It’s now 3 years since, under Theresa May’s Premiership, UK Drug Laws were altered to accommodate cannabis becoming available on prescription as a Controlled Drug (1). You may recall that these changes were preceded by some high profile cases involving children including Alfie Dingley. His family moved to Holland after finding that cannabis helped their young son’s terrible seizures, but with it being unable unavailable in the UK, they continued to campaign with other families. My strong sense at the time, rightly or wrongly, was that the change of heart from the government was largely due to the fact that stories that involve wronging children tend to not go away where negative publicity is concerned. This apparent triumph was nonetheless celebrated in the media, thus reaching the eyes and minds of so many of us, and the matter seemed for the time being, closed.
In reality, even at the time it wasn’t quite the victory it appeared. In fact, cannabis had already been licensed for treatment on the NHS since 2010 (2), in the form of Sativex spray for the treatment of Multiple Sclerosis. In practice, this became a Postcode lottery as to whether it was prescribed, as it was regularly refused on the basis of cost (3). One thing that got virtually no coverage was the fact that Mr Philip May, said Prime Minister’s husband, was employed by The Capital Group, financiers with shares in vast companies like Starbuck’s, Coca-Cola, Boeing, Microsoft and Amazon (4) …...and GW Pharmaceuticals. Why does this matter? It matters a lot, because GW Pharmaceuticals was already the World’s biggest exporter of medical cannabis for the foreign market, and it’s grown in the UK! The International Narcotics Control Board (5) found that in 2016, …
“The United Kingdom continued to be the main exporter of cannabis (2.1 tons, or 67.7 per cent total)” and…
“The large majority of the stocks was held by the United Kingdom (93.1 tons, or 78.2 per cent)”.
So what actually did change? Well one thing that really didn’t is the Sativex situation, in that it still doesn’t often get prescribed. Sativex is an alcohol-based cannabis spray and alcohol is an incredibly effective delivery system for herbs (this is why, if you’re making tinctures, glycerin alternatives to alcohol are far gentler but far less efficient). It plays havoc with the state of your mouth though, as somebody who’d been prescribed it told me. Post-2018, there is now access to a greater range of strains and forms of cannabis, such as oil and flower, indica, sativa, hybrid etc. This naturally broadens the scope for what this sacred herb can do, and improves the users options to experiment until they’ve found their therapeutic dose and regime. Dry herb vaping is a popular, therapeutic and widely embraced alternative to smoking as it delivers rapid results without combusting half the therapeutic components. Herbs such as chamomile and peppermint can also be vaped and many herbs and essentials oils enhance the effects because of the therapeutic components they share. Cannabis oil, usually taken under the tongue will have more cumulative effects and it takes longer to take effect. If it turns out one ‘Brand’ doesn’t work for you, you have the option often to try another, though there will often be a price difference.
So, what’s The Problem? Well, it turns out that the assumption about cannabis becoming available on the NHS was an incorrect one, but a myth that still looms large in the public psyche in the absence of anything to correct it. I know this because I talk about this to anyone who will listen, and I can’t recall a single person not having been of the impression that my cannabis prescription would have been available for an NHS prescription charge. Not so! My medicine costs me hundreds of pounds each month. I’ve read reports that for some, it’s thousands. Hannah Deacon, Alfie Dingley’s mother, wrote this very month (November 2021) that since the law change, just 3 NHS prescriptions have been given, her son’s being one of them. (6). Meanwhile, in a 2021 interview with Health Europa (7), Dr.Mike Barnes (Maple Tree Consultancy) states that “there are around 2500 patients being prescribed cannabis in the UK”.
Another shift, a troubling one in my view, is that police and state hostility towards growers appears to have risen, in terms of the presence and attitudes towards cannabis growers on social media. What’s considered ‘personal possession’ has even been reduced by the latest policing bill), which will potentially increase sentences, including jail time for many, many people who take cannabis for reasons no less understandable than my own. Who am I to judge anyway? It gives the impression that people are being smoked out (pardon the pun) to make private prescriptions their only route. It ignores affordability and prescription supply problems and turns a blind eye to the potential benefits of growing too. Not just choice and reliable supply, but a worthy hobby with all the potential health benefits usually associated with gardening horticulture. Cannabis growers aren’t all drug king-pins, far from it, and it’s prohibition that creates the market (and where big money is involved, crime), not the plant. This was the case in prohibition-era America, and it is the case now! Many of those growers are people who can’t afford a prescription or heaven forbid, just try to be as happy and healthy as they can to help prevent developing health problems. These clampdowns perpetuate the deviant rhetoric, which seems at odds with making cannabis legal under the right conditions in the first place. After all, is there really much difference between someone prescribed cannabis for anxiety and depression, and someone else who has not seen a doctor but finds it relaxes them? Moreover, should people not be congratulated for taking control of their health, which ultimately saves the healthcare system money and resources further down the line?
So what are the risks to cannabis users? Risk of potential drug-induced psychosis continues to be cited as a reason for cannabis prohibition. It’s a very real problem for people pre-disposed to it, but given the high numbers of people that report cannabis use irrespective of whether it’s legal, it’s threat would seem to be exaggerated, especially when compared alongside the many serious potential effects of perfectly legal pharmaceuticals. Any other medicine would be weighed up in terms of risks versus potential benefits, as medical cannabis is surely meant to be. Gage (2019, 8) points out that...:
“Given the changing legal status of cannabis across the world, and the associated potential for an increase in use, the next priority is to identify which individuals are at risk from daily potent cannabis use, and to develop educational strategies and interventions to mitigate this”.
Cannabis is already deemed safe for children after all? So much makes so little sense. Why is somebody relaxing with a couple of vapes or a smoke in an evening, if that’s what relaxes them, any more harmful than a couple of glasses of wine? Okay, smoking is harmful, but then legalise and educate. Vaping is a healthy alternative. Or oil. Or whatever works for you.
So who qualifies for NHS prescription now? People with Multiple Sclerosis, certain types of epilepsy and chemotherapy-induced sickness qualify on the NHS in theory, but we’ve already established that’s not really happening. Sapphire Clinic in 2021 (9) state on their website 32 different conditions that may be eligible for private prescription. 32! Money talks loudly my friends! It’s a pity that apart from anything else, those who are sick or disabled are the least likely to have any. Those conditions are so wide-ranging, including Parkinson’s Disease, Post-Traumatic Stress Disorder, Arthritic pain and so much more. Think what a happier, healthier society we could have if more people had access to try cannabis, given how many people suffer from health issues that remain poorly controlled. As it is, most people are unaware it’s an option, even if they could afford it, and many would still be reluctant because of the scare stories and remaining stigma (or employment rules). The absence of research that is referred to within the caution and prohibition approach is apparently of no concern for private customers. It doesn’t seem to matter much at all. Dr. Mike Barnes, Chair of The Medical Cannabis Clinician’s Society (10), reported in 2020 that at point of print, not a single medical cannabis trial had even been commissioned since the 2018 law change.
This takes me back to GW Pharmaceuticals (still UK-based but now owned by American Company, Jazz Pharmaceuticals). It states on their own website that the first clinical trials by them begun in 1999, the year after they were founded (11). How on earth is a dearth of research on cannabis still being cited as a reason for caution over cannabis safety anyway, when clinical trials have been taking place right here in Blighty for 22 years!
There is also the far from insignificant point of safely carrying and using cannabis even when it’s legally prescribed. Rules and changes are only helpful if they’re clear and everyone that needs to understands them. Again, this is clearly not the case, mainly because different initiatives, which have gallantly tried to solve this omission seem in many respects to be working against one another. Whereas I’ve heard positive tales about both CanCard (aimed to protect non-prescription users) and MedCannID (a database containing users prescription) there is a clear mistrust within the cannabis community about these schemes, about where the data is kept, how it might be used and how effective the schemes are. I think many people are more cautious and aware about data sharing in recent years, but in any case, a group of people who are even now being oppressed, this is surely even more understandable, however well meaning and even effective these schemes might be. I also know of people who have had prescription cannabis confiscated because of police not understanding the law changes surrounding cannabis use. In fairness, most patients don’t know what their responsibilities are in this regard. I know I don’t. The information doesn’t seem to be out there and if it is, it’s not easily accessible or searchable. I don’t really feel any less at risk of the police confiscating my medicine. I only feel more confident that if they did, I might be able to fight it in court. I’d really rather not have to test this theory.
The Huffington Post (12), in a 2017 article about marijuana overdose, discusses the widely accepted fact that it’s not actually possible to overdose on marijuana alone. It also directs the reader to a bold 1998 report written by a Drug Enforcement Agency Judge. If I may share a few quotes, this makes for truly astonishing reading I think:
“Nearly all medicines have toxic, potentially lethal effects. But marijuana is not such a substance. There is no record in the extensive medical literature describing a proven, documented cannabis-induced fatality.”
“...in order to induce death a marijuana smoker would have to consume 20,000 to 40,000 times as much marijuana as is contained in one marijuana cigarette. NIDA-supplied marijuana cigarettes weigh approximately 0.9 grams. A smoker would theoretically have to consume nearly 1,500 pounds of marijuana within about fifteen minutes to induce a lethal response.”
That’s a lot of food for thought, but I hope that it begins to highlight the complexity of a situation still presented as black and white, open and shut. Cannabis activists are small in number and volume. It still being illegal for most makes it hard to stay in touch and consolidate ideas and so forth. Many of us are sick and disabled and have so many other battles, with the benefits system, lack of accessibility and just keeping going, but things have to change. I hope I’ve stated a case for decriminalisation, successful in countries like Portugal, but even if it’s to remain medical, if only for the time being, it needs to be treated like a medicine and not a luxury, prescribed as any other medicine would be. Steps must be taken to ensure uninterrupted supply and acceptable quality (no more mouldy bud please) and a change to the view that different strains work interchangeably. We need louder voices, more voices. If you’re reading this and you think these points I’ve made are valid, do consider writing your own views to your Member of Parliament. Educate yourself by looking up campaign groups like Seed Our Future or MP debates in Hansard. It may seem like a niche market to some, or perhaps someone else’s problem, but it could affect you, you could benefit yourself, as could those you love. It’s privatisation on the quiet, and it’s a sign of more to come, unless it stops here. On that note, I’ll leave you with a quote from a Guardian article (13) titled ‘Warning of ‘Wild West’ in Depression Treatment as UK Clinics Offer Ketamine’. Again this year, “Health experts expressed concern about creating a two-tier system in which the novel treatment is unavailable to NHS Patients” was the quote. Sound familiar?
References (in Chronological Order)
1. British Broadcasting Corporation (2018). Doctor’s can prescribe medical cannabis from November in U.K [Online]. Available from: http://www.bbc.co.uk/news/health-45822629 [Accesssed 26 September 2021]
2. The Guardian (2011). MS patients denied licensed cannabis drug by NHS [Online]. Available from: http://theguardian.com/uk/2011/may/30/ms-patients-denied licensed cannabis drug [Accessed 26 September 2021]
3. The Observer (2011) Interview: The Man Who Secretly (and Legally) Grows 20 Tonnes of Cannabis a Year (Online). Available from: https://theguardian.com/business/2011/apr/17/gw-pharmaceuuticals-justin-gover-cannabis-satisfax-multiple-sclerosis [Accessed 24 November 2021]
4. The Independent (2016). Theresa May’s Husband is a Senior Executive at a .4tn Investment Fund That Profits From Tax Avoiding Companies. Available from: https://www.independent.co.uk/news/uk/politics/theresa-may-philip-may-amazon-starbucks-google-capital-group-philip-morris-a7133231.html#commensDiv [Accessed 24 November 2021]
5. The International Narcotics Control Board (2018). Comments on the reported statistics on narcotic drugs [online]. Available from: http://www.incb.org/doccuments/Narcotic-Drugs/Technical-Publications/2019/7_Comments_E.pdf [Accessed 26 September 2021]
6. Deacon H. (2021) 3 NHS Medical Cannabis Prescriptions in 3 Years: Alfie’s Story Available from: https://www.drugscience.org.uk/3-nhs-medical-cannabis-prescriptions-in-3-years-alfies-story/ [Accessed 24 November 2021]
7. Health Europa Cannabis Network(2021) Could the UK be a leader in the medical cannabis industry? [Online]. Available from: https//:could-the-uk-be-a-leader-in-the-medical-cannabis-industry/104985/# [Accessed 26 September 2021]
8. Gage, S. (2019) Cannabis and Psychosis: Triangulating the Evidence. The Lancet (online). Vol.6, May 2019, 364-5. Available from: https://www.research.net/publication/331878302_Cannabis_and_psychosis_triangulating_the_evidence/link/5e5eb3d8299bf1bdb85073b2/download [Accessed 4 October 2021]
9. Sapphire Clinics (2021) Conditions. Available from: sapphireclinics.com/conditions [Accessed 24 November 2021]
10. Business Cann (2021) Not One Medicinal Cannabis Trial Launched by NHS Since Law hange (online). Available from: tps://businesscann.com/not-one-medicinal-cannabis-trial-launched-since-law-change [Accessed 24 November 2021]
11. G.W.Pharma (2021) About Us: Our Vision (online) Available from: gwpharm.co.uk/about-us [Accessed 24 November 2021]
12. Huffington Post (2018) The Exhaustive List of Everyone Who’s Died Of A Marijuana Overdose (online) Available from: https://m/huffintonpost.co.uk/entry/marijuana-lethal-dose_n_58f4ec07e4b0b9e9848d6297?ri18n=true [Accessed 24 November 2021]
13. The Guardian (Sarah Marsh and Hannah Devlin, 2021) Warning of ‘Wild West’ in Depression Treatment as UK Clinics Offer Ketamine (online). Available from https://www.theguardian.com/science/2021/nov/12/growing-number-of-uk-clinics-offer-ketamine-for-depression-say-experts [Accessed 24 November 2021]