Anxiety disorders drive most of Australia's 300,000 medical cannabis prescriptions for psychiatric conditions | Research

The takeaway

One-third of Australia's roughly 300,000 medical cannabis approvals were for psychiatric conditions, with anxiety disorders accounting for two-thirds of psychiatry-related prescribing, often for conditions lacking strong clinical evidence.

Medical cannabis prescribers, psychiatric researchers, health regulators

66.7% of psychiatric cannabis prescribing was for anxiety disorders

What the researchers found

Of approximately 300,000 Special Access Scheme B approvals for medical cannabis in Australia (2016-2022), 33.9% were for psychiatric conditions. Anxiety disorders dominated (66.7% of psychiatry-related prescribing), followed by sleep-wake disorders (18.2%), trauma/stressor-related disorders (5.8%), and neurodevelopmental disorders (4.4%). CBD-dominant products comprised 20% of prescribing, particularly for autism spectrum disorder. Dramatic increases in ADHD prescribing were identified.

Why it matters

Australia has one of the largest legal medical cannabis programs globally. The dominance of psychiatric prescribing for conditions with limited evidence (anxiety, ADHD, depression) highlights a gap between clinical practice and evidence base.

The numbers in context

~300,000 SAS-B approvals total; 33.9% for psychiatric conditions; 66.7% of psychiatry prescribing for anxiety; 18.2% sleep-wake; 5.8% trauma/stressor; 4.4% neurodevelopmental; 53% oil products; 31.2% flower; 46.2% of patients aged 25-39

How the study worked

Analysis of Therapeutic Goods Administration Special Access Scheme B application data from November 2016 through September 2022. Conditions categorized according to DSM-5-TR criteria. Prescribing trends analyzed via polynomial regression.

What this study cannot tell us

SAS-B approval data does not capture actual patient outcomes or whether treatment was effective. Cannot determine if patients also used illicit cannabis. Prescribing trends may reflect practitioner marketing rather than evidence-based practice.

How to read the evidence

Comprehensive national prescribing dataset spanning six years, but approval data cannot assess treatment outcomes or appropriateness.

When this study was published

Published 2023 using 2016-2022 data

The bigger picture

The rapid growth of psychiatric prescribing, particularly for conditions like ADHD where evidence is minimal, raises questions about whether regulatory frameworks are keeping pace with clinical practice.

Questions still open

Are patients receiving cannabis for anxiety disorders experiencing clinical improvement? Should prescribing for conditions with minimal evidence require additional justification?

Common questions

What psychiatric conditions is medical cannabis prescribed for in Australia?

Anxiety disorders dominate (66.7% of psychiatric prescribing), followed by sleep disorders (18.2%), trauma/stressor disorders (5.8%), and neurodevelopmental disorders (4.4%). ADHD prescribing has increased dramatically.

Is there evidence supporting these prescriptions?

The study notes that much of this prescribing is for conditions where definitive clinical evidence of cannabis efficacy is lacking, and the high prevalence of THC-containing products raises concerns given psychiatric side effects.

Read the original research

Medicinal cannabis for psychiatry-related conditions: an overview of current Australian prescribing.

Frontiers in pharmacology, 14, 1142680

View on PubMed ↗Publisher’s paper ↗

Citation

Cairns, Elizabeth A; Benson, Melissa J; Bedoya-Pérez, Miguel A; Macphail, Sara L; Mohan, Adith; Cohen, Rhys; Sachdev, Perminder S; McGregor, Iain S. (2023). Medicinal cannabis for psychiatry-related conditions: an overview of current Australian prescribing.. Frontiers in pharmacology, 14, 1142680. https://doi.org/10.3389/fphar.2023.1142680