Cannabis is used to treat illnesses, but federal legislation has a strict hold on how people can access medical cannabis in Australia.
Medical cannabis was only legalized in Australia in 2016, and, since then, Australians have been making use of their access to the drug.
A report from the Australian Institute of Health and Welfare titled “Alcohol, Tobacco & Other Drugs in Australia" indicates that “(in 2016), 85 percent of Australians favoured the use of cannabis for medicinal purposes, rising from 69 percent in 2013."
Cannabis in Australia is used to treat everything from epilepsy to neuropathic pain, but federal legislation has a strict hold on the distribution of cannabis in the country.
Here, the Investing News Network takes a look at how to access medical cannabis in Australia, plus the challenges facing the country's patients and what it all means for the budding cannabis industry.
Access to medical cannabis in Australia: The history
Cannabis was first outlawed in Australia in 1938 in the midst of a moral panic. The uproar was ignited by a story in an Australian newspaper from the US Bureau of Narcotics that referred to marijuana as “a new drug that maddens victims."
The “war on drugs" ramped up in the Oceanic country decades later in the 1970s amid US-style drug prohibition, and communes in Queensland and New South Wales faced paramilitary raids.
Over the years, Australia's relationship with the drug has been a complex one. Cannabis use has remained fairly high despite it being illegal.
In 2016, the drug's status changed irrevocably when Australia's parliament amended the Narcotic Drugs Act 1967 to allow the cultivation of cannabis for medicinal and research purposes.
The amendment came into action exactly a year after medical cannabis campaigner Dan Haslam died after being diagnosed with bowel cancer. Haslam used marijuana to ease his pain and nausea before he died. His mother went on to create a medical cannabis advocacy group, Unite in Compassion, that petitioned the government to make it legal.
When the amended act was being passed, Haslam's story was brought up as an example of the kind of patient that counts on cannabis as a pain aid.
“It is incredibly fitting that today we are passing this bill which is one step towards making medicinal cannabis accessible to people like Dan," said Australian Senator Richard Di Natale before parliament.
Access to medical cannabis in Australia: How to access
The Therapeutic Goods Administration (TGA) works under Australia's health department and is the country's regulatory authority for ensuring the safety and quality of therapeutic materials, including medicine and medical devices.
With the exception of one cannabis extract, medicinal cannabis products aren't registered in Australia and can only be accessed through specialized pathways for unapproved medicine.
Patients can access products like raw cannabis, oils, liquid sprays and topical treatments via import from Canada or the US or from local sources. But these items can only be prescribed by a registered medical practitioner after a thorough assessment to determine if medical cannabis is right for the patient.
Patients seeking access to medical cannabis products in Australia can do so through the Special Access Scheme (SAS), the Authorised Prescriber (AP) Scheme or a clinical trial.
The SAS provides medical professionals with a way to get governmental approval for their patients to gain access to unapproved medicine, while an AP is a medical practitioner who has already been approved by the TGA to prescribe unapproved medical goods and doesn't need further permission.
As of July 2019, the TGA had approved 11,000 SAS applications. Each approval does not mean a new patient, as repeat patients are listed as well. A scheme approval doesn't guarantee access to the drug, either; that falls to the medical practitioner and the patient. If a doctor sees fit to prescribe their patients with medical cannabis products, they have to do so under the rules of the state or territory laws. These vary and can affect whether or not medical cannabis can be prescribed.
The TGA has approved SAS applications for ailments including chemotherapy-induced vomiting, paediatric epilepsy, cancer pain and spasms from neurological conditions.
But there have been efforts to streamline the application process. In June 2018, the TGA set up an online system to lodge SAS applications, replacing the old paper form system, and it has been working with the health departments of Australia's states and territories to make it easier for patients.
People looking for medical cannabis can also seek out an AP. As of June 2019, there were 56 APs in the country. Patients can submit an online form for an AP as well, expediting the application process.
There are also clinical trials that involve the use and study of unapproved goods. When a trial involves cannabis, the products used have to meet the quality standards the TGA has established.
Access to medical cannabis in Australia: The difficulties
While Australia's budding cannabis industry is well regulated, its tight restrictions have caused problems for patients who wish to access the drug.
Though cannabis companies have begun to crop up in the past few years, consumers have to go through the SAS, an AP or the clinical trial pathway, which can prove to be lengthy processes.
Adding to that, according to some Australian MPs, physicians are unwilling to prescribe cannabis because of a lack of cannabis clinical trials. It's led to some apprehension around the drug.
There have been attempts to make sense of the existing cannabis research, however.
The TGA conducted a review of medicinal cannabis in 2017 to get a better sense of how cannabis could be used to help patients.
The review found “limited" evidence that medicinal cannabis could be used for pain relief, specifically for chronic neuropathic pain conditions. The review forms the basis of the current TGA guidelines.
The TGA review ultimately suggests that medical cannabis shouldn't be considered as the first line of therapy for any condition, and should only be used when registered medicines have been shown to be unable to manage a patient's symptoms or medical condition.
Access to medical cannabis in Australia: Investor takeaway
Despite the hurdles facing patients who use cannabis, projections for Australia's medical cannabis market are favourable. A 2018 report by Prohibition Partners predicts that, by 2028, the medical cannabis market in the country will be worth AU$3 billion.
Some of the projected growth has been attributed to the legalization of overseas exports, and Australia has big plans for its international presence. “We'd like to be potentially the world's number one supplier," said Australian Health Minister Greg Hunt on a local radio station. And with the country's well-established agriculture industry, Australia is situated to become a force in medical cannabis export.
Cannabis companies have been making moves to solidify their presence on the international stage.
In July 2019, two Australian cannabis companies announced partnerships with players in the UK. Bod Australia (ASX:BDA) signed an agreement with UK-based medicine manufacturer PCCA to import and distribute its medical cannabis in the UK and Ireland. Imports are already underway, and Bod expects to receive its first prescriptions from the region later this year.
Australian cannabis heavyweight Elixinol Global (ASX:EXL) also got a foothold in the UK market, announcing that its Dutch subsidiary, Elixinol, has partnered with PharmaCare's Naturopathica brand to co-create a CBD capsule to be sold in Holland & Barrett, a UK health and wellness retailer.
Although still in its early stages, Australia's medical cannabis industry is moving in the right direction despite the challenges it's facing. As it continues to grow, Australia's cannabis space will continue to be of interest for investors as companies expand their reach through international sales and through research products that may help demystify the effects of the drug.
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Securities Disclosure: I, Danielle Edwards, hold no direct investment interest in any company mentioned in this article.