Why doctors don’t prescribe medical marijuana in UK?


“Real politics” versus medical cannabis bureaucracy

Is doctors’ ignorance behind the lack of prescriptions for medical marijuana despite its reclassification for medical use in November 2018? In fact UK has two major problems: medical ignorance and bureaucracy.

The first of November 2018 was an important day for medical cannabis in UK. That day the government finally accepted the medical properties of cannabis and the drug became listed in Schedule 2 instead of Schedule 1. This meant cannabis could be prescribed for patients who needed it.

However, thousands of cannabis users continue buying their cannabis illegally because the NHS is not giving prescriptions for it. It is the end of March 2019 and not a single person has been given the necessary prescription from NHS England to buy medical marijuana. On top of it, a few people obtained prescriptions that have been issued via private healthcare system; something that is not affordable for most people.

The change of cannabis status in UK has been a hard battle between politicians and many professionals who proved cannabis was a medicine in many cases. Cannabis users must feel grateful to Sajid Javid, who was home secretary of state, and Nick Hurd, minister of state at the Home Office. They were able to listen and learn from the experts and acted accordingly.

Unfortunately they did something that the cannabis users are regretting. Looking for help to regulate the cases of pain, they consulted the Royal College of Physicians (RCP) and the British Paediatric Neurology Association (BPNA) about the childhood epilepsy. But both organizations are well known for being very conservative and close minded.

After being asked, the RCP answered that there were not evidences enough to prescribe marijuana to treat pain. They completely ignored the evidences published by different experts such as the National Academies of Science, Engineering and Medicine, and the UK government’s own chief medical advisor too.

They ignored the data from the USA, which suggest that medical cannabis could avoid many deaths caused by opiate prescriptions. As we have published in our article “Opiate use reduction after cannabis legalization”, many patients who suffer chronic pain use opiates to alleviate their suffering and, in many occasions, they take an overdose and die. So far, nobody has died from cannabis overdose. As it happened in the USA before legalization, many doctors are prescribing hydrocodone, oxycodone, morphine, methadone and fentanyl. These drugs are extremely strong opiates and the possibility of overdose it too high. How long will they continue ignoring the facts? Because it is difficult to ignore that about 1000 deaths a year could be avoided if patients were prescribed medical cannabis instead of those tremendous and addictive opiates.

It is estimated that almost half a million people in the UK are consuming cannabis without a prescription to treat their chronic pain. They are sick; not criminals, who must buy from the black market.

In the mean time and due to the public pressure, the BPNA stated that Epidiolex (isolated CBD) could be eventually treat some cases of childhood epilepsy and only after any other possibility, including surgery, has failed. They ignore that many children slightly respond to CBD and, however, they need THC to increase the ability of the cannabis CBD to treat their disorder.

Among many other evidences, we must remember a case that influenced to change the law. We will not publish his name although it is well known. He suffered from epilepsy and even though CBD reduced his seizures by about a 50 per cent, only when the doctors gave him THC added to the CBD, the seizures completely ended. But even with this and other cases, the BPNA keeps saying they need more evidences. It is difficult to understand!

Even though doctors could ignore the rules from the RCP and the BPNA because they aren’t obligatory, prescriptions need the approval from the hospital hierarchy. If a doctor ignores the recommendations of both organizations he will be considered like someone who acts against the leaders. But maybe not. The last recommendations from the Medical Cannabis Clinicians’ Society and the All-Party Parliamentary Group on Medical Cannabis under Prescription were published few days ago, on March 2019. These recommendations should provide certain clarity of the evidences to the top hierarchy. In fact, guidance from the National Institute for Health and Care Excellence is supposed to be available for its consultation in July 2019.

Unfortunately, many doctors don’t know and don’t understand the abilities of cannabis. They weren’t taught at the university and ignore the endocannabinoid system in our organism. They grew up thinking marijuana was a bad drug and they aren’t able to change their minds suddenly. And we must admit that a good doctor cannot prescribe something he or she doesn’t fully understand. In order to change this ridiculous situation, education is the only way we have to get results. It has been calculated that just 100 doctors who have been trained in the medical capacity and benefits of cannabis could change the current situation about medical weed and begin to prescribe it in the UK. Of course these doctors should work alongside other professionals.

Bureaucracy

If you think the situation about medical cannabis in UK is surrealistic, you must consider that most cannabis related products don’t have the necessary license. Only Sativex has it. Due to this, those doctors who dare prescribing cannabis will be responsible if something goes wrong. Even though the doctors who have studied the medical properties of cannabis know it is very safe, don’t dare to prescribe it. It’s like walking on the razor’s edge.

On top of it, it is very difficult to get medical marijuana in a short period of time. The pharmacists need to ask for an import permit to the Medicines and Healthcare products Regulatory Agency. Normally it takes almost one month and the supplier (Canada in most cases) needs an export permit, which usually takes two months. And the supply is allowed for just four weeks. On top of it, the whole process needs to be repeated when the treatment lasts more than one month. Until a real cannabis industry in UK is not fully developed in order to stop needing importations, the situation will remain the same.

Even though the political war for medical marijuana has been won in UK, in fact it is necessary to win the medical bureaucracy battle too.

Most people who use cannabis in UK have to buy in the black market or grow their own herb. London, for example, is the most expensive city in UK for cannabis lovers. Be ready to pay a minimum of £6.44 a gram in the black market and don’t expect high quality.

But if you live or visit the Shetland Islands, be ready to pay up to £800 for an ounce of weed. Due to its illegal status and the location of the islands (a bit more than 100 miles away from the Scottish mainland), weed is tremendously expensive, and again, don’t expect good quality. In fact, weed is almost as expensive as gold in these beautiful islands.

As a matter of fact, being a cannabis user in Britain is a nasty and expensive question. When will UK normalize cannabis growing and consuming? It all depends on the politicians. And politicians in this country are like…politicians are in the rest of the world. What else can be said?

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