Major Australian Survey Reveals Key Differences Between Legal and Illicit Medical Cannabis Users

A new national survey offers insights into how Australian medical cannabis consumers are navigating the legal and illicit markets in the nearly eight years after medicinal use was federally legalised.

The Cannabis As Medicine Survey 2022-2023 (CAMS-22) collected anonymous responses from over 3,300 Australian adults who had used cannabis medically in the past year. Around 73% were accessing legally prescribed products while 27% still relied on illicit sources.

The findings, published in the journal Addiction, highlight some important differences in demographics, consumption patterns, reasons for use, and experiences between the legal prescribed and illicit consumer groups.

Differing User Profiles
Those using prescribed medical cannabis tended to be older males who started using cannabis medically later in life compared to illicit users. Prescribed consumers were more likely to have higher education levels, be employed, and use cannabis solely for medical rather than recreational purposes.

Prescribed users were also far more likely to know the exact cannabinoid composition of the products they were using and consume via safer oral/edible or vaporised routes instead of smoking.

Reasons for Use
Both groups were using medical cannabis primarily to treat chronic pain (37%), mental health issues (36%), and sleep conditions (15%). However, prescribed users had higher odds of using it mainly for pain or sleep issues, while illicit users were more inclined to use it predominantly for mental health conditions.

Interestingly, around 97% of both consumer groups rated their medical cannabis as effective for improving their condition's symptoms. This contrasts with limited rigorous evidence so far for the efficacy of cannabis for many mental health and sleep indications.

The study authors raised concerns that many legal prescribers appear willing to recommend medical cannabis for conditions like these where there is still a lack of solid clinical trial data on efficacy and appropriate use.

Benefits of Legal Access
A key finding was that prescribed consumers reported experiencing significantly fewer side effects overall compared to illicit users. They were also less likely to smoke their medicine and consume tobacco.

Among those who had experienced both legal and illicit medical cannabis, the vast majority preferred prescribed products for qualities like consistency, ease of access, effectiveness, side effect profile, and reduced legal risks.

The only area where the study found illicit cannabis was preferred, was on cost, by factoring in those "obtaining illicit cannabis for free" (aka #homegrow), making a point that prescribed consumers on average paid slightly less per week than those who paid for their illicit cannabis..

Need for More Research
While praising the increasing move towards regulated medical cannabis following decades of casual self-medication, the authors emphasised the need for more rigorous clinical trials and independent patient education.

The study findings suggest Australia's legal medical cannabis program has been a positive harm reduction step, but optimal practices, product standards, and approved indications still require much more research.

study link - https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-00992-1