New private clinics offering medical cannabis in the UK

The Medical Cannabis Clinic has revealed that it will be opening its flagship clinic in London, in Harley Street, this summer.  The opening of London's first such clinic follows the opening of Britain's first medical cannabis clinic in Greater Manchester earlier in the year. As reported in the Guardian, Analytical Cannabis emphasises the importance of this for those suffering from conditions such as chronic pain, epilepsy and neurological and psychiatric disorders who have long been seeking access to what they hope is a transformative medicine. Access is clearly in demand from Londoners as there is already a waiting list of 150 patients at the London clinic ahead of its opening.

Background to the legalisation of medical cannabis in the UK

The opening of private cannabis clinics in the UK is in response to the British Home Office making medicinal cannabis legal from 1 November 2018, reclassifying it from Schedule 1 to Schedule 2 under the 2001 Misuse of Drugs Regulations. The new legislation permits specialist doctors to legally prescribe cannabis-based medicines. The push to legalise medicinal cannabis came after a summer of high-profile media cases that demonstrated the life-changing effects of the drug. One such story reported by the BBC, was that of Alfie Dingley, a young boy who suffered from a rare form of drug-resistant epilepsy that led to him having hundreds of epileptic seizures a day; after being granted a licence to medical cannabis, Alfie's seizures dropped to one seizure every 40 days. Gov.UK outline the huge impact stories like this had on government officials such as Home Secretary Sajid Javid, who said "After hearing of the cases involving sick children, I pledged to make cannabis products legally available for medicinal use as soon as possible".

What are the rules for prescribing medical cannabis?

Gov.UK states how the UK's Home Office, Advisory Council on the Misuse of Drugs, Department of Health and Social Care and Medicines and Healthcare Products Regulatory Agency, have collaborated to establish three requirements for when a cannabis prescription can be made:

  1. The product is or contains cannabis, cannabis resin, cannabinol or cannabinol derivatives
  2. The product must be produced for medicinal use in humans
  3. It must be a product that is regulated as a medicinal product or an ingredient of a medicinal product

How controversial were the changes in the law?

The legislation was passed in June 2018 despite criticism from many concerned by the risks the drug may pose to users' mental health. The Independent has reported how Prime Minister Theresa May's spokesperson immediately dismissed any plans to legalise the drug due to the "serious harm" it can cause such as "risk of psychotic illness and [how it] can impair the health of unborn babies". The BBC also reported how The Royal College of Psychiatrists has evidence to show younger cannabis users are at a higher risk of developing psychotic illnesses. However, in October 2018 the Telegraph reported that the Royal College is reviewing its opposition to the legalisation of cannabis (although it is yet to update its position on the effects of cannabis on its website). Moreover, the chief medical officer for England, Dame Sally Davies, remained concerned in March 2019 as she warned a Parliamentary committee of the potential dangers of cannabis. 

Why aren't more patients in need able to access medicinal cannabis via the NHS, and will this improve?

Despite the - apparently - relatively dramatic legalisation of medicinal cannabis, many patients remain unable to access the drug via the NHS in the UK. Reasons for this are twofold:

  1. Medical cannabis remains an unlicensed form of medicine that cannot be prescribed by GPs; rather, cannabis-based medicinal products can only be prescribed by specialist doctors such as neurologists or paediatricians. NB. This situation is currently being challenged by Charlotte Caldwell - mother of Billy Caldwell, sufferer of severe epilepsy who is reliant on medicinal cannabis to control his seizures - who is testing the law surrounding the prescription of medicinal cannabis in a judicial review at Belfast High Court currently.  This challenge could potentially "loosen up" current restrictions on the 35,000 general practitioners from prescribing the product across the UK.
     
  2. There is an apparent reluctance amongst NHS doctors to prescribe medicinal cannabis prior to more data being available from UK based randomised controlled clinical trials; Analytical Cannabis highlights how the NHS has not issued a single prescription since the law was passed in 2018. It appears that until trials take place the drug will only be available to those who can afford £250 for private appointments and between £600-700 for monthly prescriptions from The Medical Cannabis Clinic in London.  NB. However, the UK government has commissioned the National Institute for Health and Care Excellence to create a set of detailed long-term guidelines for medical staff, due in October 2019, which may help reassure NHS prescribers. 

Prospect of a wider legalisation of cannabis in the UK?

While medicinal cannabis products has been rescheduled from Schedule 1 to Schedule 2 drugs under the 2001 Misuse of Drugs Regulations, other forms of cannabis remain Class B illegal substances under the 1971 Misuse of Drugs Act. Possession of a Class B drug carries a maximum sentence of up to 5 years in prison, an unlimited fine, or both.  Despite public opinion polls showing that the majority do support the legalization of recreational cannabis as well as medicinal cannabis, the two largest British political parties - do not support legalization or decriminalization of recreational cannabis use. It therefore seems unlikely that any material changes to the control of the wider use of cannabis will be made in the UK in the near future.

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