Abstract
BACKGROUND AND PURPOSE: Epilepsy is a common indication for medicinal cannabis (MC) prescription in Australia. Despite legal MC products being available for 8 years, some individuals continue to rely on illicit cannabis. Here, we conducted a survey of Australian persons/people with epilepsy (PWE) and caregivers of a PWE to assess whether the current legal framework supports PWE and/or their caregivers to access prescribed MC. METHODS: The cross-sectional survey consisted of five sections examining sociodemographics, medical history, history of MC use, attitudes towards MC, and barriers to accessing MC. RESULTS: Of the 126 respondents included in these analyses, 102 were PWE (mean age, 40.9±12.3 years) and 24 were caregivers of a PWE (mean age of PWE, 14.1±8.9 years). Among PWE, 27.5% (28/102) had only used illicit MC products, 27.5% (28/102) had transitioned to prescribed MC products, and 16.7% (17/102) used both. Most caregivers 70.8% (17/24) had only accessed prescribed MC products. Most respondents 77.0% (97/126) reported using MC as an adjunct to conventional anti-seizure medications. Caregivers were more likely to administer prescribed high-cannabidiol products to children using oral routes of administration (p<0.001). In contrast, PWE often used inhaled cannabis (p<0.001). Overall, 67.0% (83/124) of respondents reported that MC "improved" or "greatly improved" their epilepsy, irrespective of MC type. The main barrier to accessing prescribed MC was "cost" (69.0%, 87/126), while tetrahydrocannabinol (THC)-related driving restrictions were also a significant concern for PWE. CONCLUSIONS: The current regulatory framework in Australia supports MC access for PWE and their caregivers, primarily through cannabis clinics. However, cost remains a significant concern. The prevalent use of Δ9-THC-containing and inhaled MC products, either illicit or prescribed, highlights the urgent need to further investigate their safety and efficacy in epilepsy.