Retired nurse Lucy Haslam became a fierce campaigner for medicinal cannabis during her son Dan’s battle with terminal cancer after witnessing the relief it gave him. She spearheaded the United in Compassion (UIC) Medicinal Cannabis Symposium in 2014 and continues to advocate for greater access to medicinal cannabis in Australia. 

What continues to drive your advocacy for increased medicinal cannabis access in Australia?

I still see a strong element of stigma around the use of medicinal cannabis, even though there are now possibly around a million Australian patients being legally approved to use it. It disappoints me that many health professionals rely so heavily on randomised controlled trials to be convinced about medicinal cannabis and that they cite a lack of gold-standard evidence, when their patients are obviously showing benefit. The lack of RCT evidence is directly related to the fact that cannabis is a plant that cannot be patented and thus there is little incentive for the investment of millions required to do such trials. Person-centred medicine or N=1 trials are a far more appropriate measure in the world of cannabis medicines.

What progress has been made in addressing challenges since the last UIC symposium?

Unfortunately, I feel that we have gone backwards in some ways. Costs are coming down but for some patient types, they remain outside patients’ reach, especially with the high cost of living. Drug driving is still a huge issue in all states, except Tasmania, where a legal prescription is a legal defence. Other states are showing interest in reform, such as Victoria who are embarking on a trial. Stigma can only be overcome through education, and it would be great if education on the Endocannabinoid System became commonplace in higher education, but uptake remains almost non-existent and that is why events such as UIC2025 are so important.

What are the biggest challenges?

Some of the big problems that have emerged over the past 12+ months have been around health professionals not acting professionally or ethically…this has been especially evident with the rise of online clinics/telehealth, especially where the prescribers receive a kick-back for prescribing particular products, or worse still, where the clinic is vertically integrated and the producers of the cannabis products own the clinics and the dispensary, and sometimes this is the health professional.

Nurses have been caught up in some operations by being expected to operate outside their scope of practice and actually do the work that should be done by a doctor.

These models are very profit-driven and often give little to no assessment of the patient, which of course is not in the interests of the patients, who often have complex care needs and may be on multiple medications. The patients that often use these clinics have been denied access to medicinal cannabis by their regular GP.

The 2025 UIC symposium theme is ‘Optimising quality and compliance’. What are your goals?

We want to encourage all sectors of the industry to do their bit by providing quality service to patients and by adhering to the regulations that are ultimately in place to ensure patient safety. This is necessary to try and shake off the poor reputation that the sector has quickly received due to things such as unethical prescribing and egregious advertising. We want to remind all delegates that cannabis is largely a Schedule 8 medicine and that requires standards of quality and service, as well as caution to avoid any potential risks associated with its use. We will have the TGA and Ahpra on hand to reinforce the message. We’re aiming to revive confidence in the sector more broadly as well as continue to highlight the impressive safety profile of cannabis when it is prescribed ethically and responsibly.

What role are nurses playing in medicinal cannabis?

Nurses are increasingly exposed to medicinal cannabis in the normal workplace as more and more patients bring it to hospital or aged care etc. We still hear frequently of patients being ostracised in those settings because nurses lack the basic understanding of the legal status of medicinal cannabis and, unfortunately, bring their own personal biases to work. That can only be overcome with education and direction via policy development within the workplace.

Nurses are also increasingly working in medicinal cannabis as a specialty. They need to understand their scope of practice to ensure that they are not taken advantage of and remain protected.

Nurses are also more involved as patients themselves. Many nurses bear chronic pain issues, for example, and use medicinal cannabis themselves. There are implications for the workforce as a whole and responsibilities to manage workers with respect for their human rights to access prescribed medicine.

We know that the presence of THC often attracts the label of a drug user and the impression that the person is impaired. The reality is far from that in the case of medicinal cannabis patients. These patients are usually not impaired and in fact the opposite…they are able to perform better at work due to management of pain and other symptoms.

This is a completely new way to look at cannabis, and again, education is key. Nurses need to be the key champions of patient rights and also of being professionally informed, so they provide adequate care.

What are the most common myths and misconceptions about medicinal cannabis?

There are many misconceptions about cannabis! So many in fact, we are devoting a whole session to this at the symposium, and we will have a number of highly qualified academics to debunk them. Here are just a few:

• There is insufficient evidence to support the medical benefits of cannabis
• Cannabis use causes psychosis
• Medicinal cannabis is a dangerous gateway drug that will lead to harder drugs
• Smoking/vaping medicinal cannabis is as dangerous as smoking/vaping tobacco
• You can overdose on cannabis
• Cannabis causes memory loss and motivational deficits
• Medicinal cannabis use was banned by the United Nations
• Medicinal cannabis is addictive
• Cannabis use is strongly associated with increased road traffic accidents
• There are a high number of adverse event reports associated with medicinal cannabis use
• THC is not medicinal cannabis

Where do you see medicinal cannabis heading in the next 5-10 years in Australia?

Medicinal cannabis will continue to rise in popularity as it proves itself to be a safe alternative to many of the far more impairing and dangerous drugs it replaces. The hurdles we face are not surprising due to the decades of prohibition that have kept cannabis use limited to those prepared to break the law to use it recreationally.

Perceptions are changing despite Australia being so conservative in its politics. I expect that eventually cannabis for adult use will be legislated…our challenge then will be to ensure that patients with genuine medical needs are not compromised and that efforts around education, prescribing and providing quality medicine are not diminished.

One of the big keys to wider use will be an understanding that cannabis use does not necessarily cause impairment and that patients who use medicinal cannabis responsibly can drive and work safely. A change in drug driving laws will be most welcome and is currently overdue.

Education around the Endocannabinoid System (ECS) must become part of any health curriculum of merit. When you understand the physiology of the ECS you understand the mechanisms of action of cannabis and suddenly cannabis use becomes a respectable and valuable medicine, and attitudes change.

United in Compassion 2025 will be held from 21-23 February in Brisbane