Guidance on medicinal cannabis prescribing targets unsafe practice

09 Jul 2025

Practitioners reminded to put patients’ wellbeing above profit as medicinal cannabis prescriptions soar

Regulators are stepping in to guide practitioners who prescribe medicinal cannabis due to evidence that poor practice is leading to significant patient harm.

Ahpra and the National Boards are concerned by reports of patients presenting to emergency departments with medicinal cannabis induced psychosis. This, combined with evidence of over-servicing and ethical grey areas around single-purpose dispensaries, has led the regulator to clarify the expectations of practitioners working in the industry.

The guidance reminds prescribers that medicinal cannabis should be treated as a medicine and to be as careful and diligent when prescribing medicinal cannabis as they are when prescribing other drugs of dependence.

‘We don’t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different. Patient demand is no indicator of clinical need,’ said Medical Board of Australia Chair, Dr Susan O’Dwyer. 

The guidance addresses the regulator’s concern that profits are being prioritised over patient safety and aims to support practitioners to provide safe care, particularly for those patients at most risk of harm.

Adjunct Professor Veronica Casey AM, Chair of the Nursing and Midwifery Board of Australia, urges nurse practitioners within the industry to combine this guidance with their professional practice framework when conducting assessments.

‘Nurses and other registered practitioners must provide holistic care in all areas of their practice. They must take their professional responsibilities with them no matter where they work,’ said Adjunct Professor Casey.

Safe prescribing of medicinal cannabis includes assessing patients thoroughly, formulating and implementing a management plan, facilitating coordination and continuity of care, maintaining medical records, recommending treatments only where there is an identified therapeutic need, ensuring medicinal cannabis is never a first line treatment, and developing an exit strategy from the beginning.  
 
Ahpra CEO Justin Untersteiner said practitioners were also warned of the inherent conflict of interest for practitioners working in an organisation that only prescribes and dispenses a single medicine.

‘Some business models that have emerged in this area rely on prescribing a single product or class of drug and use online questionnaires that coach patients to say ‘the right thing’ to justify prescribing medicinal cannabis,’ said Mr Untersteiner. 

‘This raises the very real concern that some practitioners may be putting profits over patient welfare.’ 

Ahpra and the National Boards are working with other regulators like the Therapeutic Goods Administration (TGA) and state and territory authorities to understand prescribing patterns and stay ahead of emerging trends.

Current prescribing data raises red flags that some practitioners are not meeting their professional obligations, including eight practitioners who have issued more than 10,000 scripts in a six-month window and one practitioner who appears to have issued over 17,000 scripts.

‘We will investigate practitioners with high rates of prescribing any scheduled medicine, including medicinal cannabis, even if we have not received a complaint,’ said Mr Untersteiner.

The guidance on medicinal cannabis prescribing is published on the Ahpra website. It builds on existing regulatory guidance about safe care, including each Board’s code of conduct and their guidance on telehealth and virtual care.

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