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Change how we test and regulate medical cannabis, MP argues

Despite the law change in November 2018 to allow some medical cannabis products to be legally prescribed to some patients, people are still not getting access to medicinal cannabis, and this needs to change, argues Crispin Blunt, Conservative MP for Reigate.

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Blunt argues that there needs to be a regulatory system in the UK that will support more rapid access to medical cannabis. 

“People aren’t getting access to cannabis based medicine on the NHS, it’s very expensive if it’s accessed privately, the supply chain remains criminal, and around 100,000 people are growing cannabis for medical purposes and are at serious risk of long sentences in prison for trying to make their medical conditions better.

“We need to get this business into the regulated light where people can get proper access to it in a sensible way,  not criminalising large numbers of citizens for no purpose,” says Blunt, who was the first conservative co-chair of the APPC for drug policy reform. 

However, Liz Shanahan, director of UDG healthcare, says the process of prescribing cannabis is convoluted. 

“The doctor has to make personal decision, there’s personal liability associated with prescribing. Alongside that the pharmacist has personal liability for the quality of the product, then they have to put the case to a clinical team within the hospital, which then goes through variety of rigorous assessment, and nine times out of ten you will have to then go to the CCG to ask if they’ll fund it,” she says. 

In the NHS it’s the same for every medicine, she says, in terms of how a physician makes that decision and how the NHS reimburses it. 

The other significant barrier to getting medical cannabis to patients is the lack of research that reaches the standards of regulators in order to be sold in the CBD market. 

Blunt argues the UK needs to recognise that medical cannabis doesn’t lend itself to current assessments around standard pharmaceutical practices, such as double-blind trials. Instead, he argues, we must see whether there are different regulations and licensing conditions that can be applied to cannabis.

“We must enable an assessment process that’s relevant to cannabis as a medicine to be put in place that the NHS, private medicine and the states regulators can rely on,” he says.

But Shanahan says there’s still some way to go, and that randomised control trials, while difficult to do, remain the gold standard for all medicines, and the rigorous testing medical cannabis is subject to is the same for all medicines in the UK.

“There’s no conspiracy here,” she said at this year’s Prohibition Partners online event.

“A lot of science is very staccato, we don’t have level of detail and research that we really need. 

“Real world data is what everyone’s talking about at the moment – AI would allow us to gather more data and analyse it in new ways. But is going to take a couple of years. 

“The reality is there are patients desperate to have products, so it’s a very difficult situation where patients are having to go private with very little data to back them, so you’re asking patients to pay lot of money for products with not much data. We don’t know what doses to give them, we don’t know whether an inhaler is better than gel is better than tablet.”

Blunt has his hopes on Brexit pushing forward change. He says the Food Standards Agency bringing its own regulatory oversight to the CBD wellness market from March next year gives the UK scope to produce its own national set of regulations.

“The Home Office has an interest in not trying to pursue an almost an immoral policy of not taking peoples medicines away from them, and the Department of Health has interest in enabling the fastest, safest access to medicinal cannabis to people,” he says.

The UK’s medical cannabis industry, he goes on, can be sustained by decent regulation, decent licensing and a proper legal framework that makes it possible for investors to make sensible decisions on whether to invest. 

“Given the probable efficacy of products derived from cannabis, those investments ought to be substantial, but they can’t be substantial if they’re surrounded by a thicket of regulations and laws that mean investors will run a mile from taking a risk. 

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