The Australia Cannabis Report 2024 is published by the Pennington Institute.

The message is clear: cannabis policy in this country is adrift. The lack of strategic direction is visible in the data about public attitudes, in the medicinal sector, and even in developments related to politics and law enforcement.

When it comes to cannabis, facts on the ground are changing, but our strategy remains stagnant.

One clear example is community attitudes toward cannabis, which continue to diverge further from public policy. As the data from the National Drug Strategy Household Survey (NDSHS) released this year reveal, the public does not view our criminalised cannabis model as effective or appropriate.  

NDSHS data also show that millions of Australians continue to use cannabis, and at least 42 percent of adults have used it in their lifetime. The billions of dollars spent on law enforcement are not deterring people from using – and certainly not deterring the criminals who reap the gains of the $5 billion illicit market.

Cannabis is widely available, cheap, and viewed as relatively benign.   Our policing strategy is similarly incoherent. Many states and territories have codified alternative policing tools such as diversion schemes – and the ACT has decriminalised possession of small amounts of cannabis – but overall we continue to arrest, in relatively arbitrary fashion, thousands of people for minor cannabis offences with little apparent purpose.  

The medicinal cannabis sector is increasingly falling into this same purgatory. In terms of growth, the industry is flourishing, with hundreds of thousands of patients benefiting from access to safe, quality-controlled products that are dispensed according to a doctor’s directions. Yet many of the headlines related to medicinal cannabis this year have been negative, with regulators and journalists investigating producers that treat regulations as optional and medical clinics that act more like retailers, leaving vulnerable people at risk.  

Some medicinal cannabis clinics are clearly prioritising high-volume access over high-quality medical care. Regulators must actively enforce laws and regulations against companies and individuals who flout them. But parliamentarians and other policymakers must also understand the broader context: it is short-sighted to make medicinal cannabis the sole access point for a high-demand, relatively low-harm product.

The effect is that people who can navigate and afford prescription medicinal cannabis are able to avoid being criminalised for their cannabis use, while those at highest risk of arrest – Indigenous, rural, and lower-income people – lack such protection.

The pathway out of this incoherence is the establishment of a regulated adult-use cannabis model. Of course, all forms of cannabis access need to emphasise protections for the people most vulnerable to experiencing harms from cannabis use.  

Medicinal cannabis prescribers need to take more steps to ensure they have a full understanding of their patients’ medical history and co-present conditions. Clinics, pharmacies, and companies supplying cannabis medicines must ensure their businesses operate lawfully and ethically. And participants across the industry need to identify, disclose, and minimise commercial conflicts of interest and incentive structures that prioritise profit over patient care.  

Any regulated adult-use model should pay careful attention to potency and other product characteristics. People under 18 should not be able to access adult-use cannabis, and anyone found providing it to them should face severe penalties.

Advertising and promotional activity should be banned entirely. The good news is that other jurisdictions are already paving the way. Canada’s strict bans on marketing and promotion are largely effective, according to an independent legislative review released this year. Even in the comparatively unfettered markets in the 24 US states with legal cannabis, studies have shown that regulating cannabis had no effect on diagnoses of psychotic disorders and has not resulted in increased cannabis use by adolescents, in part because retailers are complying with age limits.

An approach tailored to Australia can do even better.

Medicinal cannabis should be the domain of patients, doctors, and pharmacists, working under clear ethical standards. A regulated cannabis regime should replace our criminalised model so adults can legally access qualitycontrolled products rather than facing both arrest and the danger of purchasing untested goods from criminals.

Australia has created a policy muddle, but we know how to get out; we just need the will to do so.

#