Medicinal Cannabis

Medicinal Cannabis Legalised

From November 2018 specialist Doctors in England, Wales and Scotland can prescribe cannabis-derived medicine in exceptional circumstances. It was the first change to the law on medicinal cannabis, which had been in place since 1971.

What Does This Mean?

Certain cannabis-derived products have been reclassified as Schedule Two. This means they have a potential medical use and can now be legally prescribed in cases of children with rare, severe epilepsy, adults with vomiting/nausea from chemotherapy, and adults with muscle stiffness caused by MS – if other treatments have failed.

As medicinal cannabis can only be prescribed by specialist physicians and cannot be imported until a prescription is written, very few patients have actually been prescribed it since the change in regulations.

Patients Not Getting Medicinal Cannabis

Whilst the law has been changed, many patients trying to get medicinal cannabis have not – and will not – be able to get it soon. That’s because England’s Chief Medical Officer has called for scientific trials to check its safety, which may take years.

Key Things To Be Aware of:

• In 2019, the NHS provided only 18 prescriptions for cannabis-related medications.
• Many campaigners who fought to get cannabis oil available for those with serious medical conditions feel let down. A report has concluded that families’ hopes were unfairly raised when the law changed last year, and products remain unlicensed due to lack of research.
• The NHS published a report detailing the key barriers to accessing medicinal cannabis.

Key Patient: Billy Caldwell

Medicinal cannabis hit the headlines back in 2018 when a child suffering from autism and severe epilepsy had his medication confiscated at Heathrow airport. The coverage of this case caused a public outcry and started a campaign to change the law.

Billy Caldwell had previously been treated for his seizures by a specialist in Chicago, and his antiepileptic medication intake was reduced from six medications to one. The treatment was very successful and saw the remission of his seizures for eight years.

In 2016 the seizures returned, becoming more frequent and severe.

What Happened?

1. In 2017 Billy was prescribed cannabis oil by his GP. This was the first prescription of cannabis oil in the UK – but the GP received a letter from the Home Office saying he must not renew the prescription or would face serious consequences. That’s because the oil contains low amounts of THC, which is illegal in the UK.
2. His mother travelled to Toronto to pick up medicinal cannabis and this was confiscated.
3. Billy wasn’t weaned off the medication, and he suffered seizures. He was admitted to hospital, where Doctors struggled to keep the seizures under control.
4. There was a huge public outcry and, due to mounting pressure, the Home Office decided that Billy would be allowed the cannabis oil as a special measure.
5. A hospital trust was given a special license to administer doses to Billy, which meant a daily four-hour round-trip for the family. His mother described it as being under hospital arrest.
6. Billy was later getting a prescription from a private paediatric neurologist in London, but this meant flying to England every few weeks to collect more oil.
7. In 2019, Billy was ultimately awarded a lifelong medicinal cannabis prescription on the NHS, in a decision that could pave the way for more patients to receive the treatment in the future.

Key Patient: Alfie Dingley

Another high profile case about medicinal cannabis was that of Alfie Dingley. His condition improved when he was prescribed cannabis in Amsterdam, and it was predicted that his seizures would fall from 3,000 a year to just 20 on this medication. His family eventually moved there because they couldn’t get the medication in the UK.

His mother became the first person to be granted a special license to import medicinal cannabis back to the UK.

Alfie has since become tolerant to his medication and needs a new strain – but his mother said it would take months to get access to this.

Medicinal Cannabis Questions

You may not be directly asked about medicinal cannabis, but you can show your knowledge by referencing this when you answer some broader questions on medication or ethics. For example:

• If a medication is suggested as a possible treatment but there is a very limited evidence base to support the use of it, should we try these treatments or not?
• Why is it important for medical professionals to be empathetic with their patients?

You may find ethics and empathy questions most applicable to this topic.