When cannabis for medicinal purposes was legalised in November 2018, the hope, or rather the expectation, was that anyone in need of the drug as a means of improving their quality of life could now receive it.
However, since that momentous change in the law, for many people, little has changed. The struggle to access the cannabis they believe could well transform their life – based on the evidence-based testimonials of many other patients – remains very real.
Some of the frequently-cited issues in accessing cannabis are the cost – prescriptions for some can cost more than £1,000 per month – and continual resistance from many within the medical profession.
Stories from patients of their doctor reacting in shock at their desire to try medical cannabis are common; and their mission to obtain the prescription they so badly want ends at that point.
These are issues Dr Samuel Murray comes across frequently, and which he is helping patients to overcome. As director of Cannabis Access Clinics, an Australian prescribing clinic which now has a base in London’s Harley Street, he has seen it all before in his native country.
Since cannabis was legalised there on a federal level back in 2016, a huge amount has changed in terms of attitudes towards the medicinal drug, particularly among the medical community.
“Australia is roughly two years ahead of where the UK is now and I do think the situation here will change over time, as it has done in Australia,” says Dr Murray.
“Most patients in the UK contact us directly, but in Australia 90 per cent are referred from their GPs, so that’s quite telling in itself.
“As more evidence becomes apparent and more people show the benefits, that will play a big role.
“Even the most hard-nosed, evidence-driven GP will surely take notice of these benefits once they see the effect on one of their patients who has struggled with chronic illness. The difference this can make to their quality of life is huge.
“It’s not a magic cure and might not work for everyone, but it should be an option for people.
“I believe is a person is being treated for their GP and they can’t offer any other alternatives, then absolutely medical cannabis should be considered if there is a possibility it can change this person’s life.”
As someone who regularly prescribed cannabis in Australia, and has seen many instances of how the results have been life-changing for patients, Dr Murray frequently offers to impart the benefit of his experience to fellow, less accepting, medics.
“I always offer to speak to someone’s GP directly if they have doubts, as it is still a very new concept for many of them, whereas it is an area I have prescribed in widely. Some respond really well, some still don’t, but I do think it’s a situation that will change. It’s a matter of time,” he says.
“I appreciate there is a big barrier as far as GP education goes. I studied at graduate medical school quite a few years ago now, but the cannabinoid system is still not something that is taught, it’s just not acknowledged at all in education. That is something that will hopefully change too.”
Having become a pioneer of widening access in Australia, Cannabis Access Clinics is helping to do the same in England, with Dr Murray and the team of prescribing doctors being a lifeline for patients who have felt they have nowhere else to turn.
The COVID-19 pandemic has seen even greater numbers of patients contacting the clinic, in desperation after their NHS appointment was cancelled. In response, Dr Murray and the team have introducing consultation by video, allowing them to easily interact with patients across the country.
“Until recently, we have held all of our consultations in person in the UK. Video consultations are used widely in Australia and they work really well. It’s something we have pushed for in the past here, but now we’re being enabled to do so through the circumstances and they’re working really well here too.
“A lot of our new patients have had appointments cancelled with their pain specialists, or can’t see their GP for their repeat prescription, and they are looking for alternatives. We have had women coming to us with endometriosis, in tremendous pain, and they can’t get an appointment anywhere else.
“I’d say patients by and large prefer video consultation, it’s very simple. You follow a link sent to you by email and there is a doctor there waiting to speak to you.”
While video consultation is a ‘needs must’ measure at present amidst COVID-19 social distancing measures, it is something Dr Murray believes should become much more commonplace.
“COVID or no COVID, it’s not always the best or safest option for people to travel to see us if someone is suffering from chronic pain or mobility issues.
“In the past, our patients have been from London, with very few exceptions to that. But in the past few weeks, we have had patients from across England and Scotland,” he says.
“While the situation can be different with patients with acute conditions, they are patients we would probably prefer to examine in person, but with chronic conditions consultations via video are normally more straightforward.
“We are hopeful that this period will lead to new opportunities in how people are able to access their medical cannabis, and that it is realised how effective and positive video consultations can be. We hope the use of video will be embraced more widely than it has been previously.”
As well as enabling access to a prescribing doctor, Cannabis Access Clinics also wants to make cannabis more accessible price-wise, so those who do qualify for a prescription can actually afford to obtain it.
“We regularly hear stories about prescriptions costing £1,000 a month, but as an average, our patients can expect to pay between £150 to £200 a month. Some even less although some will be more, it depends on the individual circumstances of the person and their treatment. We continue to be surprised to hear what some patients are charged elsewhere.
“I think as more companies enter the UK with bulk imports, this helps to make cannabis more affordable. I think this will help to change the price for the longer term, prices will inevitably come down, but we are pleased to be one of the leaders in offering accessible pricing. We aren’t tied to any one producer or company, so this helps to make things more affordable.
“We have also recently introduced a free initial consultation, which helps people to understand their eligibility for treatment without having to commit. We know that in some clinics this alone can cost a lot, without even getting to the costs of the prescription.
“We want the process to be about accessing cannabis in a timely and affordable manner, so all of the appropriate checks and assessments are made and costs are kept down.”
Alongside evidence from patients, and greater awareness and education of cannabis and its effects, Dr Murray believes more accessible pricing will be another key factor in its wider acceptance within the medical profession.
“I do believe cost has also been an issue for GPs as a cannabis prescription can seem completely unaffordable.
“If some patients are accessing their NHS prescriptions for free or a few pounds, then others could be paying £1,000 a month for cannabis, then that is a huge difference. Understandably, GPs are trying to look after their patients’ best interests from both a health and financial point of view, and when those kinds of sums are involved, it is very difficult for some to find any acceptance of that.
“I think as the costs come down, which they inevitably will and are starting to do now, they will become more open to the idea.”
While Cannabis Access Clinics has attracted widespread attention for its efforts to widen access to cannabis during the COVID-19 pandemic, it hopes to continue to do that and enable those for whom cannabis could be an option to at least explore that further.
“Our aim is to improve access to specialist doctors who prescribe medical cannabis to patients in need, and that’s what we will continue to do.
“It’s great we are able to help people at the minute during the COVID pandemic, but this is what we do. Video is working so well and whereas before we had one patient from Scotland, which was a real exception, now we have a number and can hold consultations with people wherever they are. That is something we very much want to continue.”
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