A new analysis of submissions to the 2019 Senate Inquiry into patient access has uncovered a sharp divide in opinion, with government agencies and healthcare bodies on one side and patients alongside the medicinal cannabis industry on the other.
The research team examined 121 submissions drawn from patients or their family members (63), government bodies (five), non-government organisations (25), medicinal cannabis and pharmaceutical companies (16), and individual health professionals, academics, or research centres (12).
Submissions originating from government agencies and professional health organisations consistently defended the existing regulatory framework and access pathways, while calling for greater research into whether medicinal cannabis is effective.
Among the typical responses were:
"There are very few well-designed clinical trials using medicinal cannabis, resulting in limited evidence for its use in successfully treating different medical conditions, or on effective forms and dosages." (Northern Territory Government)
"The development of a sound evidence base remains a critical enabler to ensure safe and effective use of medicinal cannabis in chronic pain and requires further research and investment." (Pain Australia)
By contrast, the vast majority of patients, advocacy organisations, and medicinal cannabis companies characterised the current system as unfit for purpose.
Their submissions included statements such as:
"What patients are reporting 'anecdotally' is their lived experience. I think it more sensible in the complex space of medicinal cannabis to instead consider a 'risk vs benefits' approach and to make care-related decisions accordingly because, regardless of political and medical opinions, thousands of Australian patients are using cannabis medically and illegally." (Individual submission)
"No patient can find anything praiseworthy in a scheme that is deliberately crafted to present a daunting minefield of barriers impossible to negotiate, and, for the accepted few, culminating in an extortionately priced, limited-range product so dilute and watered-down as to be next to useless." (Individual submission)
Publishing their findings in Plos One, the researchers attributed the opposing viewpoints to "divergent perspectives on what and how much evidence is needed for policy and practice, and how patients should be given access to medical cannabis products amid empirical uncertainty."
The team also noted: "Notwithstanding these differences, there were commonalities among some stakeholders regarding the various supply, regulatory, legislative, financial, and dispensing challenges that hindered timely access to cannabis-based medicines."
Their conclusions identified bridging the urban–rural gap in healthcare access, separating recreational cannabis from its medicinal counterpart, and shifting attitudes among both the public and health professionals as "essential first steps to destigmatise and improve access."