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It’s almost three years since cannabis-derived medical products were placed in Schedule 2 of the Misuse of Drugs Regulations 2001. For the first time, that represented official recognition in the UK that these products have a therapeutic value, enabling doctors to prescribe them. But for people suffering persistent pain and other symptoms which may be relieved by cannabis products, obtaining a prescription remains as distant a dream as ever.
The only available data confirms that just three NHS prescriptions have been dispensed for cannabis oil. While it’s possible to obtain a private prescription, the number of centres is limited and you will need deep pockets as the monthly cost can exceed £1,000!
The irony is that the UK is by far the world’s largest producer and exporter of medical cannabis; production here has risen by almost 700 per cent in the last five years. In 2019 alone, 320 tons were produced.
NICE Guidelines on cannabis
In November 2019, the National Institute for Health and Care Excellence (NICE) published its guidelines on prescribing cannabis-based medicinal products. They provide for extremely limited use, specifically for:
- intractable chemotherapy-induced nausea and vomiting (with Nabilone);
- moderate to severe spasticity in multiple sclerosis (with THC:CBD spray); and
- drug-resistant paediatric epilepsy – Dravet and Lennox-Gastaut syndromes (with CBD).
NICE says that people with chronic pain should not be prescribed drugs containing THC (delta-9-tetrahydrocannabinol), the main psychoactive ingredient in cannabis. The reason given is a lack of evidence of its benefit. In essence, this pretty much amounts to a ban on NHS-prescribed medical cannabis for chronic pain.
Street cannabis
While around six thousand private prescriptions have been dispensed in the last three years, this is dwarfed by the use of ‘street cannabis’ for therapeutic purposes. A YouGov poll in 2019 suggested a staggering 1.4 million people in the UK risked criminal sanction by accessing cannabis from illegal and unregulated sources to treat chronic health conditions. Last year, Dr Steve Hajioff, a former chair of the British Medical Association, said that cannabis should be made available on prescription to avoid the need of having to turn to the black market for pain relief.
Certainly, the UK lags significantly behind many countries in adopting broader change and embracing medicinal cannabis as mainstream medicine.