Has the UK really legalised medical cannabis? That was certainly how it was reported last winter when Sajid Javid, the Home Secretary, overhauled government policy to give more UK patients access to cannabis-based medicines. But now the groups that lobbied for those changes - and the parliamentarians that support them - say the new scheme is a disappointment, benefiting only a tiny number of patients.
What’s really going on? That was the question that kicked off yesterday's Spectator cannabis briefing which brought together practitioners, politicians and legal experts to get to the bottom of cannabis policy in Britain. What’s changed? Who benefits? And where will it go next?
When campaigners say that cannabis-based medicines are hard to get hold of, they’re not wrong. As one clinician explained at our event, the new rules only permit licensed-medicines (i.e. not home-grown cannabis) to be prescribed in those limited cases where there is a serious clinical need which all other treatments have failed to address. This isn’t a decision for high-street GPs; only specialist clinicians are allowed to make that call. And it's a high threshold to meet.
But that has nothing to do with Sajid Javid or anyone at the Home Office. It’s because NICE, the body which advises the NHS on structuring its services and treatments, has looked at the cannabis medicines available at present and concluded that they aren't good value for money. So NHS trusts aren't purchasing the drugs for general prescription. If individual patients feel they’re the exception - and that the drugs are essential for their treatment - they have to make that case to the specialists.
Is that fair? Our panel certainly didn’t think so. But it’s worth remembering that the health service has reason to be cautious: cannabis-based medicine is still a developing area of knowledge and there would be serious consequences if doctors got it wrong. What about the risk that cannabis might negatively affect a patient's mental health? Professor Mike Barnes, our expert clinician, noted he would not prescribe the drugs to anyone with a history of psychosis. No wonder doctors are cautious.
There are signs things are changing: when the Chief Medical Officer Dame Sally Davies led a review into the medicinal benefits of cannabis last year she found ‘conclusive or substantive’ evidence that cannabis was effective for pain-relief and symptoms of multiple sclerosis (at least according to the patients themselves - clinician-measured evidence is more limited). That report that didn’t exist when NICE assessed the cost-effectiveness of Sativex, a cannabis-based medicine for MS sufferers. If it had been, they might have reached a different conclusion.
Hence why there will be keen interest in October when NICE publishes its first dedicated guidelines on cannabis medicines (until now it’s only referenced individual drugs in its guideline for particular treatments). These will give a much clearer picture of cannabis’s place in UK healthcare - something which could delight or infuriate campaigners. It might also make it easier for some patients to access cannabis flowers themselves (provided those plants are grown in line with pharmaceutical manufacturing standards and imported under Home Office license).
Either way, there’s no doubt that a shift is underway regarding cannabis in the UK, and one which could affect more than just our healthcare.
Our cannabis briefing was sponsored by European Cannabis Holdings and supported by Prohibition Partners.