The National Health Service (NHS) in the UK is a government-funded medical and health care service that allows patients to receive care without paying the full price of treatment. The NHS is largely funded by UK residents’ income taxes.
As of November 2018, NHS cannabis prescriptions for medicinal cannabis became legal. The regulations are rather tight, as anything with .05 percent THC or more is not allowed to be sold over the counter, or at all, unless a special waiver is granted. Low strength CBD oils are often available at pharmacies.
High profile cases, such as Billy Caldwell's, are part of the reason legalization occurred, but even he is having challenges with the new law, largely due to logistics. Caldwell previously received an emergency license for his medication, but due to the new law’s guidelines, he and his mother are continuing their fight and had to file a lawsuit.
Epilepsy and MS Patients First to Benefit
Two cannabis-derived pharmaceuticals that can legally be prescribed in the UK are Sativex and Epidiolex. They are each indicated for very specific conditions.
Sativex is an oral spray with a combination of both THC and CBD for multiple sclerosis (MS) patients that helps to relieve moderate to severe muscle spasms caused by inefficient communication between the brain and nerves. MS is a complicated and unpredictable neurological condition that can, among other things, impair movement, affect mental health, and severely impede activities of daily living.
Epidiolex is an oral solution derived from CBD and is indicated to control seizures for two rare types of epilepsy that are treatment resistant, Lennox-Gastaut Syndrome and Dravet Syndrome. Both seizure disorders are severe, found early in life, and cause children to experience impaired cognitive function and developmental delays, among other symptoms.
Parents are Taking Other Avenues
Patients are having to go to private physicians at their own expense, which not all patients have the means to do. Limited access to NHS cannabis prescriptions has led some parents to smuggle their child’s medication from other countries, such as the Netherlands. These parents are risking seizure of the medication, some of which cost £1,500.
Visits to private physicians are expensive. Adding on travel costs, plus the cost of medication, and parentsoften have to resort to fundraisers to keep their children comfortable and alive. Unfortunately, the law these parents expected would help them has instead created additional barriers to treatment for their children, and it could take years for needed changes to come.
NHS Cannabis Prescriptions Not Being Written
Despite cases such as one that could be viewed as a miraculous result for a young boy with a brain tumor, whose life changed dramatically once he began a regimen of consuming CBD, physicians in the UK are reluctant to write NHS cannabis prescriptions. This is partially due to confusing and unclear guidelines, which makes physicians reluctant to potentially risk their medical career over writing a prescription. Guidelines are also unclear regarding which physicians can prescribe medical cannabis, as well as how to get access to a safe supply. A lack of adequate clinical research within the UK has also been cited as a reason that NHS cannabis prescriptions are not being written.
Not so Nice
The National Institute for Health and Excellence (NICE) functions to essentially decide whether treatments are cost effective for the NHS. If not, a helpful treatment that would allow an MS patient to walk, or an immunotherapy treatment to enable a cancer patient’s own body to fight off cancer cells, may not be available to them regardless of potential benefit.
The NHS guidance provided to physicians regarding medical cannabis products includes weaning children off of THC and giving CBD products instead. Unfortunately, as seen with several children with epilepsy such as Billy Caldwell, CBD alone may not be enough. With each seizure, a child’s life may be at stake. Changing their regimen, especially when they have made progress, could be devastating.
Exportation of Cannabis
The hypocrisy lies in the fact that the UK is, perhaps surprisingly, the largest exporter of medical cannabis but continues to deny its benefits to citizens. It is estimated that the UK’s medical cannabis market would be worth £8 billion per year. So, while the government has been trying to deny that cannabis has any medicinal value, they’re making a great deal of money from that industry, with much of it going to the U.S.
Much of that is revenue from GW’s cannabis-derived pharmaceuticals, including Sativex. Ninety tons of medicinal cannabis is grown annually through a partnership between GW and British Sugar. There have been some ethical issues, though, surrounding the drug minister’s husband being the managing director of British Sugar, who grows the cannabis. After being labeled a hypocrite, the drug minister excused herself from speaking on behalf of the government about cannabis.
Though the NHS has rescheduled medical cannabis to remove its illegal status, the process seems to have been rushed. Fewer than one hundred NHS cannabis prescriptions have been written and it is unlikely, due to the limitations of the law, that patients were able to fill them. It could be months, but will more likely be years, before patients receive easier access to the medications they need.
This article was originally published on RxLeaf and is republished with permission.
Photo credit: The Cannabis Radar