Legal access to medicinal cannabis should be made simpler, Labor MP Sharon Claydon says.
"We know that medicinal cannabis can alleviate a range of conditions and reduce the use of dangerous opioids, but there are simply too many roadblocks to access," Ms Claydon said.
Ms Claydon said it was time for action to "ensure that sick Australians can get the therapeutic treatment they need without red tape and onerous costs".
A Senate inquiry into the "Current barriers to patient access to medicinal cannabis in Australia" is due to release its report on Thursday.
Lucy Haslam, a retired nurse and co-founder of United in Compassion, is a leading advocate for access to medicinal cannabis. Ms Haslam witnessed the dramatic relief that medicinal cannabis gave her son Dan, while he was suffering from bowel cancer. He died in 2015. In her submission to the inquiry, she said the issue was "as much about denial of human rights and harm minimisation", as it was about patient access. She had seen governments, advisors and bureaucracies install "complicated and arduous" processes to access medicinal cannabis.
If they weren't so serious, they would be funny.Lucy Haslam
"If they weren't so serious, they would be funny. Governments and their advisors have well and truly demonstrated that Australian patients are not foremost on their minds." The Medical Cannabis Users Association of Australia said cannabis was "not a new drug".
"It is a herbal remedy that has been used throughout history with no recorded deaths," it said. "It should be treated as a botanical substance rather than tying it up so tightly in pharmaceutical red tape that prevents patient access."
The user group's submission said the general consensus from patient feedback was that "the current regulatory regime is not working" and patients were facing significant financial barriers to access products.
The Therapeutic Goods Administration said it had approved more than 34,500 "Special Access Scheme Category B" applications for unapproved medicinal cannabis products. This included access for people with chemotherapy-induced nausea and vomiting, refractory paediatric epilepsy, palliative care, cancer pain, neuropathic pain, spasticity from neurological conditions, anorexia and wasting from chronic illness such as cancer. "A number of applications for indications [medical conditions] other than those listed above have also been approved," it said.
The federal Department of Health's submission said most prescriptions had "so far have been written for unapproved products".
"The government's ultimate goal is to have a wider range of medicinal cannabis products included in the Australian Register of Therapeutic Goods (ARTG) as registered medicines."
Currently, there is one medicinal cannabis product Sativex (nabiximols) included in the ARTG. Another product, Epidyolex (cannabidiol - also known as CBD), is being assessed. The department said medicines which the TGA approved "may then apply for PBS [Pharmaceutical Benefits Scheme] listing".
A company called Canopy Growth is one of three companies that the federal government has given "major project status" in Australia. Canopy Growth is establishing a base in Victoria through its Australian arm, Spectrum Therapeutics.
Dr Mark Ware, chief medical officer for Canopy Growth, said the government was "trying to fit medicinal cannabis into the traditional pharmaceutical registration pathway, which can lead to barriers for patient access".
Dr Ware said medicinal cannabis has been legal for more than 20 years in Canada. In Australia, it was legalised in 2016.
"A key barrier that patients continue to face is a lack of knowledge and confidence by medical practitioners to consider medicinal cannabis as a viable option of treatment," Dr Ware said. "There is a gap in knowledge about the risks and benefits of medicinal cannabis."
This was partly due to the need for more investment in "clinical research and educating Australian healthcare professionals generally on the endocannabinoid system [within the human body] and the use of medicinal cannabis as a viable option for treatment of various indications".
The endocannabinoid system was "involved in regulating many physiological functions, including inflammation, sleep, pain, memory, digestion, immune function, neuroprotection".
"The phytocannabinoids (such as THC and CBD) produced by the cannabis plant interact with these elements of [the body's] endocannabinoid system. This could partly explain why cannabis seems to affect such a vast range of conditions and symptoms."
Medicinal cannabis represents a "unique class of therapeutics".
"It's rare for any one class of drug to have such a broad spectrum of effects. It is used by many patients to treat a wide range of symptoms including pain, spasticity, nausea, anxiety and seizures. These effects are supported by significant scientific advances in our understanding of the body's endocannabinoid system ... which plays an important balancing role in a variety of conditions and processes."
He said general practitioners and specialists should have access to "high-quality unbiased education, so they are able to make informed decisions for their patients".
"With better education, GPs may feel more confident to consider medicinal cannabis as a credible option for patients who have unmet medical needs and seek a better quality of life."
In Canada, medical cannabis products can qualify for "insurance coverage as part of extended health benefits plans". In Australia, patients receive no subsidy support, except for veterans. He said the Australian government had a responsibility to make regulated medicinal cannabis at least on par in cost with illicit cannabis to "encourage patients to access the regulated channels".
For patients wanting to access medicinal cannabis in the Hunter Region, Dr Ware said it was "important to speak to your GP or specialist". He said Australia could learn from Canada's system.
"One of the most important things to learn from Canada is that doctors need to be able to communicate with their patients across a range of treatment options, including medicinal cannabis," he said.
"As a physician myself, I understand the conflicting pressures that doctors face, from patients who wish to have access to cannabis, to the regulatory bodies and colleagues who may not support such access. We need to be able to talk openly and non-judgmentally about its use, including why they may wish to try it, and their legal options," he said.
"Physicians need to be empowered to make an educated and informed decision on whether medicinal cannabis is an appropriate option for their patients. In Canada, a range of both for-profit and non-profit organisations have established accredited educational programs."