Arthritis patient Richard* gave up on legal medical cannabis after the Australian national drugs regulator told his GP the medication did more harm than good.

Richard believes cannabis can help alleviate symptoms of the severe arthritis he suffers in his hands.

He’s not alone. In Canada, as many as two thirds of patients who use cannabis for medical purposes do so to help manage arthritis symptoms, according to Canadian charity the Arthritis Society.

Unfortunately for Richard, the Australian government’s Therapeutic Goods Administration doesn’t agree.

The TGA told his doctor that “in terms of harm, only six patients need to be treated with a cannabinoid for one patient to have clinically relevant harm”.

And so Richard gets his medical marijuana elsewhere.

Several local medical cannabis groups — including at least one ASX-listed player — hope to change that by opening cannabis clinics in Australia.

But winning over people who have been knocked back multiple times could be a big ask.

“I’ve made a good attempt to try and do it the legal way but they can get stuffed. I’ve made two attempts to do it through my GP,” Richard told Stockhead.

“Reading this letter [from the Therapeutic Goods Administration], if what they’re saying to my GP is there’s more chance of harm than good, then what hope have you got?”

By early April, only 525 people had been approved to use medical cannabis in Australia.

The Royal Australian College of General Practitioners estimates there are 5 million Australians who suffer from chronic or nerve pain, like Richard.

A spliff a day

This week The Hydroponics Company (ASX:THC) changed its mind about building Australian medical marijuana clinics.

Its Canadian partner, on whose expertise THC was was relying, didn’t believe it could adapt the North American model to Australian regulations.

That leaves CannabisAccess — part-owned by MMJ Phytotech (ASX:MMJ) — and soon-to-launch Emerald Clinics to open the country’s first specialist clinics.

CannabisAccess has had an operational Sydney CBD base for “several months”, although it won’t reveal exactly where the clinic is.

Emerald Clinics is due to open its first clinic in central Perth near a pain centre at the St John of God Subiaco Hospital within a month — followed by Melbourne and Sydney clinics

CannabisAccess charges $370 for an in-person consult and $300 for a tele-consult.

Emerald will charge “around $400”, says chairman Dr Stewart Washer.

Delays for patients

It’s unclear why so few patients are able to use the TGA’s special access scheme two years after medical cannabis was legalised.

Richard blames the TGA for scaring doctors.

He tried twice to access the cannabis special access scheme with his GP, who was put off the second time by the email from the TGA, and has approached a rheumatologist and a pain clinic which both said they don’t support medical cannabis applications.

He reckons medical cannabis would be more expensive by about $2-4 dollars a gram than his current $300/ounce black market habit.

Stewart Washer, his father Mal and wife Patty are all involved with AusCann, and are all on the board of Emerald.

But he also reckons that’s better than the eight to ten Panadeine Forte tablets he takes per day on a legal prescription.

Emerald Clinics’ Dr Washer believes doctors are the bottleneck.

“We’ve seen the TGA turn an application around in three hours,” he told Stockhead.

“We know the TGA approves with good evidence. We also know [doctors]… aren’t paid to do three hours of application work after a consult.”

Dr Washer belives the answer is clinics that aren’t owned by a drug maker or producer, like Medlab’s (ASX:MDB) and Cann Group’s (ASX:CAN) online Medicinal Cannabis Medicines Portal, or CannaTrac’s CannaHealth portal.

Emerald is setting up three clinics as a launch pad for an IPO towards the end of 2018.

Will cannabis clinics succeed in Australia?

It is difficult to gauge how successful the newly emerging specialist clinic model might be.

Emerald is raising $2 million as part of a pre-IPO round, and Dr Washer says they are fielding an increasing number of offers from clinic owners keen for tenants.

The clinics plan to make money from consultations, selling de-identifiable data to regulators, drug manufacturers and insurers, doctor training and franchising.

Dr Washer says they’ll try to mitigate the inevitable happening — a medical cannabis patient ending up on the front of a tabloid for having a bad reaction — by extensive mental health screening.

But with patients beginning to view the TGA as the stumbling block, Dr Washer and his rivals may have some work to do to make people believe again that medical cannabis clinics are workable.

*Name changed.

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