What's the outlook for medicinal cannabis in Australia?

Accessing medicinal cannabis in Australia is a complex and highly regulated process that requires patients and doctors to navigate a range of administrative hurdles. It is managed by the Therapeutic Goods Administration (TGA), a branch of the Australian Department of Health and Aged Care. The TGA is responsible for ensuring the safety, quality and efficacy of treatments in Australia, including pharmaceuticals, medical devices and biologicals. In order to supply medicinal cannabis to Australians, cannabis companies must be registered with the TGA and undergo a rigorous approval process.

Doctors who wish to prescribe medicinal cannabis must apply for approval from the TGA through the Special Access Scheme (SAS), which allows them to do so on a per-patient basis, or through the Authorised Prescriber (AP) program, which allows them to prescribe specific products to multiple patients with a particular medical condition. The TGA also requires doctors to provide detailed documentation and justification for their prescribing decisions.

Australians with medical conditions that have not responded to other treatment options can be prescribed medicinal cannabis by APs or doctors using the SAS if they believe medicinal cannabis is the best treatment option.

Overall, the regulatory framework for medicinal cannabis in Australia is strict and requires strong oversight and accountability from both suppliers and prescribers, making obtaining legal medicinal cannabis challenging. This is especially the case for patients who live in Australia’s many remote communities. What's more, medicinal cannabis products can be expensive and are not covered by the country’s Pharmaceutical Benefits Scheme, a subsidiary program for low-income residents, children under the age of 16 and, in some cases, patients with certain chronic illnesses.

Nevertheless, the Penington Institute, an Australian think tank focused on drug policy and harm reduction, notes that the medicinal cannabis sector in Australia is expanding. Approvals to access medicinal cannabis through the AP pathway have increased dramatically since that process was implemented, with the most significant jump coming between 2020 and 2022 — Penington attributes that increase to growing awareness and acceptance of the medicinal properties of cannabis among healthcare professionals and patients.

As research into the benefits of cannabis continues, and as other countries like Germany and the US make reforms to their legislation for cannabis, analysts at Penington suggest that this trend will continue.

What's the outlook for adult-use cannabis in Australia?

Possession and use of cannabis for recreational purposes remains illegal across the country, except in the Australian Capital Territory, where possession of small amounts for personal use was legalised in 2020.

Adults in the Australian Capital Territory can now legally possess up to 50 grams of dried cannabis and 150 grams of fresh cannabis, and can grow up to two plants per person or a maximum of four per household.

Across the rest of the country, possession, use and cultivation for personal use are punishable offenses, although the rules vary widely per state. In many cases, possessing small amounts of cannabis, equal to or less than 50 grams, comes with a lighter sentence like a fine or the option to attend a cannabis intervention session in place of a criminal conviction, and first-time offenders may only be issued a citation. Laws are tougher in the Northern Territory and Tasmania; possession of cannabis in public is an offense that comes with prison time in the Northern Territory, and anyone caught with cannabis accessories can be fined nearly AU$8,000 in Tasmania. However, Queensland carries the harshest penalties, with a maximum prison sentence of 20 years just for possession.

According to Penington, law enforcement related to cannabis comes with an annual AU$1.7 billion price tag.

Despite these risks, the Australian Criminal Intelligence Commission’s Illicit Drug Data Report for 2020/2021 outlines 24,255 instances of illicit cannabis being detected at the Australian border in 2020/2021, nearly double the number of instances detected in the 2019/2020 period. Ninety percent of these were Australians attempting to import cannabis themselves by mail. The report also references analysis conducted by the National Wastewater Drug Monitoring Program, which found the highest levels of cannabis in wastewater ever recorded in August 2021.

These statistics indicate the huge demand for cannabis in Australia. Unsurprisingly, the potential for a legal recreational cannabis market in the country has generated significant interest and speculation in recent years, with many experts predicting that the market could be lucrative if and when recreational use is legalised.

Efforts toward some kind of cannabis reform have been ongoing for years in Australia. In June 2023, the Legalise Cannabis Party planned the coordinated introduction of bills in Victoria, New South Wales and Western Australia that aim to legalise adult use, possession and cultivation of small quantities of cannabis.

In November 2023, Victoria's Legislative Council met to debate the bill that was put forth in the state, the Drugs, Poisons and Controlled Substances Amendment (Regulation of Personal Adult Use of Cannabis) Bill 2023. While Minister of Health Ingrid Stitt openly stated that Victoria would not support the bill, she also said the government would be open to continuing discussions around cannabis decriminalisation.

At the federal level, the Australian Greens introduced an amended version of the Legalising Cannabis Bill 2023 this past August. As of press time, the bill remains under consideration with a reporting date of May 31, 2024. However, not many policymakers are impressed with the Greens' bill, and the Australian Medical Association has expressed concerns over the health implications that would come with legalisation.