The HSE announced the first products available through Ireland’s medical cannabis access programme (MCAP) this week, but the system has been “sabotaged” by a medical establishment “hostile to cannabis”, argues Peter Reynolds.
Ireland has the most restrictive medicinal cannabis programme anywhere in the world and it’s still not operational more than four years after it was announced.
What’s even worse, as demonstrated by the letter, nine leading neurologists have sent to Minister for Health Stephen Donnelly, is the four products that the Health Products Regulatory Authority (HPRA) have selected are unsuitable for the conditions they are supposed to treat.
The story of how this has unfolded is a lesson in how not to regulate medicinal cannabis, or, indeed, any medicine. The programme is the result of public demand based on increasing recognition of the value and safety of cannabis when used responsibly under medical supervision. But it has been sabotaged by an Irish medical establishment that is hostile to cannabis, and officials who have refused to take expert advice, preferring the opinions of clinicians who know nothing about it.
The problems started right at the beginning with a report compiled by the HPRA early in 2017 described as from an ‘expert working group’, yet not one person in the group is an expert in cannabis. It’s not clear that any of them had any knowledge about the use of cannabis as medicine when they were appointed.
Ireland and cannabis
Unsurprisingly the report is full of errors and misunderstandings. It claims there is “an absence of scientific data” on the efficacy of cannabis and not enough information on safety. This is palpable nonsense.
History records cannabis being used as medicine for more than 5,000 years and ironically, it was an Irishman, William Brookes Shaughnessy, who published the first scientific paper on it in the Lancet, in 1840. Since then it has been one of the most studied medicines on the planet. It has over 26,000 references on Pubmed, the foremost source for medical literature whereas paracetamol has around 12,000.
California has had a medicinal cannabis program since 1989, the Netherlands since 2001 and its use is now widespread throughout the world. Millions of people are using medicinal cannabis safely and effectively. There is a vast amount of information and evidence available.
The most glaring error in the report is the omission of pain as a condition for which cannabis should be available. Pain is the condition for which cannabis is most often used and is most effective. In 2020 the global market was valued at around $9 billion, this is expected to reach $47 billion by 2027 and over 60% of this is for treating pain. Yet the HPRA’s supposed experts thought it best to leave it out.
The HPRA started work on MCAP in March 2017. Officials claim to have sought “solutions to the supply of products from Denmark, UK, Canada and further afield”, which has included at least some officials going on international trips. It has taken four years to select four products, one of which is for epilepsy in adults and the other three are, as anyone with any expertise will confirm, best suited to treating pain!
Responsibility for this situation lies squarely with the HPRA. It is matched by its corresponding failure to deal with many attempts to set up a medicinal cannabis industry in Ireland. At least a dozen serious proposals have been presented offering multimillion euro investments in Ireland, promising the creation of hundreds of new jobs.
Irish Cannabis industries
Professor David Finn at NUI Galway is one of the world’s leading researchers into cannabinoid medicines and even his participation has failed to galvanise the HPRA into action.
Medicinal cannabis is the fastest growing business sector in the world. It is coming to Ireland, irrespective of the negative and Luddite attitudes that prevail amongst the establishment.
What is clear is that public health, the Irish people and the Irish economy are missing out in a big way and many of the opportunities have now been lost for good.
Peter Reynolds is president of CLEAR Cannabis Law Reform in the UK and an advisory board member of the Irish Medical Cannabis Council.
Cannabis is medicine – just ask people with epilepsy
Dr Evan Lewis on why the opinion that cannabis is not a medicine is not only outdated, but is also dangerous.
Dr Evan Lewis, a paediatric neurologist and founder of the Neurology Centre of Toronto (NCT), has treated hundreds of epilepsy patients, for whom there is no doubt that cannabis is medicine.
I’m a paediatric neurologist and epilepsy specialist, with over 500 adult and paediatric patients in my practice currently being treated with medical cannabis for epilepsy and a broad range of other neurological conditions.
For these patients, there is no doubt that cannabis is medicine.
As a start, five major randomised controlled trials have been completed, with recently published follow-up data, in complex, drug-resistant paediatric epilepsy. These studies show that medical cannabis exerts the same degree of anti-seizure control as our traditional anti-seizure drugs, with comparable side-effect profiles.
It might also be helpful to point out that cannabis, in the form of a purified CBD oil called Epidiolex®, has been approved as a medical treatment for certain types of epilepsy in children by the FDA in the US, the EMA in Europe, and NICE/MHRA in the UK.
I can personally share numerous stories of the children I have treated with unrelenting seizures who, after failing multiple medications for several years, finally responded to cannabis.
However, none of that is needed.
While there may be some subjectivity inherent in the management of pain and anxiety, the clear effects that cannabis can produce in drug-resistant epilepsy are difficult to argue.
A child is either seizing or they are not. The child is treated with a cannabis oil. The seizures stop.
If that is not a medicine, then what does one tell the parents of these children they are giving to their child.
Here in Canada, there is a well-defined medical pathway within the Cannabis Act that provides a mechanism by which patients can undergo a consultation with a physician or nurse practitioner and be provided medical direction, oversight, follow-up and medical authorisation to receive the treatment.
In the UK too, cannabis for medicinal purposes was legalised in 2018. There are now over 10,000 patients prescribed cannabis-based medicines, including about 150 children with drug-resistant epilepsy, according to the Medical Cannabis Clinicians Society.
The majority of these children are thriving, several have now been seizure-free for a prolonged period of time, and all have seen dramatic improvements in their quality of life.
Despite the above and years of medical legalisation, families who seek cannabis treatment after trying numerous options are still met with reluctance on the part of the health care system. Some of that reluctance lies in the challenges that practitioners perceive with cannabis products and safety.
Producing a consistent cannabis product from batch-to-batch is one of the many challenges faced by licensed producers of cannabis, but that should not serve as rationale to delegitimise cannabis as a medicine or pressure families to feel compelled to work with medications they feel will not work for their child. This only works to reinforce inaccessibility, and children should not be the ones to suffer because of these challenges.
Reflexively turning away from the medical potential of cannabis for epilepsy does a great disservice to the many children and families struggling with the condition.
The opinion that cannabis is not a medicine is not only outdated but is also dangerous.
Dr. Evan Cole Lewis is a Neurologist and Clinical Neurophysiologist with expertise in paediatric neurology and epilepsy. He is the founder and medical director of the Neurology Centre of Toronto (NCT) and VP Psychedelic Neurology at Numinus. He is assistant professor with the Department of Paediatrics at the Hospital for Sick Children and the University of Toronto.
Estimated reading time: 4 minutes
Simply CBD: The beginner’s guide to CBD
New to CBD? Simply CBD has put together a beginner’s guide to help you find the right product.
New to CBD? Simply CBD has put together a beginner’s guide to help you find the right product for you.
Chances are you may have seen or heard about CBD in recent years. And as we’re starting to learn more about it, a variety of new ranges are hitting the shelves, including lotions, oils, vapes, balms, edibles and water-soluble solutions. Here, Simply CBD gives you all of the information you need to get started.
What is CBD?
CBD products come from the cannabis plant. They contain minimal THC – less than 0.2%, in fact. As THC is the psychoactive component of marijuana, this means that they won’t get you high.
Popular with adults and pensioners, it is legally sold to people aged 18 and over. If you’re looking to buy products, you can find them in the form of oils, edibles, lotions, balms, gummies, capsules and more. They’re easily accessible too, which means you can pick them up on high streets and from a range of recommended online stores.
Will it get me high?
This is probably one of the most common questions asked, and the simple answer is no. This is because products must contain less than 0.2% THC, which is the psychoactive part of the plant. You can even find products on the market that contain no THC at all.
Want to find a product that’s right for you? The good news is that there’s an extensive range of products that are helping many people try it for the first time. Several factors determine which one to buy, and sometimes this comes down to preference of how you want to take it.
Simply CBD always advises that you should ‘start low and slowly grow’ when you set out on your CBD journey. Here are some of the options from the range that are ideal for beginners, and are great value too!
The Green CBD oil is a great starter product because it is low strength, and you can simply place it under your tongue. This is a full spectrum oil mixed in a base of hemp seed oil, which is high in both CBD and CBDa. Because it’s a full spectrum oil, it has multiple cannabis plant extracts, including essential oils, terpenes and cannabinoids.
The signature Liquid Gold CBD Oil with turmeric and black pepper combines full spectrum CBD with double-strength curcumin turmeric and black pepper. It has a pleasantly earthy, spicy and nutty flavour, and is placed under the tongue. This oil is low strength, and perfect for those looking to combine it with curcumin turmeric.
Alternatively, Entourage Aqua Water Soluble CBD is a full spectrum, water-soluble CBD that can be added to drinks. This revolutionary product is an alternative to taking traditional oils, plus you can add it to both hot and cold beverages.
Simply CBD also offers CBD gummies that you can easily take on-the-go. They come in packs of 20 delicious, mixed fruit-flavours. Each one contains 10mg CBD extract, plus they are suitable for vegans and vegetarians.
You don’t have to take products orally. In fact, other options such as balms are a great option. The CBD Muscle Balm is particularly great for beginners as it’s gentle on the skin and absorbs easily.
A new product is the CBD Patches which are a convenient alternative to starting with CBD. They are simply placed onto the body and last for up to 36 hours, even better they are discreet!
How do I build up my use?
No matter what type of product you choose, it’s important to follow the ‘How to use’ instructions.
Simply CBD offers a complete range in varying strengths, types and flavours to make it accessible to everyone. What’s more, its products are all independently tested and are extracted from Dutch high-grade cannabis. You can also benefit from customer support and join the unique, thriving Facebook community forum with over 45,000 other members. Here, users share their experiences and views on products, which can help you decide what you want to try. Ratings are an average of 4.93 stars!
The company also offers express delivery on all orders shipped in the UK and promises to supply products at competitive prices. The team is happy to answer any questions or concerns you might have.
To find out more, visit simply-cbd.co.uk
“Millions of cannabis patients face criminalisation behind the wheel – even if completely unimpaired”
Campaign group, Seed Our Future, is calling for urgent reforms to protect patients from criminalisation on the road
Urgent reforms are needed to driving laws to protect patients from criminalisation on the road, writes Seed Our Future founder, Guy Coxall.
In October 2020, Seed our Future released our first report, Cannabis and the Law – No Evidence, No Crime, a report which assessed the unjust and unfounded cannabis laws in the UK via the Misuse of Drugs Act 1971 (MoDA).
The report concluded that cannabis laws are based on ideology, racism and political motivations and that the alleged harms associated with cannabis use are not based on scientific evidence but causal assumptions. It also demonstrated the urgent need for reform so as to protect our health, the environment and our economy.
The second report, developed to support the complete removal of cannabis from the MoDA 1971 via a judicial review, covers approximately 130 years of investigation into the alleged harms of cannabis and the story of prohibition to the present day.
It is clear that the evidence of relative safety was ignored, whilst propaganda campaigns of fear and lies protected political and corporate interests, whilst millions suffered and died.
Rising numbers of driving convictions
Although the chance of being incarcerated for personal possession or cultivation of cannabis is unlikely these days – a caution, suspended sentence or community order is more likely – but these still carry a criminal record. The seemingly forgotten recent developments in driving laws are the greater threat to cannabis users in the UK, where over 10,200 people were convicted in 2019 and these numbers are increasing year on year.
Up until March 2015, cannabis users who drove a motor vehicle were provided with a fair and impartial trial as the police had to provide evidence of driving impairment in order to secure a conviction.
I’m sure we can all agree that anyone getting behind the wheel of a vehicle whilst impaired should have the book thrown at them as they are endangering other road users. But for the majority of cannabis consumers, like those who use prescribed medicines such as opiates and benzodiazepines, are responsible enough not to drive when unfit to do so.
Due to a low conviction rate, the police struggling to carry out field impairment tests properly and to follow other European and international countries, a review was carried out, led by Sir Peter North in 2010 to assess the implications of drug driving. A later report was published in 2013 by a so-called expert panel on drug driving. The findings of both led to an amendment to the Road Traffic Act, Section 5 (A) which essentially removed the need to prove impairment and relied entirely on blood tests showing above a per se zero tolerance level of specified schedule 1 drugs.
The evidence used was seriously lacking and completely inconsistent as much of the data of road collisions showing THC in the system also showed presence of alcohol or other drugs and so there was little to no evidence of cannabis being a primary cause of driving impairment, in fact many trials showed that cannabis users were more careful drivers.
No evidence of impairment
Due to global changes in legislation for cannabis, a great deal of research has been carried out over the past several years to assess the implications for road safety. The new evidence shows that collisions have stayed constant, that the blood tests have no correlation with impairment and are thus inadmissible in a court as evidence of impairment, validated by the UN and that the blood tests do not provide evidence of recent use.
What does this mean? Millions of cannabis users in the UK are at risk of being criminalised and punished every time they get behind the wheel, even if they are completely unimpaired and may not have consumed cannabis for several days.
In court you will not be provided with a fair and impartial trial, as there is no evidence that you were a risk to road safety, no evidence of impairment or even that you consumed cannabis on the day of arrest. The lack of evidence and the infringement on our civil and human rights doesn’t seem to matter and at present, tens of thousands of drivers are being unfairly prosecuted every year.
The ‘medical defence’
Only those with a medical prescription are provided with a ‘medical defence’, but this does not stop the many police – who are still ignorant of the change to legislation in 2018 – dragging you through the courts and unfortunately, thousands of those with prescriptions are currently unable to meet the full criteria for the defence (something Seed Our Future are looking to rectify in the coming weeks).
What about the millions of cannabis users who use cannabis medicinally but simply can’t get access on the NHS or can’t afford a private prescription? Seed our Future have been supporting several members with this issue over the past year and have built a defence which we hope will soon set a precedent in law. It’s high time that the courts accept that to criminalise people for using essential medicine, is a clear breach of human rights and that persecuting people for not being able to access or afford a prescription is medical and financial discrimination.
What happens now?
As more people become aware of the unique and expansive therapeutic properties of cannabis and as the roadside use of swabs (which detect only cannabis and cocaine) are increasingly used, Section 5 (A) of the Road Traffic Act has become the leading cause of criminalisation and punishment for cannabis users in the UK.
Seed our Future feels it imperative that the Department for Transport revisit the legislation, using the most recent evidence and take the recent change in legislation for medical cannabis use and the current inability of access into account in order to protect our human rights and civil freedoms. We recommend and will call for cannabis being removed from section 5 (A) of the Act and reverted to Section 4 where evidence of impairment was required.
Guy Coxall is a prominent cannabis campaigner, and the founder of Seed Our Future. To access the report and for more information visit www.seedourfuture.co.uk
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