A survey of more than 1,000 practicing UK GPs, suggests that 73 percent would be open-minded about prescribing medical cannabis.
Results from the UK’s largest ever survey on attitudes towards medical cannabis among GP’s, indicate that almost three quarters were open-minded about having a more active role within the field.
When asked if they would support the idea of trained, specialist GPs facilitating prescriptions for eligible patients, 39 percent of respondents answered with yes, while 34 percent said they weren’t sure and only 26 percent said no.
In addition, almost a quarter (24 percent) of respondents said they would be willing to take on the role of prescribing and overseeing medical cannabis treatments.
The survey, published on Monday 12 July, by The Primary Care Cannabis Network (PCCN) is the first insight into UK GP’s attitudes towards medical cannabis.
Over half believe cannabis-based medicines could benefit patients who have exhausted conventional treatments, while 27 percent feel it can offer improved quality of life.
Just under a quarter believe it can offer multi-symptom management and reduced dependency on other prescribed medications, while 13 percent believe it can offer more patient-led personalised medicine.
A third of GPs (33 percent) said they were asked about medical cannabis treatment by their patients approximately every six months, but access for UK patients remains extremely limited, with most prescriptions of unlicensed cannabis medicines having been issued by specialist consultants working within private clinics.
With at least 1.4 million people in the UK thought to be self-medicating with cannabis, GPs could have a significant role to play in initiating access and overseeing prescribing for a wide range of conditions that are commonly managed within a primary care setting, such as chronic pain and anxiety, say the authors.
According to the survey, UK doctors favoured medical cannabis for use in chronic cancer pain, palliative care, intractable epilepsy, and spasticity in multiple sclerosis (MS), all of which – apart from epilepsy – can be managed within primary care.
However, mood disorders such as anxiety, depression, and PTSD were not generally seen as suitable indications for medical cannabis treatments, despite growing numbers of patients being prescribed privately for these conditions.
The majority of doctors (72 percent) cited their main concern around cannabis-based treatments as the fact that the majority of the available medicines are unlicensed.
Lack of evidence around efficacy also continues to be a problem.
Those behind the survey say more awareness and access to education for GPs is crucial, with 48 percent of respondents asking for clear and concise summaries of the most up to date evidence-based research on cannabis-based medicines.
GP focused e-learning platforms and quick reference desktop guidance were also called for.
Founder of the PCCN, the UK’s largest network of GPs with a professional interest in learning about medical cannabis, Dr Leon Barron explained: “GPs make up the majority of medical cannabis main prescribers in many of the more established legalised medical markets.
“They can enable patient access to this medicine in Canada, USA, Germany and Australia to name a few countries. In the UK however, GPs have largely been left out of the conversion and we feel it’s time to change that.”
While the survey points to some positive attitudes among doctors in the UK, it highlights the need for standardisation in how GPs approach the subject of cannabis medicines with their patients.
As they are often the first port of call, GPs can offer a patient a positive – or negative – experience when enquiring about medical cannabis.
Patient advocacy group PLEA (Patient-Led Engagement for Access) has called for doctors to educate themselves to be able to provide a more open environment to discuss cannabis medicines.
PLEA advocacy lead, Lucy Stafford says she was lucky that her GP was open-minded and helped her find a specialist prescriber.
“GP knowledge is crucial. Having a GP that is non-judgmental, supportive, and open to understanding medical cannabis could lead to the patient discovering a treatment that works for them as I did,” she commented.
“I was lucky to have an open-minded GP who referred me to a specialist prescriber – the difference in how I am able to live now after treatment is like night and day.
“Doctors always ask for evidence but actually, it’s not the academic evidence that convinces them, it’s the living, breathing evidence – hearing from the patient themselves – that changes their mind towards the efficacy of medical cannabis.”
Dr Barron continued: “There has been a growing groundswell of doctors in the UK willing to learn more about this medicine and support their patients’ interests. Cannabis based medicines such as Cannabidiol is a rapidly emerging field of medicine which is only just gaining popularity.
“It is our duty to be informed and approachable on the subject but further to that doctors now have the opportunity to develop professional skills in an area of personalised medicine which is growing rapidly.
“We encourage UK GPs to join us at PCCN and to expand our knowledge as we are just at the cusp of a huge growth area in healthcare.”
US Congresswoman speaks out about how cannabis helped her depression
Nancy Mace spoke out about using cannabis to help her depression after experiencing a traumatic event as a teenager
A Republican congresswoman who has proposed a federal bill to legalise cannabis has spoken out about her experience using cannabis to combat depression.
It also includes expungement for non-violent cannabis crimes and imposes a revenue tax that would support reinvestment into communities hurt by the war on drugs.
The bill titled the States Reform Act would federally legalise and tax cannabis has been proposed ahead of competing Democrat proposed bills. While the bill was originally proposed in July, Mace shared her story after officially filing the State Reform Act in November.
At the end of the discussion, host, Lisa “Kennedy” Montgomery asked the congresswoman if she smoked cannabis.
Nancy replied: “When I was 16, I was raped. I was given prescription medication that made the feelings I had of depression worsen, and I stopped taking those prescription drugs and I turned to cannabis for a brief period of time in my life.”
She added that she believed her experience with cannabis made her more sympathetic to veterans who may use cannabis for conditions such as post-traumatic stress disorder (PTSD).
— Kennedy (@KennedyNation) November 17, 2021
Bill protection for veterans
The congresswoman explained that the new bill is “particularity protective of veterans, ensuring they are protected, not discriminated against and that the US Department of Veteran Affairs can utilise cannabis for their PTSD.”
She added: “When I talk to vets and I see that pain, it hurts because I felt that pain before in my life. Veteran suicide, we see every single day.”
One other provision in the bill is that cannabis would be under the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau (TTB) instead of the Food and Drug Administration (FDA). The FDA would have some involvement similar to its current control over the alcohol industry.
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Mace has already won an exception for rape and incest victims in a fatal fetal heartbeat bill. She mentioned her history when it came to proposing that bill in 2019.
She said: “I’ve had family that have overdosed from hardcore opiates and prescription drugs. And I’ve mentioned part of this in 2019, at the time I got the exception for rape and incest in the fetal-heartbeat bill I told my story about being raped when I was 16, but I’ve never said this part publicly before: I was prescribed antidepressants afterwards, and it made my feelings a lot worse. And so I started using cannabis for a brief moment, for a time in my life. It helped me. It cut down on my anxiety and helped me get through some dark periods.”
Study: States with full legal access show fewer registered medical cannabis patients
“If true, this could have implications for public health and policy,” say researchers.
Study shows U.S states where cannabis is legal for recreational purposes have experienced a decrease in patients registering for medical cannabis programmes.
The study on different US states, published in the International Drug Journal, revealed that numbers of registered and active medical cannabis consumers increased while it was not legal for recreational use.
Researchers in Arizona took data from the medical cannabis registry from two dozen states between 2013 and 2020. These are mandatory registries that record the number of medical cannabis patients. They analysed the data to see if there were any changes around the times that recreational legalisation was introduced.
There are currently 19 states in the US that have legalised recreational cannabis including New Jersey, Vermont, Arizona and New York. However, more states have medical cannabis programs although some are still not operational. Some states such as Colorado have had recreational access since 2012, the year before the study was started.
Medical cannabis patients
The results confirmed that medical cannabis cardholders increased during times when recreational use was not legal. It then subsequently decreased when it became legal.
It also revealed an increase of 380 patients per 100,000 people per year when just medical cannabis was legal. This corresponded to a decrease of 100 patients per 100,000 after recreational cannabis was allowed. The researchers noted that active registered active male patients decreased faster than women. In states where only medical cannabis was legal, the older age groups (35 or older), increased faster.
They also found that in three states with medical-only use, the results showed significant increases in enrollment from 2016 to 2020 across white, African-American and Hispanic patients.
The researchers wrote: “There is speculation that enrollment in U.S. state medical cannabis programs differs depending on whether adult recreational cannabis use is legal. If true, this could have implications for public health and policy.”
“Findings suggest that recreational cannabis legalisation is associated with decreasing enrollment in medical cannabis programs, particularly for males.”
Fibromyalgia and medical cannabis: “I find my pain is completely gone”
Natalie began experiencing fibromyalgia pain when she was a teenager but wasn’t diagnosed until her 20s.
Natalie talks to Cannabis Health about living with fibromyalgia and how cannabis has helped her with pain relief.
Fibromyalgia can be a debilitating condition leaving patients with chronic pain, fatigue and increased sensitivity. Other side effects can include poor sleep, cognitive issues and headaches. It is thought to affect around 1.5-2 million people in the UK.
Natalie was diagnosed with fibromyalgia when she was in her first year of teaching. She had been experiencing some of the symptoms since she was in her early teens but doctors told her it was growing pains.
“Since I was about 12, I had a lot of pain that came and went with a lot of fatigue,” she explains.
“The doctor’s put it down to growing pains. When I was I was in my first year of teaching, one day I woke up and couldn’t do anything. I was incredibly tired and in so much pain.
“I felt that way for months and I was really struggling. I got my formal diagnosis from a rheumatologist. I had a lot of blood and strength tests to make sure I didn’t have arthritis or lupus because of the similar symptoms.”
Life with fibromyalgia
Once Natalie had her diagnosis, her life began to change. She quit her teaching job as it became too much to cope with when her symptoms were bad. She took on jobs where she could choose her own hours or work part-time.
“I ended up working as a children’s entertainer because it was good money,” she says.
“I could do it over a few days a week and make an acceptable amount of money to cover my bills. I did retail work alongside it.”
When it came to socialising, to stop herself from feeling isolated, Natalie turned to online communities to meet people and make friends.
“I’m not amazing at socialising, so I’ve always found it a struggle. I didn’t stay in touch with a lot of people from university or school because I also have mental health problems that held me back. This isolated me a lot so I did turn to online communities where I met a few people who I’m still friends with now,” says Natalie.
It wasn’t until she joined online fibromyalgia communities that someone suggested that cannabis may have benefits.
“I never really knew about its benefits, although I knew it would relax you,” she admits.
“People in my fibromyalgia groups said they used medical cannabis and found it helpful. It’s only really been the last few years where I’ve used it properly as a medicine.”
Cannabis may help with the pain experienced by fibromyalgia patients. A recent study on patients diagnosed with fibromyalgia and other inflammatory rheumatic diseases reported a reduction in pain levels following medical cannabis use. The study surveyed 319 patients about their use of medical cannabis products. Those with fibromyalgia reported a mean pain level reduction of 77 per cent while 78 per cent also reported sleep quality improvement.
Although Natalie has family members who use medical cannabis in legal states in the US, she hadn’t considered using it herself. Despite being open to the idea of a prescription, she says there was very little mentioned to her about pursuing it by her doctors.
“It’s weird because it’s almost like a whisper network. I would never have known about the private medical thing because it’s not really mentioned and the health sector doesn’t talk about it. They don’t actively tell you about prescriptions,” she says.
Natalie has found that cannabis helps her most with the pain.
“A lot of the time, I get shoulder or lower back pain. If other people knew my pain level, they would have a different idea of what pain is, but I guess I’m used to it,” she says.
““Due to the way I work, I don’t use it until the evening. At the end of the day, I’ll use cannabis and I find my pain is completely gone. Sometimes, if I’m struggling then I’ll have a nice bath, have my cannabis and that’s the perfect combination.”
Natalie is guarded about her cannabis use because of the stigma but also due to her job. She is open with some of her friends but not her family. She chose to use only her first name to avoid being identified.
“My parents are from a different generation and they are quite conservative too. It’s very different for them so they don’t understand how it would help. My clients obviously don’t know, as some wouldn’t like it. [But] I have clients in the Netherlands who don’t drink but will go for a joint but it’s different for me,” she says.
“People still struggle to admit to taking medication because of the attitude. I’ve tried Tramadol, Xanax and all sorts of things that have more impact on how you feel, physically and mentally compared to cannabis. But that’s acceptable because it’s prescribed by a big pharmaceutical company.”
Natalie feels that there is a lot to be changed in terms of education, so that people know the benefit of cannabis when it comes to conditions like fibromyalgia. She also highlighted that there should be more awareness of the options out there when it comes to accessing a prescription.
“More people should be aware of the benefits of what it can do, rather than it being a niche internet topic or having a weird stigma around it,” she adds.
“Medical professionals need to be more aware of how it can help and the different avenues that people can go down to get prescriptions.”
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