Medicinal cannabis is big business. But the latest clampdown won’t curb unsafe prescribing

Australia’s key regulator of health professionals has announced it’s clamping down on unsafe prescribing of medicinal cannabis in the wake of surging patient demand.

The Australian Health Practitioner Regulation Agency, known as Ahpra, today warned health professionals they would need to put patients’ wellbeing ahead of profits.

Among its concerns were aggressive marketing strategies by clinics prescribing medicinal cannabis, and consultations lasting between a few seconds and a few minutes, before prescribing.

Such concerns have led to eight practitioners issuing more than 10,000 scripts in a six-month window, and one who appeared to have issued more than 17,000 scripts.

Ahpra’s other concerns include reports of patients with psychosis after taking medicinal cannabis, prescribing high doses, and prescribing to family members or people under 18.

However, overservicing, inappropriate prescribing and the health issues that can arise are issues we’ve known about for years.

Our research, for example, looked at multiple websites that offered medicinal cannabis in Australia. We found widespread examples of aggressive and misleading marketing. Some clinics breached regulatory guidelines. Others bent the rules.

Yet Ahpra’s latest announcement doesn’t tighten existing prescribing or marketing rules for medicinal cannabis. It just reminds doctors, nurse practitioners and pharmacists what the rules are.

What is the regulator concerned about?

According to the 2022–23 National Drug Strategy Household Survey, 3% of Australians aged 14 or over had used cannabis for medical purposes in the previous 12 months, equating to around 700,000 people.

Australians spent more than A$400 million on medicinal cannabis products in the first half of 2024 alone.

But Ahpra is concerned too many health practitioners are prescribing medicinal cannabis when a patient requests it, rather than whether this is the right product for them.

It suggests too few practitioners are assessing patients thoroughly, formulating and implementing a management plan, facilitating coordination and continuity of care, maintaining medical records, recommending treatments only where there is an identified therapeutic need, and ensuring medicinal cannabis is not a first-line treatment.

So Ahpra says it will investigate practitioners with high rates of prescribing any scheduled medicine, including medicinal cannabis, even if it has not received a complaint.

We found lots of aggressive marketing

Medicinal cannabis has been legally available in Australia since 2016. This means doctors can prescribe it for any medical condition when other approved treatments have not worked. Now patients can be prescribed medicinal cannabis as a capsule, oil or dried flower, for example, often via a website.

But when we analysing the websites of 54 private medicinal cannabis clinics in Australia, an alarming picture emerged.

We found multiple examples of websites that breached marketing rules, or skirted around them. This included making unsubstantiated health claims about the products they offered, such as they could treat anxiety, depression, or other mental health symptoms.

Websites often allowed people to assess if medicinal cannabis was for them. This self-assessment may mislead people into believing they would benefit from it, inadvertently “coaching” them on which medical conditions might warrant a prescription.

Other marketing tactics we found included promises of same-day or after-hours delivery, no GP referrals required, discounted consultation fees, and targeted advertisements on social media.

What we’d like to see

Ahpra’s aim of safer prescribing of medicinal cannabis is welcome. But by merely repeating the rules, rather than tightening them, this doesn’t go far enough. So Ahpra has missed out on a real opportunity to safeguard patients’ health.

For instance, we’d like to see greater emphasis on banning targeted advertisements on social media for medicinal cannabis. In a study that we’ve submitted for publication, we found this a particular concern.

We found many private clinics are using ads to reach young people, including those as young as 18. One company ran more than 170 active ads this month alone across Facebook, Instagram and Threads.

Ads we’ve seen include cryptic messaging, such as “we can’t shout about it, but our patients are smiling”, paired with bright colours and wellness-themed imagery.

One pairs an Australian sports celebrity with the tagline “move differently!” and the name of the product.

Another one promises “real doctors, real care” and “fast approvals & express delivery”, with consultations at $19.

While these ads do not mention medicinal cannabis directly, the messaging is clearly designed to spark curiosity and build brand recognition, especially among younger audiences.

We’d also like to see Ahpra:

• broaden its focus beyond prescribing patterns to include digital marketing and advertising practices that target young people

• provide clear guidelines to medicinal cannabis clinics and prescribers on acceptable promotional practices

• support stronger consequences for repeat offenders, including prescribers who continue to engage in misleading advertising after being sanctioned.