Health care safety commission reports no high-quality evidence for medicinal cannabis as a first-line option

The Australian Commission on Safety and Quality in Health Care has published a medicinal cannabis safety and quality report for clinicians, summarising a review of systematic reviews and meta-analyses published from 2020 to 2025.

According to the report, the review was carried out for the Commission by the Quality Use of Medicines and Pharmacy Research Centre at the University of South Australia (Adelaide University) and is listed as unpublished. The report does not state how many reviews were included, and says it reflects the evidence as of September 2025.

The Commission said it found no high-quality evidence supporting medicinal cannabis as a monotherapy or first-line option for epilepsy, multiple sclerosis, chronic non-cancer pain, symptoms in palliative care, post-traumatic stress disorder, insomnia, or chemotherapy-induced nausea and vomiting. It said limited evidence suggests adjunctive use may be more effective than placebo in reducing seizures in children with epilepsy, and that no studies assessing long-term safety were identified.

The report lists risks it associates with online medicinal cannabis services, including time-constrained consultations and limited capacity to obtain a complete medical history or monitor for adverse effects. It also notes that sponsors of unapproved products are not required to report adverse events to the TGA unless they are also the prescriber, and calls for labels that state each active ingredient and its strength.

Source: Australian Commission on Safety and Quality in Health Care — Medicinal cannabis: Safety and quality report (2026; publication date not stated on the document)