Psychiatrists have welcomed new guidance and a tougher approach to medicinal cannabis prescribing practices but say more needs to be done to protect vulnerable patients.  

The Royal Australian & New Zealand College of Psychiatrists (RANZCP) is urging regulators to remove medicinal cannabis from the Special Access Scheme (SAS) and enforce stricter controls around products containing highly potent and potentially harmful concentrations of tetrahydrocannabinol (THC).

RANZCP President Dr Astha Tomar said recent guidance from the Australian Health Practitioners Regulation Authority (Ahpra) to help practitioners meet their obligations when prescribing medicinal cannabis was a step in the right direction but did not go far enough.

“We share Ahpra’s concerns that profits are being prioritised over patient safety, especially for those patients most at risk of harm,” Dr Tomar said.

“Medicinal cannabis is being overprescribed for anxiety and sleep disorders where there is a lack of evidence for its use, and in circumstances where first-line treatments have not been tried.

"There is little evidence supporting medicinal cannabis’s effectiveness for treating mental health disorders, and it carries the risk of causing significant harm, particularly for those with a history of mental illness or a predisposition to psychosis. 

“We’re seeing too many cases where individuals who were prescribed medicinal cannabis experience their first psychotic episode or where its use triggers relapses in those with existing psychotic conditions. 

“It’s crucial that medicinal cannabis is considered only when other proven treatments haven’t worked. Even then, it must be done with great care, including thorough patient evaluation, and ensuring that prescribers follow evidence-based guidelines and maintain high clinical standards.” 

Dr Tomar said medicinal cannabis should be removed from the SAS and regulated in the same manner as all other drugs of dependence. If that was the case they would have to meet the same rigorous approval standards as other TGA-approved pharmaceuticals. 

High-potency THC-containing products posed particular risks, including:  

• Exacerbation of psychosis, especially in individuals with pre-existing mental health conditions. 
• Increased risk of cannabis-induced psychosis, particularly with high-potency strains and in younger users.

The RANZCP has met with the Therapeutic Goods Administration (TGA) and the Medical Boards and advocated for more high-quality research to better understand the long-term safety and effectiveness of medicinal cannabis. 

“We recognise evidence supporting the use of certain medicinal cannabis products for specific conditions, such as some forms of childhood epilepsy, but for mental health disorders, the evidence remains limited and unconvincing,” Dr Tomar said.  

“Patient care must always come first, and any treatment should be safe, effective, and grounded in solid evidence and careful oversight.” 

ENQUIRIES: For more information, or to arrange an interview call Phil Cullen on +61 437 315 911 or email media@ranzcp.org.  

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

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