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Drug Science welcomes medical cannabis report – but warns of ‘limited’ access

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The ACMD report has been criticised for missing a number of key issues

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.

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Six big cannabis sector stories you might have missed this week

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It’s been another week of big news in the cannabis world.

At Cannabis Health, our in depth coverage of the ongoing growth of cannabis as a medical and wellness product continues

Meanwhile, over at Cannabis Wealth, we’ve been following all the big industry and policy news in a week which has seen some important developments..

Been busy and want to get caught up in a hurry?

Here are the six things you need to read to stay in the loop this week.

1. Reprieve for medical cannabis patients

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year.

Medical cannabis

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020.

Read the full story.

2. UK largest’s medical cannabis trial reports back

The first findings from the UK’s largest medical cannabis patient study show quality of life improved by more than 50 percent.

Preliminary results from Drug Science’s Project Twenty21 study, have found medical cannabis significantly improves quality of life for people with life-limiting conditions such as chronic pain, multiple sclerosis (MS) Tourette’s syndrome and post-traumatic stress disorder (PTSD).

Published on Tuesday 11 May, the report is the first real-world data to be collected on medical cannabis in the UK.

Read more here.

3. Harrowing first-hand account of medical cannabis user
Diagnosed with a personality disorder and experiencing debilitating anxiety which left him housebound, Craig – whose name has been changed – had exhausted all treatment options and was losing all hope.
He speaks about how medical cannabis helped save his life here.

4. CBD market set to shrink

The UK’s CBD sector looks set to shrink significantly as the roll out of new regulations continues to batter the industry.

The FSA has confirmed to Cannabis Wealth it received applications for 803 different CBD products – but only 42 have been advanced to the next stage of the process so far.

More than half of all applications (445) were ‘incomplete’ and a further 41 have been withdrawn altogether.

Read the full story here.

5. CBD not linked to single doping case

CBD has not been linked to a single failed drugs test in UK sport despite fears about the undeclared levels of THC in some products.

The World Anti-Doping Agency removed the cannabinoid from its banned substances list in 2017 and since then several high profile athletes have publicly endorsed CBD products.

Even though CBD – which has no psychoactive properties – is not banned, the UK Anti-Doping (UKAD) still warns athletes to be cautious with treatments.

Read our exclusive report here.

6. School’s out for cannabis class

The first class on a pioneering university medical cannabis course have concluded their first year of studies.

The research programme at the Humboldt-Universitat zu Berlin examines the medical and nutritional uses of cannabis, production and the legal and economic frameworks of the business.

It’s the latest sign that medical cannabis is becoming a part of the mainstream education offering and a positive indication that new industry leaders will emerge in the coming years.

Full story here.

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Science finds a way for medical cannabis to relieve pain without side effects

Researchers have developed a molecule that allows THC to fight pain without the side effects.

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Medical cannabis
Many people living with chronic pain have found that cannabis can provide relief. 

Scientists may have developed a molecule which could allow medical cannabis to provide pain relief without any side effects.

Many people live with chronic pain, and in some cases, cannabis can provide relief. 

But the drug also can significantly impact memory and other cognitive functions. 

Now, researchers have developed a peptide that, in mice, allowed THC to fight pain without the side effects.

According to the US Centres for Disease Control and Prevention (CDC) around 20 percent of adults in the states experienced chronic pain in 2019. 

In some studies, medical cannabis has been helpful in relieving pain from migraines, neuropathy, cancer and other conditions, but the side effects can present hurdles for widespread therapeutic use.

Previously, researchers identified two peptides [molecules which are made up of amino acids] that disrupt an interaction between a receptor that is the target of THC and another that binds serotonin, a neurotransmitter that regulates learning, memory and other cognitive functions. 

When the researchers injected the peptides into the brains of mice, the mice had fewer memory problems caused by THC. 

Now, this team, led by Rafael Maldonado, David Andreu and colleagues, has gone one step further to improve these peptides to make them smaller, more stable, orally active and able to cross the blood-brain barrier.

Based on data from molecular dynamic simulations, the researchers designed two peptides that were less than half the length of the original ones but preserved their receptor binding and other functions. 

They also optimised the peptide sequences for improved cell entry, stability and ability to cross the blood-brain barrier. 

Then, the researchers gave the most promising peptide to mice orally, along with a THC injection, and tested the mice’s pain threshold and memory. 

Mice treated with both THC and the optimised peptide reaped the pain-relieving benefits of THC and also showed improved memory compared with mice treated with THC alone. 

Importantly, multiple treatments with the peptide did not evoke an immune response. 

Reporting in the American Chemical Society’s Journal of Medicinal Chemistry, researchers say that these findings suggest the optimised peptide is an ideal drug candidate for reducing cognitive side effects from cannabis-based pain management.

The abstract that accompanies this paper can be viewed here.

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Dutch Government to supply medical cannabis for UK patients until 2022

The Department of Health has reached an agreement to continue the supply of Bedrocan oils

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The Dutch Government will supply medical cannabis to UK patients until 2022

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year. 

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020. 

After outrage from campaigners, the Dutch government agreed to continue supplying the life-saving products until 1 July, 2021 while a more permanent solution was reached.

This waiver period has now been extended until 1 January, 2022.

Health ministers promised to work with officials in the Netherlands to find a “long-term” solution, but according to those at the forefront of the campaign, there is still “some way to go”.

Hannah Deacon and son Alfie Dingley

Hannah Deacon’s son Alfie Dingley, who is prescribed Bedrocan products for a rare form of epilepsy, recently celebrated one year seizure-free.

In a letter to Deacon on Thursday 13 May, the DofH said it was working with the Dutch government, Bedrocan and the Transvaal pharmacy to proceed as “quickly as possible” with the UK production of these medicines.

It added that domestic production is “complex” and that manufacturing “unlicensed herbal medicines” comes with “significant challenges”. 

Deacon said that the UK production of Bedrocan products was the “only solution”.

While other cannabis-based medicines are available in the UK, experts have warned that there is ‘significant variation’ from one product to the next and switching an epilepsy patient’s treatment could be ‘life-threatening’.

“With the 1 July deadline for Bedrolite supply to cease from the Netherlands looming ever closer, we made it clear we wanted an extension to the agreement to stop the situation becoming dangerous for Alfie and the other patients receiving this vital medicine,” commented Deacon.

“The long term solution of Bedrocan products being made in the UK still has some way to go, but it can be the only solution and we thank everyone who is working very hard to achieve this. 

“This is still a long way off from being okay, but for now we have the pressure taken off on the supply issue.”

With limited access to medical cannabis on the NHS, families are still calling for the Government to help fund their children’s prescriptions, which can cost thousands of pounds each month.

Deacon added: “The ever-pressing issue of financial burden on the many families and patients wishing to use medical cannabis in the UK remains and this is a huge issue which needs dealing with.

“There are many ways in which the Government could step in and help access for very vulnerable people and we will continue working as hard as we can to make things better for all.”

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