The whole article is worth reading but this caught my eye.
The Australian Medicinal Cannabis Association (AMCA) said that without suspected adverse events being published and investigated it was hard to draw conclusions about the safety of medicinal cannabis products.
If the only organisation representing cannabis prescribers is unwilling to comment on safety what does that say about the state of the industry?
As a GP I know very few doctors who don’t accept that cannabis or cannabis derived products have a role to play in medicine. I know even fewer who don’t see the recent rapid explosion of cannabis prescribing as reckless and dangerous.
As a GP are you for legalisation (similar to alcohol) or for more tightly controlled prescriptions?
Whenever this is raised the argument about legalisation for recreational use is conflated. Alcohol, cocaine, oxycodone etc all have medicinal and recreational uses and we appropriately treat then differently.
If we are using it as medicine, at a minimum we should see prescription tracking and monitoring with implications for doctors prescribing inappropriately similar to the way we treat other medications with potential for abuse.
My opinion, for what it’s worth is that there should be legalised cannabis for recreational purposes.
What we definitely shouldn’t have is a situation where I am having people turning up to my clinic expecting a prescription for recreational doses of flower to smoke.
If the only organisation representing cannabis prescribers is unwilling to comment on safety what does that say about the state of the industry?
I’m not sure if I’m misreading your intent here? The AMCA is literally saying “If you don’t give us actual proof and studies we can’t validate or disprove them”. It’s a very different thing to “unwilling to comment on safety”
I disagree, this wording from a professional organisation is concerning. The usual standard of evidence for medication is that the companies or organisations promoting provide proof of safety.
For example ANZCA (specifically the Faculty of Pain Medicine) state
There’s a lack of definitive evidence showing long-term opioid effectiveness for CNCP, and conversely, substantial evidence of potential harm. As a result, opioids should only be considered in exceptional circumstances—for example, when other treatments have failed and the pain is demonstrably responsive to opioids.
With regards to psychotropic med the RANZCP say
Medications should be part of a comprehensive care plan that emphasizes low doses, minimal number of agents, and the shortest effective duration. Explanation of risks, benefits, and off-label use must be delivered to both young patients and their guardians. Prudence and caution are essential, though when properly prescribed, these medications can significantly improve quality of life for youth with serious psychiatric conditions.
AMCA regarding the safety of cannabis say
¯_(ツ)_/¯
OP is apparently shocked that something that happens 0.0046% of the time isn’t a huge concern…
And that’s not even getting into how those “adverse reactions” includes such debilitating conditions as coughing.
600 over three years jesus. I’m pretty sure antibiotics have 100x that
Don’t get me started on antibiotic overprescribing.
600 sounds like a lot…
The ABC can reveal there were 615 reports made to the Therapeutic Goods Administration (TGA) involving unregistered medicinal cannabis products between July 1, 2022 and June 1, 2025.
600 over 3 years sounds like not as much…
“If we look at the data, which we have been provided by the Pennington Institute, it’s probably around 13 million units sold in that period.”
Bu 600 out of 13,000,000 is…
Well, that’s a 0.0046% percent chance of something happening.
And that should explain why people who know what they’re talking about aren’t freaking out.
Do you think 13million individuals have cannabis prescriptions? Do you tink 100% of adverse events are reported? Do you think psychiatrists, emergency doctors and GPs who are reporting concerning rise in adverse events are lying?
Do you think you’re not simply looking to confirm your pre-set beliefs?
No, I believe I approach the literature with an open mind and while I don’t prescribe cannabis myself I do frequently refer patients who i think will benefit. The fact that there is legitimate use of cannabis in medical settings does not mean that it isn’t being over-prescribed and under regulated.
Incidentally the reason i don’t prescribe myself is purely as I don’t have capacity to add another string to my bow in my already busy practice.
OP claims to be a GP in profile. This whole stance suggests a lot about the medical industry.
I would suggest that corporate practices going gungho prescribing medications without established safety data is more concerning than a potential prescriber impatiently waiting for the TGA to get their act together and assess these medications.
I agree. Assuming they’re telling the truth to begin with.
Do you think 13million individuals have cannabis prescriptions?
…
You think every single person only used one dose in three years?
You literally have no idea what you’re talking about here.
If you’re nicer, people might help you understand
I apologise for not being clearer. My point was that your calculation is wrong. You would need to calculate per patient which is not a published figure. Estimates are more like 1mil but I think that is based on faulty reasoning as my subjective experience is that most people remain on it for only a few months. Also that the vast majority of adverse events go unreported
For perspective, according to drugs.com:
_The chance of having a drug side effect generally falls in these ranges:
- Very common: affecting more than 1 in 10 people (>10%)
- Common: affecting between 1 in 10 people to 1 in 100 people (1% to 10%)
- Uncommon: affecting between 1 in 100 to 1 in 1,000 people (1% and 0.1%)
- Rare: affecting between 1 in 1,000 to 1 in 10,000 people (0.1% to 0.01%)
- Very rare: affecting less than 1 in 10,000 people (< 0.01%)_
In my experience with people who have been prescribed cannabis according to this metric common side effects are acute intoxication and worsening of existing mental health issues. Uncommon side effects are diarrhoea, nausea/vomiting, abdominal pain. Rare is psychosis, I’ve seen it once in maybe 200 patients but it’s probably not 0.5%.
We really need to define the risks if we’re going to prescribe cannabis at these volumes. Hence the call for TGA to investigate.
Just putting this here as several commentors seem to have misread my intention posting this here
Most responses here seem to assume that I’m opposed to medical marijuana, I’m not. I am in fact in favor of it’s use, appropriately, in select patients, as with any medication.
I also want to caution against conflating recreational use(which may be problematic but is usually fine) with medicinal use(which should be held to the highest standards of evidence as any medicine should).
Now, regarding the evidence to date, efficacy is well established for refractory epilepsy and spasticity in MS. It is quite well established to have a role in pain control. Evidence that it is superior to other treatments for anxiety is pretty scant, we hold antidepressants to a pretty low standard and cannabis fails to even be that good in the published studies.
In terms of safety we frequently see acute intoxication from prescribed cannabis and worsening of co-morbid mental health conditions is really common. Nausea, vomiting, diarrhoea, and abdominal pains are all fairly frequent and I have seen one case of psychosis from prescribed marijuana. What’s more, we see these more commonly in emergency departments, psych wards and GP clinics now that it is easily available from unscrupulous corporate owned clinics.
The article isn’t claiming that medical marijuana is inherently dangerous or that it doesn’t have a role in medicine. It states, correctly, that the TGA has never actually assessed the safety of the vast majority of products on the market. This is concerning for anyone who might want to prescribe these with confidence.
@HalfEarthMedic now let’s talk about alcohol-related adverse events
When prescribed as medicine, alcohol related adverse events are effectively zero
@HalfEarthMedic touche
genuinely curious, is that a thing?
I believe that ethanol infusion is still standard treatment for methanol poisoning but outside my expertise
Heavy alcoholics can’t safely quit drinking cold turkey, so may be prescribed a number of drinks a day while drying out.
In the movies, they always show the injured character take a huge swig of alcohol, and then splash it all over their fatal wound and that fixes everything, so it must be true!
Not every drug is suitable for every person, we are each slightly different and that’s okay. If it doesn’t work for you, don’t use it.
I am prescribed medical cannabis, but I only use it occasionally when needed. I have no doubt it is over prescribed, but I’m not sure how much of a problem that is. I think many people who want it could get it on the black market if they tried. So having medical cannabis might not create more overall cannabis users.
