Sabra Lane: New figures show that Australian doctors and nurse practitioners are writing an unprecedented number of prescriptions for high-strength medicinal cannabis products, with one doctor issuing scripts every four minutes. Medicinal cannabis was only legalised in 2016, and since then there’s been a massive growth in telehealth companies shipping their products to Australians with what some experts say is alarming ease. An ABC 730 investigation found some companies are incentivising clinicians to prescribe when a doctor says it’s like being regarded as a dealer, not a doctor. National Health reporter Elise Worthington has the story.
Elise Worthington: In late 2022, when Orange-based GP Dr Claire Noonan wanted to pick up some extra work, telehealth consulting for a medicinal cannabis company seemed like the perfect solution. But there were red flags from the moment she got her contract with the company she doesn’t want to name. She emailed them saying her greatest concern was that being paid was contingent on writing scripts.
Claire Noonan : I didn’t think it was conducive to ethical medical practice.
Elise Worthington: She had the contract changed and started consulting with patients over the phone. She quickly noticed some seemed to have a careful script to obtain high-strength THC, the chemical that causes a high.
Claire Noonan : Some patients expressed a strong preference for THC preparations and would try and convince me to prescribe those for them which I didn’t want to do on a first visit.
Elise Worthington: Dr Noonan says after refusing one patient, she got a call from the company asking her to reconsider.
Claire Noonan : We had to have a discussion about how I wasn’t prepared to prescribe against my own clinical judgment. It felt that I was being used for my signature on a script, so to speak.
Elise Worthington: There’s been a rapid rise in the number of medicinal cannabis products being prescribed to Australians, fuelled by telehealth companies providing a one-stop shop for prescription and supply. New figures obtained by 730 from the Australian Health Practitioner Regulation Agency show the amount of medicinal cannabis being prescribed by some practitioners is astounding. Eight practitioners appear to have issued more than 10,000 scripts for high-strength THC products in just six months, including a doctor who wrote more than 17,000 scripts – that’s over 130 scripts per day in a working week, or a script every four minutes. APRA says one pharmacist dispensed almost a million products in a year, equal to 2600 products per day, and that’s with no days off. AHPRA’s Executive Director of Regulatory Operations is Kim Ayscough.
Kym Ayscough: Some prescribers and some dispensers are dealing in volumes where it is very difficult to understand how they could be meeting their professional obligations.
Elise Worthington: AHPRA has a taskforce investigating medicinal cannabis prescribing issues and is focusing on high-strength THC products, which is Schedul8 Medicines, the same classification as opioids. The agency is Kim Ayscough again.
Kym Ayscough: If we were to use shorthand to describe our concern about it, we would say that there is a risk that some practitioners are putting profit over patient safety, and that of course is of great concern to us.
Elise Worthington: AHPRA is warning practitioners of their obligations when writing prescriptions for medicinal cannabis, especially over the phone.
Kym Ayscough: This is a space where there’s a lot of information available to consumers about medicinal cannabis and consumers are looking for a place to go to obtain this product. What we say is that even in those circumstances, the doctor is still the doctor. The doctor is still responsible for assessing whether the patient actually needs that particular product.
Elise Worthington: By believing there’s a place for medicinal cannabis treatment, GP Claire Noonan no longer works in the industry and says there needs to be more care taken by some prescribers to keep patients safe. The company she worked for didn’t respond to requests for comment.
Claire Noonan : There’s a catchphrase among Australian GPs where we say, I’m a healer, not a dealer. And working for this clinic, there was a bit of pressure to be perhaps more of a dealer.
Sabra Lane: Orange-based GP, Dr Claire Noonan, ending Elise Worthington’s report. You can see Elise’s investigation on 7.30 tonight or on ABC TV or ABC’s iView.
