Drug Science’s Project Twenty21 is a landmark scheme that seeks to widen access to medicinal cannabis and build Europe’s largest body of evidence for its efficacy. In a two-part series Cannabis Health speaks to a patient and prescriber about their experience on the project so far.
Project Twenty21 was launched in November 2019 by the UK drug advisory committee, Drug Science. In August 2020, the patient registry handed out its first medical cannabis prescription.
A medical cannabis prescription is notoriously difficult to access on the NHS. In fact, an Advisory Council for the Misuse of Drugs (ACMD) report from 2020 revealed that less than five have been handed out by the health service. Meanwhile, those who can afford private healthcare can sometimes be left forking out thousands of pounds per month for a prescription.
Drug Science aims to build Europe’s largest body of data on the safety and efficacy of cannabis and help more people gain access to the medicine legally.
The patient’s perspective
Matthew Taylor lives with a number of debilitating conditions including degenerative disc disease, spinal stenosis and osteoarthritis.
He has struggled for years with both chronic pain and mobility issues which, up until now, he has managed through traditional pain medication.
CH: What medication were you using before you were prescribed cannabis?
MT: Before medical cannabis, I was on a combination of opiates, opioids, muscle relaxants and general painkillers. They made me feel very distant and detached. I wasn’t able to communicate with people very well at all and I used to feel very nauseous most of the time.
I was able to get away from that with medical cannabis. The fentanyl I was previously on was nowhere near as effective as a painkiller as medical cannabis has been.
CH: How did you find out about Project Twenty21?
MT: I found out about it through another medical cannabis advocate, who I was introduced to through my local MP.
CH: How have you benefited from medical cannabis?
MT: Medical cannabis has certainly changed my life for the better. I’ve been able to come off medications that severely impacted how I was able to participate in daily activities. Even things as simple as communicating with my kids and my wife.
We play board games, I help them with their homework a lot more; my head is so much cleaner and pain is reduced incredibly. I would say 50 percent of my pain has gone from my first two inhales of medical cannabis.
I wouldn’t be able to sit in this room on this particular chair without medical cannabis. There’s only one chair that I could sit in for more than 10 minutes and it cost £400.
The difference in my life is remarkable. I feel like me again, as if I’ve come back from a long sleep. I wasn’t me for a good 10 years, to the point where I was using SSRI medications for depression, which I am currently coming off at the moment.
CH: What do you think needs to change for patients?
MT: Medical cannabis needs to become available for more patients, as it can help with a range of medical conditions, as I’m sure will become apparent from the results of Project 2021 when they come out.
I think many people just simply don’t understand medical cannabis as a medicine. They are afraid of stories that they’ve heard over the years. Misinformation claiming that it can make people psychotic, it can make people become violent or dangerous. And that is simply not the case.
There’s a doctor there alongside you during the project to make sure that you can take the medicine appropriately and it is helping your condition.They’re extremely helpful for that.
I hope that many other patients do go ahead and sign up to come on board the project because it will help with regards to fully accepting medical cannabis in the UK.
Find out more about joining Project Twenty21 here
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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