The increasing global use of medicinal cannabis, including within Australia, presents significant medicinal cannabis risks that demand careful consideration from healthcare professionals. Recent reports from Australia’s Therapeutic Goods Administration (TGA) highlight over 600 reported side effects within three years, encompassing serious concerns like psychosis and suicidal thoughts. It is important to remember these figures are likely underestimates, considering that many adverse events often go unreported. Furthermore, there’s a worrying rise in cannabis poisoning calls to poison control centers, particularly involving accidental exposures in children. This article delves into these critical risks, especially those associated with unapproved medicinal cannabis products.
The Challenge of Unapproved Medicinal Cannabis Products
Australia legalized medicinal cannabis in 2016; however, the vast majority of products available remain unapproved by the TGA. Consequently, these products lack formal assessment for quality, safety, or effectiveness, a key distinction from the few approved options that undergo rigorous scrutiny. Over 1,000 such unapproved products are currently accessible, frequently prescribed for conditions where strong supporting evidence is absent. The TGA revised access pathways in 2021, prompting a significant surge in their use, with young men showing the fastest increase. A substantial portion (around one-third) is prescribed for anxiety, despite TGA guidance recommending against THC-containing cannabis for patients with pre-existing psychotic or active mood/anxiety disorders. Currently, the TGA is consulting on these regulatory processes, which signals potential future changes.
Medicinal Cannabis Risks: Psychosis and Mental Health
Concerns linking cannabis use—both recreational and medicinal—with mental illness are not new, and global policy liberalization is intensifying these worries. For instance, a large Canadian study observed a nearly threefold increase in schizophrenia cases associated with cannabis use following legalization reforms. Likewise, Australia has reported instances of first-time psychosis explicitly tied to medicinal cannabis. While there’s an increase in emergency department visits for anxiety involving cannabis in Canada, it remains unclear if cannabis itself is a causal factor or if more individuals are using it to self-manage anxiety. It is noteworthy that not all these presentations involved medicinal cannabis, suggesting complex factors are at play. Therefore, doctors must thoroughly assess a patient’s psychiatric history before considering cannabis prescriptions. A deeper understanding of psychiatric conditions is essential for such assessments, and the Post Graduate Program In Child And Adolescent Psychiatry can provide valuable insights.
Protecting Children: The Overlooked Poisoning Hazard
The risk of accidental poisoning in children from cannabis products stands as a gravely overlooked aspect of medicinal cannabis safety discussions. Data from Australia’s largest poisons center clearly indicates a consistent increase in cannabis poisoning calls, particularly from concentrated products like oils and edibles. Unintentional poisonings, encompassing dosing errors and accidental child exposures, have risen most sharply. Children who ingest cannabis can suffer severe consequences, including comas or seizures, often requiring intensive care. Confectionery and other food items containing cannabis are especially dangerous due to their appealing appearance and high concentrations of the substance, contributing to rapidly increasing poisoning rates in children globally. Healthcare providers, consequently, need to emphasize robust safe storage practices to parents and caregivers. For those focused on pediatric care, the Certification Course In Paediatrics offers relevant knowledge.
Medicinal Cannabis Risks: Drug Interactions and Other Adverse Events
The potential for drug interactions with medicinal cannabis is frequently underestimated. Cannabidiol (CBD), a common component, interacts with various widely used medications. These include drugs for epilepsy, antidepressants, opioids, and blood thinners. Such interactions can alter drug efficacy or increase toxicity, thereby presenting additional medicinal cannabis risks. While adverse event reports inherently have limitations—as direct causation isn’t always clear—they remain vital for ongoing monitoring. In Australia, the TGA recorded 615 adverse events in three years, including significant reports of psychosis and suicidal thoughts and behavior. Other common adverse effects such as dizziness, dry mouth, and subtle cognitive deficits like impaired attention and short-term memory impairment are also noted. Critically, the long-term safety profile of many unapproved products remains poorly characterized, underscoring the need for more research into safe prescribing practices. The Certification Course In Safe Prescribing would be highly beneficial here.
Enhancing Oversight and Responsible Prescribing
Regulatory bodies, such as the Australian Health Practitioner Regulation Agency, have cautioned practitioners regarding questionable medicinal cannabis prescribing practices. Indeed, the rise of single-purpose telehealth dispensaries, often characterized by extremely brief consultations, raises serious concerns about patient welfare. Prescribing data specifically reveal a small number of practitioners issuing thousands of medicinal cannabis scripts, strongly suggesting a lack of comprehensive patient assessment. Best practice advocates for new cannabis medicines to be prescribed exclusively by a patient’s usual general practitioner or specialist. This holistic approach allows ample time for discussing risks and benefits, thoroughly screening for potential drug interactions, and identifying crucial contraindications, such as a history of psychiatric illness or substance abuse. The TGA’s ongoing review of current regulatory processes for unapproved medicinal cannabis products clearly indicates a move towards greater scrutiny and potential reforms, ultimately aiming to ensure product quality and evidence-based use. A strong foundation in general practice is crucial for this oversight, making the Certification Course In General Practice a relevant resource.
Practical Advice for Healthcare Practitioners
Given the identified medicinal cannabis risks, it is imperative that practitioners adopt a cautious and evidence-based approach. Firstly, always advise patients to consult their regular GP or specialist when considering medicinal cannabis. A thorough assessment is therefore crucial, encompassing a detailed medical history and a comprehensive review of all current medications. Secondly, engage in open discussions about the risks and benefits of medicinal cannabis, and critically evaluate the available evidence for its efficacy for the patient’s specific condition. Finally, if medicinal cannabis is prescribed, strongly advise patients on stringent safe storage practices, ensuring products are kept strictly out of sight and reach of children to prevent accidental ingestions. These steps are vital for ensuring patient safety and promoting responsible use of these products.
Frequently Asked Questions
Q1: What are the primary mental health risks associated with medicinal cannabis use?
The primary mental health risks include an increased likelihood of psychosis, particularly in individuals with pre-existing psychiatric conditions. There are also reports of suicidal thoughts and behaviors. Studies indicate an association between cannabis use and an earlier onset or worsening of psychotic disorders.
Q2: Why are unapproved medicinal cannabis products a concern?
Unapproved medicinal cannabis products have not undergone formal assessment by regulatory bodies for their quality, safety, or effectiveness. This lack of scrutiny means their true risk profile and therapeutic benefit are not formally established, unlike approved medicines that meet stringent standards.
Q3: How can accidental cannabis poisoning in children be prevented?
Prevention involves diligent safe storage practices. Medicinal cannabis products, especially appealing edibles and concentrated oils, must be kept strictly out of the sight and reach of young children. Healthcare professionals should explicitly counsel parents and caregivers on this critical safety measure to protect vulnerable populations.
References
- Medicinal cannabis concerns include psychosis, child poisonings. We’re not onlyones worried – ETHealthworld
- Australia’s TGA launches public consultation on unapproved medicinal cannabis products. Inside Biotech, Proactive Investors, August 4, 2025.
- Adverse effects of medical cannabinoids: a systematic review. CMAJ, February 2, 2012.
- A primer on medicinal cannabis safety and potential adverse effects. RACGP, May 2022.
- CANNABIS: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews. WebMD.
Disclaimer: This article was automatically generated from publicly available sources and is provided for informational and educational purposes only. OC Academy does not exercise editorial control or claim authorship over this content. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider and refer to current local and national clinical guidelines.