We reviewed 54 medicinal marijuana websites to see if they were following the rules. Here’s what we found

To meet the demand for medicinal marijuana, a multi-million dollar business has developed in Australia. The Australians released it over AUD 400 million this will only be addressed in the first half of 2024.

More Australians than ever are using medicinal cannabis for treatment long-term health conditionssuch as chronic pain, anxiety and cancer. Some people go to their family doctor and get a prescription, which they take to the pharmacy. But many bypass their family doctor. Instead, they buy it online from private medicinal marijuana clinics after a telehealth visit with the clinic’s doctor.

However, in reviewing these clinics’ websites, we found many examples of aggressive and misleading marketing. Some clinics violated regulatory guidelines. Others bent the rules.

Our new study shows how widespread this phenomenon is and why we are so concerned about the consequences for public safety.

Medicinal marijuana is legal but steep

There was medicinal marijuana legally available in Australia since 2016. This means doctors can prescribe it – for example as a capsule, oil or dried flower – for any condition if other approved treatments have not worked.

According to the plan for 2022-23 Household survey on the national drug strategy3% of Australians aged 14 and over have used cannabis for medical purposes in the last 12 months, equating to approximately 700,000 people.

The number of prescriptions as well increased tenfold from 2019 to 2022-23, indicating improved access and greater acceptance of medicinal cannabis in the healthcare system.

However, most medicinal cannabis products are not officially approved for medical exploit by the Commission Therapeutic Goods Administration (TGA), the Australian Medicines Regulatory Authority. These “not approved“Medical products have not been tested for safety, quality and effectiveness.

They too not subsidized through the Pharmaceutical Benefits Program. This means that patients have to pay for it themselves.

The cost of medicinal marijuana can range from 50 Australian dollars to 1000 dollars for a week of supplies. The exact amount depends on the patient’s medical condition, the dose required and the type of product being prescribed.

Medicinal cannabis is heavily advertised

The industry’s growth has been overshadowed by some questionable medical practices employed by for-profit medical clinics.

For example TGA prohibits the advertising of medicinal marijuana (and any unapproved medicines) to prevent unnecessary public demand and unsafe prescribing.

However, in 2023–24 the TGA collectively imposed penalties on companies that broke this rule over A$1.1 million and took legal action for alleged illegal advertising. The companies allegedly promoted cannabis for the treatment of earnest medical conditions or allegedly suggested that the TGA approved or endorsed their products.

So we investigated whether this still holds true by analyzing the websites of 54 private medical marijuana clinics in Australia.

We searched for clinics on Google using keywords such as “plant medicine” and “ecological medicine”. We then looked at their websites and checked whether they were following TGA guidelines.

We checked whether their websites contained any references to medicinal marijuana, made health claims, shared information from other sources about medicinal marijuana, or used patient reviews. These are considered forms of promotion. Therefore, posting such content on clinic websites would be in breach of TGA guidelines.

Here’s what we found

Our investigation revealed widespread breaches of TGA guidelines.

The most common was the exploit of cannabis images on websites or in logos. Clinics also avoided using “medicinal cannabis” in their trade names and instead used terms such as “plant medicine” to comply with TGA guidelines. Awards from the cannabis industry also appeared on the websites.

Another common violation was making unsubstantiated health claims about the benefits of medicinal marijuana, including that it can treat anxiety, depression or other mental health symptoms. It reflected arrangements from a previous analysis of tweets about medicinal marijuana.

Websites often allowed people to assess whether they were eligible to receive medicinal marijuana. Self-assessment can mislead people into believing they will benefit from it, inadvertently “educating” them on what conditions may warrant a prescription drug. Self-esteem may also lead people to believe that they need more medicinal marijuana than is medically necessary.

Other marketing tactics we found included:

• same day or after hours delivery

• a referral from a family doctor is not required

• discounts on consultation fees

• circumspect delivery

• targeted advertising on social media.

These practices undermine the intention of the TGA guidance to ensure responsible prescribing and push the boundaries of acceptable prescribing.

Although the TGA has released million dollar fine in recent years and have initiated legal proceedings over the way medicinal marijuana is sold, our research suggests that such violations continue to occur.

Hazardous prescribing

Some ABC news reports in 2024 alleges other unsafe prescribing practices.

These included allegations that cannabis clinics repeatedly sold products containing THC (tetrahydrocannabinol) to people diagnosed with psychosis or mental health problems. THC it may get worse psychotic symptoms, mental health and raise the risk of relapse.

In one case, a person suffering from a mental health condition tragically took their own life after being prescribed medicinal marijuana. However, the clinic reportedly continued to send packages of medicinal marijuana addressed to him, despite requests from his family to stop.

Play by the rules

Medicinal cannabis clinics have undoubtedly improved patient access. But we need more stringent monitoring and regulation of how these clinics market themselves.

Even if clinics operate legally, they must also act ethically to protect public health by putting the well-being of patients ahead of profit.

Using terms like “herbal medicines” instead of “medicinal cannabis,” for example, may technically comply with regulations, but can still confuse people. It also threatens to weaken public trust in the health care system.