On the 14th of February the UK received 800g of herbaceous cannabis. The first bulk medical shipment to reach our shores! While in Howard Marks’ time this amount was just a regular Thursday, in 2019 it has a wider significance for the nation. The shipment will enable doctors in the UK to treat patients previously thought to be untreatable.

The few who have been prescribed cannabis, described it as ‘a major breakthrough’. Prior to this they had been forced to wait for single slow shipments that took ages to process and even longer to repeat.

This arrival comes after the framework for the legal use of medical cannabis was implemented on the 1st November 2018. Those suffering from a range of conditions may be prescribed cannabis if it is believed it will improve their symptoms. Finally, after months of waiting those prescriptions can now be filled!

However, the path remains unclear for patients and their doctors. How does a patient qualify for a prescription? How can they access it? It has taken over three months for a credible supply to become available. As with any big step, this it is not as straightforward as it seems.

‘Heart-Breaking Cases Involving Sick Children’

Last year, UK citizens became aware that a small number of children were unable to get necessary cannabis treatment. Their previously incurable medical situations were among those, that some believe, to be relieved by this type of medication. The families of these children are convinced that this is the only avenue left for them to treat their conditions.

Billy Caldwell is one of these children. He suffers from a form of epilepsy that causes him to have frequent seizures. Research indicates that compounds within cannabis may significantly reduce these events.

Over the course of several months Billy and his family faced obstacle after obstacle to secure the treatment. First, his cannabis oil was confiscated at Heathrow airport. Then when he received special permission to use it, he could only receive it in hospital. His mum was outraged and felt that ‘Billy ha[d] effectively been placed under house arrest.’

Billy’s story and those of similar children were mentioned by the Home Secretary Sajid Javid. Who then fought to approve medical cannabis use.

‘Having been moved by heart-breaking cases involving sick children, it was important to me that we took swift action to help those who can benefit from medicinal cannabis.’ Initially Javid’s intervention made little progress. As Billy’s story reached a wider audience, a decision was reached to create a new framework to support its medical use.

More research and information is needed

As of November 1st 2018 cannabis can be prescribed by a specialist doctor. A prescription of this type is at the discretion of the specialist with no need to prove their case. Any person who has no other medical option for their condition can be prescribed cannabis, in an appropriate form. So long as a specialist believes it will give them relief.

However, while cannabis can be prescribed, specialists often don’t have enough research or knowledge to make a confident decision. For this new power to be used effectively, a common definition of use and a framework for prescription needs to be in place.

In a bid to address this across the European Union, Members of the European Parliament recently presented a resolution calling for a united approach towards the research and use of medical cannabis. They indicated that there are benefits linked to its use but they must be researched further. Then it can be prescribed with confidence.

£2,500 for Two Months Supply

While cannabis can be prescribed and supplied by the NHS, the patient must pay for the treatment. Carly Barton, a former university lecturer, was the first to be prescribed cannabis under the new system and had to pay £2,500 for two months supply. The high cost and long wait for delivery has been linked to the checks and regulations that must be followed in order to get the herb into the country.

There are currently 4 other prescriptions waiting to be filled. One of which had to be cancelled as the patient was unable to afford the price. The specialist who wrote the prescriptions expressed that he was pleased that there was now enough for each patient to get a repeat prescription without having to wait for an entire new shipment.

The UK is the World’s Largest Producer

Recently the UK has worked with both Canada and Holland in the supply of cannabis. The Canadian company Aurora has provided an order of cannabis sourced medicines. Holland has provided the current herbaceous shipment. This is particularly frustrating, following a report by the International Narcotics Control Board which named the UK as one of the world’s most prolific suppliers of medical cannabis.

GW Pharmaceuticals have several large cannabis farms in the UK. The largest of which is located just outside of Downham Market at Wissington. They farm the plant for cannabis medications which are supplied to a global market.

Hypocritical Policies

The UK has been farming cannabis for medical use since before 2016. This adds a level of hypocrisy to the debate around its use in the UK. How can a country that claims not to see a medical benefit from the plant, simultaneously produce it in huge amounts for others?

For the parents of Billy Caldwell who weren’t allowed to bring cannabis oil into the country it must have added a particular sting to these events knowing that GW Pharmaceuticals produce Epidiolex. An experimental treatment for Billy’s condition which recently received FDA approval in the USA.

A Land Mark?

The fact that this land mark delivery has come from Holland, when we have local supplies, seems typical of the decades of unnecessary red tape and legislation that surrounds cannabis.

Significant research, coordination and training is required to get enough specialist doctors up to speed to prescribe cannabis in a coordinated and effective way. The recent call in Europe by MEPs for coordinated measures between member states is a very encouraging step forward.

With relevant players on the global scene such as the World Health Organisation taking a stand for the medical relevance of cannabis it does feel like the barriers are slowly coming down, however, not soon enough for many people out there.

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