When the Doctor Becomes the Patient: Medical Cannabis Access in Australian Hospitals
Interview with Dr. Su Lin Wan
Read time: 4-5 mins
When Dr. Su Lin Wan was hospitalised during her journey with stage 4 breast cancer, she faced a challenge that countless medical cannabis patients encounter: maintaining her prescribed cannabis medicine within a hospital system unprepared to accommodate it.
Dr. Wan’s story is a compelling example of an oncology patient navigating the complexities of cancer treatment while advocating for the applicability and worthiness of medical cannabis within a hospital environment. Her dual perspective, both as a patient and as a physician with 27 years of experience, offers clinicians and patients insights into the challenges and opportunities of cannabinoid medicine for cancer patients.
A Doctor Becomes the Patient
"I personally found benefits from using medicinal cannabis when I had stage 4 breast cancer," explains Dr. Wan. "It helped with severe bone pain, nausea, lack of sleep, anxiety, as side effects of the cancer treatments."
Su Lin’s first breast cancer diagnosis came in 2017. In 2022, another breast lump was found and a BRCA1 gene-positive breast cancer diagnosis, and by 2023, it was stage 4 with metastases to the spine.
As both a patient and a prescribing physician, Dr Wan occupies a unique position. Her personal journey with cannabis as medicine across her cancer journey has profoundly shaped her approach to patient care. "My personal experience gives me a real understanding of the effectiveness of the drug. And then I'm in a better position to prescribe and find the right combination and titration having had that personal experience," she notes.
Institutional Barriers to Continuity of Care for Medical Cannabis Patients
Despite her medical background, Dr. Wan encountered repeated obstacles accessing appropriate cannabis dosing during her hospitalisation in Perth hospitals. Perhaps most striking was the resistance she faced from the hospital pain specialist, despite being a well-informed authorised medicinal cannabis prescriber Dr. Wan was challenged by institutional barriers and ongoing stigma.
"It was a struggle to get the cannabis dosages increased according to my circumstances," Dr. Wan tells. "Even as an authorised medicinal cannabis prescriber, it was difficult to convince the pain specialist there to authorise what I needed."
One particularly distressing incident occurred when Dr. Wan needed to be transferred between hospitals with unstable spinal fractures that could’ve potentially led to paralysis: "I needed to be transferred from my bed to the ambulance stretcher, into the bumpy ambulance ride with a nurse holding, stabilising my neck with her hands, and then to be transferred into another hospital bed," she explains.
"So you can imagine that was just anxiety ridden for me, alongside uncontrolled pain. So, I was requesting an increase for my THC oil dose at least an hour before the transfer. When the ambulance personnel arrived, I was actually speaking to the pain specialist.... Despite my trying to give a full education on dosing, with the ambulance there waiting to transfer me, the specialist wasn't comfortable increasing any oil prior to going on the stretcher."
She also points out the absence of fast-acting options in hospital settings: "Using vaporiser technology is not allowed in the hospital. So there's not that opportunity for a fast-acting cannabis treatment to happen." She therefore stresses how important it is to get dosing adjusted to prevent breakthrough symptoms such as pain.
Inside the Medical Cannabis Education Gap
At the heart of these institutional barriers lies a deep education gap. Although medical cannabis has gained traction among outpatient practitioners in Australia, acceptance and integration into hospital systems lag well behind. The flow-on effect of this creates significant barriers to continuity of care, especially for patients with complex conditions.
"The largest gap is the lack of understanding by doctors and nurses about this medication," Dr. Wan explains. "There isn't any consultation to adjust dosing with the prescribing doctor outside the hospital. Better communication needs to happen."
A recent survey of Australian healthcare providers working in cancer hospitals revealed that among oncologists, pharmacists and nurses, only 10% reported they had adequate knowledge to recommend medical cannabis, and a mere 17% were familiar with the endocannabinoid system.
Feedback from this survey noted that even clinicians who acknowledge the therapeutic potential of medical cannabis often find themselves without the necessary educational framework or institutional support to confidently apply and manage these treatments.
Dr. Wan's experience exemplifies this seemingly common circumstance. Her oncologist, though "incredibly supportive," openly acknowledged her knowledge limitations: "She doesn't know much about medicinal cannabis. And so she was happy for me to liaise with whichever doctor was familiar with it. It was just a challenge to try and find someone in the hospital system that could do that.”
To bridge this gap Dr Wan recommends, “Call upon an external GP or specialists. There are pain specialists out there who do advocate for medicinal cannabis, and it's about using them as a phone consult or a video consult, for your specialists in the hospital. Perhaps then, you can have a productive conversation about management.”
The Stigma Factor
Despite the widespread and growing acceptance of medical cannabis, lingering stigma continues to influence its application in hospital settings.
"The main fear is that it's used recreationally," Dr. Wan explains. "There's that stigma that it makes people high. However, there are also a lot of opiod-based and other medications that cause euphoria and a relaxed sensation, which are used in hospitals without an issue. So it shouldn't be treated any differently."
Dr. Wan observed a pointed example of how lack of education and ongoing stigma affect patients' care in hospitals. Within the hospital systems that treated her, CBD-only preparations were misclassified: "I found that CBD was treated as an S8 drug. It was kept in the locked cupboard," she notes. "Being in the locked cupboard meant that it requires two nurses to cross-check the medication, and this delays administration."
While hospitals may be locking up these medicines behind strict protocols in an effort to maintain medication safety, misclassification of CBD as a Schedule 8 controlled substance highlights how institutional practices are rooted in outdated perceptions that undermine current scientific understanding.
This dissonance creates not only logistical barriers to timely treatment but also reinforces stigmatising belief systems that posit medical cannabis as inherently dangerous. For patients, persistent stigma and lack of education leave them caught between evidence-based recommendations of their outpatient healthcare providers and hospital systems that continue to fail to recognise cannabis as a legitimate medicine.
“It has medicinal qualities, just like its pharmaceutical counterparts and need not be treated any differently. It is TGA approved and increasingly prescribed, so the hospital and doctors need to get up to date with this.”
Medical Cannabis as a Window to Holistic Healing
Beyond its direct therapeutic applications, Dr. Wan sees cannabis as a potential catalyst for healing and empowering patients along their healing journey. "Cannabis can be, for some people, a really good option for psychosocial stabilisation and adjustment issues, particularly for cancer patients." She explains cannabis medicines can support individuals to “be able to tap into their resilience”, which allows them to make positive changes in other areas of their health and habits.
Dr. Wan integrates holistic modalities like mindfulness, meditation, acupuncture, and Qigong. She notes that "cannabis, like any drug that can settle emotional overwhelm or provide psychosocial support, is so important in a very sterile hospital. It can be useful to stabilise someone to help them start practising mindfulness meditation."
This stabilisation creates the opportunity for sustained psychosomatic and emotional practices to yield their benefit. "Once the routine and benefits are realised and someone is stabilised for at least six months on cannabis and practising mindfulness, I would look to then reduce the cannabis dose."
The Comfy Project: Reimagining Hospital Care
Dr. Wan's has had experiences of being misunderstood in a western medicine-based world as a stage 4 breast cancer patient. Although having the benefits of being a doctor, she struggled to have her needs met as a patient and this has inspired her to develop The Comfy Project, an initiative focused on improving hospital environments for patients and families and supporting access to complementary therapies.
"The Comfy Project is about providing resources in a hospital setting to improve someone's comfort," she explains. "Whatever that means for that person to be more at ease and feel supported."
The project aims to address sterile hospital environments through a wide range of simple interventions, from orientation resources to guidance for accessing complementary therapies and nature-based healing environments. Dr Wan currently writes about her patient-doctor experience on The Gentle Kind (a weekly sub stack online article). Her articles explore how to improve your relationship as a patient with your care physicians, navigating the medical world and gaining inner peace with illness. It offers inspiration, skills in communicating needs to doctors, a guide to traversing the medical system and holistic supports.
Dr. Wan hopes to see first-time cannabis prescribing within hospital settings, particularly for patients with conditions like cancer who experience severe nausea and anxiety: "I really believe that cannabis is a really good option for that combo that can escalate quite significantly. If anyone has had nausea, it's often described as worse as pain. That's nausea. It's just so terrible."
Looking Forward
As medical cannabis continues to gain mainstream acceptance, Dr. Wan remains hopeful that hospital systems will eventually catch up to community practice. Her advice to oncologists and hospital practitioners is straightforward: "It's just a matter of oncologists understanding that it is a very useful tool and just to be open to listening to their patients that are on it, rather than just disregarding because they don't know about it."
Dr. Wan is now channelling her unique dual perspective as both doctor and patient into actionable change. Alongside her weekly publication, The Gentle Kind, these experiences and learnings are being compiled into a book and lecture series designed to bridge the educational gaps that continue to impact patient care.
The proceeds from these initiatives will directly fund The Comfy Project, her vision for transforming hospital environments into more supportive, healing-centred spaces. By supporting The Gentle Kind through subscriptions or donations to The Comfy Project, readers can contribute to this vital work of enhancing hospital care for all patients, particularly those seeking to incorporate holistic approaches or medical cannabis into their treatment journeys.
By drawing on her experience as both a doctor and a patient, Dr. Wan provides insights into the realities of medical cannabis application in cancer care and hospital settings. Through voices of patients like hers and the efforts of pioneering physicians, the divide between outpatient and inpatient prescribing, academic research and real-world clinical practice may soon be bridged, helping to streamline access for patients already navigating life-threatening illnesses.
For more information about The Comfy Project, visit https://www.sulinwan.com/the-comfy-project.html.
To subscribe to her Gentle Kind Articles, visit https://substack.com/@thegentlekind Subscriptions to The Gentle Kind supports The Comfy Project.
Dr Wan can be contacted on her email info@sulinwan.com
Dr. Su Lin Wan is a Holistic General Practitioner, Health Educator, and Lifestyle Mentor based in Fremantle, Western Australia, with over 26 years of medical experience since beginning her career in 1998. She holds a Bachelor of Medicine and Surgery (MBBS) from the University of Western Australia and is a Fellow of the Royal Australian College of General Practitioners (FRACGP), as well as possessing qualifications in Medical Acupuncture and certifications as a Mindfulness Teacher and Qigong Instructor. Dr. Wan believes in a holistic approach that combines prevention and symptom control through both Chinese and Western medicine, addressing the mind, body, and spirit to enable enriching and fulfilling lives. Her diverse medical background encompasses hospital emergency medicine, occupational medicine, surgical assisting, and rural general practice, spanning Western Australia, Queensland, New South Wales, and Victoria. She specialises in cancer support, women's health, preventative lifestyle medicine, plant-based medicine, gut health, mind-body medicine, immune system regulation, pain management, and musculoskeletal conditions, with a philosophy that laughter and compassion are essential components of good medicine.
Disclaimer: This information is shared with a global readership for educational purposes only and does not constitute medical or business advice. All patient-related information has been de-identified OR fictional to protect privacy. Nothing in this article is intended to promote the use or supply of medical cannabis to members of the public.
