Prescription of Medicinal Cannabis Legalized in Britain From November 1st
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The British Home Office has announced that as of November 1st, new laws will come into effect that will allow specialist doctors in England, Wales, and Scotland to legally prescribe cannabis-based medicines for the first time.
The announcement follows a previous commitment made by the government to reschedule cannabis under the 2001 Misuse of Drugs Regulations from a Schedule 1 drug to a Schedule 2 drug. The move would recognize the medicinal effects of cannabis, make it easier for cannabis science researchers to study the drug, and open up the possibility for the cannabis-based medicines to be legally prescribed through the National Health Service (NHS), Britain’s universal healthcare system.
The campaign for medicinal cannabis in Britain
In the spring and summer of 2018, British media picked up the stories of several young children who were suffering from drug-resistant conditions, whose families were campaigning for an exemption to the medical cannabis laws for their children in the hope of improving their quality of life.
The two most high-profile cases were those of Billy Caldwell, 12, and Alfie Dingley, 6, who both suffer from incurable drug-resistant epilepsy. Spurred on by a series of successful clinical trials demonstrating the ability of cannabidiol (CBD), a non-psychoactive component of cannabis, to lessen epilepsy symptoms, the families of both children appealed to the Home Office for emergency exemptions to the normal medicinal cannabis rules, which were granted.
After speaking to both families, Rt Hon Sajid Javid, the U.K. Home Secretary, made a commitment to have experts review the existing legislation surrounding medicinal cannabis use. In July, the Home Office announced that the review, carried out by the Chief Medical Advisor and the Advisory Council on the Misuse of Drugs, had decided in favor of making cannabis a Schedule 2 drug, and allowing it to be prescribed medicinally.
Speaking after the July announcement in a governmental press release, Home Secretary Javid said, “The recent cases involving sick children made it clear to me that our position on cannabis-related medicinal products was not satisfactory. Following advice from two sets of independent advisers, I have taken the decision to reschedule cannabis-derived medicinal products – meaning they will be available on prescription.”
“This will help patients with an exceptional clinical need, but is in no way a first step to the legalization of cannabis for recreational use.”
The significance of this latest announcement
Home Secretary Javid’s July announcement signaled the government’s intent to allow the prescription of medicinal cannabis, but it did not define several important parameters. Firstly, the announcement stated that the rescheduling would only affect cannabis-derived medicinal products, not all cannabis materials, but it did not define what criteria would need to be met in order to be considered an adequate medicinal product. Additionally, it did not contain any clinical guidelines as to what sort of illnesses or conditions would qualify for cannabis therapy or how the medicines would be prescribed.
Answers to these questions have been in development throughout the summer in the run-up to the legalization announcement that was made last week.
A formal definition of what should be considered an appropriate medicinal cannabis therapeutic was published by the Home Office at the end of September. The definition, created by a coalition of officials from the Home Office, Advisory Council on the Misuse of Drugs (ACMD), Department of Health and Social Care (DHSC), and the Medicines and Healthcare Products Regulatory Agency (MHRA), consists of three broad product requirements that a cannabis-based drug must meet in order to be prescribed. These are:
● The product is or contains cannabis, cannabis resin, cannabinol, or cannabinol derivatives.
● The product must be produced for medicinal use in humans.
● It must be a product that is regulated as a medicinal product or an ingredient of a medicinal product.
These requirements would allow most common cannabis-based medicines already in use in other countries, such as Germany, Denmark, and the United States, to also be legally prescribed for use in the U.K.
The legalization announcement itself contained answers to the remaining questions posed by the July commitment.
The government will not be imposing any restriction on the types of conditions that can be treated with medicinal cannabis products, instead choosing to leave that up to the discretion of the individual medical practitioner. Medical staff will also no longer need to seek approval from an expert panel in order to provide access to the medicines, as was the case with the exemption licenses previously given to patients.
Cannabis-based medicines will have to be prescribed by a specialist doctor, such as a neurologist or a pediatrician, not a GP. The specialist is also responsible for creating and managing a treatment plan for the patient.
What’s next for cannabis in Britain?
In terms of medicinal cannabis, the British Paediatric Neurology Association, the Royal College of Physicians, and the NHS will be providing advice to relevant medical professionals ahead of the law change so that patients in need can be given access to legal medicinal cannabis as soon as possible. The National Institute for Health and Care Excellence has also been commissioned by the government to create a set of detailed long-term guidelines for medical staff.
While medicinal cannabis products will be rescheduled from a Schedule 1 to a Schedule 2 drug under the 2001 Misuse of Drugs Regulations, other forms of cannabis will remain a Class B illegal substance 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 - the Conservative Party, who are currently in power, and the Labour Party - do not support legalization or decriminalization of recreational cannabis use. As a result, it remains unlikely that Britain will see any additional significant changes to cannabis regulations in the near future.