How Cannabis Is Helping Critical Patients - A Close Look at Australia

What is medicinal cannabis?

In Australia, medicinal cannabis refers to prescription-only products derived from the cannabis plant (or closely related compounds) that are used therapeutically to relieve symptoms of specific health conditions

1) THC (tetrahydrocannabinol) - the primary psychoactive component of cannabis.
2) CBD (cannabidiol) - a non-intoxicating cannabinoid that has generated substantial interest in therapeutic applications.

Medicinal cannabis differs from recreational cannabis because it is prescribed by a medical practitioner, and legal access in Australia is regulated by federal and state/territory governments via the Therapeutic Goods Administration (TGA) and other mechanisms.

Legal access in Australia

Australia introduced legal access pathways for medicinal cannabis from around 2016 onward. (The University of Sydney) Patients may access medicinal cannabis under the TGA's "unapproved medicines" pathways (Special Access Scheme or Authorised Prescriber) or, in rare cases, approved medicinal cannabis products listed in the Australian Register of Therapeutic Goods. (Therapeutic Goods Administration (TGA)).
It's important to note: while access has greatly increased, regulatory oversight, evidence of long-term outcomes and product registrations remain limited.

How medicinal cannabis is helping critical patients

For patients facing serious conditions, limited conventional treatment options or unacceptable side-effects from standard therapies, medicinal cannabis offers potential benefit in several areas. Below are some of the key clinical contexts in Australia:

1. Neurological conditions & rare epilepsies
One of the strongest use-cases in Australia is for specific rare neurological disorders. For example, certain CBD-based treatments have been approved for severe childhood epilepsy syndromes (Therapeutic Goods Administration – TGA).

For patients with conditions such as multiple sclerosis (MS) who experience significant spasticity or pain, there is also growing interest in cannabis products. Although evidence remains limited, medicinal cannabis may provide an additional option where symptoms are refractory to standard treatments.

2. Palliative (end-of-life) care
In palliative care settings, medicinal cannabis is being used to support symptom relief — including management of refractory pain, nausea, appetite loss, and other distressing symptoms in terminal illness. Australian guidance identifies palliative care as an important area under investigation.

For patients with serious life-limiting illness, even modest improvements in comfort, sleep, or quality of life can be meaningful. Patient reports suggest medicinal cannabis may help restore sleep, reduce nausea, alleviate pain, and allow individuals to function more comfortably.

3. Chronic pain (including advanced cases)
Chronic non-cancer pain is a major driver of medicinal cannabis prescribing in Australia. Patients experiencing refractory pain — where therapies such as opioids, neuropathic pain agents, or physical therapy have not been sufficient — may turn to medicinal cannabis for additional relief.

While clinical evidence remains mixed, anecdotal reports indicate meaningful benefits including pain reduction, improved sleep, and better overall quality of life, particularly for patients with complex comorbidities and limited treatment options.

What does the evidence say?

It's essential to understand that while the potential for medicinal cannabis is real, the evidence base in Australia is still developing.

• A 2020 survey found that although medicinal cannabis was legally available, very few users accessed legal prescriptions in early years (only ~2.7%), meaning many patients were still using illicit sources (University of Sydney).
• The TGA’s guidance emphasises that medicinal cannabis is not recommended as a first-line treatment for most conditions and that there is limited evidence about effectiveness and suitable dosing for many conditions.
• For chronic non-cancer pain, evidence summaries note there is a limited body of evidence supporting efficacy and safety in clinical practice.
• Although prescriptions are increasing (over 800 cannabis products available in Australia), only a small number are registered medicines and evidence of sustained long-term benefit remains inconsistent.

In short: For critical patients, medicinal cannabis may offer meaningful relief in selected settings, but its use must be carefully considered, monitored and integrated with other therapies.

Benefits reported by patients

From the available data and patient stories, here are some of the reported benefits for critical patients:

• Symptom relief: Especially for nausea, vomiting, appetite loss (e.g., in palliative or chemotherapy contexts), and refractory pain.
• Improved sleep: Patients sometimes report better sleep quality when pain or other symptoms are reduced.
• Reduced side-effects: For some patients, conventional treatments cause significant side-effects; cannabis may offer a gentler alternative or complementary option.
• Quality of life: For patients near end-of-life or with limited treatment options, even incremental improvements matter — such as reduced hospital visits, improved mobility, better mood or fewer breakthrough symptoms.

Risks and cautionary issues

Medicinal cannabis is not without risks or complexities — especially in critical patients who may be frail, have multiple comorbidities or be on multiple medications.

• As noted, for many indications the evidence is limited; doctors must avoid overstating benefits.
• There are reported adverse events. A recent Australian analysis found hundreds of adverse event reports (615 over three years), including psychosis and suicidal thoughts.
• Because many products are “unapproved” (not registered on the ARTG), they may lack robust data on long-term safety, standardised dosing, or drug interactions.
• Some patient groups — such as those with a history of psychosis, significant cardiovascular risk, or children — may require particular caution.
• Access and cost: Medicinal cannabis may be expensive, may not be covered by subsidies, and navigating prescriber or regulatory pathways can be difficult.

Practical considerations for Australian patients

If a critical-illness patient or their carer in Australia is considering medicinal cannabis, here are some practical points:

• Consult a specialist or experienced prescriber: The treating medical team (GP + specialist) should review whether medicinal cannabis is appropriate in light of the patient’s overall health, other treatments and goals of care.
• Start low and go slow: Because of variable dosing, product types (THC vs CBD vs combination), and patient sensitivity, cautious titration is essential.
• Monitor and document: Record symptoms, side-effects, other medications, and quality-of-life outcomes.
• Beware of illicit products: Only use legally prescribed and dispensed medicinal cannabis via pharmacy; unregulated products may lack standardisation and carry greater risk.
• Align with broader care: In palliative settings, medicinal cannabis is often one component of a broader symptom management plan including pain specialists, palliative care, psychology and physiotherapy.
• Understand regulatory environment: In Australia, the TGA regulates medicinal cannabis, while each state or territory has additional rules regarding dispensing and reimbursement. Patients should understand access pathways, costs and legal implications.

A balanced summary

For critically ill patients in Australia, medicinal cannabis offers real hope as an additional tool in symptom management, potential improvement in quality of life, and relief where standard therapies fail or are intolerable. However, it is not a magic bullet. The evidence is still emerging, and clinical judgement remains essential.

When properly prescribed, monitored and integrated with care, medicinal cannabis may meaningfully help. Patients and carers should approach its use with clear understanding — balancing benefits with risks, costs and regulatory considerations. For some patients, particularly those with refractory symptoms or in palliative care, it can make a tangible difference, while for others benefits may be limited.

In Australia’s evolving medicinal cannabis landscape, the key message is that in selected cases, under proper medical supervision, it may help — but it is not suitable for every patient or condition.

Disclaimer

This blog is for general information only and is not a substitute for professional medical advice, diagnosis or treatment. Medicinal cannabis is a prescription-only medicine in Australia and may not be suitable for everyone. Any treatment decision should be made in consultation with a qualified healthcare professional.