"They Lack Education": Why Advocates Are Teaching UK Doctors About Cannabis
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The United Kingdom officially legalized the use of medical cannabis and cannabis-based medicines last November. Yet, nearly a year on, prospective patients in the UK are still struggling to access any of these medicines on prescription.
For those that can afford them, private medical cannabis clinics do offer cannabis prescriptions to treat chronic pain, epilepsy, and a range of neurological and psychiatric disorders. However, most UK patients are reliant on the country’s National Health Service (NHS), which has been discouraged from prescribing medical cannabis.
But rather than remaining content with their market dominance, the founders of the private clinics are hopeful that educating doctors about cannabis science could be key in improving access to cannabis medicine for all patients.
Why are patients struggling to get treatment?
Patients in the UK with medical cannabis prescriptions have reported problems with pharmacies who are unwilling to stock or import medical cannabis products. But for the majority, the biggest obstacles come with trying to get a prescription in the first place.
Central to this are the NHS doctors who don’t currently feel comfortable writing a prescription for cannabis.
“I think there are two or three reasons [for this],” Professor Mike Barnes, a consultant neurologist and expert on medical cannabis, told Analytical Cannabis.
“There are some rather negative guidelines produced by the British Paediatric Neurology Association and the Royal College of Physicians – which I think are ridiculously restrictive – but some people do hide behind those guidelines,” Barnes explained.
“I think there's a cumbersome approval process for a doctor in hospitals. So far they've been stopped by the hospital hierarchy and they don't want to take that risk. I don’t think it is a risk but that’s their perception,” he said. “And it's an unlicensed medicine. So the doctor prescribing has got to take personal responsibility, which some don't want to do.”
Addressing doctors’ fears about cannabis medicine
Professor Barnes believes that better educating doctors about cannabis science could be key in improving patient access to cannabis medicine.
“They lack education, they don't want to prescribe, which is perfectly reasonable,” he said. “That's why we set up the Academy of Medical Cannabis, which is a free online teaching program to overcome that issue.”
The Academy of Medical Cannabis offers modular courses designed to give medical workers a general knowledge of cannabis science. Advanced courses are available to suit the work of different medical occupations, such as general practitioners, pharmacists, and specialists working in palliative or primary care.
The academy also provides a number of advanced topic-specific courses covering the prescription of medical cannabis for chronic pain, PTSD, movement disorders, and other relevant medical conditions.
Supporting doctors supporting patients
Dr Mikael Sodergren is the managing director and academic lead for the newly-launched Sapphire Medical Clinics.
Sapphire operates as a franchise model, providing educational resources and support to partner clinicians while managing its own specialist clinic in London. Other Sapphire clinics are planned to open soon in Manchester, Sheffield, and Birmingham.
“We're in a really unique situation that's unprecedented for any drug in the United Kingdom,” Dr Sodergren told Analytical Cannabis. “We have an unlicensed medicine that has a probably a relatively large volume of potential patients seeking it. However, we don't have a [simple] route through which we can grant patients access to those medicines, should they benefit from them.”
“And so that was the birth of Sapphire Medical Clinics; it's created by doctors for the benefit of doctors and patients. Primarily what we want to do is to provide a service to other doctors, GPs, and other specialists, whereby we can reassure them that we will be able to evaluate their patients as a second opinion,” Sodergren explained.
Like Professor Barnes, Dr Sodergren also believes that making better education and support available to doctors will be key in facilitating patient access to cannabis medicines, while still ensuring that those patients are responsibly evaluated using a clinical pathway.
“Cannabis is a relatively complex drug and it is something that doctors are not familiar with. At medical school, at postgraduate [level], there has been no training for cannabis. And quite rightly so because we haven’t been able to prescribe it. But that's all changed.”
“So we've set up this framework through which we can adhere to all the guidelines,” Sodergren added.
“We have experts in all of the specialties in which patients may prescribed cannabis. So if someone comes with a headache, you're going to see a neurologist who understands whether cannabis may or may not fit into the treatment algorithm. And they’ll able to prescribe it confidently because they, as well as all our other clinicians, have had training in the prescription practices [common to] those with huge experiences with from Canada and elsewhere. And so this service evaluates patients in a robust but responsible way.”
With the educational resources and services available through the Academy of Medical Cannabis, Sapphire Medical Clinics, and other similar British medical cannabis groups, the UK medical cannabis space is slowly becoming more accessible for doctors, and their patients.