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Telehealth medicinal cannabis providers can bypass Australia's drug safety and quality standards, GPs say
Australia's peak medical bodies say medicinal cannabis is being sold over the internet with virtually no quality control or safety standards.
www.abc.net.au
Medicinal cannabis providers can sell it without sufficient government oversight, quality control or safety guidelines, Australia's peak medical bodies have warned.
The criticisms come from the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP).
RACGP vice president Michael Clements said medicinal cannabis telehealth providers typically employed their own in-house doctors, which he viewed as a clear conflict of interest. He said doctors were incentivised to quickly sign off on medicinal cannabis prescriptions, regardless of whether the patient actually needed it.
"These companies solely exist for the purposes of mailing out the cannabis product, so you don't have to try very hard to convince a doctor that that's the product for you.
"As long as you press the right buttons in the right [order] you're going to end up with a script for a product that you ask for, and that just doesn't sit with us well as GPs."
Dr Clements says some medicinal cannabis telehealth companies advertise their products using cryptic language to get around Australia's advertising laws, which ban the promotion of prescription products.He said advertisements typically referenced "leaf-based medicine", "green therapies", and other coded language to circumvent the laws.
Dr Clements said he had seen "wild claims" on social media about the benefits of medical cannabis that were not supported by good scientific evidence.
He was concerned that doctors could make untrue or unproven claims about medical cannabis to "cash in" on the very high demand.
Australian Medical Association president Steve Robson said there was some evidence that medicinal cannabis was useful for a limited number of conditions such as epilepsy or palliative care.
But he said there was "very flimsy" evidence to support the widely-touted benefits for conditions like post-traumatic stress disorder and chronic pain.
He said in many cases, there were other medications that were more effective or more suitable for a given patient.
Montu, a parent company of online medicinal cannabis clinic Alternaleaf, said their doctors were not financially incentivised to approve prescriptions for patients.
Company spokesperson Kelly King said their doctors were paid a flat fee per consultation, regardless of whether or not they signed off on a prescription.
Ms King said their advertisements were legal because they promoted the clinic and its services, but no actual cannabis product.
She said there were bad actors in the medicinal cannabis telehealth space, but maintained that Alternaleaf was fully compliant with the rules.
"It's quite upsetting us to see people who are wildly flouting the rules when it comes to providing a medical service."
In March this year, Alternaleaf signed a sponsored partnership with the Dolphins NRL team, which has included the company's logo on its jerseys.
Professor Robson said internet cannabis suppliers were able to "totally bypass" the Therapeutic Goods Administration's (TGA) quality and safety standards that applied to other medicines.
He said it was "impossible" to enforce the TGA's guidelines on the internet.
"This has absolutely exploded from only a few years ago and it's not clear who is using it, why they're using it, what it's being used for, and whether it actually works or not."
A TGA spokesperson said they had received reports of negative side-effects from medicinal cannabis users.
"The TGA has received more than 600 reports of adverse events related to medicinal cannabis products, including unapproved medicinal cannabis products accessed through the Special Access or Authorised Prescriber Schemes," the spokesperson said.
"The most commonly reported events are nausea, diarrhoea, dizziness, drowsiness and headache."
The TGA classifies most medicinal cannabis products as "unapproved", which means they are not assessed for safety, quality or effectiveness.
The company Releaf provides medicinal cannabis through brick-and-mortar clinics as well as through its telehealth service.
Chief executive Gary Mackenzie said the telehealth service allowed better access to those who could not physically visit a clinic, such as elderly, disabled or rural Australians.
Mr Mackenzie said Medicare-covered GP clinics like his were held to a much higher regulatory standard than those who solely operated online.
"[Vocationally registered] doctors working in a physical bricks-and-mortar clinic get audited under the Medicare regime for the time they're consulting for," he said.
"I'm not saying all online doctors are bad. There are some very good ones as well who are following the process, but I think telehealth needs a little more regulation."
