Ian Freckelton's extensive report for the Law Reform Commission, recommending the legalisation of cannabis for medicinal use, is a welcome and refreshing approach to a complex issue. The challenge is this: if cannabis alleviates pain or suffering for some people, but its medical efficacy is not conclusively proved, how might a compassionate government frame laws and devise a supply scheme to ensure patients with the worst conditions could have safe, regular and equitable access to this otherwise prohibited drug?

Dr Freckelton, QC, has proposed a system whereby patients with acute conditions, under the close supervision of their medical specialists, could be prescribed cannabis-based remedies, which would be purchased at pharmacies.

The Andrews government has embraced the plan, agreeing to adopt all the Law Reform Commission's recommendations (albeit, two of them will be phased in). It is expected to introduce legislation in December and, if federal Health Minister Sussan Ley gives her assent, Victoria would have an operational scheme by January 2017 – the first state to introduce a regulated scheme for cultivating, processing and prescribing cannabis-based medicine.

This is a big development in alternative therapies in Australia, and it follows similar but flawed schemes in Canada, where the system has proved too rigid and bureaucratic, and in 23 American states, where it has been vulnerable to abuse. The Netherlands and Israel also allow medicinal cannabis.

Some medical experts believe it is premature for the government to permit cannabis in a medicinal form, because while there is emerging evidence suggesting it is effective in treating certain conditions, there is not conclusive proof. It has therapeutic potential, but many more rigorous studies are needed to demonstrate efficacy. Only one pharmaceutical-grade instance of cannabis-based medicine has passed the high standards demanded by the Therapeutic Goods Administration: Siritex, in 2012. But it was not released here because, after failing to get the product listed on the Pharmaceutical Benefits Scheme, the manufacturer decided Siritex would not be financially viable in Australia.