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“Huge concerns” over Ireland’s “restrictive” medical cannabis access programme

Politicians, activists, campaigners and patients react to the news that CannEpil will be the first drug available through MCAP



Irish activists, politicians and patients have reacted to the announcement that the first cannabis-based medicine will be available from October through the Medical Cannabis Access Programme (MCAP).

The update to the Medical Cannabis Access Programme (MCAP) has been widely criticised by Irish cannabis patients, activists and politicians.

Despite being introduced over two years ago, MCAP has yet to properly begin. In a joint committee meeting held on Wednesday 29 September, CannEpil+ was announced as the first drug to be made available through the program from mid-October.

The meeting saw officials from the Health and the Health Products Regulatory Authority (HPRA) outline the current state of the MCAP programme and the Ministerial License system.

The suppliers of two products, CannEpil and Tilray are said to have confirmed their prices to the HSE, but Tilray has yet to announce its availability date.  Two more cannabis-based products have been added to the schedule but suppliers are not thought to have current plans to supply the Irish market.

Reaction to MCAP

Irish activist and patient, Alicia Maher felt disappointed after watching the online session. She is currently living in Spain as Ireland does not currently cover the costs of her cannabis medication. She feels the government has no intention to expand the MCAP program to include chronic pain conditions.

Read more about Alicia’s story here

Speaking with Cannabis Health News, she explained her initial reaction to the news: “I was absolutely infuriated watching it. They have just come out and said they pretty much have no intention of expanding the conditions for chronic pain at all. They said that there is no evidence for the inclusion of chronic pain. In their HPRA reports from 2017, they actually said that cannabis is the most researched indication and that there is more evidence for chronic pain treatment than there is for Multiple Sclerosis (MS).”

She added: “I couldn’t believe that the product is also going to be high CBD too. It says that it can treat chronic pain but really there is so little THC in it that I don’t know if it will be a benefit to anyone. Professor Brian Lynch, a consultant and paediatric neurologist said in the meeting that he and his colleague won’t prescribe it because of the traces of THC. They just want Epidyolex and that’s it.”

“There is potentially about six months seizure control with Epidyolex and after that, they need whole plant access. They need some THC to control the seizures.”

Alicia also referred to comments from the chief executive of HPRA, Lorraine Nolan on the Denmark model. “Lorraine Nolan said they were following Denmark but she didn’t know if the scheme was GP-led or consultant-led but obviously GPs can prescribe there. She was also wrong about how long the scheme is running. She’s the chief executive of HPRA,” said Alicia.

Earlier this year, several neurologists and patient organisations wrote to Minister for Health Stephen Donnelly with concerns about the products being made available under the scheme, citing fears they are “inappropriate” and “potentially harmful” because they contain THC.

Further reaction

High profile campaigner Vera Twomey, whose daughter Ava Barry is prescribed medical cannabis for treatment-resistant epilepsy, also spoke out about the MCAP update.

“It’s good news that another product has been introduced to MCAP but there was so much more to it. For example, the hopes that there would be a constructive review done surrounding the cannabis access programme to include other conditions like chronic pain. It was disturbing to hear that there is very little evidence despite a lot of research being collated since 2017 when the last report was commissioned,” she said.

“I think this has filled a lot of people with dread and a sense of hopelessness. We were trying hard to highlight the issues and other conditions that needed to be added. If they are saying that nothing else is going to be added before the review then that is very distressing.”

Vera continued: “The other thing that struck me was surrounding the Epidolyex medication for drug-resistant epilepsy. It was a success rate in the short term of around 50 percent and not much more. It’s extraordinary to me that we have products like Bedrocan that successfully work to 90 percent seizure control but the professionals are focused on CBD isolate products like Epidyolex. It makes me sad to think that’s the only medication that is going to be offered to children in this country.”

She added: “They spoke about the numbers going through the programme and it seems they are more interested in keeping the numbers as low as possible. It also seems that they are interested in moving patients onto the MCAP to products like Epidyolex.

“I can speak confidently on this, as a few years ago we were asked to do that after we returned from the Netherlands. It’s completely illogical to move a child, who has eventually gained seizure control over seven years, onto something different and run the risk of their seizures returning. I wouldn’t have done it and thankfully we had the support not to.”

Politician reaction

Politicians who have been actively campaigning for a change to Ireland’s cannabis laws were equally outspoken about the meeting.

Speaking with Cannabis Health News, Gino Kenny, People Before Profit TD for Dublin Mid-West commented: “The positive news is that certain people will get cannabis products on prescription from October which is a positive start. There are huge concerns in regards to how restrictive the programme will be. Yesterday’s commitment shows that it will be even more restrictive than we thought because there is only a limited amount of products.”

He added: “It could be so restrictive that only a handful of people will get access. The whole idea of an access programme is that people will get access. People are extremely frustrated with the process.”

Campaigner and council reaction

Peter Reynolds is president of CLEAR Cannabis Law Reform in the UK and an advisory board member of the Irish Medical Cannabis Council. He also commented on the MCAP updates.

“MCAP is a disaster. The Department of Health doesn’t want it, the HPRA doesn’t want it and the Irish medical establishment doesn’t want it,” he said.

“None of the officials charged with implementing it understand anything about cannabis.  You only have to review the completely ignorant things they were saying about Epidiolex, a CBD isolate, substituting for a full spectrum product.”

“Not only do the officials not want anything to do with it but they are under pressure from senior clinicians to block it.”

He added: “The omission of chronic pain from the conditions covered is ridiculous and their argument that there is no evidence to support it is simply them doing the job to close it down that the senior clinicians want.  The products selected are also just a joke and are mainly suitable for pain.  You just couldn’t make it up.”

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