The team creating what will be Europe’s largest medical cannabis patient registry has welcomed the recent Government report into the impact of the 2018 law change – but warned that access is still ‘too limited’.
Last week, the Advisory Council for the Misuse of Drugs (ACMD) released a landmark report assessing the impact of the 2018 rescheduling of medical cannabis. But following its publication, the report has faced criticism for overlooking a number of key issues.
The UK’s independent scientific body for drugs, Drug Science, was among those to respond, highlighting several of its concerns and stressing the need for a registry to measure outcomes of patients using cannabis based products for medicinal use (CBPMs).
The ACMD report indicated that there is strong clinical evidence regarding the effectiveness of licensed cannabis medicines in the UK. However, Drug Science was quick to point out that many unlicensed cannabis medicines, which are currently deemed unsafe or ineffective by medical professionals in the UK are being successfully prescribed at a large scale in other countries.
Although the UK has three licensed cannabis-based medicines (Sativex, Nabilone, Epydiolex), Drug Science said evidence from other nations shows that CBPMs could be used for a much broader range of conditions than NICE’s “limited” list of recommendations.
While it agreed with the need for randomised control trials (RTCs) to provide clinical evidence, it urged the UK to look to other countries and take global findings into account.
The charity also voiced its concerns about the limited number of products available to patients who require medical cannabis, referring to evidence it collated from twenty children with treatment-resistant epilepsies.
The survey supported the use of unlicensed products such as Bedrocan, Bedica and Bedrolite rather than the approved cannabis-based treatment for epilepsy, Epidiolex.
In its official response, Drug Science commented: “Some of these patients who were treated successfully with these unlicensed products had to revert to a less effective CBPMs due to cost reasons, causing their children’s seizures to return.
“No parent should have to do this. Whilst there are options of private prescriptions, as the ACMD reports, costs are prohibitive for most of these families with a chronically ill child.”
This echoed other criticisms which have surfaced over the past week, many of which have focused on lack of affordable access to CBPMs for the average patient.
Members of the PLEA (Patient-Led Engagement for Access) Community, for example, said that it was “disgraceful” for the report to overlook this issue.
Despite its concerns, Drug Science agreed with the ACMD’s conclusion that a patient registry for CBPMs is vital for effectively monitoring the pattern of CBPM prescriptions and the associated effects on patients.
Its response drew attention to the recently launched Project TWENTY21, which aims to collect data of up to 20,000 medical cannabis patients over the course of the next two years.
CEO of Drug Science, David Badcock, says: “We welcome the recent report from the ACMD on CBPMs in humans, and strongly agree with its recommendation that the availability of a CBPM registry is crucial for future assessments of the impact of rescheduling of CBPMs.
“This is the reason that Drug Science is delivering the largest patient registry in the UK, collecting private prescription data for up to 20,000 patients, monitoring safety and effectiveness.”
With a focus on anxiety disorder, chronic pain, MS, PTSD, substance use disorder and Tourette’s syndrome, the charity aims to create the largest body of evidence in Europe for the safety and efficacy of CBMPs.
Drug Science hopes that this new evidence base will galvanise the NHS into taking action and direct more funding into cannabis-based medicine.
The charity called on the National Institute for Health Research (NIHR) to fund research on medical cannabis products so that “peer-reviewed research can continue to determine the benefits and harms of these products.”
Badcock added: “Project Twenty21 will provide evidence for NHS funding where the benefits of treatment with medicinal cannabis is proven to outweigh the potential risks. We welcome any opportunity to support and interact with the Government’s registry and to be able to collate both private and NHS prescription data.”
In June of this year, Project TWENTY21 began beta testing its patient pathway and started working with the London-based medical cannabis clinics to offer an initial 100 patients access to medical cannabis.
Around 8,000 people have signed up since the project launched, with more than 200 having received an initial consultation.
Drug Science will publish its first peer reviewed article on the initial findings of the initiative early next year.
Ireland to fund patient’s medical cannabis up front
Campaigner Vera Twomey described “relief” that her determination has finally paid off.
Campaigner Vera Twomey has described her “relief” as the Irish Government agrees to fund medical cannabis patient’s prescriptions up front.
Eligible medical cannabis patients in Ireland will now have their medication paid for up front, after months of pressure on the Government from campaigners.
Health Minister Stephen Donnelly announced on Monday 19 July that the refund system for patients who obtain their prescribed cannabis-based products from the Netherlands, will now be replaced by a direct payment system.
The HSE will pay the dispensing pharmacy in the Netherlands directly, rather than the burden falling to the patients and their families, who were then required to apply for a refund.
Vera Twomey, whose daughter Ava Barry, 11, has a severe form of epilepsy known as Dravet syndrome, is among 40 patients who have now been granted an individual ministerial licence to import Bedrocan oil to Ireland.
But the family were paying 10,000 Euros up front every three months for Ava’s prescription and waiting up to five weeks for it to be refunded.
Twomey, who has four other children, has previously spoken of the huge financial strain this system placed on her family.
Over the last 16 months she has relentlessly called for action, making dozens of phone calls daily to politicians and lobbying ministers on social media with the backing of thousands of supporters in Ireland and across the world.
Twomey, who received a phone call from Ireland’s Prime Minister, Micheál Martin on Monday confirming the news, says she is “delighted” that her determination has finally paid off.
“There’s a sense of relief that we have accomplished this, but also a little bit of shock because we have been trying to resolve it for so long,” she told Cannabis Health.
Twomey’s activism gained national attention in 2017 when she walked from her home in Cork to Leinster House in Dublin to ask former Health Minister Simon Harris to grant access to medical cannabis for her daughter.
Initially having to travel to the Netherlands to collect the prescription herself, during the pandemic Twomey successfully campaigned to secure the permanent delivery of Bedrocan oils for Ava and other patients.
Now she says she is looking forward to focusing on her family and putting the phone down for a while.
“I don’t think anybody who has gone through this fight, seeing the injustice that we have had to deal with could ever walk away,” she said.
“But at the same time, I’ve made a lot of sacrifices and for the moment at least, I need to give 100 percent to my other children, to do normal things and be a family.”
But the fight in Ireland isn’t over.
The Irish Government announced the provision of funding for the Medical Cannabis Access Programme (MCAP) in January – almost two years after it was introduced – but only four low dose cannabis-based medicines are covered by the programme, for people living with one of three qualifying conditions.
“There are other issues – we still need expansion and improvement in medical cannabis access, the journey is over by any means, but we’re at the beginning and getting Bedrocan recognised as a medicine that is funded up front is very important.
“I think the Irish are actually miles ahead of the British on this one and I hope [politicians] will take notice and catch up.”
She added: “The greatest gift you’ll ever receive is to lose your fear, then you can accomplish anything with focus and determination.
“If you have the determination to keep going you will get there. It’s not going to be easy, they are not going to make it easy but it can be done.”
Patients eligible for the direct payment system are those suffering from one of three stated conditions; spasticity associated with multiple sclerosis, intractable nausea and vomiting associated with chemotherapy and severe, refractory (treatment-resistant) epilepsy.
The HSE says it will be contacting patients directly.
Health Minister, Mr Donnelly, commented: “I am delighted that the HSE and Transvaal Apotheek in the Netherlands are implementing a new process which will give peace of mind to the seventeen patients and their families who until now have been using the refund process.”
Kanabo’s cannabis vaporiser for metered dosing launches in UK
The VapePod will give thousands of UK patients access to pain relief in a metered dose.
Cannabis company Kanabo’s new extract formula and vaporiser will give thousands of UK patients access to pain relief in a metered dose.
UK patients will be the first in Europe to have access to Kanabo’s vaporiser, the VapePod, and its new extract formula when is it delivered later this month.
The deal, in conjunction with LYPHE Group, will see patient’s of LYPHE Group’s ecosystem, including The Medical Cannabis Clinic and Dispensary Green, able to access the VapePod under the brand name NOIDECS.
Under the agreement, PharmaCann and Kanabo established a customised production line for Kanabo’s VapePods cartridges.
An alternative to cannabis flower
The VapePod is a medical-grade, handheld vaporiser which enables accurate and precise micro doses of cannabis extract, dispensing 1mg of formula for each inhalation.
This will benefit to patients as inhaling extracts rather than tinctures and oils allows for faster onset and higher bioavailability.
It will also allow clinicians to more confidently prescribe and monitor a patient’s dosage, as well as providing more accurate patient data.
Previously, cannabis patients in the UK have only been able to access medical cannabis dry flower and oil tinctures for which the majority of patients consume via inhalation due to fast onset time.
Kanabo’s medical line aims to enable patients to move away from the harmful act of smoking medical cannabis flowers as they can now take their medicine without inhaling soot, tar and carcinogens into the lungs.
Avihu Tamir, Kanabo’s CEO, said: “The VapePod is a world first allowing specialist consultants to prescribe a metered dose of medicinal cannabis that is healthier for patients than the alternative, which is typically smoking.
“Medical cannabis is a safer alternative to the conventional opiate solutions and other pain management treatments. This announcement ensures that thousands of UK patients have access to the most effective medicinal cannabis delivery system.
“The fact that the VapePod gives exactly 1mg on every inhalation is crucial for GPs because they can prescribe an exact dose which they haven’t been able to do before. For patients who want the similarity to smoking but know they are not inhaling soot and tar. There’s also the bioavailability factor too.
“The reason GPs haven’t been prescribing is the issue of dosing and flowers – they don’t feel comfortable asking patients to smoke. With Kanabo, they can prescribe exact dosing in a safe and consistent way.”
The medical extract formula, which is based on the Israeli medical cannabis pharmacopoeia as a recommendation for the treatment of pain management, has a purity of 70 percent THC with 15 percent minor cannabinoids and terpenes.
Earlier this year Kanabo became the second cannabis company to list on the London Stock Exchange.
Dean Friday, LYPHE’s CEO commented: “Kanabo are experts in novel delivery with their VapePod greatly improving onset times, and for our chronic pain patients we now have an alternative to flower vaporisation. This is the start of a revolution in medical cannabis application and we are delighted to be supplying it under the NOIDECS brand.”
Cancer survivors turn to cannabis for physical and mental health – study
Cancer survivors are more likely to use cannabis to help pain, anxiety, sleep and nausea.
Cancer survivors are frequently using cannabis to manage physical and mental health symptoms, says a new study.
Research from the US indicates that cancer survivors are more likely to use cannabis for symptoms such as pain, anxiety, trouble sleeping and nausea.
A team of investigators analysed results from a Covid-19 cannabis health study to examine changes to cannabis use, methods of cannabis delivery, and coping strategies among cancer survivors since the pandemic.
They found that individuals with a history of cancer are more likely to report cannabis use to manage mental health and pain symptoms.
This group of people were also more likely to report fear of a Covid-19 diagnosis, compared to adults without a history of cancer.
Data was collected from 158 responses between 21 March 2020 and 23 March 2021, from cancer survivors who identified as medicinal cannabis users.
These were then compared to medicinal cannabis users without a history of cancer of the same age.
According to the study, cancer survivors were more likely to report using cannabis as a way of managing nausea/vomiting, headaches or migraines, seizures, sleep problems or as an appetite stimulant.
Sixty one percent of respondents with a history of cancer used cannabis to manage anxiety symptoms and 54 percent for chronic pain.
Forty eight percent said they used it to manage depressive symptoms and 25 percent for PTSD, while smaller numbers used it for symptoms of another autoimmune disease, and irritable bowel syndrome.
While there were no differences in how often they used cannabis or their method of administration, cancer survivors were “more likely to have an advanced supply of cannabis”.
The findings support the need for more conversations between doctors and their patients about the use of cannabis, say those behind the study.
The authors concluded: “Overall, we observed that cancer survivors are frequently reporting the use of cannabis to manage both physical and mental health symptoms associated with their cancer diagnosis and that cancer survivors are more likely to report fear of a Covid-19 diagnosis compared to those without a history of cancer.
“Given the frequency of mental and physical health symptoms reported among cancer survivors during the Covid-19 pandemic period, clinician–patient interactions should include questions around cannabis use, particularly those with a history of cancer.”
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