What just happened

Medicinal cannabis prescriptions in Australia have grown 5,455% in five years. That number is not a typo. Five years of exponential growth in access to a medicine used for pain, insomnia, anxiety, nausea, and a range of conditions where the conventional pathway has often failed the people who needed it most.

In early 2026, the RACGP lodged a submission to the TGA’s consultation on medicinal cannabis prescribing pathways, calling the current framework a major public health risk. The college demanded a single-step, single-portal approval system — something that replaces the multi-authority, multi-step process it describes as “highly bureaucratic, time-consuming, and expensive” for the GPs trying to do this properly.

At the same time, the same submission named what “properly” is competing against. AHPRA data showed eight practitioners issued over 10,000 medicinal cannabis prescriptions in a six-month period. One GP: 17,000 scripts in six months. One nurse practitioner: 31,000. That is one prescription roughly every five minutes across a standard clinical day, continuously.

Two stories live inside that number. The RACGP is trying to tell both simultaneously.

The both-and

The current medicinal cannabis system is simultaneously too complex for careful GPs to navigate and too thin a barrier for volume operators to exploit. Both are true. A reform that resolves one without the other fixes nothing.

The access problem is real and documented. Under the current Special Access Scheme and Authorised Prescriber pathways, a GP who wants to prescribe medicinal cannabis appropriately faces paperwork across multiple government agencies, variable state-based scheduling, and persistent uncertainty about which products fall where. The outcome is predictable: GPs with the time and resolve to learn the system prescribe; GPs who can’t navigate it don’t; patients fall through to the telehealth operators who have industrialised the approval paperwork.

The integrity problem is equally real. The same structural simplicity that would help a thorough GP navigate the system more easily would lower the barrier further for models already issuing a script every five minutes. A simplified portal is not inherently safer — it is faster. Whether faster-and-simpler is also safer-and-better depends entirely on what clinical standards are built into the portal design, and whether TGA enforcement can reach operators who paper over those standards.

The RACGP’s position statement on medicinal cannabis is coherent: simplify access for GPs who assess thoroughly; simultaneously enforce minimum clinical standards that volume mills cannot bypass through documentation. The TGA has named cannabis a 2026–27 compliance and enforcement priority alongside vapes and weight-loss drugs — a signal that the regulator is watching.

Whether enforcement actually reaches high-throughput telehealth models, or merely adds documentation burden to the GPs already proceeding carefully, is the unresolved structural question.

2 cents

For the woman managing chronic pelvic pain, fibromyalgia, treatment-resistant insomnia, or chemotherapy-related nausea who is weighing whether medicinal cannabis is worth pursuing:

The access question is real. Whether your GP can navigate the current pathway depends on their familiarity with the Special Access Scheme — which varies considerably. The telehealth route is available and often accessible, but the 17,000-scripts-in-six-months figure is the signal that some operators in that space are not conducting thorough individual assessments.

The RACGP position statement sets out what a sound prescribing encounter should involve: thorough clinical assessment, a documented indication, a discussion of alternatives and risks, and ongoing follow-up. That is the standard to look for when deciding where to seek assessment — not the fastest or cheapest pathway to a script.

Reform is moving. The shape of it — whether it resolves access and integrity simultaneously — is genuinely unknown at the time of writing. The TGA enforcement actions over the next 12 months will tell you more than the policy documents.

This is general information. Medicinal cannabis prescribing requires individual clinical assessment, a documented indication, and TGA-regulated products. None of that is navigable through an article. Your GP is the right starting point.

Verdict

Verdict: maybe — watch this.

The RACGP and TGA are both engaged with a prescribing system that is simultaneously too burdensome for careful GPs and too porous for high-volume operators. Reform is on the table. Whether the redesign is access-positive for patients without being integrity-negative — whether it actually closes the mill models while opening the door for legitimate prescribers — is the open question. Watch the TGA compliance enforcement announcements alongside the portal redesign. They will tell you whether the reform was real.

RACGP wants one door for cannabis prescribing — but who guards it?

What just happened

The both-and

2 cents

Verdict

Sources cited