Why has the law changed?

The decision has come after the cases of two sick children helped to garner unprecedented public support for medicinal cannabis.

The cases of Alfie Dingley and Billy Caldwell, who have severe epilepsy, inspired sympathetic headlines in sectors of the press traditionally hostile to cannabis, after it emerged that each had been successfully treated with cannabis oil. Their families and doctors said the drug had drastically reduced their numbers of seizures each day.

Billy’s case soared to the top of the news agenda after his mother, Charlotte, flew to Canada to get a new supply of cannabis oil for her son, which was then seized at customs on her return. Billy’s health deteriorated and within days he was taken to hospital suffering “life-threatening” seizures, prompting the Home Office to grant him an exceptional licence to use the cannabis oil medicine.

There has also been a behind-the-scenes push for liberalisation, led in large part by an internet tycoon, Paul Birch, who has donated millions to the Volteface lobby group, which is campaigning for a change in the law.

Volteface – run by Steve Moore, former chair of David Cameron’s Big Society Network – helped to organise Charlotte Caldwell’s trip to Canada, and brought her together with key political and media supporters.

Who will the drug be available for?

Medical cannabis advocates are worried that, as it was extreme cases that forced the government into action, only extreme cases will be considered for prescriptions. The Home Office has already set up an expert panel to assess patients who may have an “exceptional and unmet clinical need” for cannabis-derived medicine.



However, the immediate reaction from campaigners was that it would help only those who were already able to access a legitimate supply and could prove it helped with their conditions.

Alfie Dingley, whose mother appealed to Theresa May to grant a licence so his epilepsy could be treated with cannabis oil. Photograph: Stefan Rousseau/PA

Clark French, founder and director of the United Patients Alliance, which campaigns for medical use of cannabis, said it would most likely go to patients with epilepsy, multiple sclerosis and cancer. “They are the three big ones they are most likely to give it to because there’s a lot of research on them and a lot of media attention on those patients at the moment,” he said.

French said he was pleased by the change in the law, but also cautious. “We are quite concerned that it could be like Sativex [a drug for treating MS]: limited to a few patients that can get it and often patients are left to fund it for themselves,” he said.

“They haven’t defined what is a cannabis medicine at all. We don’t really know what is going on. It is definitely a step in the right direction and it should mean that more patients will get medicine through their doctor.

“But we don’t know whether it’s going to be widespread or whether it’s going to be for the high-profile cases, to get them out of the media.”

Who will profit?

The global leader in developing cannabis-based medicines is a British company, GW Pharmaceuticals, which developed and markets Sativex and has recently launched a new epilepsy drug.

In May, it emerged that the drugs minister, Victoria Atkins, had “voluntarily recused herself” from speaking on cannabis, because her husband runs a company that has been growing acres of the plant for GW.

Paul Kenward is managing director of British Sugar, which has been growing marijuana in Wissington, Norfolk, under a licence from the Home Office. The cannabis was destined for use in GW’s latest epilepsy drug, Epidiolex, which has just been approved by the US Food and Drug Administration.

In June, it emerged that Capital Group, the investment fund that employs Philip May, the prime minister’s husband, was the largest investor in GW.

Many of the world’s biggest medical cannabis companies are based in the Canada and the US, the two countries with the longest standing medicinal and recreational markets. They have spent years developing cannabis brands, strains and extractions for various uses and have grown to multibillion-dollar businesses.

However, it looks as though UK rules will allow only for medicines derived from cannabis, rather than medicinal cannabis itself, meaning that they are likely to benefit the kinds of extensively trialled products marketed by drug companies such as GW.

Does this mean herbal cannabis will be available on prescription?

That’s unlikely, but not impossible. The home secretary, Sajid Javid, has been very specific that it is cannabis-derived medicinal products that will be available – however, it’s not yet clear what that means.

Dame Sally Davies, the chief medical examiner, said in her initial report this month that only cannabis products produced for medical use could be assumed to have “the correct concentrations and ratios” of the drug’s active chemicals. “Using other forms, such as grown or street cannabis, as medicine for therapeutic benefit is potentially dangerous,” she added.



Now it is up to the Department for Health and Social Care and the Medicines and Healthcare products Regulatory Agency to develop a definition of what a cannabis-derived medical product is. They are likely to be conservative and only recommend processed medicinal products. However, pharmaceutical herbal cannabis, such as Bedrocan, does exist and could be considered.