In his first post for Cannabiz, editor-at-large Rhys Cohen analyses the findings of the 2019 National Drug Strategy Household Survey to find out more about the 97% of Australians who still source their medical cannabis from the black market.

As of July 2020, there are now more than 50,000 Australians who have at some time been approved to be prescribed a medical cannabis product. And the number of active, current prescribed cannabis patients is around 20,000.

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It’s relatively straightforward to account for these people because they’ve all been formally assessed by a doctor and approved for use by the regulators. But does seeing a doctor or getting an approval define you as a medical cannabis patient?

What if you’ve tried to find a doctor but none of them have been interested in considering a cannabis prescription? Or the doctor has agreed to seek an approval but you’ve declined because the medication would be too expensive? Perhaps you live in a rural/regional area with limited access to medical services and you know it will all be too hard, so you don’t even bother? Or perhaps you have some other medical, philosophical, or social reason to not pursue a prescription?

Definitions matter

The definitions we use to identify medical vs non-medical cannabis users are important. The more restrictive our definition is, the fewer people are captured in that definition, and the less important medical cannabis becomes. And when assessing medical cannabis policies, if we only consider prescribed users to be ‘true’ medical cannabis patients, we can easily ignore all the many reasons why otherwise perfectly eligible people are excluded, or choose to exclude themselves, from the prescription framework.

At the other extreme, some argue that all cannabis use is medical by definition, but this should be understood as a political argument. It fails to distinguish why certain people use cannabis in particular ways, places, and times, which from a policy standpoint makes it rather useless.  Let’s call this definition ‘it’s all medical’.

Perhaps you, the person using cannabis, are best placed to decide if your use is medical? There are some issues with this definition of course. In particular, very heavy users who experience harm from cannabis might like to believe their use is non-problematically medical. Let’s call this definition ‘self-identification’.

2.5 million Australians used cannabis last year

The National Drug Strategy Household Survey is a large, government-funded survey of Australians which asks them about their drug use. It has been published regularly every three years since 1995 and its findings help inform drug policy development in Australia.