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<\/p>\nInstead, a flood of prescriptions is now issued each year, with TGA data showing 6.59 million units of legal medicinal cannabis products sold in Australia last year.<\/p>\n
But as commercial platforms automate consultations and prioritise script volumes, \u201cthe real elephant in the room for us is the telehealth model that is causing a lot of this really low-value care\u201d, Langham said.<\/p>\n
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Therapeutic Goods Administration chief medical adviser Robyn Langham.<\/p>\n
Telehealth prescribing surged during the pandemic and is now a national marketplace with fast-growing single-medication players in areas ranging from weight-loss drugs to cosmetic injectables, vaping, ADHD diagnoses and others.<\/p>\n
Asked about the comments, a TGA spokesman said it was important to strike \u201cthe right balance between access to services to patients, particularly those living in rural and regional Australia, and the public safety risks associated with isolated prescribing practices\u201d.<\/p>\n
Federal Health Minister Mark Butler said on Tuesday that while telehealth had been a significant innovation in healthcare \u2013 particularly since the beginning of COVID for those who found travel difficult \u2013 serious issues had emerged.<\/p>\n
\u201cI think we\u2019ve found over the last five years, as the model has frankly exploded in some areas, that we need to make sure that there are proper quality controls on the system,\u201d he said.<\/p>\n
Butler said the TGA was reviewing medicinal cannabis which would be crucial for ensuring proper \u201cquality controls [are] in place\u201d. He said there had been ample coverage of the medicinal cannabis sector\u2019s \u201cclosed-loop models \u2013 business models where people get a referral and a script and then a dispensed product from essentially the same business\u201d.<\/p>\n
The regulator\u2019s review of the rules around medicinal cannabis prescription<\/a> will help establish for the first time just how much of the drug is being prescribed.<\/p>\n At present, there are multiple ways doctors can provide scripts for cannabis, meaning the TGA does not record the number of patients accessing cannabis products.<\/p>\n One of the only available measurements of the medicinal cannabis market is sales data, obtained under freedom of information by drug policy research body the Penington Institute each quarter.<\/p>\n \u201cWe don\u2019t know how much is being prescribed,\u201d the TGA\u2019s Langham said.<\/p>\n Loading<\/p>\n In July, the body that polices doctors, the Australian Health Practitioner Regulation Agency, also warned it believed some practitioners were putting profits over patient welfare<\/a> and that it would target doctors it considered were overprescribing.<\/p>\n \u201cWe don\u2019t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different. Patient demand is no indicator of clinical need,\u201d Medical Board chair Dr Susan O\u2019Dwyer said at the time.<\/p>\n One doctor caught up in AHPRA\u2019s crackdown is Justin Welsh, a South Melbourne practitioner who approached this masthead after he was barred from prescribing medicinal cannabis to his more than 4000 patients.<\/p>\n In November, after a lengthy legal dispute, AHPRA suspended the 54-year-old emergency medicine veteran from prescribing cannabis (he can still practise medicine), in part because of the volume of his prescriptions.<\/p>\n Welsh himself is not bashful about his prescribing: \u201cThis year alone, I have written 14,711 prescriptions. That\u2019s 102,977 cannabis products worth an estimated $9,782,815 to the cannabis industry,\u201d he said.<\/p>\n Welsh concedes the numbers are high, but argues he is dealing with a patient cohort that regulators have never managed properly and that would otherwise buy from the black market. \u201cI\u2019m not creating new users,\u201d he says. \u201cI\u2019m reducing harm. If I don\u2019t prescribe, they go to the street.\u201d<\/p>\n Welsh spent two decades in emergency medicine at the Epworth before turning full time to cannabis prescribing during the pandemic. He is furious at the current enforcement push, accusing AHPRA of \u201cacting above the law\u201d and ignoring the regulatory vacuum that governments created from 2016 when they legalised medicinal cannabis but misjudged the scale of demand.<\/p>\n Welsh\u2019s suspension was triggered by state health complaints \u2013 particularly from Western Australia, where THC limits are lower than in Victoria where he predominantly prescribes. For a national telehealth doctor, he argues, the inconsistent maze of state rules is unworkable. \u201cThere is no regulation for what a dose is, or an overdose. It\u2019s random.\u201d<\/p>\n Welsh said the real safety risk in cannabis lay in people accessing the unregulated market: \u201cStreet marijuana contains mould, pesticides, twigs and dog shit,\u201d he says. \u201cMedicinal cannabis is [a high] standard and often cheaper than illegal product.\u201d<\/p>\n Welsh\u2019s suspension has left his patients in limbo \u2013 on the day this masthead visited his clinic, dozens of text messages and phone calls peppered his phone from patients wanting to know why he had cancelled their appointments. Welsh said the calls from distressed patients were upsetting.<\/p>\n \u201cPeople need this medication. Otherwise, they use other drugs that are more dangerous than cannabis.\u201d<\/p>\n An AHPRA spokesman said the Medical Board of Australia had \u201caccepted an undertaking\u201d from Welsh prohibiting him from prescribing medicinal cannabis but could not comment further.<\/p>\n On Friday, the Penington Institute released its annual Cannabis in Australia<\/a> report, which showed product sales plateauing in 2025 after years of rapid growth, and the sale of edible cannabis products, such as gummies, almost doubling in the last year.<\/p>\n The report noted Australia imports two-thirds of its medicinal cannabis medicines, leaving domestic growers sidelined.<\/p>\n