Yes we should!

Or at least that is the view of the All Party Group for Drug Policy Reform (APGDPR) in a report published last week (13 September 2016).

Entitled “Access to medicinal cannabis: meeting patient needs“, the report recommends that we should follow the 11 European countries and 24 US states who either already allow lawful access to medicinal cannabis or are in the process of doing so.

How many Brits currently use cannabis for medicinal reasons?

The APGDPR found very different answers to this question; here’s their summary:

One estimate of current users of medicinal cannabis in the UK puts the figure at 30,000 daily. However, the campaign group End Our Pain puts the estimate at approaching 1,000,000 in total. This is based on the fact that Home Office figures put the number of UK cannabis takers (both recreational and medicinal) at 3,000,000, and figures from the USA suggest that approaching 1 in 3 will be for primarily medical reasons. If this figure seems high, it is interesting to note that Germany, which is currently introducing legislation to allow legal access to medicinal cannabis estimates that nearly 800,000 of its citizens may be eligible under their scheme.

The MPs commissioned an online survey of medicinal cannabis use in the UK. This revealed cannabis use for a considerable range of conditions including:

• chronic and severe pain (24% of respondents);
• arthritis (12%);
• insomnia (21%);
• fibromyalgia (9%);
• post-traumatic stress disorder (PTSD) (7%);
• depression (30%); and
• anxiety (26%).

The report states these are very similar results to an Australian survey of medicinal cannabis users.

Other findings from the APGDPR survey were that cannabis was perceived to provide “great relief” overall by 86% of patients, and substantial relief of specific symptoms such as pain, nausea and insomnia. Over 90% reported no or mild side effects from cannabis treatment. By contrast, respondents experienced “significant”, “severe” and “very severe” side effects from prescribed medication.

A majority of survey respondents (63%) had discussed using a cannabis-based treatment with their GP or Consultant, but 72% of patients had obtained their cannabis on the street, directly or indirectly. Some respondents reported stress and anxiety associated with obtaining cannabis illegally.

Effectiveness review

The group commissioned a review of the evidence of the effectiveness of medicinal cannabis by Professor Mike Barnes and Dr Jennifer Barnes which made the following key findings:

• There is good evidence for one or more of the cannabis products or “natural” cannabis in the management of chronic pain, including neuropathic pain; spasticity; nausea and vomiting, particularly in the context of chemotherapy; and in the management of anxiety.
• There is moderate evidence for the use of cannabis in sleep disorders; appetite stimulation in the context of chemotherapy; fibromyalgia; PTSD; and for some symptoms of Parkinson’s disease.
• There is some limited evidence of efficacy for a further list of disorders.

The review also identified a number of disadvantages:

• There is probably a small link between cannabis and schizophrenia for those who start using cannabis at an early age and if the individual has a genetic predisposition to psychosis.
• There is a small dependency rate of around 9%.
• Researchers recommend caution in prescribing cannabis to younger people, given the possible susceptibility of the developing brain.

Models of regulation

The group also considered different models of regulation for cannabis and noted that there are challenges in terms of ensuring the strength, quality and purity of herbal cannabis for medicinal purposes. These seem to be best met by controlling supply via regulated outlets, such as pharmacies, and cultivation by licenced growers.

However, cost and a limited variety of strains being made available in such outlets may restrict patient access to the best medicinal cannabis product to meet their needs. This is why some jurisdictions have opted for programmes where patients can grow a limited amount for their own use.

Conclusions

The report comes to five principal conclusions:

1. There is a sizeable population of patients in the UK who have found that medicinal cannabis works for them. For many, it is the only substance that brings them relief from their symptoms.
2. As access to medicinal cannabis is not lawful in the UK, these patients have to suffer the added stress of breaking the law to obtain what for them is a medicine.
3. The review of the literature clearly shows that there is a broad range of evidence that medicinal cannabis works for a range of conditions.
4. The fact that so many countries now have or are introducing a form of cannabis regulation to ensure access to herbal cannabis to help those with serious chronic conditions, where prescription medicines have been ineffective, undermines the UK Government’s current position which makes all use of cannabis illegal.
5. The issue of medicinal cannabis should be treated as a matter of compassion and be viewed separately from the wider issue of drug policy reform.

The All Party Group further recommends that its preferred method for making access to medicinal cannabis legal is the German model and recommends that the Government decriminalises home growing of small quantities of cannabis for medicinal purposes as happens in Uruguay and some US states.