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“This is not compassionate”: Ireland’s medical cannabis scheme ‘excludes thousands of patients’

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Campaigners have said the scheme is not inclusive enough

Ireland’s government has finally announced funding for its Medical Cannabis Access Programme – but the scheme remains ‘extremely restrictive’, say campaigners.

Almost two years since the legislation was introduced in June 2019,  Ireland’s Health Minister Stephen Donnelly announced funding for the Medicinal Cannabis Access Programme on Thursday 21 January.

The programme is expected to commence later this year, with Donnelly claiming it will allow for “compassionate access” to cannabis medicines.

But campaigners have been quick to criticise the scheme, which only offers access to four low dose cannabis-based medicines to people living with one of three qualifying conditions.

These include intractable nausea and vomiting associated with chemotherapy, severe treatment-resistant epilepsy and spasticity associated with multiple sclerosis (MS). 

But despite all of the patients who are currently being prescribed cannabis under a ministerial license, using Bedrocan products from the Transvaal pharmacy in the Hague, none of these have been approved for the programme.

This suggests children – including 11-year-old Ava Barry – who have had their quality of life significantly improved by Bedrocan oils, will have to switch products in order to have their prescriptions reimbursed.

Ava Barry is prescribed Bedrocan oils for severe epilepsy

As has been highlighted extensively by campaigners in the UK in recent weeks, in regard to the issues importing Bedrocan due to Brexit, changing treatments for epilepsy can lead to a worsening of seizures and could be life-threatening. 

Alicia Maher is a patient and advocate who moved to Spain in 2019 in order to have better access to cannabis medicines, which she uses to manage chronic pain.

While she welcomed the news that the programme would finally be funded, she will still not be able to return to her hometown of Limerick.

“Many people have asked me whether this will impact me and whether I will be able to come home, but sadly the answer is no,” she said.

“Chronic pain is not one of the qualifying conditions, despite the Health Products Regulatory Authority (HPRA) acknowledging in their 2017 report that it is the most researched indication for cannabinoids, with the majority of reports concluding that cannabis is an effective treatment for chronic pain.”

According to Alicia, recent reports suggest that approximately 25 percent of the population suffer from chronic pain, with the condition affecting over 1.5 million people.

She was granted a ministerial licence to be legally prescribed medical cannabis last year, but would have to fund the costs of the prescription herself.

She continued: “I, along with many others that currently hold the ministerial licence and fall outside the three qualifying conditions, will not be allowed onto the access programme, even though our doctors are currently prescribing cannabis. 

“We won’t have access to any of the cannabis products that have been approved and we won’t have our costs reimbursed. 

Alicia added: “It is fiscally irresponsible as the cost of my cannabis prescription is less than my prescription was for 30 opioids per day, yet they were completely covered on my medical card.”

Campaign group, Cork Cannabis Activist Network said excluding patients from accessing these medicines is in no way “compassionate” or “acceptable”.

“The headlines are designed to paint a rosy picture favouring those in government, but this is not the truth, and most certainly for not the countless Irish citizens who consume cannabis daily for various medical reasons,” Nicole Lonergan spokesperson for the group, told Cannabis Health.

“Cannabis is complex and so are patients and their individual physiological needs. Yet the Irish government thinks it’s acceptable to offer limited access to four cannabis-based medicines and restrict access to three qualifying conditions.”

Nicole is among those who want to see cannabis legalised in Ireland, with thousands of patients still forced to access medication illegally.

The group has called for an education programme to improve understanding of the medicinal benefits of cannabis among healthcare professionals.

“Week after week, I receive hundreds of messages from people of all ages and backgrounds crying out for cannabis to be legalised,” she said.

“A comprehensive cannabis education programme needs to be urgently rolled out to GP’s and consultants in Ireland and the law needs to be changed so that no one is forced to continue relying on the illegal market for their medicine.”

Nicole added: “It is not ‘compassionate’ to exclude certain patients from accessing cannabis medicines, or to offer an extremely limited selection of products that do not suit the majority of patients’ needs. It is not ‘compassionate’ to condemn patients to rely on an illegal market or force patients to leave their homes and families to access cannabis legally.

“We deserve answers as to why the Irish government continues to uphold a law that ruins lives and prevents access to legitimate, effective medicine in all its forms.”

Announcing the provision of funding and delivery of the Medical Cannabis Access Programme, Minister Donnelly said:  “The purpose of this Programme is to facilitate compassionate access to cannabis for medical reasons, where conventional treatment has failed. It follows the clear pathway laid out by the Health Products Regulatory Authority in their expert report ‘Cannabis for Medical Use – A Scientific Review’. 

“Ultimately it will be the decision of the medical consultant, in consultation with their patient, to prescribe a particular treatment, including a cannabis-based treatment, for a patient under their care. 

“It is important to state that there are no plans to legalise cannabis in this country.”

READ MORE  German pharma giant launches medical cannabis for chronic pain patients

Industry

Spain approves first cannabis based medicine

The approval for Epidyolex was based on the results of four randomised controlled Phase III trials

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Spain cannabis: A Spanish flag in the air with an old building behind it

Spain has approved the first cannabis based medicine, Epidyolex for patients with severe conditions such as epilepsy.

Epidyolex, an oral cannabis-based medicine, has been approved in Spain by the Ministry of Health after a large two-year trial. The approval for Epidyolex was based on the results of four randomised controlled Phase III trials. The clinical development of the therapy was spread over 10 different hospitals.

The trial involved over 700 participants with severe forms of epilepsy.

Until recently, there was no distinction between recreational and medicinal cannabis use in Spain which made it difficult to obtain products with higher quantities of 0.02 percent THC.

The medicine will only be available in hospital pharmacies for the treatment of seizures caused by Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome (DS).

Spain and medical cannabis

Speaking at a press conference, neurologist Vicente Villanueva, head of the Refractory Epilepsy Unit of the Hospital Universtiari i Politècnic La Fe de València said the trials have found a 40 percent reduction in seizures.  “As clinicians and researchers, we are satisfied to have these new options”, 

Antonio Gil-Nagel Rein, a neurologist and director of the Epilepsy Program of the Hospital Ruber Internacional de Madrid reported: “The potential improvement of the quality of life in an area where therapeutic options are very small is good news. Access to a new drug with a novel and clinically proven mechanism of action is a reason for hope for patients and satisfaction for specialists.”

Epidyolex received approval from the European Commission in September 2019. This made it the first cannabis-based prescription medicine to receive authorisation.

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Industry

Royal Society of Medicine and Integro Clinics announce pain and cannabis medicines event

The event takes place on October 11 from 8:30 to 17:30. It will explore the potential of cannabis medicines in the field of pain medicine in the UK

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Event: The Royal Society of Medicine logo in green and red on a white background

The Royal Society of Medicine has announced a collaborative event, Pain and cannabis medicines: Everything you want to know (but were too afraid to ask) in association with Integro Medical Clinics.

The event takes place on October 11 from 8:30 to 17:30. It will explore the potential of cannabis medicines in the field of pain medicine in the UK

Since the legalisation of cannabis medicines on prescription in November 2018, patients and clinicians alike have been awaiting more data or information regarding these medicines. 

The event aims to provide those attending with a comprehensive understanding of the uses of cannabis medicines and the practicalities of using them in their own practice. It will consist of presentations on the history, regulatory environment and pharmacology of cannabis medicines including the use of different cannabis-based medical preparations in treating pain and related symptoms in a wide variety of clinical fields in the context of the current UK regulatory framework. 

Event presentations

The day will feature presentations from international leaders in cannabis medicines such as Professor Raphael Mechoulam, the chemist who discovered the endocannabinoid system and THC, Dr Anthony Ordman, Leading UK Consultant in Pain Medicine and previous President of the Pain Medicine Section of the Royal Society of Medicine and Dr Arno Hazekamp PhD, who worked as Head of Research and Education at Bedrocan, the first European company to produce EU GMP grade cannabis medicines.  

If you wish to sign up, please click here.

Event speakers
Dr Anthony Ordman, Consultant in Pain Medicine

Event: A black and white headshot of Dr Anthony Ordman Founder of the highly respected Chronic Pain Clinic at London’s Royal Free Hospital, he is one of the UK’s most experienced specialists in the treatment of pain. For his contributions to Pain Medicine, Dr Ordman was awarded a Fellowship of the Royal College of Physicians in 2005, and he is the Immediate Past President of the Pain Medicine Section of the Royal Society of Medicine. Dr Ordman is also Senior Medical Consultant and Lead Clinician at Integro Medical Clinics and has a special interest in the potential benefits of cannabis medicines in pain medicine.

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Alex Fraser, Patient Access Lead at GrowPharma

Event: A black and white headshot of guest speaker Alex FraserAlex Fraser is a leading medical cannabis patient advocate. He is a patient himself having been diagnosed with Crohn’s Disease in 2010 at 19 years old. In 2014 he founded the United Patients Alliance and has since appeared on mainstream media multiple times, including on the BBC and ITV, to highlight the urgent need for access to cannabis medicines for the many patients who may benefit from them. He has taken delegations of patients to parliament to give testimony to politicians at the highest levels and organised educational events, rallies and protests calling for law change on medical cannabis. In February 2019 Alex joined Grow Pharma, one of the leading suppliers of cannabis medicines in the UK, as their patient access lead. He utilises his extensive knowledge of medical cannabis, his understanding of patient needs and his network in the industry to ensure patient voices are heard and represented. His work includes informing top-level policymakers, educating healthcare professionals and conceiving and running projects that increase general awareness and provide practical help for patients.

Professor Raphael Mechoulam, Professor of Medicinal Chemistry at the Hebrew University of Jerusalem in Israel

Event: A black and white headshot Most well-known for the total synthesis of delta-9 tetrahydrocannabinol (THC) and the discovery of the Endocannabinoid System. Since the inception of his research in the 60s, Professor Mechoulam has been nominated for over 25 academic awards, including the Heinrich Wieland Prize (2004), an Honorary doctorate from Complutense University (2006), the Israel Prize in Exact Sciences – chemistry (2000), the Israel Chemical Society Prize for excellence in research (2009) and EMET Prize in Exact Sciences – Chemistry (2012

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Dr Sally Ghazaleh, Consultant Pain Specialist

Event: A black and white headshot of a guest speakerDr Sally Ghazaleh, is a Pain Management Consultant at the Whittington Hospital, and the National Hospital of Neurology and Neurosurgery, London. She qualified from the University of Szeged Medical School, Hungary in 2000, and then completed her specialist training in the Anaesthesia and Intensive Care Medicine at Semmelweis University in 2007. She went on a fellowship at University College Hospital, London, to gain her higher degree in Pain Medicine

During her time at the pain management Centre at University College Hospital, she gained extensive experience in dealing with and managing patients with complex multiple pain problems. She is accomplished at a variety of interventional and non-interventional treatments for this specific patient group. Sally specializes in managing patients with lower back pain, neck pain, neuropathic pain, abdominal pain, cancer pain, complex regional pain syndrome, post-stroke pain and Fibromyalgia. She has a particular interest in bladder and abdominal pain in women, and women’s health in general.

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Advocacy

Celebrities including Drake call for a general pardon for those involved in cannabis offences.

There are over 150 signatures from rappers, artists, producers, law enforcement and more.

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Celebrities: A judges gavel on a wooden table next to a green cannabis leaf

Over 150 celebrities including the rapper Drake and NBA athletes have signed an open letter to President Biden calling for a general pardon of non-violent cannabis offences.

NBA athlete Al Harrington, rapper Drake, world champion boxer Badou Jack, rapper and activist Killer Mike, NBA star John Wall along with Meek Mill and Julio Jones announced at a live-streamed event that they have co-written and signed a letter addressed to President Joe Biden. The letter requests a general pardon for ‘all persons subject to federal criminal or civil enforcement on the basis of a nonviolent marijuana offence.”

The idea for the letter to president Biden came from Weldon Angelos of the Weldon Project/ Mission Green and Academy for Justice Director Erik Luna. The Weldon Project aims to help fund social change and financial aid for those who are still serving prison time for cannabis-related offences. Angelo was an emerging musician before he was sent to prison for selling less than $1,000 worth of cannabis.  Despite it being his first offence,  Angelos went on to service 13 years of his term before eventually being released in 2016. He founded the project upon being released.

The letter includes signatures from 150 athletes, artists, law enforcement officials, academics, business leaders, producers, lawmakers, policy experts, reform advocates and other professionals.

It reads: “This resolve is witnessed today in both red and blue states, from coast to coast, as the American people call for an end to cannabis prohibition. Whatever one thinks of other drugs and other defendants, incarcerating cannabis offenders in federal prisons is a misuse of our nation’s resources and grossly hypocritical, given that a clear majority of Americans oppose cannabis prohibition and about half admit to using the drug during their lifetime.”

The live-streamed event discussed the letter to President Biden while placing an emphasis on a call for a general pardon. Speaking with Benzinga, Angelos said that the celebrities who had signed the letter had done so in support of a fellow artist, Ralo who is facing eight years for a cannabis offence. Despite several states switching to safe, regulated cannabis programs.

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“When Biden ran for president, he promised to take action and use the pardon power of the presidency to release those serving prison time for marijuana and pardon their felony convictions,” Angelos said. “At a time when dispensaries are as prevalent as liquor stores in some states, it is time for President Biden to now make good on that promise.”

In a press release, Ralo said: “I appreciate my friends and peers in the hip-hop community, such as Drake & Killer Mike, for supporting my clemency because it’s just not right that corporations are allowed to violate federal law and become millionaires while people like myself go to prison for years,”

He added: “This is hypocrisy. But I am hopeful that Joe Biden will honour his campaign promise and grant us clemency, without delay, so that we can return home to our families and communities.”

Angelos also highlighted that the long term effects for those incarcerated ‘go beyond the prison walls’ making it difficult for former prisoners to get jobs, access to affordable housing or educational loans. “They’re limited in so many ways that people don’t realize when they just want to begin again and contribute to society. Enough is enough. No one should be locked up in federal prison for marijuana.”

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