The accessibility and availability of medicinal cannabis in Tasmania remains a point of contention almost three-and-a-half years after the Tasmanian government's Controlled Access Scheme was introduced.
As of February 19 there had been 19 Tasmanians approved to use medicinal cannabis under the scheme.
On the mainland, over 85,000 Australians have been approved to use medicinal cannabis under the federal government's Special Access Scheme introduced in October 2016.
The difference between the two schemes is that, in Tasmania, an authorised medicinal specialist needs to prescribe the use of medicinal cannabis and can only do so after all approaches of "conventional treatment" have been exhausted. Medicinal cannabis can also only be purchased from Tasmanian Health Services pharmacies located in public hospitals.
The special access scheme is different in that any registered medicinal practitioner can prescribe medicinal cannabis.
The reason either scheme is in place is because no medicinal cannabis products have been registered by the Australian Therapeutic Goods Association.
Despite the downgrading, it the product will not be available in chemists until it becomes registered by the TGA. And, due to its nature, it is restricted in the conditions it is effective in treating.
Pharmacy Guild of Australia Tasmania president Helen O'Byrne said the current process in Tasmania was "very difficult" for anybody considering seeking medicinal cannabis for treatment.
"There's two streams of issues that reduce access. There's the prescriber and then there's the supply issue," she said.
The process of access in Tasmania have caused many to go through what is colloquially known as the "green market" to purchase medicinal cannabis from the mainland, or to grow their own crops.
Cannabis Awareness Tasmania founder Lyn Cleaver has long called for easier access to medicinal cannabis in Tasmania and she said her son Jeremy has now tried and failed over 17 different "conventional treatments" without being granted access to the CAS.
Aside from the conventional treatments, Ms Cleaver said Jeremy had faced waits of up to two years to see a neurologist.
Ms O'Byrne said, from the perspective of pharmacists in Tasmania, a more easily accessible medicinal cannabis would ensure people did not have to use the "green market" and would be assured of what they are receiving.
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"We want our patients to take a safe medicine that we know is going to do what it's meant to do for that patient. And we will feel very assured when there is a product registered through the TGA that can be prescribed by our GPs and then it should be accessible through pharmacy," she said.
RACGP state chair Dr Tim Jackson declined to be interviewed by The Examiner. The RACGP's latest position on the use of medicinal cannabis products, from 2019, calls for "further high-quality research into the safety and effectiveness of medicinal cannabis products, as the current evidence is limited and inconclusive".
However, the position also states current evidence "suggest a possible role for medicinal cannabis products in a number of areas" and says specialist GP's be able to prescribe medicinal cannabis products "as other specialists can".
Labor's health spokesperson, former RACGP president and GP, Dr Bastian Seidel has called for easier access to medicinal cannabis for Tasmanians.
"Unfortunately the scheme we have in Tasmania is not meeting the needs of vulnerable patients. It's just not good enough and this has to change," he said.
"There is a simple process available that's been adopted in NSW that the Tasmanian Government could follow, but it refuses."
The process in NSW Dr Seidel is referring to allows most potential patients to access medicinal cannabis by applying directly to the TGA. A seperate scheme in NSW allows adults who have terminal illness further ease in accessing the medication.
A similar recommendation was made after a federal Senate inquiry last year.
"The committee recommends that the Tasmanian Government immediately join all other jurisdictions in participating in the Therapeutic Goods Administration's single national online application pathway for accessing unregistered medicinal cannabis and reducing state-based requirements for medicinal cannabis approval," it said.
Questions put to Health Minister Sarah Courtney about whether the state government had plans to change the CAS were unanswered.
"The scheme continues to support the safe and responsible use of unregistered medical cannabis products, informed by evidence and expert clinical advice," Ms Courtney said.
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