Medicinal cannabis: Health watchdog warns of prescribing cannabis to patients as psychosis cases spike

The health practitioner watchdog has cracked down on doctors prescribing medicinal cannabis, with poor practices leading to a spike in patients presenting to emergency departments — including in WA — experiencing psychosis. The Australian Health Practitioner Regulation Agency issued new guidelines on Wednesday reminding practitioners to put patient wellbeing over profits following a rise in telehealth companies providing easy access to medicinal cannabis. The directions were also sparked by reports of patients presenting to emergency departments with medical cannabis induced psychosis. Most medicinal cannabis is a Schedule 8 medicine — prescription medications that carry a high risk of misuse, abuse, and dependence. Australian Medical Association WA president Kyle Hoath said he had reports from most of the State’s emergency departments about an increase in cannabis-related psychosis presentations since late last year. “We support the use of cannabis where it’s appropriate but the ease in which people can access cannabis prescriptions online through telehealth is unacceptable and poses a real risk,” he said. “There has to be some control here so we don’t end up with situations where somebody is writing a cannabis script every four minutes — they’re a dealer. “If a patient’s history is not taken, then the risk for that individual is huge. The impact of having a psychotic episode can be life-altering so we need to be making sure that we aren’t prescribing to the wrong people.” The crackdown comes as AHPRA found eight prescribers issued more than 10,000 scripts in six months and one practitioner prescribed over 17,000 scripts in the same time. According to the Therapeutic Goods Administration, there have been 6556 approvals for medicinal cannabis prescriptions in WA since 2017. There have been 862 approved so far in 2025 compared to 1062 at the same time last year. The main reasons for prescription in WA included chronic pain, anxiety, and sleep disorders. AHPRA chief executive Justin Untersteiner said the regulator would investigate practitioners with high rates of prescribing the medicine even if a complaint had not been received. “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,” he said. “This raises the very real concern that some practitioners may be putting profits over patient welfare.” AHPRA’s latest guidelines highlighted that medicinal cannabis should never be a first-line treatment, it should only be prescribed if there is a therapeutic need and an exit strategy should be developed for the patient to cease taking the medicine. The regulator also urged practitioners to assess patients thoroughly and maintain continuity of care. Medical Board of Australia chair Susan O’Dwyer reminded prescribers they should be diligent when prescribing medicinal cannabis as they would for any 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,” she said. The Pharmacy Guild of Australia backed AHPRA’s new cannabis prescription guidelines. AHPRA and the Medical and Nursing and Midwifery Boards said they were working with the TGA and state and territory authorities to keep an eye on the issue.