Talking to your GP about CBD

A GP who is asked about CBD will usually start from caution, ask what has already been tried, and weigh the evidence, your other medicines and the risks. Healthdirect, the government health information service, says questions about medicinal cannabis are a matter to discuss with a doctor.¹ The GP may look into it, suggest other treatment, refer on, or decline.

This page explains what that conversation usually covers and what a prescriber must consider. It does not suggest that anyone should seek CBD, and it is not a guide to obtaining a prescription.

Why does your own GP matter?

Your GP knows your medical history, your other medicines and what has already been tried. Those are the things a prescriber must weigh. The Medical Board says good care includes “communicating (with permission) with the patient’s usual treating practitioners”, so your GP should end up in the loop even if someone else prescribes.²

A GP can prescribe CBD themselves, with approval from the Therapeutic Goods Administration (TGA). See who can prescribe CBD.

What position is your GP likely to start from?

A cautious one, and it helps to know why.

• The Royal Australian College of General Practitioners (RACGP) calls the evidence “limited and inconclusive”. Its position statement “does not recommend nor encourage” medicinal cannabis products, and says they should only be considered when all first-line, conventional, evidence-based treatments have been exhausted.³
• The Medical Board and the Nursing and Midwifery Board say medicinal cannabis “should never be a first line treatment”, and that with a few exceptions “there is little evidence to support the use of medicinal cannabis”.²
• Almost every CBD product is unapproved, meaning the TGA has not assessed it for safety, quality or effectiveness.⁴

These statements cover all medicinal cannabis, most of which contains THC. For CBD alone the picture depends on the condition. Trials support it for certain severe epilepsies. For several common reasons people ask about it, including some kinds of pain and sleep problems, controlled trials found CBD no better than placebo.⁵⁶⁷ The conditions section sets out what trials found for each condition. How we grade the evidence explains the grades.

What does a prescriber have to assess?

The Boards expect a full assessment before any cannabis medicine is prescribed, “including a social, mental health and substance use history”.² If the GP applies to the TGA for you, the application must summarise “relevant past treatments and procedures trialled or considered” and why registered medicines may not be appropriate.⁸ The information a prescriber needs includes:

• a list of every medicine and supplement you take, with doses
• what you have already tried for this problem, and what happened
• any history of liver problems, mental health conditions or substance use
• whether you are pregnant, planning a pregnancy or breastfeeding
• whether you drive for work or are drug tested at work.

Be accurate. The point is a safe decision, not a particular outcome.

What is worth asking?

Healthdirect suggests these questions.¹

• Can medicinal cannabis help my condition?
• Is it safe for me to use?
• Will it affect my other medicines?
• Are there any side effects?
• Will I be able to drive, work or care for my children if I take it?

Others follow from what the TGA says a patient must understand before agreeing to an unapproved product.⁹

• Are there approved treatments I have not tried?
• Would this be a CBD-only product, or does it contain THC?
• What would it cost each month, and for how long?
• What would we measure to decide whether it is working, and when would we review it?
• What is the plan for stopping if it does not help?

That last question matters. The Boards say there “must always be an exit strategy, formulated at the beginning” for when treatment goals are not reached.² Healthdirect notes that the TGA suggests a one-month trial as a first treatment plan.¹

What should the GP tell you?

Before prescribing an unapproved cannabis medicine, the prescriber must obtain informed consent and record it. According to the TGA, a patient should clearly understand:⁹

• that there could be approved alternative treatments
• that the product is unapproved and not on the Australian register
• that its safety, quality and efficacy may not be well established for the condition
• the known and potential risks, side effects and interactions
• possible effects on thinking and daily activities
• that it may affect the ability to drive, and that state and territory laws apply
• the costs and what ongoing treatment involves.

You can ask questions and withdraw consent at any time.⁹

Why might a GP say no?

Common reasons, all legitimate:

• The evidence for your condition is weak or negative. The Boards say practitioners should only recommend treatments where there is “a reasonable expectation of clinical efficacy and benefit”.²
• Other treatments have not been tried. The TGA’s pathways are for cases where other clinically appropriate registered treatments have been considered.⁴
• Safety. CBD interacts with a number of medicines and can affect the liver. See drug interactions, CBD and the liver and who should not take CBD.
• Experience. The Boards say prescribers must have “the necessary knowledge, skill and training”.² A GP without it may prefer to refer you to a specialist.

The Boards also state plainly that “patient demand is not an indication to prescribe”.² A refusal is not a judgement about you.

What if my GP has not prescribed it before?

Many have not. A GP in that position has several options. They can read the TGA’s guidance for prescribers, seek a letter of support from a relevant specialist (which the TGA requires where the practitioner lacks experience with the product or condition), refer you to a specialist, or decline.⁸ The paperwork involved is described on the Special Access Scheme page.

What if a different doctor is involved?

Whoever is involved, the same safety points apply:

• tell the new doctor about all your medicines and conditions, and give permission for them to contact your GP
• tell your GP afterwards what was prescribed, so they can watch for interactions
• read cannabis clinics and telehealth first. Regulators have raised concerns about some services, including consultations too short for a proper assessment and questionnaires that “coach patients to say ‘the right thing’”.²

Will it go on my records?

The prescription is recorded in the prescriber’s clinical notes, as any prescription is. The Boards expect prescribers to comply with state and territory rules, “including using government real-time prescription monitoring service (RTPM) or equivalent, and My Health Record”.² Real-time prescription monitoring shows prescribers and pharmacists a person’s history for certain high-risk medicines.¹⁰ Which medicines are monitored is decided by each state and territory. We could not confirm whether CBD-only products are included everywhere.

Questions about employers and drug testing are covered in CBD at work and will CBD show up on a drug test?

This page is general information, not medical or legal advice. Laws and evidence change; we show the date we last checked the facts at the top of every page. Talk to your doctor or pharmacist before starting, stopping or changing any medicine.

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