New research from the University of Sydney’s Lambert Initiative seeks to take closer look at cannabis consumers’ habits. The results found that most Australians medicate with illicit cannabis, though the number of patients accessing medicinal cannabis has risen dramatically over the years. The study’s findings were recently published in Harm Reduction Journal.

It’s the third Cannabis as a Medicine Survey (CAMS20), following two previous iterations, CAMS16 and CAMS18. The authors note that, even though Australia has had its legal framework for medicinal cannabis since 2016, prior surveys indicated most consumers were still using illicit cannabis products, while regulatory data indicated an increase in medicinal cannabis prescriptions since 2019.

Researchers administered a cross-sectional anonymous survey to 1,600 participants from September 2020 to January 2021. Participants were eligible if they were over 18 years of age, used cannabis for self-identified medical reason(s) in the past year, and a resident in Australia.

The survey ultimately found that 37.6% of respondents received a legal prescription for medical cannabis, a major increase from the 2.5% of respondents who reported prescription use in the 2018 iteration of the CAMS survey. Those who exclusively used prescription cannabis were often older, women, and less likely to be employed.

Prescribed participants were more likely to use cannabis to treat pain than those using illicit cannabis (52% vs. 40%) and were also less likely to treat sleep conditions (6% vs. 11%). Mental health conditions were also common indications for both groups (26% and 31%, respectively). Additionally, prescribed medicinal cannabis was predominately consumed through oral routes (72%), while illicit cannabis was more often smoked (41%).

As far as medicinal cannabis access, and despite the fact that medical patients in Australia have drastically increased over the past several years, few participants (10.8%) described the existing model for accessing prescribed medicinal cannabis as “straightforward or easy.”

Survey participants mostly called out the cost of medicinal cannabis as a barrier, with an average cost of $79 per week, highlighting the need to reexamine the cost of treatment for patients. People using illicit cannabis also reported that they had trouble finding medical practitioners with the ability or willingness to prescribe medicinal cannabis.

The study’s lead researcher, Professor Nicholas Lintzeris from the Faculty of Medicine and Health at the University of Sydney, said this data suggests that Australia has seen a transition from illicit use toward the legal use of medicinal cannabis.

“A number of benefits were identified in moving to prescribed products, particularly where consumers reported safer ways of using medical cannabis. People using illicit cannabis were more likely to smoke their cannabis, compared to people using prescribed products who were more likely to use oral products or vaporised cannabis, highlighting a health benefit of using prescribed products,” Lintzeris said.

Respondents also reported positive outcomes from their medical cannabis use overall, with 95% stating that using medical cannabis has improved their health.

Professor Iain McGregor, academic director of the Lambert Initiative for Cannabinoid Therapeutics, added that there are advantages in using medicinal cannabis instead of its illicit counterpart, including safer routes of administration, greater certainty of access, and better communication between patients and doctors.

“Patients can also be informed of the exact THC/CBD composition, which is an ongoing problem with illicit product,” McGregor said. “There should be further efforts to transition patients from illicit to regulated, quality-controlled, cannabis products.”

In the study conclusion, authors echo similar sentiments, noting the progress and uptick in medicinal cannabis prescriptions since the regulatory framework was first introduced in 2016. While they similarly note the benefits of using medicinal cannabis, authors recognized the barriers that may keep illicit cannabis users from securing a prescription.

In closing, the authors suggest further research to address the barriers respondents reported in accessing medical practitioners willing to prescribe medicinal cannabis in Australia. The CAMS series is conducted every two years, and if the stark contrast between this survey and the previous iteration is any indicator, hopefully the upcoming iteration will close some of these gaps in patient access to medicinal cannabis in the future.

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