Legislation to lift a ban that stopped medicinal cannabis patients from driving passed the NSW parliament on Thursday night.
It is yet to receive assent from the NSW governor, meaning existing restrictions remain in force.
Drivers on an unrestricted licence will be required to enrol as a registered medicinal cannabis user with Transport for NSW and provide proof of a valid prescription.
Registered drivers will also need to return a roadside THC (tetrahydrocannabinol) result below 50 ng/mL to be permitted to continue driving.
The road law change will also mean drivers will avoid the automatic licence suspensions that arise when THC is detected.
A three-strike system will also be enforced if a reading is higher with warnings given twice, followed by a fine of $704 and a minimum three-month licence suspension.
NSW Premier Chris Minns said it would make road legislation fairer to a growing community of about 300,000 medicinal cannabis users across the state while still keeping the roads safe with several provisions.
Independent Sydney MP Alex Greenwich, who revealed last year he uses medicinal cannabis to treat anxiety and insomnia associated with a PTSD diagnosis, said the change means people will no longer be forced to choose between taking their prescription medication or driving.
"(The new laws) will reduce stigma and deliver freedom and opportunity to hundreds of thousands of people who use medicinal cannabis for anxiety, sleep, pain and other prescribed purposes," he said.
The NSW opposition opposed the changes after a 2025 study found most medicinal users take a higher dose than recommended.
In Victoria, a trial is under way to evaluate the effects of THC-prescribed medicinal cannabis on the driving performance of patients within a controlled-track environment.
Since March 2025, Victorian motorists who have medical cannabis in their system but are not impaired by the drug have not faced automatic driving bans.
Drivers with a drug present in their blood or saliva in Queensland however, will face tougher penalties under new laws passed in the state parliament.
People caught more than 40km/h over the speed limit will receive an immediate six-month licence suspension following the changes.
Changes rolling out next year will streamline roadside drug testing as the government takes a zero-tolerance approach to dangerous behaviour.
"These new laws send a clear message to offenders, if you choose to act dangerously behind the wheel, you will face serious consequences," Integrity Minister Deb Frecklington said.
