Consumer story: Caitlin and medicinal cannabis

In Australia, legal access to medicinal cannabis is always organised by a doctor on behalf of a patient.

Patients who try to obtain medicinal cannabis directly are not only breaking the law, they risk getting a product that is unsafe or does not contain what is advertised.

Caitlin's story explains what happens when someone tries to import cannabis illegally, and how a patient can legally access medicinal cannabis.

Caitlin's Story

Caitlin is 36, loves cars, and works as an auto mechanic. Her job requires her to bend over cars to service their engines, but over the last six months she has felt a sharp pain in her lower back. On some days the pain keeps her in bed, and she worries that she will be forced to leave a job she loves.

Caitlin wants something to manage her back pain, and has heard that medicinal cannabis may be able to help. Caitlin searches for 'medical marijuana' on the internet and discovers an online store selling medicinal hemp oil.

The website hosts testimonials from patients who claim the oil helps them control their chronic pain. The product is expensive, but the website claims that the oil is a 'natural' treatment with few side effects. Caitlin knows that cannabis products are regulated in Australia, but the website explicitly offers free shipping to Australian customers, so Caitlin assumes the product must be legal to access.

Caitlin decides to purchase the hemp oil, and pays for it by credit card.

A company in the United States receives Caitlin's order, and sends a package containing hemp oil to Australia. The hemp oil contains the cannabis extract cannabidiol, which means that it can only be imported on behalf of a patient by a licensed doctor. When the order reaches Australia, it is seized by customs.

Caitlin does not receive the hemp oil, loses her money, and is warned that she is breaking the law.

What should Caitlin have done?

Caitlin needed to consult a doctor about her back pain. In Australia, only a doctor can legally access medicinal cannabis on behalf of a patient. Patients are never able to purchase medicinal cannabis directly from a website, even when they have a prescription.

Any general practitioner (GP) is capable of prescribing medicinal cannabis, although they must be able to show that medicinal cannabis is an appropriate treatment for a particular condition. They may also decide another treatment will be safer or more effective.

If a doctor with relevant experience with a condition decides that medicinal cannabis is an appropriate treatment for a patient, they are able to write a prescription and organise the supply of an appropriate cannabis drug.

What is medicinal cannabis?

Medicinal cannabis products are those that contain cannabidiol (CBD) or tetrahydrocannabinol (THC). Other cannabis products that do not contain either CBD or THC may also need to be accessed through a doctor, depending on the claims made about the product and state and territory laws. If a cannabis product makes any claim about medical benefits, then it is considered a therapeutic good and must always be accessed by a doctor for a patient.

What is cannabis oil?

'Cannabis oil' usually refers to two kinds of cannabis products:

• Hemp oil: This oil is made from the green matter of the cannabis plant, and usually contains a combination of CBD and THC. This is sometimes also called cannabis extract or 'hash oil', and is a form of medicinal cannabis.
• Hemp seed oil: This oil is made by pressing the seeds of a cannabis plant, and usually does not contain either THC or CBD. Some varieties of hemp seed oil are legal to access without prescription, provided the product complies with the Food Standards Code and import requirements

Can Caitlin import any medicinal cannabis products?

The traveller's exemption allows people entering Australia to carry a limited supply of a medicine for their own personal use, or the use by an immediate family member who is travelling with them. The traveller must possess a valid prescription for that medicine.

If Caitlin is granted a medicinal cannabis prescription and is travelling overseas, she will be able to bring no more than three months of supply back into Australia for personal use, provided it is legal in the country she is visiting.

If Caitlin wants to bring a non-medicinal cannabis product into Australia, she should consult a local food enforcement agency on whether this product is legal to access in her state or territory.

What should Caitlin do now?

Caitlin's first step should be to make an appointment with her GP, and describe her symptoms. The doctor will make an assessment, and decide on an appropriate plan of treatment.

Caitlin's job requires her to operate machinery while servicing cars, so the doctor could determine that side effects of medicinal cannabis would interfere with Caitlin's ability to work as a mechanic. The doctor is also aware that recent research that suggests a need for caution when prescribing cannabis for chronic pain. In Caitlin's case, the doctor might prescribe a combination of other available medications and physical therapy, and monitor the treatment to determine whether it needs to be changed in the future.

If the doctor decides to prescribe medicinal cannabis, they will organise the supply of a medicine with the appropriate balance of ingredients. The doctor will also ensure that the supply complies with all regulations about access to cannabis, both federal and those specific to the state or territory.

Access to medicinal cannabis is not guaranteed, but depends on the judgement of the doctor that it is an appropriate treatment for a specific patient, and the treatment must also be consistent with the cannabis laws for the state or territory.

For more information about the evidence for medicinal cannabis in treating specific conditions, consult the TGA's patient information guide for medicinal cannabis products.