A recent tragic case in Australia has cast a spotlight on the booming but little-policed cannabis industry now being accessed by hundreds of thousands of the country’s citizens, as is the case in South Africa.
Long after Dominic McCabe committed suicide, packages kept being delivered to his house, reports Sydney Morning Herald, the small tubs in plain packaging being delivered month after month as his family grieved.
His family asked that they stop, but they kept coming. His bank account was repeatedly debited, even though his family sent back the packages.
Inside the packages was medicinal cannabis from Melbourne firm Dispensed.
McCabe’s family now questions whether the 41-year-old should have been able to so easily access cannabis when he was already taking other drugs for his mental illness.
A New South Wales Coroner’s Court spokesman said the court was now “waiting on a final post-mortem report to determine whether an inquest will be held” into McCabe’s death.
McCabe had been diagnosed with bipolar disorder and schizophrenia, and neither his GP nor his psychiatrist was aware of the cannabis prescriptions. His family only discovered he was receiving medicinal cannabis when the tubs kept arriving.
“A couple of weeks after he died, we received a package of medicinal cannabis in the mail, which we took back to the post office and we returned, taking note of where it had come from,” McCabe’s mother Ann said.
“I emailed the pharmacy concerned, told them my son had died, and that he would no longer be requiring that medication.
“But it arrived again another month later. And then another month later. Which meant they were taking money out of his account after he had died because it was a private prescription worth several hundred dollars. Each time, we sent it back.”
The prescriptions were coming from a clinic called Dispensed, majority-owned by pharmacist Adam Riad Younes, who runs two Priceline chemists in suburban Melbourne.
In August, he was suspended from dispensing cannabis. Health authorities declined to provide the reason, saying only the conditions have been imposed “using immediate action powers” under national laws.
The prohibition does not prevent Younes from owning a stake in a cannabis business.
In the same month, using the same “immediate action powers”, the Medical Board of Australia also suspended two doctors who worked for Dispensed.
Dispensed is a medium-sized player in an industry with 3 000 approved Australian prescribers of medicinal cannabis.
The country’s medicinal cannabis industry began modestly in 2016 after parents of children across Australia with epilepsy and cancer fought to have the drug legalised for medical use.
It has since grown into a scheme used by hundreds of thousands of people to access cannabis legally with a doctor’s script.
There are growing concerns over the ease of access to medicinal cannabis particularly via online clinics like Dispensed, which allow those seeking the drug to get it delivered in the mail, usually after a telehealth appointment. Some clinics do not require customers to participate in a telehealth session.
The industry is now worth more than $500m annually in Australia.
Most prescriptions are for the treatment of chronic pain, followed by anxiety, sleep disorders, post-traumatic stress disorder and cancer pain management.
Dispensed allows customers to have cannabis products – with names such as Devil’s Driver, Amnesia Haze and McFlurry – posted to their door. An industry source said it claimed privately to have about 30 000 subscribers across the country. Its website describes itself as “incredibly affordable with $0 in set-up and upfront fees”. To get cannabis delivered, patients fill out an online form and then do a telehealth consultation, after which the drug is delivered.
Dispensed’s business model relies on subscribers paying a monthly fee, “starting from $155 per month, which includes monthly medication, ongoing clinician consultations, express delivery and LiveChat patient support”, its website says.
Launched in 2021, it proclaims itself “Australia’s easiest-to-use online platform for access to therapy with medicinal cannabis”.
Younes did not respond to requests for comment.
McCabe’s mother said her son had “strong reactions to (cannabis) so it wasn’t a product that would agree with him”.
He held degrees in horticulture and accounting and a graduate diploma in agriculture, but, she added, his mental health condition had been diagnosed as “bipolar at some stages; at other stages, they called him schizophrenic”. He had attempted suicide before February.
She said he was already taking some medicines required to be registered on the national SafeScript website. Cannabis is a schedule-eight drug, and prescriptions must also be registered on SafeScript.
Under Australia’s health rules, pharmacists and doctors are meant to access the SafeScript system to ensure a patient is not on conflicting medicines or “script shopping”.
John Ryan, chief executive of public health and drug research centre Penington Institute, said there were potential harms and benefits from medicinal cannabis that needed to be balanced.
He said that legal cannabis was relatively new in Australia’s medical system and while most prescribers acted responsibly, some didn’t, and this bad behaviour had to be targeted.
He said it was not just medicinal cannabis where patients suffered from bad health practices.
In July, the Australian Health Practitioner Regulation Agency set up a rapid regulatory response unit to look at the medicinal cannabis, weight loss medication, vaping products and cosmetic injectables industries.
See more from MedicalBrief archives:
Physicians search for medicinal cannabis knowledge – Australia and SA
Health professionals wary of medicinal cannabis misuse and adverse effects