The UK Needs Greater Access to Medical Cannabis, And That Can Start With R&D
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Medical cannabis has been legal in the UK since November 2018, but good luck trying to get it. Unfortunately, it’s still the reality that most of the cannabis in the UK is supplied by the black market and not through a regulated health system.
The best existing estimates are that about 1.4 million people in the country regularly use cannabis illegally for medical reasons. With so few prescriptions by the National Health Service (NHS) and costly private cannabis clinics filling the supply gap, patients who use cannabis for a variety of health conditions, including chronic pain, are faced with a stark choice of debt or turning to unlawful means to obtain cannabis for medical use.
Many people are quick to point the blame with NHS doctors who are still reluctant to prescribe it. The argument is doctors do not have the confidence because they have never learnt about cannabis or the endocannabinoid system. Yet, guidance by the drugs advisory body the National Institute for Health and Care Excellence (NICE) also remains cautious; the regulatory community has called for more evidence and data from large scale clinical trials to support the mainstream use of medical cannabis.
If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences.
For the NHS, pain is one of the most troubling and expensive issues to treat with patients often jumping from one prescription drug to another. Health experts have warned that the opioid painkillers often prescribed do not work for nine in ten people with chronic pain. While prescription opioid painkillers have increased drastically from a common-use pill to a massive public health crisis, the perception of medicinal cannabis, once shrouded by taboo and prohibition, is now being seen as an effective medical alternative.
And patients are embracing it – even demanding it. Doctors in the UK will be desperate to help their patients, rather than block care but clinicians need to be in a position to advise patients on the risks and benefits of safe usage, and meaningfully contribute to the conversation (assuming they have a level of education about cannabis and how it works on the endocannabinoid system). Once we are all on the same page, guided by evidence in new studies about reduced opiate use and adding medical cannabis to the pain relief arsenal, we can start helping patients to minimize their use of opiates.
However, despite some cited examples of people suffering from chronic pain or severe epilepsy who have reported benefits hitting the headlines, regulatory bodies remain cautious. More scientific data and clinical evidence is needed to prove its quality, safety, and efficacy and support its prescription for patients.
Cannabis prohibition has slowed the evolution of cannabis product development. Social misinterpretation has impeded the investigation of cannabis in human clinical trials. Currently, there is no accepted or validated measure of a human endocannabinoid study to correlate clinical significance. To evolve toward medical claims, research must set the groundwork for comparison.
The evidence must be based upon smart rigorous science and not hype to break restrictive guidelines and pave the way for medical cannabis to be normalised and reach the people who need it most.
The increase in the legalisation of medical cannabis throughout the world has piqued consumer interest and driven growth in research and development. With the entrance of pharma-based cannabis companies and a scientific led approach, we’ve gone from having a rudimentary understanding of the plant’s compounds to discovering crucial connections among cannabinoids and human physiology.
Despite not having all the studies completed and delivering a “gold standard” proof of the benefits and risks in the eyes of regulatory bodies, cannabis is a spectacularly complex plant with almost 500 active pharmaceutical ingredients and has a broad spectrum of applications. These include, but are not limited to, neurodegenerative disorders, autoimmune and inflammatory diseases, metabolic disease, and neurological disorders.
The cannabis industry, then, has arrived at a critical moment. Attitudes towards cannabis products for medicinal use need to change and products used appropriately to meet patient needs and experiences. With the increased interest in using cannabis for a myriad of medical problems, including pain, we as an industry need to continue to demonstrate its quality, safety, and efficacy through evidence.
The UK needs a science-led cannabis industry where products have been refined and proven in its through clinical trials and data. This will help to remove the stigma, kickstart conversations with regulatory bodies, build further political and medical support, and importantly facilitate patient prescriptions.
Cannabis offers the chance to set a new course in healthcare. The medical implications and opportunities are endless.
Robin Emerson is head of corporate social responsibility at Brains Bioceutical, one of the few companies in the world producing natural CBD as an active pharmaceutical ingredient for pharmaceutical applications, research & development, and clinical trials.