How Australians use medical cannabis since legislation: new survey

Australians report using medicinal cannabis for chronic pain, mental health and sleep with the majority sourcing cannabis illicitly, despite medicinal cannabis being legal, a new survey from the University of Sydney has revealed.

The results from the Cannabis As Medicine Survey (CAMS:18), conducted by staff at the Discipline of Addiction Medicine in conjunction with the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney, provide insight into how Australians are using cannabis as medicine.

The results of the previous Cannabis As Medicine Survey ( CAMS:16 ), the biggest national survey of medicinal cannabis users in Australia in more than a decade, provided a snapshot of people self-medicating before any medicinal cannabis use was legalised. 

The aim of the two-year follow-up survey was to monitor changes in how Australians were accessing and using medical cannabis following its legalisation in 2016. The survey of 1388 Australians was conducted between September 2018 and March 2019.

Illicit sources of cannabis appear to be the mainstay for patients despite two years of legal availability of medicinal cannabis, with only 2.7 percent of respondents accessing legal product.

The impediments to obtaining a prescription include the cost of products, the difficulties in locating a doctor willing to prescribe and the perception that a person’s usual doctor was not interested in investigating medicinal cannabis as a treatment option.

The survey revealed that pain, mental health (mainly anxiety and depression) and sleep remain the main clinical indications for which participants report using cannabis medicinally.

There is a current lack of clinical guidance for conditions such as anxiety, depression, insomnia - highlighting an urgent need for more clinical trials.

Results indicate a positive move away from smoking (joints, bongs) to non-smoked cannabis-based products (vaporised cannabis, oral products) since the CAMS-16 survey.

While most respondents in the survey continued to express disappointment with the legal models of medical cannabis availability, those who had actually pursued the illicit avenue reported quite positive experiences.    

Medicinal cannabis prescriptions

Lead author and addiction medicine specialist Professor Nicholas Lintzeris said: "There continues to be considerable demand for medical cannabis in Australia that has not been completely met by available models of prescription by medical practitioners. The uncertainties experienced by people in the community around the cannabis products they are accessing illegally is a concern.

"However, the few people who report accessing legally prescribed medical cannabis products did have favourable reports, suggesting there is a path forward. I think it is still early days for the Australian medicinal cannabis system."

Risks and challenges   

Co-author and academic director of the Lambert Initiative Professor Iain McGregor said: "This is an important snapshot into the reality of medicinal cannabis access in the Australian community. There are clearly many Australians with serious medical conditions who are yet to gain official access to medicinal cannabis products, even though they would like such access. These users continue to risk hazards associated with non-standardised cannabis products of unknown origin as well as a possible criminal conviction as a result of their current patterns of self-medication.

"We need to accelerate the pace of change through innovations such as over-the-counter access to CBD (cannabidiol, the chemical found in cannabis plants) products and improved education and guidance for doctors and specialists in this area. Better quality evidence around medicinal cannabis effectiveness, particularly for conditions such as insomnia and depression, is also critical."

Declaration: This work was supported by the Lambert Initiative for Cannabinoid Therapeutics, University of Sydney


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