The Future of Medical Cannabis in the UK: Increasing Access, Improving Patient Wellbeing and Supporting Innovation.

External Event - 27th Jul 2023

Time of Event: 9:30 AM — 1:00 PM
Place of Event: Webinar

Key Speaker

Ronnie Cowan MP, Vice Chair of the APPG for Access to Medical Cannabis under Prescription & the APPG for Drug Policy Reform, & Member of the APPG on Industrial Hemp and CBD (Cannabidiol) Products

Overview

According to a November 2022 YouGov poll, approximately 1.8 million people in the UK with diagnosed medical conditions are using illegally obtained cannabis to manage their illness, up by around 400,000 since 2019. Despite it being made legal in 2018 for doctors to prescribe medical cannabis in the UK, there has been a reluctance within the NHS to offer such treatment, with people turning instead to private GPs or pharmacists, purchasing CBD oils from retailers, or turning to recreational dealers. The strict guidance which is given to doctors has led to many potential recipients being unable to access treatment through the NHS, placing large financial burdens on individuals forced to resort to private prescription. According to data from the Care Quality Commission, in the year 2019, less than 10 patients were prescribed unlicensed cannabis-based products for medicinal use (CBPMs) through the NHS, the vast majority of CBPMs being prescribed privately, increasing from 67% to 98% between January and December. This is largely due to concerns about the safety and necessity of such treatment, particularly with regard to children. For example, whilst there are around 26,000 children in Britain with drug-resistant epilepsy, with thousands being prescribed it as treatment, of the 150 who take whole plant medication containing THC, only three have had it prescribed on the NHS.

Following the legalisation of medical cannabis in 2018, changes to these regulations meant that unlicensed cannabis-based medicinal products could be prescribed under certain circumstances by doctors on the GMC specialist register. There are currently only three products licensed by the UK-wide Medicine and Healthcare products Regulatory Agency (MHRA), one used to treat MS patients, another to reduce chemotherapy-induced nausea, and the last to treat rare forms of childhood epilepsy. Therefore, at present, the majority of products which consultants are able to prescribe are unlicensed, with a review into barriers to access finding that clinicians were reluctant to prescribe such products, particularly to children with severe epilepsy. In 2021, the Medical Cannabis (Access) Bill was introduced by Jeff Smith MP, undergoing its Second Reading in December 2021. The Bill aims to improve access to medicinal cannabis products through two measures, expanding the ability to prescribe unlicensed cannabis medical products to GPs and establishing a Commission for the assessment of such products. By removing such barriers, patients would be able to access treatment without being forced to pay excessive amounts for private prescriptions. The Bill has been blocked by the government, however.

While many people advocate for medicinal cannabis on the basis of its ability to provide effective treatment, many health professionals continue to question the safety of such products. This is particularly true with regard to THC, the psychoactive component of cannabis, which, according to some studies, can be linked to an increased risk of psychosis, despite enhancing the effects of CBD. Many concerns are linked to a lack of evidence with regard to the risks and rewards of medicinal cannabis, with groups calling for increased testing so as to enable clinicians to confidently prescribe the products to patients in need of treatment. Many have also drawn attention to the role of stigma in determining the likelihood of CBPM prescription, as a history of punitive drug policy and assumptions connected to recreational cannabis use place barriers in the way of both patients and doctors. PLEA have warned against the impact of misinformation in this area, promoting greater education and understanding with regard to the use of CBPMs. In October 2020, it was reported that the NHS had been repeatedly refusing to fund medical cannabis for children with severe epilepsy, with at least twenty families paying for private prescriptions after not being provided by the NHS, with medicine bills sometimes amounting to thousands of pounds per month.

This symposium will enable medical professionals, legislative figures, campaigners and other key stakeholders the opportunity to review both existing and potential policy on medical cannabis, aiming to address concerns and formulate strategies for future innovation.

Programme

• Evaluate the existing legislative framework surrounding medical cannabis and opportunities for reform in this area
• Analyse the measures proposed by the Medical Cannabis (Access) Bill
• Engage with the NICE guidelines on medicinal cannabis prescription
• Examine the reticence within the NHS to prescribe medical cannabis more widely
• Formulate strategies to better ensure the safety of cannabis and increase clinical confidence in medical cannabis products
• Discuss the regulatory and financial implications of private sector cannabis distribution
• Assess the value of cannabis in meeting patient needs relative to financial costs for NHS trusts
• Develop awareness of how legalised medicinal cannabis will impact on the consumption of alcohol and prescription drugs
• Construct approaches to improve practitioner understanding of medicinal cannabis
• Discuss key aspects of research and trial design that must be planned to better understand cannabis as a medicine
• Assess the potential side-effects of cannabis and how to mitigate the potential risks
• Consider the role of racialised stigma in discussions around cannabis regulation and methods to limit the role of such stigma in decision-making
• Evaluate the merits and risks of further deregulation, and its potential impact on the wider health of society