The promise of medicinal cannabis as a treatment for various ailments has been a beacon of hope for many Australians since its legalisation in 2016.

However, recent reports from the medical community are sounding the alarm on a disturbing trend: a significant rise in hospitalisations due to psychosis linked to prescribed medicinal cannabis.

This has raised serious concerns about the safety and regulation of these products, particularly as the number of 'single-issue' cannabis clinics and telehealth prescriptions surge across the country.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has observed an alarming pattern of patients experiencing their first psychotic episodes or relapses in existing psychotic conditions after being prescribed medicinal cannabis.

Professor Brett Emmerson, the Queensland chair of the RANZCP, has called for stronger regulations on products and prescribing practices.

‘We're seeing a lot of people getting medicinal cannabis who end up with their first psychotic episode, or we're seeing it dispensed to people who have psychotic conditions, and these people are relapsing,’ he said.

Doctors reported a significant rise in hospitalisations for psychosis after medicinal cannabis prescriptions in Australia. Credit: Shutterstock

‘Part of the issue … are these single-issue clinics which, if you ring up, it doesn't matter what you say you want.’

‘They'll provide it for you even though there is probably no indication that it will work, and the prescribers never contact the person's treating doctor.’

‘You find out two or three months down the track that one of your patients has been on medicinal cannabis — not prescribed by you but by some other prescriber — usually a doctor who hasn't had the professional courtesy of contacting you and letting you know.’

Metro North Health, Australia's most significant public health service, has reported that some of their new early psychosis cases were linked to medicinal cannabis use.

‘The Metro North, early psychosis service, reports 10 per cent of their new presentations — so these are kids aged 16 to 21 — are people who've ended up on medicinal cannabis and are becoming psychotic,’ Professor Emmerson continued.

‘A lot of other mental health services are reporting several admissions a week of people who have been placed on medicinal cannabis who shouldn't be on it.’

‘Medicinal cannabis is causing harm. The medication is unregulated and being used widely for a whole range of conditions for which there is no evidence.’

Professor Jennifer Martin, a clinical pharmacologist and general physician, has highlighted another concerning condition emerging from medicinal cannabis use: cannabis hyperemesis syndrome.

This condition, characterised by severe and persistent vomiting, is placing additional strain on emergency departments and hospital resources.

‘Some of these products have a lot of very psychoactive products in them.’ she stated.

‘These are big problems for our hospital system because those people sit in the emergency department [and] they potentially take up a bed for a long period of time.’

Professor Martin explained that many medicinal cannabis prescriptions are now being issued online through web interactions or telehealth services.

‘It's actually very difficult to get access to the doctor that actually signed the script for a patient,’ she added.

The prescribing of medicinal cannabis, which can contain varying levels of cannabidiol (CBD) and tetrahydrocannabinol (THC), the psychoactive component, has been particularly prevalent for conditions such as anxiety and insomnia.

Concerns rose over 'single-issue' cannabis clinics and telehealth prescriptions with minimal checks. Credit: Shutterstock

However, Professor Emmerson stressed that there is no evidence to support the effectiveness of medicinal cannabis for these conditions.

‘There's no evidence that medicinal cannabis is helpful or treats those conditions,’ he clarified.

‘Treatment for anxiety, and often insomnia, is cognitive behavioural therapy from a good psychologist.’

‘Getting people hooked on a drug of dependence when there are other non-drug treatments available and haven't been accessed is wrong. ‘

‘The medicinal cannabis industry is marketing and making claims that cannabis can cure a whole range of different medical conditions, and there's just no evidence for it.’

The medicinal cannabis industry's aggressive marketing tactics have been likened to those of alcohol and tobacco companies, with a focus on profit over patient well-being.

While there are legitimate uses for medicinal cannabis, such as treating severe childhood epilepsy and managing nausea and vomiting associated with cancer treatments, the current state of prescribing practices is causing harm to patients.

The RANZCP has issued a clinical memorandum calling for regulatory changes to ensure patients receive evidence-based treatments and minimise harm.

‘There is insufficient evidence to support medicinal cannabis as a treatment for anxiety and other mental disorders,’ the memorandum read.

‘As there are no restrictions on the medical conditions for which a prescriber can apply to use unapproved medicinal cannabis products, given the high rates of prescribing for anxiety, in particular, RANZCP is concerned that patients are not receiving evidence-based treatment.’

‘Refinements to legislation and treatment frameworks for medicinal cannabis should be considered in line with available evidence and harm minimisation strategies.’

Professor Emmerson advocated for making medicinal cannabis a regulated medication, similar to other drugs of dependence, and for the Therapeutic Goods Administration (TGA) to ban THC-containing products except for specific approved uses.

The Australian Health Practitioner Regulation Agency (AHPRA) has also recognised the need for a collaborative approach among health regulators to protect the public regarding medicinal cannabis prescribing and dispensing.

‘The use of unregistered medicinal cannabis products has spiralled in recent years, from around 18,000 Australian patients using products in 2019 to more than one million patients using medicinal cannabis up to January 2024,’ they announced.

‘The number of prescribers accessing the authorised prescriber and the special access scheme has also risen sharply to more than 5,700 medical and nurse practitioners using these schemes to prescribe and dispense medicinal cannabis products.’

With over one million patients using medicinal cannabis products and a sharp increase in authorised prescribers, the urgency for regulatory refinement is apparent.

The TGA has only evaluated two medicinal cannabis products for safety, quality, and efficacy: Epidyolex for severe childhood epilepsy and Sativex for spasticity in multiple sclerosis.

TGA data shows that the variety of medicinal cannabis products available in Australia increased from 504 in 2022 to 690 in 2023.

However, the TGA was unable to provide the ABC with the number of times medicinal cannabis has been dispensed in Australia.

‘Data cannot be extracted from PBS (Pharmaceutical Benefits Scheme) information as they are purchased on private prescription,’ a spokesperson said.

‘The TGA is not aware of a single source that can provide complete and accurate dispensing data on medicinal cannabis products.’

Key Takeaways

• Doctors reported a significant increase in people being hospitalised with psychosis after being prescribed medicinal cannabis in Australia.
• Concerns have been raised over the practices of 'single-issue' cannabis clinics and prescriptions via telehealth consultations with minimal checks.
• The Royal Australian and New Zealand College of Psychiatrists called for stronger regulations of medicinal cannabis products and prescribing practices.
• There was a call to refine legislation and treatment frameworks for medicinal cannabis in line with available evidence and harm minimisation strategies.

Have you or someone you know been affected by these issues? How do you feel about the current state of regulation and prescribing practices? We’d love to hear your insights in the comments below.

 

[Suzanne rose]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

 

[mylittletibbies]

I know a lady who is prescribed medicinal cannabis. I do not know exactly what her medical problem is,but she is certainly not well.
The medicinal cannabis, she states, has helped her a lot.
It is very expensive so I don't feel she would be taking it if it didn't work.
She certainly doesn't have any psychotic episodes. I was under the impression that the THC, which causes psychosis was removed from medicinal cannabis??
My best friend has recently retired as a nurse was discussing this with me recently said that she has seen psychosis in some young people who smoke "pot"
but not from medicinal cannabis.
If theTHC is removed why should people be suffering from psychosis??
As far as it being "commonly" prescribed, I'm not so sure, I was under the impression it was hard to get. My brother in law tried to get it for pain he was suffering before he passed away. He had no luck finding anyone who would prescribe it.
He ended up getting cannabis and smoking it and it relieved his pain considerably, but illegal.
Go figure.

 

[mylittletibbies]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

So sorry to hear about your grandson, this is a very sad situation.
We have a nephew who is the same.
Whether cannabis oil would be helpful I have no idea but I do believe the drugs they have him on are doing more harm than good, most times he is drugged up to the eyeballs, in a zombie state.
Surely it would be worth a try.
There is so much paranoia about cannabis and yet most drugs come from plants.

 

[Robeo56]

I have a good friend on medical cannabis, he uses it to help him relax, and relieve anxiety as he has been battling prostate cancer for a number of years. He only takes it in the evenings. He did say that the particular strand he was on originally was a little to strong, it definitely has THC in it. However, he has tried many prescribed, prescription drugs that were doing nothing but causing horrible side effects.

 

[gamiry]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

I can only say that I tried the cannabis capsules and they did nothing for me but I hope your Grandson isn't on RITALIN, My youngest son was a guinae pig for this stuff and it almost cost him his life on two occasions that I know of. He ended up a drug addict like many of the young people I took in and tried to help. Some lived some didn't sadly but to this day doctors are handing out this poison. It's been dealt out to kids for almost 60 years that I know of.

 

[Luckyus]

I think I'd rather a can of piss, than cannabis?

 

[DLHM]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

There are many prescribed medications that do more harm than good. It depends on the knowledge, (of the patient and the drugs), of the medical practitioner prescribing them.

My youngest son had been prescribed numerous medications for ADHD, depression, anxiety as well as other mental issues over the decades, (he’s now 41). Most of those drugs did so much harm, turning him into a numb non-human. The only thing that makes him “normal”, is cannabis.

 

[DLHM]

I can only say that I tried the cannabis capsules and they did nothing for me but I hope your Grandson isn't on RITALIN, My youngest son was a guinae pig for this stuff and it almost cost him his life on two occasions that I know of. He ended up a drug addict like many of the young people I took in and tried to help. Some lived some didn't sadly but to this day doctors are handing out this poison. It's been dealt out to kids for almost 60 years that I know of.

I fully understand what you’re saying @gamiry. My youngest son was treated the same way as yours when prescribed Ritalin at age 9. That was just the beginning….

 

[Clancieblue]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

Suzanne, my Grandson had his Epilepsy drugs changed a few months ago-around the same time he started to have slight changes in ability to hold items. he was having trembling and falls, became scared to walk upstairs. After a neurologist visit, he was sent for MRI and blood tests and ECG, all showed nothing.
When I asked my daughter when the different drug was prescribed the timing matched with the new drug that the neurologist had prescribed. On reducing the medication drastically, he has started to feel better.
Perhaps the medication your Grandson is on just doesn't agree with him and he might respond better to something else. I hope your Grandson is able to have some peace it must be awful for him.

 

[Ebby]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

So sorry for your family it must be awful not being able to do anything.

 

[Jamman]

I have tried it with no noticeable effect for arthritis but hemp seed oil is effective and noticeable within a few days.

 

[Luis Toro]

Not long ago I read something from the US Dr, they said the psychiatrist prescribe the same medicine to all they patients, and they has the psychotic effect to,many suicide and been violent, but its not the Marihuana oil or the smoking, its three drugs they prescribed

 

[Jo Piper3]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

I'm so sorry for you, your son and grandson. Hope there will be a breakthrough, so he isn't placed in a home.

 

[Ebby]

l supposed you can only be advised by your doctors but saying that l was not impressed by the doctor of a neighbour friend l had in Launceston who showed me a handful of about 10 tablets she took 4 times a day.She was taking most of them to counteract the effects of others . The pills caught up with her and she died of a bad heart in her fifties. l said she should change her doctor but she she said he had been treating her for years and she trusted him.

 

[Bridgit]

I know a lady who is prescribed medicinal cannabis. I do not know exactly what her medical problem is,but she is certainly not well.
The medicinal cannabis, she states, has helped her a lot.
It is very expensive so I don't feel she would be taking it if it didn't work.
She certainly doesn't have any psychotic episodes. I was under the impression that the THC, which causes psychosis was removed from medicinal cannabis??
My best friend has recently retired as a nurse was discussing this with me recently said that she has seen psychosis in some young people who smoke "pot"
but not from medicinal cannabis.
If theTHC is removed why should people be suffering from psychosis??
As far as it being "commonly" prescribed, I'm not so sure, I was under the impression it was hard to get. My brother in law tried to get it for pain he was suffering before he passed away. He had no luck finding anyone who would prescribe it.
He ended up getting cannabis and smoking it and it relieved his pain considerably, but illegal.
Go figure.

There are CBD Oil's that only have 0.04% of THC plus Cannabidiol and these are the most common - there are others with varying amounts of THC and strengths for various conditions. When it was prescribed for my husband approx 4 years ago - only registered medical practitioners could prescribe it. He has Parkinson's which is classed as a movement disorder and he had to apply for permission to prescribe it for him - every year he had to get permission to keep prescribing it for him. It made a huge difference to him - it lessened the pain and dystonia - improved his gait - he was able to stand up fairly straight - relaxed him so he could sleep and not so stressed and quietened the internal tremors. He used to have 4 - 6 drops morning and night - these days he only takes it at night as he is too slow if he has it in the morning. When we first started on CBD it was $ 243 for 10 ml - now we get 30 ml for $201 which is much better for the budget. He has been on the same strength all the way thru and our GP checks all the time that it is still meeting his needs. The problem is very man and his dog has climbed on the CBD gravy train and prescribing it for people who haven't been assessed properly to address their needs - most of them have not seen the person face to face to see how they actually are. We took a video of my husband for the doctor to see and he only watched about 5 mins of it and said he had seen enough - if anyone needed CBD he did - then he applied right then and there to the TGA to be able to prescribe it for him. There are so many different strengths of Cannabidiol/THC combos available you really have to understand the affects on the human system and I don't believe that using online medicos should be allowed - these doctors don't see you face to face and they don't know you like your GP - bad move by government to allow this.

 

[Bridgit]

There are many prescribed medications that do more harm than good. It depends on the knowledge, (of the patient and the drugs), of the medical practitioner prescribing them.

My youngest son had been prescribed numerous medications for ADHD, depression, anxiety as well as other mental issues over the decades, (he’s now 41). Most of those drugs did so much harm, turning him into a numb non-human. The only thing that makes him “normal”, is cannabis.

Yes you are right - there are drugs out there that shouldn't be given to your worst enemy - the side effects are horrendous. If he could see a registered practitioner and get the right formula in CBD he would be on the right track and avoid the side effects of too much THC.

 

[Bridgit]

I have a good friend on medical cannabis, he uses it to help him relax, and relieve anxiety as he has been battling prostate cancer for a number of years. He only takes it in the evenings. He did say that the particular strand he was on originally was a little to strong, it definitely has THC in it. However, he has tried many prescribed, prescription drugs that were doing nothing but causing horrible side effects.

He needs to tell whoever has prescribed it what his concern is and have it adjusted to his needs.

 

[Bridgit]

My brother who is 58 is using cannabis oil for severe pain. His GP prescribed it and its helped alot.

My son was looking at using it for his severely Autistic son. But decided against it. Although I'm thinking the meds he is on is probably worst.
As my grandson is getting older ( he is 15) and becoming very very strong and violent. Ge was put on the meds as requested by his school due to attacking teachers.

It's a sad and horrible situation. I could watch him when he was young but even now when he visits he hugs me that hard it hurts.

I have often wondered if he was given canabis oil if it would have helped.

It's only a matter of time until he is placed in a home. It's sad when my son has tried and tried even with help from carers

Get your son to go to a prescribing GP - they can be hard to find - and take his son to him/her - it is amazing the results in a very short time and it would change their lives if he could get the right combo for his needs. All the best Suzanne.

 

[Rob44]

I have tried it with no noticeable effect for arthritis but hemp seed oil is effective and noticeable within a few days.

Likewise a tablespoon of cod-liver oil every night. That's the tuff the doctor's scoffed at before someone discovered it had anti-inflammatory properties and now it coss an arm and leg when in 1980 I could buy 1 litre bottles of the stuff for next to nothing