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GMC must address “serious concerns” over BPNA guidelines on prescribing medical cannabis

An open letter has been signed by more than 30 parents and carers of children with intractable epilepsy

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Ben Griffiths, 11, who suffers from treatment-resistant epilepsy

Dozens of parents whose children rely on medical cannabis have written to the General Medical Council (GMC) outlining their concerns about the blocks to access.

More than 40 parents and carers of children who are prescribed medical cannabis to treat conditions such as intractable  epilepsy have signed an open letter to the GMC outlining a number of issues.

Earlier this week, 50 medical professionals issued a letter  from the Medical Cannabis Clinician’s Society, expressing their concerns over the British Paediatric Neurology Association (BNPA) guidelines on prescribing unlicensed cannabis medicines.

The letter, which was published in the Times,  claims that the guidelines play a part in denying medical cannabis treatment for children with epilepsy, many of whom have had their lives significantly improved it.

It includes a comment from an expert witness in a case brought to the GMC by the BPNA, reported as stating that: ‘The BPNA position that only paediatric neurologists should initiate treatment is not supported by other national guidance, and probably not in the best interests of children, as it may impede debate and research into the appropriate use of Cannabidiol (sic) in refractory epilepsy’.

In response the parents of these children say they felt moved to write directly to the GMC to express “serious concerns”.

In the letter they stress that they feel the guidance issued by the BPNA plays a significant role in preventing doctors from prescribing.

It states: “The quote from the GMC expert witness highlights that the BPNA guidance is ‘not supported by other national guidance’.

“From our knowledge of these matters, we believe that this other national guidance may well be that from NHS England, NICE and indeed, to some extent, your own.

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“If a professional medical body is producing guidance that is ‘probably not in the best interests’ of the patient cohort at issue, surely that matter should be investigated and then appropriate steps taken to ensure that the guidance in question is corrected?

GMC must address families denied access

Ben Griffiths, 11, who suffers from treatment-resistant epilepsy, and mum Joanne.

Speaking with Cannabis Health, Joanne Griffiths, mother of Ben, 11, who suffers from treatment-resistant epilepsy, said: “We felt moved, as a group of parents and carers with loved ones affected by intractable epilepsy, to write to the GMC to ask that they address what we believe to be serious concerns relating to the BPNA position on the prescription of medical cannabis following the recent article in The Times.”

Joanne added: “This is clearly extremely concerning and needs to be addressed. The almost total block on NHS prescriptions is causing untold huge emotional and financial distress to our families.”

Open letter

The parents also highlight the ‘dramatic’ benefits of medical cannabis for these children, but says that the lack of prescriptions on the NHS means parents are facing the ‘daunting and emotionally and financially draining’ burden of finding the money to fund the medication privately.

The letter states: “Without exception our loved ones have shown very significant improvements in their symptoms following the administration of medical cannabis.

“In many cases, the improvements could more accurately be described as ‘dramatic’ with children who were suffering up to hundreds of seizures a day and being rendered semi-comatose due to the effects of conventional pharmaceutical drugs being able to lead almost normal drugs.

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“However, since the law change, to the best of our knowledge, there have only been three NHS prescriptions for whole-plant extract medical cannabis for cases of paediatric epilepsy. The rest of us have had to face the daunting and emotionally and financially draining burden of having to find up to £2,000 a month to fund the medicine privately

“Raising this money is a massive challenge in normal times. During Covid, it has been impossible.”

The parents have now called on the GMC to address their concerns, stating that failure to do so may mean doctors may be “unwittingly failing” in their ethical duty to patients.

The letter is open for other parents to sign and can be accessed through the Boisterous Ben Facebook page or Twitter.

Advocacy

Medical Cannabis Awareness Week returns with call for real world evidence

Three years since the law changed supporters call for regulators to consider real world evidence

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medical cannabis flower tolerance break
Medical Cannabis Awareness Week returns from 1-7 November

Medical Cannabis Awareness Week will return to mark three years since the law changed, with a fresh call for regulators to consider real world evidence and ensure fair access for patients. 

Led by patient advocacy group, PLEA (Patient-Led Engagement for Access), Medical Cannabis Awareness Week takes place in the first week of November and brings together patients, doctors, supporters and stakeholders across the sector to raise awareness of the plea for fair access to medical cannabis.

Medical Cannabis Awareness Week logo

On 1 November 2018, medical cannabis was made available on prescription in the UK. Three years on, only three prescriptions have been issued by the NHS.

Out of desperation, patients are now funding private prescriptions and up to 1.4 million patients are forced to turn to illegal methods. 

Patients unable to afford and access treatment are suffering due to the fear, stigma and financial barriers preventing them accessing this safe, and potentially life-changing, treatment. 

The first Medical Cannabis Awareness Week to take place last year saw over 50 speakers and 1500 live attendees, with 60,000 people reached. 

This year, taking place from 1-7 November, Medical Cannabis Awareness Week 2021 aims to highlight the real need for real-world evidence in evolving access to this new treatment, calling for fair access to medical cannabis treatment on the NHS.

Patients from across the UK will be sharing their stories about the life-changing impact of medical cannabis and their difficulties in accessing a prescription.

medical cannabis patient Gillian Flood

Medical cannabis patient, Gillian Flood

Gillian Flood, member of PLEA’s Management Committee who is prescribed medical cannabis for fibromyalgia and PTSD, commented:“Life before and after cannabis medicine really is like night and day, before constant pain left me feeling hopeless and depressed, unable to function, trying all different medications, dealing with awful side effects. After, well, I feel like me again, I can enjoy a meal, go for a walk, sleep and manage my pain better while having a clear head.

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“While all this is amazing the financial cost bring a whole new anxiety around how I afford my medicine, every month I struggle to pay for it, I don’t want to go back to my life before, not now I know I don’t have to suffer so much, there is a relief available, my plea is that this medication becomes available through the NHS so no patient has to endure the pressure of trying to fund a private prescription.”

How you can get involved

There are several ways supporters can get involved, with virtual events taking place each day, aimed at patients, doctors, supporters and anyone else with an interest in medical cannabis.

Join patients, advocates and organisations to help raise awareness, address the stigma and call for change by sharing a video or audio clip or written post of your PLEA on social media using the hashtag #MCAW2021. 

Have a conversation about medical cannabis. Ask questions, and connect with medical cannabis supporters, patients, and allies via the #MCAW2021 hashtag on social media.

Help spread the word about fair access to medical cannabis treatment by writing to your MP.

Abby Hughes, chair of PLEA commented: “Having witnessed the transformation of quality of life for many patients like myself, it is hard to accept that the only access many have to medical cannabis treatment is through the private sector. Why is there enough evidence for a private pain consultant or psychiatrist to prescribe unlicensed cannabis medicines, yet the same treatment is not afforded to patients via the NHS, which was created to provide universal, comprehensive and free health care?

“With only three NHS prescriptions having been issued three years on from Sajid Javid’s promise to make medical cannabis treatment accessible, my plea for Medical Cannabis Awareness Week 2021 is that the real need for real world evidence is explored and accepted in evolving access to this new treatment.”

We’ll be sharing more details of all the events and how you can get involved in the coming days. 

For full event listings and to access resources for patients, doctors and supporters visit www.pleacommunity.org.uk/mcaw

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Cannabis and driving – Calls for urgent law reforms to protect patients

A new report highlights the myriad of issues facing medical cannabis users on the road. 

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Campaigners are calling for urgent reforms to driving laws

Campaigners are calling for urgent reforms to legislation around cannabis and driving as patients risk criminalisation.

A new report, published by the Seed Our Future campaign, highlights the myriad of issues facing medical cannabis users on the road. 

The group, which lobbies for the decriminalisation of cannabis, is calling for the removal of THC from Section 5 and reverted to Section 4 of the Road Traffic Act 1988 (RTA), where evidence of impairment would be required to convict.

Following an amendment to the RTA in March 2015, any driver who is stopped by the police can expect to be swabbed and if THC is identified, a blood test is enough to secure a conviction. 

This means that anyone who has consumed cannabis within the last few days – or has been subject to passive smoking – may be over the zero-THC limit and at risk of prosecution, regardless of whether there is evidence of impairment.

According to the report, the effects of THC have generally gone after two to four hours when inhaled, longer when orally ingested. And the research conducted by Seed Our Future has found no cases of any serious vehicle accidents which conclusively shows cannabis as the primary cause.

Patients facing criminalisation

Although patients who hold a legal prescription have a right to a medical defence, this is not always taken into account and those who are unable to afford one are being criminalised and having their licences removed without any evidence of driving impairment, argues the report.

In 2021 alone, Seed our Future has supported four people with legal cases in relation to cannabis driving offences. All four suffer from long-term conditions and fit the criteria for obtaining medical cannabis prescriptions, with one holding a legal prescription at the time and two accessing one shortly after arrest. 

In all cases, the subjects had taken cannabis several hours before driving and there was no evidence of any sign of driving impairment. 

According to the report, in 75 per cent of the cases, the police had “no idea” that the law had changed regarding medical cannabis in 2018.

Seed our Future claims that the inclusion of cannabis in Section 5 of the RTA was based on “political and financial  motivations” and not “conclusive road safety data”. 

The report concluded:  “The concept that a laws exists which leads to a criminal record, fines and a driving disqualification  without any evidence of the defendant being a risk to road safety, whom  with all likelihood is practicing their inalienable human right to health by utilising globally recognised essential medicine risks jeopardising the fabric and integrity of the judicial system and exposes the incompetence of the police force in being able to gather evidence sufficient to constitute criminal intent.”

Calls for standardisation

Guy Coxall, the groups founder is also asking for standardisation of labelling for medical cannabis prescriptions and health practitioner advice in regard to guidance for driving.

He has called on the Cannabis Industry Council to ensure all importers of cannabis-based products have the correct labelling, in line with UK regulations, and all practitioners provide advice to patients in line with guidance from the Medical Cannabis Clinicians Society (MCCS).

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It states: “Patients, on higher THC products especially, should be warned not to drive or operate heavy machinery whilst under the influence of side effects of a cannabis product… Like any other medications that may cause impairment, do not drive or operate a vehicle if feel impaired or are unsure if you feel impaired and follow your physician’s advice.”

Coxall said:This lack of standardisation places a number of UK patients in danger of criminalisation and penalties.

“We would also like to see discussions surrounding basic educational programmes for Police Officers, CPS solicitors and Judges to update on legislative changes and provide information to reduce stigma and medical and financial discrimination against medical cannabis users/patients, as identifying ways of protecting medical cannabis users who are at present unable to afford private medical prescriptions until availability is made accessible on the NHS.”

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“Children’s lives are at risk” – let GPs prescribe medical cannabis, says paediatric neurologist

Dr Adelaida Martinez has called for GPs to be able to prescribe medical cannabis to children with severe epilepsy.

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Murray Gray has been seizure free for over two years on medical cannabis.

A leading paediatric neurologist has called for GPs to be able to prescribe medical cannabis to children with severe epilepsy.

Dr Adelaida Martinez, a consultant at the Portland Hospital for Women and Children in London, is one of the few paediatric neurologists who prescribed medical cannabis to children with retractable epilepsy.

Dr Martinez, who has now retired, has written to the Health Secretary Sajid Javid outlining her concerns for these patients, who without access to this medication would be left “fighting for their lives”.

The words come following the publication of an open-letter signed by over 50 healthcare professionals about the British Paediatric Neurology Association (BPNA) guidelines, which they say prevent doctors from prescribing cannabis-based medicines.

Dr Martinez claims that she has looked for an alternative paediatric neurologist to take over her patients but this has proved to be “extremely difficult”. According to the letter there is currently only one doctor in the UK taking patients on a case by case basis through a private clinic.

There are real fears among patients and their families that the lack of paediatric neurologists willing to prescribe medical cannabis in the UK will leave patients unable to access this medication at all.

Calls for GPs to prescribe

Dr Martinez wrote to the Health Secretary before retiring just days ago, but so far there has been no response.

In her letter she calls for a policy change to allow GPs to prescribe, as is the case with other unlicensed, controlled medicines.

Currently in the UK only specialist consultants are permitted to prescribe unlicensed cannabis medicines or a GP under the consultant’s direction.

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Dr Martinez wrote: “Children who have epilepsy which is alleviated by cannabis medication should be able to have prescriptions fulfilled by their GPs. This is exactly the same process as already exists for any other type of unlicensed controlled drug in the United Kingdom.

“I know a majority of the GPs dealing with this group of children wish to prescribe but in order to do so this requires a change in policy… because it is CBD medication which has been treated differently to other controlled drugs.”

Future prescriptions

Parents are concerned that their children’s lives will be placed at risk without access to this medication.

According to Dr Martinez, most have been taking it for at least two years and have been “stable or significantly improved” during this time.

Karen Gray’s son Murray, has a rare form of epilepsy known as Doose syndrome. He has been seizure free for over two years on medical cannabis.

Karen told Cannabis Health: “A policy change is all we need to secure our children’s prescriptions. Without this medication, our children’s lives will be at risk. Our GPs are willing to write the prescriptions, however Sajid Javid is the only person that can make this happen.”

Read more: CBD may reduce effects of anti-seizure medication

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