Real Time Prescription Monitoring Taskforces.

Mr Matthew McCrone
Department of Health and Human Services

access_time 01:01, 26 June 2016
Jennifer H Martin

The authors acknowledge the information that the Access to Medicinal Cannabis Act 2016 passed the Victorian Parliament on 12 April 2016, after their manuscript was accepted for publication. The legislation increases from one (New South Wales) to two the number of Australian States that enable patients with life-threatening conditions to access medicinal cannabis under the supervision and support of their treating doctor. Both schemes should facilitate some of the research and education that needs to be undertaken to enable information to be generated about safety for future patients. Both enable access to patients with symptoms from life threatening disorders.

These compassionate access schemes are developing on a state-by-state basis, in response to community demand.  A national framework however, would enable consistency in roll out of medicinal cannabis programs and all that these entail including research and education agendas and a national pharmacovigilance program.  The authors remain concerned that increasing compassionate supply could reduce the likelihood that NHMRC and similar bodies fund the high quality (including randomised, and/or with a control arm of current best practice) research that is vital in this area.

Competing Interests: We wrote the original manuscript in MJA

Prof Jennifer H Martin
University of Newcastle