Why is the NHS Still Refusing To Prescribe Medical Cannabis?

Medical cannabis syringe for severe epilepsy

Many people still think that cannabis is just for the lazy wasters out there. It’s time to let that go.

Cannabis is an incredibly useful medicine for many people out there. From its roots as a traditional medicinal herb before being criminalised, it has helped countless people across the globe with pain, PTSD, anxiety and a whole range of other conditions.

The NHS primarily prescribes opioids to people in pain. They often just make patients feel groggy and spaced out and don’t really help with the pain anyway. Exercise helps, sleeping well and eating healthily, but pain is difficult to live with. Widely available CBD is very helpful for many people living with chronic pain. But for a large minority nothing works as well as full-spectrum cannabis. It has a massive difference on pain levels that you have to live with daily.

For children with epilepsy, cannabis can be a wonder drug, stopping them from having dozens of terrifying seizures a day and allowing them to live a normal life. Technically, they could be prescribed cannabis on the NHS to help relieve their symptoms. It’s not quite as simple as this. In reality cannabis is only been legal in theory. In July 2020 it was reported that no new NHS prescriptions have been made since it’s legalisation in 2018.

A few months ago the parents of a three year old boy suffering from severe epilepsy began the first legal challenge on the guidelines for prescribing cannabis on the NHS. The boy, Charlie Hughes, went from having 120 seizures a day to just 20 after taking medical cannabis. But two years after it was licensed as a medicine, Charlies parents can only get it by purchasing it privately.

Professor Branes stated that the NHS guidelines on medical cannabis are “unhelpful and simply wrong”. Guidance by the drugs advisory body the National Institute for Health and Care Excellence (NICE) is “hopelessly negative”, and healthcare professionals do not have enough education to confidently prescribe cannabis: “99 per cent of doctors have never learnt about cannabis or the endocannabinoid system” (the system in our own bodies through which cannabis compounds work). 

“NICE and the Royal College of Physicians have basically said there’s not enough evidence to prescribe [medical cannabis], which I think is complete nonsense,” said Prof Barnes: “It’s a brave doctor that says: ‘No’, actually I do want to prescribe this.’”

Alfie Dingley was admitted to hospital dozens of times before he was prescribed medical cannabis to stop his regular seizures. His mother, Hannah Deacon, told me: “The granting of Alfie’s medical cannabis licence and the subsequent law change raised the hopes of many other families. We felt every child and adult who had tried everything else may get the chance to use medical cannabis, to keep them out of hospital and improve their quality of life. 

Medical cannabis vape for epilepsy
Why is the nhs still refusing to prescribe medical cannabis? 3

“Yet for vulnerable families and their suffering children, this optimism has now been replaced by despondency. To the best of my knowledge, access to medical cannabis on the NHS is totally blocked, forcing families to fundraise to pay thousands of pounds a month for a medicine that is legal here.”

Private prescriptions are now rising 20 to 30 per cent month-on-month at clinics opening around the country. Most prescriptions are for pain and neurological conditions, but also for multiple sclerosis and complaints like anxiety and PTSD. Most pay around £400 or £500 a month, but children with severe epilepsy, because of the doses involved, can pay up to £2,000 a month. Clinics supply either cannabis flower, which is vaped, or cannabis oil, which is taken orally. 

Last year the Health Secretary, Matt Hancock, promised that cost wouldn’t be an obstacle to the prescription of cannabis. Cannabis itself is cheap, and Prof Barnes thinks it could be supplied by the NHS at “net zero cost”. In Alfie Dingley’s case, repeated intensive care visits cost the health service “many, many thousands”. But even in less severe cases, savings made by replacing other prescription medication like anti-anxiety drugs, opioids and so forth, means that medical cannabis could be supplied, in Prof Barnes’s words, “without actually costing the National Health Service a single penny”.

The solution, said Prof Barnes, is for a “patient-led revolution”. He urges anyone who thinks they could benefit from a cannabis prescription to go to the GP, and “not take ‘no’ for an answer”. GPs themselves are currently not allowed to prescribe cannabis but patients can ask to be referred to a hospital specialist. If the specialist says ‘no’, then the patient needs to ask why, and have the case referred to the local hospital trust. If the trust cites cost, then they can be referred to the Department of Health to test Matt Hancock’s pledge. If it cites lack of evidence, Prof Barnes says, this goes against a tide of medical opinion worldwide that has shown cannabis to be effective for many conditions.

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