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It has been four years since cannabis became available on the NHS. Why have things hardly changed?

Updated: Jun 30

Although technically possible, trying to obtain cannabis through the NHS will result in failure.

Think about what it would be like to hold your infant as they suffer their 100th possibly lethal seizure of the week, or to have chronic pain so bad that you can't risk using the energy it would take to drink a glass of water.

On Medical Cannabis Awareness Week, which ran from November 1st to the 7th, our UK government were to make the easy amendment that would allow GPs to prescribe medical cannabis if it is legally available on the NHS.

Instead, GPs are required to recommend their patients to a consultant, who then submits the patient's case to a committee that is advised by drug manufacturers that actively oppose access to cannabis and run for profit.

Related Article: Cocaine and cannabis to be "part decriminalized" say UK police chiefs.

You are aware that there is a medication that could be helpful and would enable you to live, rather than just exist. It would prevent seizures in your youngster. It's a medication that has been available by prescription in more than 50 countries since 2018, is backed by tens of thousands of studies demonstrating its efficacy, and has been reclassified by the UN Commission on Narcotic Drugs (CND) in acknowledgment of its therapeutic usefulness.

You are aware that this medication is available, but you are unable to obtain it because, on the back end, the channels for doing so have not been established. The supply structure for NHS access to cannabis is essentially a fraud even though it is allowed for prescription.

The panel for other disorders was discontinued in 2019, not long after it was established; this panel (RESCAS) solely evaluates people with epilepsy. Thus, if you have MS and your GP refers your case, no one will take it into account, and there will be no financing. Although theoretically legal, trying to get cannabis through the NHS will lead you nowhere.

Three patients have received whole plant cannabis prescriptions through the NHS since 2018. Others are given access to isolate drugs, which are cannabis formulations with other substances like ethanol and separated plant-based chemicals (a known carcinogen). These have been shown to be far less effective for a variety of ailments.

One such drug, Epidyolex, was approved by the NHS in 2019 with help from members of the aforementioned panel, and in 2020 it brought in $510.5 million for GW Pharmaceuticals (out of $527.2 in total revenue, a 69 percent increase from the year before).

This drug's side effects include liver damage, sedation, and suicidal thoughts, in contrast to whole plant cannabis, where negative reactions are generally mild.

Related Article: 10 UK Cannabis Websites Worth Visiting.

Vulnerable people now have to choose between selling their home, leaving their country, or going to the black market in order to obtain their medication. The justifications offered by our government and regulatory organisations like the BPNA (advised by the MHRA) and the MHRA (supported by the Department of Health and Social Care) are muddled.

"We need proof to verify safety and efficacy," is what is said. Despite the fact that since 2000, more than $40 million has been spent on cannabis research in the UK alone (albeit, dominated by studies trying to find the potential harms rather than benefits).

We also have more Real World Data (RWD) than any other pharmaceutical drug to demonstrate the safety and effectiveness of cannabis, spanning decades and millions of users.

Project Twenty21, a Drug Science programme, offers the NHS peer-reviewed publications and regular data from 2,000 people for whom cannabis considerably improves life when other medications have failed. Contrary to the majority of pharmaceutical pharmaceuticals it might replace, it has never directly resulted in death. Before being permitted to purchase cannabis-based treatments privately, patients must first try alternative, occasionally illegal medications.

Even so, this is insufficient.

Even though RCTs are notoriously bad at evaluating long-term safety and are unsuited for investigating complex organisms - such as cannabis - they are still essential. The low incidence of major adverse effects has been demonstrated by more than 100 million users globally, but this is insufficient. However, it only took a little more than a year's worth of data from 200,000 US women to confirm the safety of the Moderna and Pfizer Covid vaccinations during pregnancy.

Safety is certainly not the problem.

The best outcome of commonly prescribed NHS medications, such as benzodiazepines or the CBD isolate medication Epidiolex, is 50%, and children with intractable epilepsy conditions could have a 95% chance of a significant reduction in seizures with whole plant cannabis (as opposed to a 50% chance with those medications), and who would die or suffer brain damage without it. It is unsafe for hundreds of thousands of people with chronic pain who could be living without suffering and without the worry of overdosing on prescribed medications.

Related Article: How to access prescription medical cannabis in the UK.

If only they could obtain this treatment, more than a million people with critical diseases may experience improvement.

Of course, if cannabis were actually made available through the NHS, billions in earnings would be lost. Prescriptions for anti-seizure drugs, antidepressants, pain relievers, and other pharmaceuticals have dropped in nations where legal cannabis is available.

The stark and fatal contradiction between medicine and profit exists. Too many people—who are everything but safe—will continue to endure pain or pass away needlessly unless the issue is settled in the patient's favour.

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