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Emigration: “I tried cannabis again and I noticed that I was in less pain when I took it.”

In a new series, we speak to Irish cannabis patients about their decision to emigrate in search of easier, safer cannabis access.

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Emigration: A stack of suitcases against a window revealing a sunset and a plane

In a new series, Cannabis Health News talks to people who have experienced emigration in search of safe, legal cannabis access.

Our previous stories have focused on the difficulty of packing your entire life into boxes and emigrating with your family to a new country for access. However, there is another side to emigration: the potential for return.

What happens once you are a medical cannabis patient in another country and need to travel home?

The returning Irish from emigration in the past few years has hit record numbers. As people settle into life away from home, it gets harder to return. Travel options have never been easier with several flights to and from Ireland daily from all over the country, ferry options and failing that, zoom calls are a vast improvement on Skype.

COVID lockdowns meant that it’s been a difficult year for travel. Families who have experienced emigration may not have seen in their families since the beginning of the crisis. Now thanks to vaccines, travel is starting to become a possibility again.

This leaves medical cannabis patients in a confusing situation. What do you do if you have a prescription in one country yet need to go to another?

Joe’s story

This is the situation *Joe is in. This is not his real name but he has asked to remain anonymous due to the persisting negative attitudes towards cannabis which he is prescribed for debilitating arthritis.

“I have since the age of 14 suffered from debilitating rheumatoid arthritis. I also suffer from sciatica. I played rugby six days a week for my school, worked on the family farm and lived a full and normal life. My body then changed and while initially my shoulders were affected but then my knees. It felt like someone was trying to tear my arms from their sockets and that I had broken glass in my knees. That was 36 years ago.”

Arthritis is a common condition that causes pain and inflammation in a person’s joints. Osteoarthritis and rheumatoid arthritis are the two most common forms of the condition. It can start when a person is between 40 and 50 years old although it also affects children and teenagers.

In rheumatoid arthritis, the body’s immune system targets affected joints causing pain and swelling. The outer covering of the joint is the first place to be affected before it spreads across the joint leading to further swelling and a change in shape. This may cause the bone and cartilage to break down. People with rheumatoid arthritis may also develop problems with other tissues and organs.

The Irish Children’s Arthritis Network (iCAN) estimates there are over one thousand children and teenagers currently diagnosed with juvenile arthritis.

Emigration return

Emigration in Ireland soared in the 1980s as a result of a harsh recession and lack of jobs. It is estimated that during the ten years of the 1980s, 206,000 more people left Ireland.  Like a lot of Irish teenagers unable to find work and looking to leave home, Joe decided to leave Ireland for the UK. While working on a building site, he encountered other workers using cannabis.

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“Although I had my condition to contend with it, my symptoms were at their worst in autumn and winter and I went to the UK in the summer to work on building sites (I had no idea my short visit would last 33 years and counting.”

“I was brought up in Ireland with typical conservative social values. Many fellow workers on site were smoking cannabis but I had no interest and indeed felt it was both inherently morally wrong as well as being illegal.”

“For months my fellow workers would say to try some. I relented when we were out together one night as I had a few drinks so my guard was down. I smoked some cannabis. I was violently ill. I did not know that smoking cannabis with drink would have such an immediate and obvious effect.”

Emigration: A red Irish passport sitting on a black bag

Emigration, cannabis and pain

Joe began to feel more pain as winter began and his joints reacted to the cold. Despite his illness the first time, he tried cannabis again and noticed an effect on his pain levels. His quality of life began to improve and he started to make positive changes.

“I tried cannabis again a few weeks later and by this time the winter was in full flow and my bones were aching. I noticed that I was in less pain when I took it. I prayed for guidance on the issue and felt it was not a sin for me to use cannabis because it was helping to alleviate my symptoms.”

“I then started to use cannabis more frequently. When I reached 19, I no longer needed to take my prescription and I was able to cancel an appointment for injections. As my condition had relented I was able to reengage with my passion for sport and would swim a mile per day, cycle to and from work and work as a scaffolder during the day.”

“I studied A levels at night school. I returned to studies as I felt if my condition worsened I would not be able to engage in physical labour and I also had a calling to be a lawyer. Anyone who has handled scaffolding tube on a cold winters day will also understand why I felt a move indoors could be a welcome change.”

Joe did well enough in his A levels to gain a place to study law at university. He qualified as a solicitor and worked at one of the top regional practices in the country. He had the honour of meeting Irish President Mary McAleese on one of her trips to Manchester. He credits being able to live such a full life to the benefits of cannabis.

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Breaking the law

However, he was starting to worry about what could happen if his use was to become public knowledge. Especially as someone working in law.

“Cannabis had managed my condition so effectively that I was able to play football for the corporate team and had no outwards signs which could not be dismissed as being down to simple stiffness. I was concerned however that should my use of cannabis become public knowledge my career would be brought to an abrupt end.

“I was leading a double life – cannabis at the time was dismissed as having no medical use and I was afraid no-one would believe me if I said I was taking it for my arthritis.”

Joe stopped using cannabis for three years as he became fed up with breaking the law. He had also noticed attempts to change the law in regards to medical cannabis and wanted to see if he could access it legally. But his symptoms flared up as a result of him stopping his treatment.

“During my cannabis break however my arthritis flared up with a vengeance. Although now prescribed methotrexate, sulfasalazine and naproxen. During my near 30 year use of cannabis prior to this point, I needed no other drugs. Significant bone erosion occurred in this 3 year period.”

“My hands and feet were badly affected and I was unable to form a fist with either hand for about 2 years. I had to stop playing classic guitar. In addition to studying law, I also studied music and played guitar in ensembles and gave performances with others in my spare time so losing the ability to play was quite hard to take”

Joe was delighted when his prescription for cannabis was approved. After taking it for about a year, he found his condition far more under control and began to come off some of the drugs he had been prescribed. He was also able to play the guitar again.

One of the biggest things, he notes, is the feeling of being able to access his medication responsibly and not break the law.

“Cannabis, for me, does have limitations. Once I take it, I won’t drive for the rest of the day. It can give me mood swings although nothing too extreme. I can be grumpier in the mornings. I am mindful that all drugs have their side effect. I am losing my hair due to methotrexate which gives me a number of bladder issues as well as nausea.”

Emigration: two hands packing a suitcase with clothes ready to travel

Emigration and settling

Although Joe is happily settled in the UK with no plans to move home, he still has family in Ireland who he would like to visit. This presents him with an issue, how to pack his prescription?

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Going without cannabis while abroad can result in a lot of pain as Joe discovered when he stopped taking it. However, bringing it with him can result in having to again break the law. The other alternative is accessing the black market which is not safe for patients.

“My elderly parents live in Ireland and I would love to visit them. Ireland’s policy on drugs is different to that of the UK. There is nothing unusual about this as individuals states have their own laws. The UN passed the psychoactive Substances Convention in 1971. The Convention enables international travellers to bring their medication with them to other jurisdictions, even though they have different drug policies. Ireland is a signatory to this convention. The Irish State also supplies details of who to write to seek prior approval for the carriage of controlled drugs.”

Seeking approval

Joe has started an email and letter campaign of writing for help. He is not the only Irish person in the UK who has experienced emigration and wants to travel home. He encourages others to get involved.

“I have on many occasions asked both the relevant Secretary for Health and the Minister for Health for permission to travel to Ireland with my cannabis prescription and for clarification of Ireland’s drug policy for tourists and have pointed out the large numbers of people who could be affected. It’s not just persons prescribed cannabis if Customs is going to seize all controlled drugs.”

“Although nearly 6 months have passed, I am yet to receive either a formal approval or rejection of my request to travel home. In the meantime, my parents are of course getting older as indeed am I.”

There are also other concerns about using cannabis medicine while in another country besides emigrating.

Joe cautions: “To anyone who is thinking of just leaving their cannabis medication at home in the UK and then driving in Ireland, please bear in mind that in addition to dealing with withdrawal symptoms you may also fail a roadside drugs test.”

“It’s not at all clear that you will have a medical defence to a drug driving charge in Ireland. Thus if you want to travel lawfully with a car, consider not taking your cannabis prescription for sufficient time to pass a drug driving test, but obviously, this is impractical for sick people who are only granted a prescription for cannabis where other medicines haven’t worked.”

Joe advises that those thinking of travelling to Ireland with their prescriptions for CBMP should seek approval for their medication. This can be done by writing to the Controlled Drugs Unit in Dublin.

Catch up on part two: Adrienne’s story in our series on medical cannabis and emigration.

Advocacy

Scottish MPs back medical cannabis patient following police action

Medical cannabis patient Liam Lewis and his husband are “overwhelmed” by the support they have received.

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Medical cannabis patient
Lerwick police, on the isle of Shetland, seized Liam's medication from his local delivery office.

A Shetland MP has voiced his support for a medical cannabis patient who had his prescription seized by police.

MP for Orkney and Shetland Isles, Alistair Carmichael, has described what happened to medical cannabis patient Liam Lewis as “disproportionate” after Lerwick police seized his medication from his local delivery office on Saturday 22 January.

The 28-year-old, who suffers from functional neurological disorder, has been prescribed medical cannabis for chronic migraines from Sapphire Medical Clinic for two years.

Liam attended the police station later that day with documents and medical notes from the clinic and asked if he could present a copy of his prescription when the clinic reopened on Monday.

medical cannabis patient Liam Lewis and husband

Medical cannabis patient, Liam Lewis and husband Edward

However, officers apparently believed that the documents were fake and issued him with an official warning which will become part of his criminal record.

Liam is now facing up to three months without his medication.

Mr Carmichael, Lib Dem, and MSP Beatrice Wishart are now said to be preparing to make representations to Police Scotland.

Speaking to the Shetland News, Mr Carmichael said: “This is a massively unsatisfactory situation for Mr Lewis or anyone else to be relying on medicinal cannabis which is now legally available in the UK.

“If Mr Lewis had a prescription, as I understand to be the case, then surely he could have been allowed time to produce that for the police officers.”

He added: “Beatrice [Wishart] and I will be making representations to Police Scotland – there is a public policy issue here about them apparently denying access to medicine.

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“There may be some technical reason why the medicine should not have been distributed in this way, in which case that needs to be dealt with.

“In the meantime, this will count as a criminal record, it will stay on his [Liam Lewis] criminal record, and to my mind this is disproportionate.”

Liam and his husband Edward told Cannabis Health that police officers had been in touch following the incident, after his story appeared in the Scottish press.

The couple are calling for a Government-funded identification card to be issued to patients who hold legal prescriptions to avoid them facing law enforcement. 

Edward said: “We are overwhelmed by the support that this issue is getting. The more traction this gets the better, as we want to make sure that others do not find themselves in this situation.”

He added: “I thank Alastair Carmichael for his support and we hope this goes a long way, not just to solve the immediate problem, but also the wider social issues behind this.”

In a statement to Cannabis Health on Wednesday 26 January, a spokesperson for Police Scotland said: “A 28-year-old man was issued with a recorded police warning following the seizure of a controlled substance which had been found by officers within a sorting office in Lerwick on Saturday 22 January.

“He was unable to provide satisfactory evidence to police that the substance had been prescribed legitimately by a medical professional and when the recorded police warning was given to him he accepted it.

“Officers will continue to engage with him as we try to establish the full circumstances of the situation.”

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A spokesperson from Sapphire Medical Clinic, commented: “We are unable to comment on individual cases due to patient confidentiality. However, it’s important to highlight that medical cannabis was legalised for prescription in November 2018 across the UK.  As the only medical cannabis clinic registered by Healthcare Improvement Scotland, we abide by stringent regulations which include assessment by a specialist doctor and the requirement that prescriptions are dispensed by an approved and licensed pharmacy.”

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Boris Johnson faces fresh questions on NHS access to medical cannabis

In the midst of the Number 10 party scandal, the Prime Minister faced questions about NHS access to medical cannabis.

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Prime Minister Boris Johnson, 10 Downing Street in London, medical cannabis

In the midst of the Number 10 party scandal, the Prime Minister faced more questions about when patients would see NHS access to medical cannabis.

Conservative MP Mike Penning, who has been a prominent advocate for medical cannabis access, raised the issue again during Prime Minister’s Questions today (Wednesday 26 January).

Speaking in the House of Commons, Mr Penning, MP for Hemel Hempstead, said: “Many children in this country are suffering from a special form of seizure… which medical cannabis prescribed by a consultant actually helps them live. Only two children in this country get that free on the NHS, the rest are having to beg, borrow and scrape to try and get that prescription issued by a consultant, paid for.”

He added: “I know the secretary of state has the political will, but please push this forward so these children live.”

Karen Gray, whose son Murray has been seizure free for two years on medical cannabis, told the Edinburgh Evening News this month that she was feeling “optimistic” following a “positive” meeting between her MP, Lib Dem Christine Jardine and the Health Secretary, Sajid Javid.

Ms Jardine said her meeting with Mr Javid on Monday had been “much more positive” than her previous contacts with ministers on the issue.

She said: “He is looking for a way to break the logjam to allow the medical profession to feel confident in offering NHS prescriptions for patients with conditions like severe epilepsy.”

Responding in  Parliament, the Prime Minister said he was also “keen to support it” –  before going on to place the responsibility with the MHRA.

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“We’ve already changed the law for doctors to prescribe cannabis products where clinically appropriate,” said Mr Johnson.

“And I’m very keen to support it, provided the MHRA is happy as well.”

Cannabis has been legal for medical purposes in the UK since 2018, but still only three patients are able to access it on the NHS.

The rest are forced to pay up to £1,200 a month for a private prescription.

Charity Medcan Support reached out to the Prime Minister on Twitter following the broadcast.

The organisation, which supports families of children with epilepsy, said: “@BorisJohnson changing the law isn’t enough – we hope to see you at Parliament to hear and meet these families whose children are benefitting at huge costs.”

It might not be the answer many are looking for, but with most political focus on what really happened behind closed doors at Number 10 in the spring of 2020, it’s promising to see some MPs have the will to keep the conversation going.

Irish medical cannabis campaigner, Vera Twomey, pointed out on Twitter: “So happy to see Sir Mike Penning making representation on behalf of UK patients seeking access to medical cannabis. In such turbulent political times it’s great to see the issue raised.”

Home » Advocacy » Emigration: “I tried cannabis again and I noticed that I was in less pain when I took it.”

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Medical cannabis patient ‘distraught’ after medication seized by police

Liam Lewis is “distraught” as he faces three months without his cannabis medication.

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Liam Lewis (left) and his husband Edward Douglas are appealing the decision.

 

A Scottish medical cannabis patient who had his prescription seized by police says he is experiencing a “mental and physical health crisis”.

Liam Lewis, who lives in Lerwick on the island of Shetland, says he is “distraught” as he faces three months without his cannabis medication.

The 29-year-old suffers from functional neurological disorder, which causes severe migraines, which he says left him “bedbound” before medical cannabis treatment.

Liam has been prescribed cannabis through Sapphire Medical Clinics for two years, but on Saturday 22 January, his prescription was seized by police after it arrived at his local delivery office via Royal Mail. 

Liam and his husband say they attended the police station later that day with documents and medical notes from the clinic, and as his prescription had recently been changed, asked if they could present a copy this when the clinic reopened on Monday.

However, officers apparently believed that the documents were fake and threatened to bring charges against Liam.

He was issued with a written police warning on Sunday 23 January.

“Nothing like this has ever happened before,” Liam’s husband and registered carer, Edward Douglas, told Cannabis Health.

“The package arrived on the island on Friday [21 January] but the police dogs were at the delivery office on Saturday morning and the medication was seized. It was only when Liam went to track the package that we saw it had been taken by Police Scotland.

Edward continued: “The sergeant said that people are now coming up with sophisticated ways of sending cannabis and that the evidence we had wasn’t proof enough that it was a legal prescription.

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“We showed him clinical letters and the Sapphire patient portal where the prescriptions are logged, but he said that all of it could be made up. He even said to Liam ‘we know that you are just after drugs’.”

Liam is now in the process of appealing the decision, but says the police warning means that he will be unable to legally access cannabis-based medicines for another three months.

“Before I started using medical cannabis I was practically bed bound and was sick all the time,” said Liam.

“I was agitated and just genuinely dissociated from my body, I was like an observer in my life. Cannabis actually gave me my sense of purpose, because I was able to live again.”

Liam is no longer prescribed cocodamol by his GP – due to the fact that the cannabis was working – so is now left without any pain medication and only anti-sickness tablets to manage his condition. 

“I’m in a mental health and physical health crisis,” he said.

“I feel distraught and I don’t want to go back to feeling completely disassociated from my life again.”

Edward and Liam have 28 days to appeal the decision and plan to approach the Scottish Government’s cross-party group on medical cannabis to urge them to lobby for a state-issued identity card to protect patients from this situation.

“I can be Liam’s voice when he’s too unwell to fight for himself, but there’s people out there who might not have someone who can advocate for them,” added Edward.

“They might be too scared to continue this treatment and that’s who we want to stand up for.”

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A Police Scotland spokesperson said: “A 28-year-old man was issued with a recorded police warning following the seizure of a controlled substance which had been found by officers within a sorting office in Lerwick on Saturday 22 January.

“He was unable to provide satisfactory evidence to police that the substance had been prescribed legitimately by a medical professional and when the recorded police warning was given to him he accepted it.

“Officers will continue to engage with him as we try to establish the full circumstances of the situation.”

Advice for patients

Medical cannabis patients are advised to keep any medication in its original packaging and to have a copy of their prescription to hand, should they be approached by law enforcement.

Abby Hughes, chair of patient advocacy group PLEA (Patient-Led Engagement for Access), said: “Unfortunately some law enforcement officers may not be aware that cannabis medicines are legally available to be prescribed in the UK.

“If meaningful documentation showing legal possession of cannabis is not able to be immediately demonstrated, it is lawful that your medication may be seized. Once sufficient documentation has been provided however, patients are entitled to have cannabis medicines returned.

“If you face any setbacks or are disbelieved even after demonstrating lawful authority, continue to present any thoughts in a calm and structured way. Ask for time to be given to explain that you hold a valid prescription for medical cannabis, and for them to familiarise themselves with the 2018 rescheduling of cannabis-based products for medicinal use in humans, as well as the guidance issued to clinicians by NHS England.”

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A spokesperson from Sapphire Medical Clinic commented: “We are unable to comment on individual cases due to patient confidentiality. However, it’s important to highlight that medical cannabis was legalised for prescription in November 2018 across the UK.  As the only medical cannabis clinic registered by Healthcare Improvement Scotland, we abide by stringent regulations which include assessment by a specialist doctor and the requirement that prescriptions are dispensed by an approved and licensed pharmacy.”

Patients can contact PLEA for support on hello@pleacommunity.org.uk

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