Australia’s medicinal cannabis industry is experiencing unprecedented growth, but at what cost to public health and medical standards? As state governments rush to establish new cannabis facilities and prescription rates soar to record heights, medical experts are sounding increasingly urgent alarms about a system veering dangerously off course. What began as a carefully controlled therapeutic option has morphed into what industry insiders now describe as the “Wild West of medicine” – a landscape where regulatory oversight struggles to keep pace with commercial interests, and where social media advocacy often carries more weight than clinical evidence. The transformation of Australia’s medical cannabis framework from cautious experimentation to mass prescription raises profound questions about the intersection of public demand, commercial opportunity, and medical responsibility.
The Marketing Masquerade
The headlines practically write themselves these days: “Medicinal cannabis supply to reach new high” – an unintentional double entendre that would be amusing if it weren’t so telling of our current predicament. State governments are falling over themselves to establish cannabis facilities, despite GW Pharma in England having already invested a decade in properly clinical trials for their epilepsy medicine.
The numbers tell a story of explosive, arguably reckless growth. From serving a mere 18,000 patients in 2019, the industry now claims over one million patients as of January 2024. In just the first half of 2024, Australians spent an eye-watering $402 million on medicinal cannabis prescriptions – nearly matching 2023’s entire total of $448 million. Unit sales have skyrocketed to 2.87 million in just six months, leaving 2023’s 1.68 million figure in the dust.
The media’s handling of this issue would be comical if it weren’t so concerning. Take Channel 7’s coverage, where personal anecdotes and “social commentators” – not medical experts – hold court on medical science. The formula is predictable: throw in a tear-jerking personal story, add some anti-“big pharma” sentiment, and top it off with the timeless appeal to parental instinct: “Parents know what’s best for their children.” Science? That’s apparently optional.
The Thalidomide Echo
Those who cannot remember the past are condemned to repeat it, and Australia’s medical history offers a stark warning. The Thalidomide disaster of the 1960s – which Australia could have avoided by following the FDA’s cautious approach – seems to have taught us little. While the United States saw fewer than 50 cases of birth defects, Australia’s more permissive approach led to thousands of casualties. Yet here we are again, watching history rhyme as regulatory caution gives way to commercial expedience.
The statistical explosion in prescriptions is staggering. Only two medicinal cannabis products have actually been evaluated for safety and efficacy by the TGA, yet we have over 800 different products flooding the market. In one particularly egregious case, a single doctor prescribed cannabis to 12,000 patients in just six months – a volume that should raise red flags visible from orbit.
The Vertical Integration Virus
Perhaps the most insidious aspect of this new frontier is the rise of vertically integrated clinics owned by cannabis suppliers. It’s a conflict of interest so obvious it barely needs stating, yet it flourishes in plain sight. As one experienced prescriber noted, “The industry has a serious conflict of interest problem with clinics being owned by suppliers, which is rampant, and zero transparency about that.”
While the industry celebrates its financial success, the human cost mounts. Health authorities report 461 patients diagnosed with mental and behavioral disorders due to cannabinoid use and psychotic disorder in 2022-23 – a 23% increase from 2019-20. Yet these statistics barely register in the rush to expand access.
The Regulatory Retreat
The TGA’s position is particularly telling. Under “Accessing Unapproved Products,” they’ve created a new category for cannabis that essentially admits defeat: prescribers and dispensers know little about medicinal cannabis because there’s been minimal research and even less education about it in medical training. Yet somehow, this acknowledgment of ignorance serves as a basis for expanded access rather than increased caution.
Victoria’s early adoption serves as a cautionary tale. Their taxpayer-funded program saw more than one-third of child patients drop out when the treatment proved ineffective – right as properly trialed alternatives like Epidiolex were receiving FDA approval through conventional clinical testing. But why let evidence get in the way of a good story?
The medical community finds itself divided. Many doctors keep their cannabis prescribing quiet, facing skepticism from colleagues who dare to ask for evidence. Meanwhile, the industry pushes forward, armed with testimonials and backed by a chorus of social media support.
The Way Forward?
Associate Professor Vicki Kotsirilos, Australia’s first authorised GP prescriber, advocates for returning control to primary care physicians who know their patients’ histories and can properly assess risks. But in a system where profit drives policy and anecdotes outweigh evidence, such voices of reason struggle to be heard.
As we watch this experiment unfold, one thing becomes clear: we’re witnessing a massive public health experiment in real-time, with minimal controls and maximum profit potential. The parallels to both the Thalidomide disaster and Big Tobacco’s playbook are impossible to ignore, yet we march forward, eyes wide shut to the lessons of history.
Only time will reveal the full cost of our haste, but if history is any guide, the bill will be steep, and it won’t be the industry picking up the tab. (Source: WRD News)
