Medical Cannabis in Australia: Conditions, Evidence and Patient Guide (2026)

Last updated: June 2026 | Reviewed against current TGA guidance and available clinical literature.

This page is intended as patient education only. It does not constitute medical advice. Always consult a registered Australian healthcare practitioner before seeking or changing any treatment.

What Is Medicinal Cannabis in Australia?

Medicinal cannabis refers to pharmaceutical-grade products derived from the Cannabis sativa plant that are prescribed by an authorised clinician to treat a specific medical condition. In Australia, these products are regulated by the Therapeutic Goods Administration (TGA) and are not the same as illicit or recreational cannabis.

Most medicinal cannabis products in Australia are not listed on the Australian Register of Therapeutic Goods (ARTG) as approved medicines. Instead, they are accessed through two legal pathways: the Special Access Scheme Category B (SAS-B) and the Authorised Prescriber (AP) scheme. A smaller number of products hold full ARTG approval, including Epidyolex (cannabidiol oral solution) and Sativex (nabiximols oromucosal spray).

As of early 2026, the TGA reports that more than 150,000 SAS-B approvals are issued annually, reflecting significant growth in patient access since regulatory reforms in 2021 made the process more streamlined for prescribers.

How the TGA Classifies Medicinal Cannabis

Medicinal cannabis products contain one or more active cannabinoids. The two most clinically studied are:

• Cannabidiol (CBD) — non-psychoactive; associated with anti-inflammatory, anticonvulsant and anxiolytic properties.
• Tetrahydrocannabinol (THC) — psychoactive; associated with analgesia, appetite stimulation and anti-nausea effects. Remains a Schedule 8 (controlled drug) in most Australian jurisdictions.

Products are broadly categorised as CBD-dominant, THC-dominant or balanced (roughly equal CBD:THC ratio). The appropriate formulation depends on the condition being treated, the patient's history and clinician judgement.

TGA-Recognised Conditions and Clinical Evidence

The TGA does not publish a fixed list of approved conditions; rather, it assesses individual patient applications. However, clinical practice and published TGA guidance consistently identify the following areas as having the strongest evidence base or established prescribing history in Australia.

Chronic Non-Cancer Pain

This is the most commonly approved indication in Australia, accounting for the majority of SAS-B applications. Evidence supports modest but meaningful reductions in pain scores for neuropathic pain, fibromyalgia and musculoskeletal pain when conventional therapies have been inadequate. The 2021 systematic review by Aviram and Samuelly (published in PLOS ONE) found CBD-THC combinations showed greater efficacy for neuropathic pain than either cannabinoid alone. Prescribers are generally expected to document prior treatment failure with at least two standard analgesic classes before approval.

Chemotherapy-Induced Nausea and Vomiting (CINV)

One of the earliest accepted uses. THC-based products, including dronabinol and nabiximols, demonstrate efficacy as adjunct antiemetics where first-line serotonin antagonists or corticosteroids have been insufficient. CINV remains a well-supported indication in Australian oncology settings.

Epilepsy and Seizure Disorders

Epidyolex (pharmaceutical-grade CBD) holds full TGA registration for two rare childhood epilepsy syndromes: Dravet syndrome and Lennox-Gastaut syndrome. Clinical trials (including the landmark Devinsky et al. 2017 New England Journal of Medicine study) demonstrated statistically significant seizure frequency reductions. CBD-dominant products are also prescribed under SAS-B for other refractory epilepsies, though evidence quality varies by syndrome.

Multiple Sclerosis (MS) — Spasticity

Sativex (nabiximols, a 1:1 THC:CBD oromucosal spray) is TGA-registered specifically for MS-related spasticity that has not responded adequately to other antispasticity medications. Multiple randomised controlled trials support its use for reducing spasm frequency and improving patient-reported mobility. MS Australia recognises medicinal cannabis as a legitimate adjunct therapy for appropriate patients.

Palliative Care

In end-of-life settings, medicinal cannabis is used to address pain, nausea, anxiety and appetite loss. Prescribing in palliative care is generally more flexible given the clinical context. Both THC and CBD formulations are used depending on the symptom profile.

Anxiety Disorders

CBD-dominant products are increasingly prescribed for generalised anxiety disorder (GAD), social anxiety and PTSD-related anxiety in Australia. Evidence quality is improving — a 2019 retrospective study by Crippa et al. and more recent Australian registry data (from the Lambert Initiative at the University of Sydney) suggest meaningful patient-reported improvements. This remains an area of active research, and prescribers are cautioned that high-THC products may worsen anxiety in some patients.

Sleep Disorders

Insomnia and sleep disturbance represent a growing proportion of SAS-B applications. Low-dose CBD or balanced CBD:THC products are commonly used. Evidence is still emerging and largely based on observational data, but patient-reported improvements in sleep onset and duration are consistent across Australian registry studies.

Other Conditions with Emerging Evidence

Prescribing under the SAS-B pathway also occurs for the following, though the evidence base is less established:

• Post-traumatic stress disorder (PTSD)
• Inflammatory bowel disease (IBD) — Crohn's disease and ulcerative colitis
• Tourette syndrome
• Autism spectrum disorder (ASD) — primarily paediatric, with strict oversight
• Cancer-related pain and anorexia
• Migraine and headache disorders

Patient Eligibility: What the TGA Looks For

There is no single eligibility threshold, but in practice, SAS-B approvals are more likely when:

• The patient has a diagnosed condition with a reasonable evidence base for cannabinoid therapy.
• Conventional treatments have been trialled and documented as ineffective or causing unacceptable side effects.
• The prescribing doctor is satisfied that potential benefits outweigh risks for the individual patient.
• Paediatric applications involve specialist review and parental/guardian consent.

Patients cannot self-refer to the TGA. A registered Australian medical practitioner (GP or specialist) must initiate the application. Some states and territories impose additional requirements — for example, Queensland requires specific endorsement for certain Schedule 8 cannabinoid products, and prescribers in all states must comply with their relevant state health department regulations alongside TGA requirements.

Administration Routes and Product Types

Dried flower for inhalation is legally available under SAS-B in Australia but must be used with an approved medical vaporiser. Smoking medicinal cannabis is not a sanctioned method of administration under TGA guidelines and carries respiratory risks.

Contraindications and Cautions

Medicinal cannabis is not appropriate for everyone. Contraindications and situations requiring heightened caution include:

• Personal or family history of psychosis or schizophrenia — THC can exacerbate or precipitate psychotic episodes.
• Pregnancy and breastfeeding — cannabinoids cross the placenta and are present in breast milk; not recommended.
• Severe cardiovascular disease — THC may increase heart rate and blood pressure acutely.
• Children and adolescents — except in approved epilepsy indications; developing brains may be more susceptible to THC-related harm.
• Substance use disorders — particularly where cannabis dependence has been a prior issue.
• Driving — THC impairs driving capacity. Roadside drug testing in all Australian states detects THC regardless of prescription status. Patients must not drive while THC is detectable. Laws vary by state; consult your prescriber and check current state transport authority guidance.

Common Side Effects

Side effects depend heavily on the cannabinoid profile, dose and individual patient factors:

• CBD-related: Diarrhoea, fatigue, changes in appetite, elevated liver enzymes at high doses (particularly relevant when co-administered with valproate).
• THC-related: Dizziness, drowsiness, dry mouth, increased heart rate, impaired memory and concentration, anxiety or paranoia (dose-dependent), cannabis use disorder with long-term high-dose use.
• Drug interactions: Both CBD and THC are metabolised via CYP450 enzymes and can interact with anticoagulants (particularly warfarin), antiepileptics, antidepressants and immunosuppressants. Always provide your prescriber with a full medication list.

How to Access Medicinal Cannabis in Australia

1. Speak with your GP or specialist about whether medicinal cannabis is appropriate for your condition and treatment history.
2. Your doctor submits a TGA SAS-B application (this is completed by the prescriber, not the patient) or applies to become an Authorised Prescriber.
3. If approved, your prescription is dispensed by a licensed pharmacy. Not all pharmacies stock medicinal cannabis — your prescriber or a medicinal cannabis clinic can advise on dispensing options.
4. Follow-up appointments are standard to monitor effectiveness and side effects.

Telehealth medicinal cannabis clinics have expanded access significantly across regional and rural Australia. Medicare does not currently subsidise medicinal cannabis products, and out-of-pocket costs vary widely depending on product type and dosing requirements.

Sources

• TGA Medicinal Cannabis Hub — tga.gov.au
• TGA: Guidance on the use of medicinal cannabis in Australia — Patient information
• Lambert Initiative for Cannabinoid Therapeutics, University of Sydney — lambertinitiative.com
• Devinsky et al. (2017). Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. NEJM.
• MS Australia: Medicinal Cannabis — msaustralia.org.au
• Australian Government Department of Health and Aged Care: Medicinal Cannabis
• Aviram J, Samuelly-Leichtag G (2021). Efficacy of Cannabis-Based Medicines for Pain Management. PLOS ONE.