The federal government legalised cannabis for medical purposes across Australia in 2016 but did not create provisions for patients needing to drive.

Testing positive to any amount of cannabis while driving can lead to a loss of licence and fines.

That means medicinal cannabis patients living with easy access to metropolitan public transport networks have an advantage that rural patients do not have, Victorian Legalise Cannabis MP Rachel Payne told ACM.

Cannabis patients who need to drive for work or to buy groceries have limited transport options.

Ms Payne said she would like to see laws updated so patients can consult with doctors and settle on a safe prescription to use while driving.

"It's a real deterrent from accessing cannabis," Ms Payne said.

Cannabidiol (CBD), one of cannabis' therapeutic components, has minimal affect on driving abilities, Ms Payne said.

Traces of cannabis's other therapeutic component, tetrahydrocannabinol (THC), can appear on drug tests for weeks after dosing - despite the affects of drugs wearing off for most users within hours.

Medicinal cannabis patients can lose their licence, even if their last dose was weeks before, due to the zero tolerance approach.

Testing positive for THC is not enough evidence to conclude driving impairment, the International Council on Alcohol, Drugs and Traffic Safety (ICADTS) said in a report.

"Victoria led the way when it came to legalising medicinal cannabis but the process hasn't been finalised," Ms Payne said.

Medicinal cannabis patients should be subject to a different limit or threshold, the ICADTS report said.

In late 2020, the Victorian Government set up the Medicinal Cannabis and Safe Driving Working Group to consider ways that medicinal cannabis patients might be able to drive safely.

"The safety of all road users is the highest priority and we make no apologies for our focus on this," a Victorian Government spokesperson told ACM.

"We also recognise that medicinal cannabis patients need to be able to get around," they said.

Driving under the influence of THC, while the drug is actively working, can affect cognitive and motor skills necessary for safe driving, NSW deputy secretary of safety, transport, environment and regulation Tara McCarthy told ACM.

THC affects skills like attention, judgement, memory, vision and coordination, she said.

"These rules are in place to deter people from driving a vehicle if they are affected by drugs and reduce the risk of a fatal crash," she said.

"As part of the 2026 Road Safety Action Plan, the NSW Government has committed to continuing to monitor drug driving research and developments relevant to drug driving policy," she said.

The Queensland Government is reviewing the state's approach by looking at research and practices around the world and talking with people affected by drug driving, a Queensland Transport and Main Roads spokesperson told ACM.

"The government is acutely aware of the challenges faced by those wanting to use medicinal cannabis and continue driving," they said.

But the impairment caused by THC threatens drivers ability to anticipate hazards and unexpected situations, their decision making and their ability to respond quickly to changes in the traffic environment, they said.

All Australian states take a zero tolerance approach, with the exception of Tasmania.

"If a person is lawfully using medicinal cannabis, that person does not commit an offence in respect of driving with a prescribed illicit drug present in their oral fluid/blood," Tasmania Police told ACM's The Examiner in 2021.

"There are many prescribed medications which have the capacity to affect driving, therefore this principle is not limited to cannabis only," they said.

"We see patients losing their licence, losing their jobs," Astrid's head of advocacy and government relations Bee Mohamed told ACM.

"Having law enforcement on the same page as the current medical regime is an important first step," she said.

Astrid is Australia's first female-led dispensary based in Melbourne and Byron Bay with a team of pharmacists and nurses that supply, support and educate patients accessing medicinal cannabis.

Around 70 or 80 per cent of Astrid's patients use medicinal cannabis to taper off benzodiazepine or opioid dependencies, Ms Mohamed said.

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"It allows patients to manage their conditions using cannabis in a calculated way," she said.

Chronic pain, anxiety and epilepsy are some of the conditions that could use cannabis as an alternative, or adjunct, to current treatments to help with pain reduction and mood-related symptoms.

"In the last six months we've had two truck drivers who lost their licence and needed to resign," she said.

Ms Mohamed said that patients who lose their licence and job often also lose access to cannabis, a prescription can cost hundreds per month.

Astrid dispensary works with pro bono lawyers helping medicinal cannabis patients defend against charges.

"They can argue in front of a judge that roadside testing regimes need to change," she said.