UK Medical cannabis fact or farce 2019

Last year we were promised medical cannabis legalisation in the UK. On 1st November 2018, then Home Secretary Sajid Javid outlined plans for CBPMs (cannabis based products for medicinal use in humans) to be made available.

Initial reaction was skeptical – after over 50 years of prohibition many thousands of medical cannabis patients and non medical cannabis consumers alike have been discriminated against for their use, whether they need cannabis or not. At one end of the scale we have the harmless stoner, at the other a patient in urgent need of cannabis medicine, possibly with life-threatening issues if the medicine is not given. And still this medicine is being restricted from those who need it because of a fear of the drug itself in the hands of the public.

And, like I suspected, months (now a year) after “medical cannabis legalisation” patients are still left waiting for their medicine, tied up in red tape and bureaucracy.

And now with Brexit looming and overshadowing our first December election in over 100 years cannabis does not even seem to be on the agenda.

In the past year some patients have been taking matters into their own hands, getting private prescriptions for cannabis for their conditions which cost around £700 per oz. Others who couldn’t afford this have continued to rely on the black market or growing their own supply, and even some of those I have spoken to with private prescriptions have gone back to illegal supply as costs mounted.

So the latest announcements in UK cannabis legalisation should sound good to the ear – because NICE (National Institute for Health and Care Excellence) guidelines have come out suggesting two CBPMs should be prescribed by the NHS.

Let’s dig a little deeper though, because this is still far, far too restrictive and leaves the vast majority of patients suffering.

In the latest NICE guidlines document (which can be found here) a number of suggestions are made. Summerising this, the BBC reports that:

“Doctors will be able to prescribe Epidyolex, for children with two types of severe epilepsy – Lennox Gastaut syndrome and Dravet syndrome – which can cause multiple seizures a day.

Clinical trials have shown the oral solution, which contains cannabidiol (CBD), could reduce the number of seizures by up to 40% in some children.”

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UK medical cannabis legalisation, UK Medical Cannabis Legalisation: Fact or Farce?, ISMOKE

My main bug bear with these new guidelines is that cannabis-based medicine will still not be available for chronic pain. This is an area where it is clearly effective, and these new guidelines were called a massive missed opportunity by the End Our Pain campaign.

The guidelines are only recommending two drugs, both manufactured by the same company, GW Pharmaceuticals. They are Sativex (1:1 THC:CBD) and Epidyolex (CBD Dominant).

Ironically, in the new guidelines price is stated as a cause for concern, and NICE mention this had initially restricted the route to market of CBPMs until GW agreed to lower their cost to the NHS.

Patitents, Doctors and indeed NICE themselves should know that the treatment cost per patient is massively marked up when a CBD or a 1:1 strain can be grown at home for a fraction of 1% of the cost once the setup has been paid for:

But we now have a situation in this country where by definition the cannabis sold by GW to the NHS is legal, but other medical cannabis products remain illegal.

So what does this mean?

Your doctor can now potentially prescribe you Sativex or Epidolex for MS or certain forms of epilepsy, but nothing else. No other products, no other conditions covered.

Genevieve Edwards (director of external affairs at the MS Society) said the approval was “brilliant” but did not go far enough:

“No cannabis-based treatments have been recommended to treat pain, a common symptom of MS,” she said. “Additionally, because Sativex will be funded by local bodies – who might not have the resource they need to prescribe it – even more people could miss out.”

Quote reported in the Guardian

In fact, this move effectively increases GW Pharmaceutical’s monopoly on the medical cannabis market in the UK. While it is positive that some patients will now receive these CBPMS on the NHS, until every patient with unmet medical cannabis needs can be legally treated we are a long way off true medical cannabis legalisation in the United Kingdom.

So I’m asking: is the UK Medical Cannabis Legalisation announced last year simply a farce? Or will we see better access soon for those who need it with appropriate and sensible guidelines instead of two steps forward, one massive step back.

Tyler Green

UK medical cannabis legalisation, UK Medical Cannabis Legalisation: Fact or Farce?, ISMOKE

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