Ahpra releases guidance for compliant prescribing of medicinal cannabis
- Regulation
- Medicines
Released in conjunction with the National Boards, including the Dental Board, the guidance targets poor prescribing practices which can result in “significant patient harm”.
Ahpra and the National Boards, which include the Dental Board of Australia, is targeting unsafe medicinal cannabis prescribing practices with the release of guidance which aims to help all practitioners meet their obligations.
With evidence showing that failure to prescribe in a correct manner can result in “significant patient harm”, the guidance places practitioners on notice that most medicinal cannabis is a Schedule 8 medicine and that safe prescribing practices must apply.
Examples of poor prescribing practices can include:
• Practitioners who have issued more than 10,000 prescriptions for medicinal cannabis products in six months
• Consultations lasting between a few seconds and a few minutes, making a proper assessment impossible
• Prescribing without a legitimate indication, including because the patient requested it
• Failing to fully assess a patient’s mental health and/or history of substance use disorders prior to prescribing
• Not checking the identity of the patient, including prescribing for people under the age of 18
• Prescribing excessive quantities of medicinal cannabis in each prescription
• Providing multiple prescriptions for a single patient so they can ‘try which one suits them’
• Not checking real time prescription monitoring (RTPM) systems and therefore not being aware of other medicines prescribed
• Not coordinating care with a patient’s other treating practitioners especially where a patient’s history or other prescribed medicines suggest they are not a suitable candidate for treatment with medicinal cannabis
• Self-prescribing or prescribing for family members
• Having a conflict of interest by only prescribing a product supplied by a company which the practitioner is associated with
Ahpra underscores why adherence to its safe prescribing practices is paramount:
"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 ..."
Examples of safe prescribing of medicinal cannabis include:
• 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 and the National Boards are working with other regulators like the Therapeutic Goods Administration and state and territory authorities to understand prescribing patterns and stay ahead of emerging trends.
Report unsafe practice
Ahpra encourages patients and practitioners to report unsafe practice by calling the Notification Hotline on 1300 361 041.
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