Medicinal cannabis has become a routine part of health care in Australia far more quickly than many expected.

What began in 2016 as a tightly controlled pathway for patients with complex conditions that had not responded to other treatments has grown into a large, mainstream prescribing market. Today, medicinal cannabis is increasingly delivered through telehealth and online platforms.

But our health system was not designed for this demand, nor for the shift in prescribing practices. So many of the safeguards in place for other medicines don’t exist for medicinal cannabis.

Now, Australia’s medicines regulator is deciding how best to update medicinal cannabis prescribing and regulation to make it safer.

Its yet-to-be released review is focusing on “unapproved” medicinal cannabis products, ones that are legal but that it hasn’t assessed to make sure are safe, of good quality and actually work.

The rise and rise of medicinal cannabis

Prescribing of medicinal cannabis rose sharply from 2019. By the end of 2025, publicly available Therapeutic Goods Administration (TGA) data I analysed shows close to one million approvals for medicinal cannabis in Australia.

However, the systems needed to monitor safety, effectiveness and longer-term outcomes have lagged behind this rapid growth.

Doctors told us as far back as 2018 (in research published in 2021) of their concerns about medicinal cannabis prescribing. They described how the rollout had occurred before the system was fully prepared.

At the time, they raised the potential for fragmented care (patients seeking health care from multiple professionals, not all aware of what the others were prescribing), limited guidance for prescribers, and the........

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