The father of a man who took his own life after being prescribed medicinal cannabis says his dead son was repeatedly sent more cannabis, despite the family notifying the telehealth platform of his death.

The pharmacist who founded the company, Dispensed, has been banned from supplying cannabis and two doctors have been suspended as authorities launch an investigation into the man’s death, and alleged inappropriate prescribing to another patient, the ABC can reveal.

The men’s families said they were gravely concerned a complete failure of regulation had allowed their loved ones access to medicinal cannabis, despite both men having a history of hallucinations or psychosis.

The New South Wales coroner is preparing a report into the death of a 41-year-old man, who had a mental health condition, and was prescribed medicinal cannabis by two doctors at Dispensed before he took his own life.

The father of the man, who is grappling with the loss, said his highly intelligent son had three university degrees, but had struggled with auditory hallucinations and was prescribed antipsychotic medication at the time of his death.

He believes that given his son’s history, he never should have been sold medicinal cannabis, and said his son’s regular GP and psychiatrist did not know about the cannabis prescription.

The man said his wife contacted Dispensed to tell them their son, who lived with them, had taken his own life in February.

But the company, which operates a subscription service, sent two more packages of medicinal cannabis addressed to their dead son after that.

An ABC investigation has found another Dispensed patient was repeatedly sold medicinal cannabis despite his desperate mother pleading with the company that he had been diagnosed with schizophrenia and was at risk of psychosis.

After taking the cannabis, the 31-year-old man’s mental health rapidly deteriorated.

He was taken to hospital by police and ambulance in an acute psychosis, and held on an involuntary treatment order for weeks.

The case raises broader questions about the multi-million dollar cannabis telehealth industry, which has led to an explosion in the prescribing of medicinal cannabis, and growing reports of harm including an increase in psychosis presentations.

Australia’s peak medical bodies have repeatedly warned medicinal cannabis operators are poorly regulated, with some driven by profit.

Mother contacted company to raise alarm

Most medicinal cannabis products are not assessed by the Therapeutic Goods Administration (TGA) because they are unapproved medicines.

Doctors can apply to prescribe medicinal cannabis by becoming an Authorised Prescriber or applying through the TGA’s Special Access Scheme.

From there, prescribing decisions are up to individual doctors.

Telehealth providers like Dispensed, which describes itself as “Australia’s easiest to use online platform”, offer medicinal cannabis to patients with a wide range of conditions through online questionnaires which are reviewed by a doctor or nurse before a telehealth appointment.

Documents show in late January that Dispensed was notified in writing by the second patient’s mother that he had schizophrenia and was at risk of psychosis, and she was concerned he had not disclosed his diagnosis.

The company responded to the woman confirming the information had been passed on to the medical team.

Transaction records show Dispensed continued to sell the patient THC-containing medicinal cannabis in four separate payments over the following six weeks.

When the woman contacted the company again to advise her son had been hospitalised with psychosis, the company refunded his purchases and sent him a ‘discharge letter’.

The following month, while still in a mental health facility, the patient received an email from a new doctor working for Dispensed advising if his treatment was “not working in the way that was expected” there was a range of other THC-containing medicinal cannabis products which “may get better results”.

It encouraged the man to book a follow up appointment, and also listed a dozen other cannabis products on offer including “black cherry punch”, “gelato sherbet” and “joker juice”.

Professor Brett Emmerson, chair of the Queensland branch of the Royal Australian and New Zealand College of Psychiatrists, said in his opinion it was inappropriate to prescribe medicinal cannabis to any patient with a history of psychosis or schizophrenia.

“There are now many medicinal cannabis products that contain THC or tetrahydrocannabinol, which is the psychoactive component, and it is that component that causes the psychotic episodes.”

The company’s online pre-admission quiz asks patients if they have a history of psychosis or schizophrenia and its terms and conditions also states patients must declare they do not have a personal or family history of schizophrenia, psychotic illness or substance addiction.

Professor Emmerson said some telehealth clinics are not thoroughly checking the patient’s history and “very rarely check with the person’s prescribing … psychiatrists or general practitioners”.

“And so, they will start people with psychotic illnesses on medical cannabis. And, as I say, they will ask no questions, and they’ll have it delivered very quickly to the person,” he said.

Pharmacist banned from supplying medicinal cannabis, doctors suspended

In August, Dispensed founder and Melbourne pharmacist Adam Riad Younes was prohibited access to medicinal cannabis including supplying, administering, handling or dispensing the drug.

Company searches show he resigned as Dispensed Pty Ltd’s director earlier this month, but remains the director of VeteranCann, a medicinal cannabis telehealth platform specialising in treating veterans.

A spokesperson for the Australian Health Practitioner Regulation Agency (AHPRA) said conditions were imposed on Mr Younes’s licence through immediate action powers available when there is “a serious risk to the public, or strong public interest, requiring restrictions on a practitioner’s registration”.

Two doctors working for Dispensed also had their ability to practice completely suspended by the Medical Board of Australia in August under immediate action powers, AHPRA confirmed.

The ABC asked Dispensed a series of questions about the patients and its practices, but in a statement said it could not respond “due to privacy and confidentiality obligations”, and that it did not accept the ABC’s allegations related to its conduct.

Over the past few months, some Dispensed patients have posted online about having scripts suddenly cut off because they were also prescribed antipsychotics, or had a history of psychosis, suicidal ideation or illicit drug dependence.

Dispensed did not respond to questions about whether any reviews had taken place, how many patients they’d had stopped prescribing to, or whether Mr Younes or either of the doctors still worked for the company.

‘He’s literally being groomed’

Professor Brett Emmerson said the current regulation scheme was never intended to cover the explosion of medicinal cannabis.

“No-one anticipated … there would be a burgeoning market of single-issue clinics and companies who want one thing — people using their products to make money,” he said.

Documents show since he was released from hospital, the former patient who lives with schizophrenia has been sold medicinal cannabis by two other well-known online telehealth platforms.

It raises questions over whether the companies’ prescribing doctors checked the man’s medical history with his regular GP or treating psychiatrist.

His distressed mother told the ABC she spent hours tracking down contact details for the companies to tell them to stop selling him medicinal cannabis.

She said it was clear there were not enough safeguards in place to prevent serious harm to patients.

Executive director of Lived Experience Australia, Professor Sharon Lawn, said a week after she received an email about the Dispensed case, her own family member who lives with schizophrenia was sent targeted advertising by another company.

“He’s literally being groomed by an online medicinal cannabis provider, saying, ‘What tactic will you choose — proceeding with constant mental and physical suffering, having no life joy and staying stressed, or getting started with a happier life?'” she said.

In a statement, the TGA said it did not regulate clinical practice but that it had taken, and would continue to take strong enforcement actions to address unlawful advertising of medicinal cannabis, consistent with the regulatory framework.

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