Today I’m asked about:

… the use of prescription cannabis products for healthcare workers in Victoria generally, and for Paramedics specifically.

I’ve spoken with the prescribing doctor and been clear about what I do for a living so she’s suggested dried flower products for evening use because of the rapid onset, distribution, metabolism and excretion. The doctor is hoping this will work for PTSD, depression, insomnia and chronic pain when everything else I’ve tried has been unsuccessful.

Interested in your perspective of the medico-legal situation considering its recent availability and public image.

Medicinal cannabis ‘is pharmaceutical-grade and regulated in Australia with labelled levels of THC and CBD’ that is available upon prescription (see https://www.healthdirect.gov.au/medicinal-cannabis).   

A paramedic must notify the Paramedicine Board if another paramedic is practising their profession ‘whilst intoxicated by alcohol or drugs’ (Health Practitioner Regulation National Law (Victoria) s 140).  Whether one would describe a person as intoxicated or not, if a person is affected by medicinal cannabis, as with any prescription drug, they must be conscious of any side effects and consider whether it affects their ability to work.   A person who practices paramedicine whilst impaired by the effect of drugs, even prescribed drugs, may be guilty of unsatisfactory professional performance, unprofessional conduct and in most extreme cases, professional misconduct.

With respect to driving it is an offence to drive a motor vehicle whilst ‘impaired by a drug’ (Road Safety Act 1986 (Vic) s 49(1)(ba)) or whilst there is any detectable delta-9-tetrahydrocannabinol (THC) in their blood or oral fluid (Road Safety Act 1986 (V(c) ss 49(1)(bb) and 3 definition of ‘prescribed concentration of drugs’ and definition of ‘prescribed illicit drug’).

It can be a defence (s 49(3B)) to an allegation of driving whilst impaired if the defendant

(a) … did not know and could not reasonably have known that the … the prescription drug, … would impair driving if consumed or used in accordance with advice given to him or her by a registered medical practitioner, a dentist or a pharmacist in relation to the drug or combination of drugs; and

(b) …  consumed or used that drug … in accordance with that advice.

It would be difficult to make that argument where the drug includes THC, and the HealthDirect patient information warns agsinst driving whilst taking medicinal cannabis.

That the drug has been prescribed is no defence to the offence of driving with the prescribed concentration of a drug (noting that the prescribed concentration is any detectable amount of THC).

Conclusion

Taking prescribed cannabis should not be a barrier to practice as a health professional provided that, whilst practicing, the practitioner is not impaired or ‘intoxicated’ by the drug.

Taking prescribed cannabis would however be a problem for paramedics, or any one who drives for work, as driving with any detectable amount of THC is an offence, even if the drug has been prescribed.

POSTSCRIPT (2 November 2024)

After writing this my correspondent got back in touch with a link to an article – ‘Victoria to end automatic licence loss for drivers testing positive for medicinal cannabis‘ The Guardian (Online) 1 November 2024 and I’m asked whether it makes a difference to my answer. The article says:

Victorian medicinal cannabis users will no longer automatically lose their licence if they’re caught driving with traces of the drug in their system.

Instead, magistrates have been given the power to exercise sentencing discretion for drivers who test positive for the cannabinoid chemical tetrahydrocannabinol (THC), if they hold a valid prescription for medicinal cannabis and are unimpaired while driving.

… a user who has taken their medication as directed, can appear before a magistrate, explain their circumstance and the magistrate can allow them to keep their licence.

Despite the change, it’s still an offence to drive with THC in your system – the only change is that magistrates have been given discretionary power.

The article says these changes will take effect from 1 March 2025.

The amendments to the Road Safety Act 1986 (Vic) will mean that where the person is detected with THC in their saliva, and where the presence of that THC is due to ‘the use of a prescription drug that is a legal medicinal cannabis product by a person in accordance with a prescription or other authority’ then the court may, not must, cancel the person’s drivers licence and disqualify them from holding a licence for six months for a first offence and 12 months for a second offence. It will still be an offence to drive with detectable THC even if the penalty no longer includes a mandatory loss of licence. Paramedics will be expected to comply with the law and so will be subject to both professional and employer discipline if they drive whilst THC is detectable in their saliva. It follows that these amendments do not make any difference to my conclusion.

I also note that these amendments have been passed by the Victorian Legislative Council (the upper house) but are yet to be considered by the Legislative Assembly (the lower house). Assuming, as the article says, the government supports the amendments their passage through the lower house should not be an issue.

This blog is made possible with generous financial support from (in alphabetical order) the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), the Australian Paramedics Association (Qld), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.

This blog is a general discussion of legal principles only.  It is not legal advice. Do not rely on the information here to make decisions regarding your legal position or to make decisions that affect your legal rights or responsibilities. For advice on your particular circumstances always consult an admitted legal practitioner in your state or territory.