Eight doctors write 87,000 prescriptions for medical cannabis in six months

A group of eight doctors penned a combined total of 87,000 prescriptions for medical cannabis in the space of half a year in Australia, sparking concerns of malpractice.

New guidance for prescribing medicinal cannabis has been issued in Australia, with health watchdogs voicing concerns that some "practitioners may be putting profits over patient welfare". The Australian Health Practitioner Regulation Agency (Aphra)says a combination of poor medicinal cannabis prescribing practices and a surge in patient demand is "leading to significant patient harm".

The body says current prescribing data "raises red flags that some practitioners are not meeting their professional obligations. This includes eight 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".

They also identified a number of cases of poor practice where prescribing the drug is concerned, including:

• consultations that last only a few seconds or minutes (ruling out the possibility of a proper assessment)
• prescribing medicinal canabis without a legitimate indication, such as because the patient asked for it
• failure to fully assess the mental health of a patient's mental health and/or their history of substance use disorders before issuing the prescription, which the bodies said can lead to to serious adverse outcomes like psychotic episodes which then require inpatient admission

Aphra chief executive Justin Untersteiner said: "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.

"This raises the very real concern that some practitioners may be putting profits over patient welfare," he warned.

The watchdog has said it will "investigate practitioners with high rates of prescribing any scheduled medicine, including medicinal cannabis, even if we have not received a complaint".

Explaining the move to put out new guidance this week on their website, they also pointed to fears over the health impacts, namely "reports of patients presenting to emergency departments with medicinal cannabis induced psychosis".

The body said this, in addition to evidence of "over-servicing and ethical grey areas around single-purpose dispensaries", prompted Aphra to take the step of clarifying what is expected of practitioners.

The guidance reminds those issuing precriptions that the drug should be treated as a medicine and that practitioners must be careful and diligent when signing scripts "as they are when prescribing other drugs of dependence".

It makes clear that there is "little evidence to support the use of medicinal cannabis" apart from in the treatment of "certain childhood epilepsies, muscle spasms and pain symptoms associated with multiple sclerosis, some neuropathic pain and chemotherapy-induced nausea and vomiting in cancer".

Meanwhile, Australian outlet ABC News reported on Tuesday that Aphra has taken action against 57 medical practitioners, pharmacists and nurses over prescribing practices for the drug, and are investigating 60 others.

Mr Untersteiner said, "And for those that choose not to meet our requirements, we will be knocking on their door in the near future."

A legislation changed legalised medicinal cannabis prescription in in the country 2016, and prescriptions have soared amid a boom in telehealth, News GP reports.