Ricardo Geada explores medicinal cannabis and the issues surrounding patient access in The Times

Regulatory Solutions

Ricardo Geada
June 2023

Director and Head of Regulatory Solutions Ricardo Geada argues that millions of Britons are being denied access to medicinal cannabis due to unnecessarily restrictive guidelines around prescription, in The Times.

Ricardo’s article was published in The Times, 15 June 2023, and can be found here.

Despite the Government’s legalisation of medicinal cannabis in November 2018, patient access remains shocking half a decade later, to the detriment of millions of Britons whose health conditions would benefit greatly from such treatments. While the law change was a step in the right direction, in practice guidelines continue to be unnecessarily restrictive.

Cannabis regulation in the UK is a complex and evolving topic, particularly in the aftermath of Brexit. However, despite the challenges legislators face, there is no justification for the status quo to persist any longer, in which countless Britons are prevented from accessing life-changing treatments in the form of cannabis-based products for medicinal use (CBPMs).

At present, there are only a handful of prescriptions for CBPMs made available through the NHS, and are mainly used for the treatment of children with epilepsy. The vast majority of CBPM prescriptions are made through private clinics, meaning only those able to afford private medical care are able to obtain the medicines while their less affluent peers are denied access.

The National Institute for Health and Care Excellence (NICE) guidelines underpinning the prescribing of CBPMs are inherently flawed, since they are written as though cannabis is a pharmaceutical product, when it is a botanical product. As such, they focus mainly on double-blind placebo-controlled studies, and ignore real-world evidence in the form of thousands of studies proving the benefits of CBPMs to a wide range of patients.

Sufferers of chronic health conditions who would be greatly aided by CBPMs are further restricted from access by the fact that only medical practitioners (doctors) on the General Medical Council (GMC)’s specialist list can initiate such prescriptions. GPs are unable to initiate but can write follow up prescriptions. This adds a superfluous layer to prescribing for so many ‘GP conditions’ such as pain and anxiety, sleep issues and appetite problems – all of whom could benefit from CBPM prescriptions.

The Government must refresh its approach to the medicinal cannabis sector, not only to help people with chronic health conditions, but also to establish a viable new industry which is currently constrained by a regulatory minefield. Until CBPMs are allowed to be prescribed on a far less restrictive basis, demand will remain suppressed, and thus potential entrants to the market are highly disincentivised to invest time and money into product development and distribution.

In the absence of a regulatory overhaul, hundreds of thousands of patients denied access to CBPMs will continue to turn to black market cannabis to treat their conditions, which often contains contaminants and pesticides and is not tested for safety. Instead of exposing patients to health risks as well as to the risk of prosecution, NICE should urgently rethink its approach to CBPMs and allow access to all those patients in need.