Medicinal cannabis has become an increasingly prominent part of healthcare for many Australian veterans, placing greater focus on how treatment policies are developed, evaluated, and implemented. As the Department of Veterans’ Affairs introduces tighter prescribing rules, debate has shifted beyond clinical guidance to broader questions about evidence, consultation, and whether the lived experiences of veterans should play a greater role in shaping policies that directly affect their care.
The Department of Veterans’ Affairs (DVA) has defended its medicinal cannabis crackdown despite conceding the policy was not informed by analysis of its own veteran cohort, instead relying on published medical literature and broader clinical evidence to justify the changes.
The changes introduce tighter controls on prescribing, including limits on the number of medicinal cannabis products veterans can access, caps on THC concentrations and daily dosages, specialist oversight and new face-to-face consultation rules. While the department insists medicinal cannabis remains available, the revised framework is aimed at addressing what it describes as rapid growth, patient safety concerns and inappropriate prescribing practices.
The policy follows an extraordinary rise in medicinal cannabis use among veterans. Department officials told Senate Estimates spending increased from $36 million for just over 85,000 prescriptions in 2023-24 to $88 million for more than 188,000 prescriptions in 2024-25, before reaching $105 million by the end of April this year. However, DVA was adamant the changes were not driven by cost alone.
DVA Chief Health Officer Dr Steph Davis repeatedly cited concerns about patient safety, pointing to high-THC products, vertically integrated prescribing businesses targeting veterans and a growing number of doctors prescribing medicinal cannabis as a “panacea” rather than as part of broader clinical care.
“We know there are risks associated with medicinal cannabis, particularly with high THC percentage products,” Dr Davis told the committee. “We know there have been adverse events associated with high THC products.”
Dr Davis said the revised framework was designed to improve clinical oversight while ensuring medicinal cannabis remained available for veterans who met the criteria.
The discussion took a different turn when Greens senator David Shoebridge questioned whether DVA had actually examined outcomes based on findings within its own veteran population before introducing the restrictions. With nearly 200,000 prescriptions funded in the previous financial year, he questioned whether DVA had used that data to assess if medicinal cannabis was helping veterans reduce opioid use or improve their health outcomes.
“Did you do a review of veterans to see what impact it had on their opiate prescriptions?” Senator Shoebridge asked the Chief Health Officer. “No,” Dr Davis replied.
Dr Davis said DVA had reviewed existing published literature but had not undertaken its own targeted literature review or analysed outcomes across the veteran cohort before implementing the new policy.
“As far as I’m aware, there was not a targeted literature review done on behalf of DVA into this, insofar as looking at primary sources of literature,” Dr Davis said.
Instead, she said the department had relied on broader peer-reviewed medical evidence, which showed medicinal cannabis produced benefits for some individuals but did not demonstrate strong benefits across the wider population and identified significant safety concerns, particularly around high-THC products and mental health.
The exchange highlighted a central tension running through the debate. DVA argued policy should be guided by published clinical evidence and population-level safety data, whereas critics argued that veterans themselves represented a substantial sample size that had not been adequately examined.
Senator Shoebridge said many veterans had contacted him to express their deep concerns about the changes in policy as well as the lack of consultation before its implementation.
“Medicinal cannabis has been a lifesaver for them, reducing their opiate use and allowing them to get a degree of stability in their life that they didn’t have before,” Senator Shoebridge said. “Secretary, you didn’t consult with the veterans community; this was just delivered to the veterans community.”
That became the centrepiece of criticism across the political spectrum with Senator Jacqui Lambie raising similar concerns, arguing that DVA was overlooking the lived experience of veterans who had reported successfully reducing their reliance on opioids and other pharmaceuticals after commencing medicinal cannabis.
“I don’t know who you’re speaking to at your roundtables – you need to put your boots on – you need to go and speak to those vetereans,” Senator Lambie said. She also warned that restricting access to medicinal cannabis risked pushing some veterans back onto opioids or even the illicit drug market.
Dr Davis rejected suggestions that DVA was attempting to remove access to medicinal cannabis, maintaining the changes were intended to improve safety rather than reduce availability. She acknowledged some veterans experienced enormous benefits, but policy needed to reflect the broader evidence base.
“We need to be cognisant of the fact that there are risks associated with medicinal cannabis and the evidence at a population level — that is, the peer reviewed evidence — doesn’t show enormous benefits,” Dr Davis said. “There are certainly benefits for some individuals, but there are also risks for some individuals.
“We certainly have also had direct reports of individuals who’ve had adverse events associated with medicinal cannabis, so we need to ensure that our funding framework is promoting veteran health and wellbeing and minimising those adverse events and the risks of those occurring.”
DVA also defended tighter prescribing controls, citing concerns about some commercial businesses that had built vertically integrated models around medicinal cannabis, heavily targeting veterans through advertising while prescribing increasingly high-THC products.
Under the revised framework, DVA has reduced the maximum number of medicinal cannabis products funded for each veteran to three, limited dried cannabis to two grams per day, capped THC concentrations at 25 per cent and introduced new face-to-face consultation requirements for new patients, significant dose increases and changes of prescriber.
Liberal senator Paul Scarr raised concerns from veterans who were already being transitioned to the new scheme despite six-month grandfathering arrangements intended to protect existing patients. He also questioned whether veterans in regional areas would face unnecessary travel to comply with new face-to-face consultation requirements.
DVA said prescribers were expected to begin transitioning existing patients during the six-month grandfathering period so they would comply with the revised framework once the existing arrangements expired. Secretary Alison Frame responded by saying that every action the department made emanated from its concern for veterans’ well-being.
“You seem to be suggesting that they can’t access medicinal cannabis, the access remains in place,” Ms Frame said. “There are just guidelines we have put in place to ensure that veterans’ wellbeing is paramount in every prescription that is applied. I would also point out that, at the time we announced the changes, they were endorsed by the Royal College of Psychiatrists and the Royal College of General Practitioners.”
The debate exposed broader questions about how DVA developed policy. While officials emphasised the changes were driven by safety concerns, senators repeatedly scrutinised whether the department should have examined outcomes within its own large veteran cohort before relying primarily on published medical literature.
The discussion echoed concerns raised earlier during Senate Estimates about DVA’s controversial $5,000 annual cap on allied health services. Senators similarly questioned whether major policy changes affecting veterans had been developed using sufficient evidence drawn from, and engagement with, the veteran community.
