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Irish politicians receive cannabis in mail to mark National Legalise Cannabis day

The letters outlined the reasons why legalising cannabis in Ireland needs to be a top priority for government officials.

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Irish: A banner advert for National Legalise cannabis day

Two hundred Irish TDs received a letter outlining the reasons for cannabis legalisation and a roll-up in the post sparking an investigation

The cannabis was sent by An Póst by leading cannabis activists to mark National Legalise Cannabis Day in Ireland. The cannabis was accompanied by a letter outlining ten reasons why cannabis should be legalised and made accessible. Cannabis activists including Cannabis Activist Alliance, ReLeaf CBD Café, and Martin Condon from the podcast Martin’s World shared images of the letters online before sending them to ministers.

Two hundred letters containing cannabis roll-ups and edibles were sent to ministers including the President of Ireland, Michael D Higgins. A further forty were sent to members of the media and senators. Mary Lou McDonald of Sinn Fein was even sent a tricolour roll-up.

In a statement online, those involved encouraged other cannabis consumers and activists to get involved in the action.

“To mark the 20th anniversary of this event the Martins World Podcast, The Cannabis Activist Alliance and the ReLeaf Cafe have teamed up to recreate this event. Cannabis containing joints will again be posted to every TD and Senator in Ireland. With the joint, we will include a letter about the campaign and 10 reasons why Cannabis prohibition should be ended (there are thousands to choose from). We encourage anyone who wants to get involved to do so. It will only cost you the price of a stamp and envelope.”

Some of the benefits listed in the letters included the creation of jobs, open access for patients and researchers, the end to the discrimination faced by patients and also the protection of minors with the introduction of regulation.

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Irish cannabis market

While the letter highlighted the reasons why cannabis should be legalised in Ireland, it also gave a stern warning about the dangers of buying cannabis from an unregulated market.

“As this product was sourced from an unregulated market, you as a consumer have very little protection. There is no guarantee that this joint contains any cannabis. If it does contain cannabis you as a consumer have no idea as to the potency of the cannabis. This makes dosing incredibly difficult and could put you at risk.”

The action has sparked an investigation by Irish authorities after scanners at the ministerial buildings failed to recognise the substance. It was reported that nearly all of the Green party received a letter along with members of Fianna Fáil and Fine Gael.

Irish ministers response

Most of the ministers have not confirmed if they have or have not received the letters. However, Cathal Crowe, a Fianna Fáil TD for Clare posted a photo of the letter on Twitter confirming he had received one.

Irish Green party councillor, Oliver Moran also received a letter and tweeted his response. “Many thanks for including me in this action—and for the prudent warning that potency and content are unknown when drugs are purchased from an underground market.”

November 5 was declared  National Legalise Cannabis Day by Independent TD, Luke Ming Flanagan back in 2001. The letters campaign was created to mark the 20th anniversary of this.

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Ireland’s cannabis reform

The campaign comes amidst criticism that the Medical Cannabis Access Programme is still not functioning despite reassurances that Cannephil would be available from mid-October.

People before Profit TD for Dublin Mid-West, Gino Kenny raised the issue in the Dáil to Taoiseach, Michael Martin.

“Many families would have been very joyous during the summer when the medical cannabis access programme was to commence. But sadly, in a PQ response today, not one patient has been given access thus far. That is a huge disappointment to those families that this treatment could make life-changing benefits,” he said.

He added: “So what do you say to families that feel let down by the program and now they have to look at other treatments and probably getting no treatment at all?”

Michael Martin replied by saying that a lot of patients have been facilitated by the original ‘imported license’ but was unsure as to why patients had not availed of the MCAP. He promised to follow up with the Minister for Health which is currently Stephen Donnelly of Fianna Fáil.

Gino also announced changes to the Cannabis Regulation and Control bill that he is due to submit. It will now take place next year with a focus on production and consumption for personal use.

Image credit : Martin’sWorld

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Irish: A banner advertising a competition

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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

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Image credit: Nancy Mace/Instagram

A Republican congresswoman who has proposed a federal bill to legalise cannabis has spoken out about her experience using cannabis to combat depression.

Nancy Mace, a republican politician from South Carolina appeared on Fox Business’s ‘Kennedy’ show to talk about the bill which would legalise cannabis but would also focus on veteran access.

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.

Bill: A banner for always pure organics

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).

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.”

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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.

Bill history

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.”

 

Fibromyalgia: A banner advert for cannabis health news

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First patient set to receive cannabis products on Ireland’s MCAP programme

CannEpil is the first drug available through the programme but has yet to be prescribed

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Ireland HSE offer medical cannabis
CannEpil was announced as the first drug to be made available through the programme

Earlier this year, the Irish Health Service Executive (HSE) has announced that the first cannabis-based products will be available through the Medical Cannabis Access Programme from mid-October.

Despite an update from the Irish health service (HSE) and Health Products Regulatory Authority (HPRA) that CannEpil would be prescribed by the middle of October, the first prescription has been delayed.

People before Profit TD for Dublin Mid-West Gino Kenny tweeted that the first prescription should be available from next week.

The HSE has yet to confirm that the products will be available from next week but says they would not be aware until the consultant neurologist has issued claims at the end of the month.

In a statement to Cannabis Health News, a press officer at the HSE stated: “The HSE has registered three patients under the MCAP in recent days. We would not be aware whether the consultant neurologist has proceeded with prescribing for an individual until claims were submitted from pharmacies at the end of the month.”

He also raised the issue in the Dáil earlier this month to Taoiseach, Michael Martin.

“Many families would have been very joyous during the summer when the medical cannabis access programme was to commence. But sadly, in a PQ response today, not one patient has been given access thus far. That is a huge disappointment to those families that this treatment could make life-changing benefits,” he said.

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“So what do you say to families that feel let down by the program and now they have to look at other treatments and probably getting no treatment at all?” He asked.

Michael Martin replied that a lot of patients have been facilitated by the original ‘imported license’ but he was unsure as to why patients had not availed of the MCAP. He promised to follow up with the Minister for Health, Stephen Donnelly of Fianna Fáil.

Gino announced changes to the Cannabis Regulation and Control bill that he is due to submit. It will now take place next year with a focus on production and consumption for personal use.

HSE committee meeting

In a joint committee meeting held in September, CannEpil was announced as the first drug to be made available through the program from mid-October.

Ireland’s Health minister Stephen Donnelly announced funding for the Medical Cannabis Access Programme (MCAP) in January, almost two years since the legislation was signed off in June 2019.

The programme will offer access to cannabis-based medicines to people living with one of three qualifying conditions. These include intractable nausea and vomiting associated with chemotherapy, severe treatment-resistant epilepsy and spasticity associated with multiple sclerosis (MS) where patients have failed to respond to authorised treatments.

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

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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.

Morris O’Connor, the assistant national director of primary care reimbursement, announced that two additional products were expected to be added to the schedule in the coming weeks and that the programme may be extended for longer than the initial five year pilot period.

He stated: “There are currently four cannabis products on the schedule and two more to be added to schedule one of the regulations in the coming weeks. I understand that one of the products in the schedule namely CannEpil is expected to be available in October, subsequent to the introduction of the necessary legislation.”

According to Lorraine Nolan the chief executive of HPRA, since the MCAP regulations came into force in June 2019, 34 applications have been made for cannabis-based products.

Of these four cannabis oils have been placed in schedule one of the regulations, and two dry herb products have completed the final HPRA review and are awaiting a ministerial decision. Five are currently under active review.

Nolan commented: “The first cannabis-based products are expected to be made available to Irish patients through MCAP in October 2021. Once these are accessed by Irish patients, the HPRA will receive any reports of suspected adverse events and review them for any signals of concern regarding the safety of the product.

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“The HPRA will also have a role in investigating any quality issues that may arise and coordinate any action that might be subsequently required.”

Doctors are asked to register patients who may benefit from this treatment to the HSE including the condition they are being prescribed for.

The HPRA will be monitoring patients for adverse effects over the coming weeks once the medication is available.

The MCAP programme has been criticised by patients who are still waiting for access to products despite the introduction of the scheme in 2019 under then Minister for Health, Simon Harris.

O’Conner also highlighted that 192 ministerial licenses have already been issued for 67 individuals who access medication from the Netherlands.

In July a direct funding scheme was announced to remove the need for patients to pay for these prescriptions up front and then apply for reimbursement from the Government.

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‘Crisis’ in paediatric access to medical cannabis forcing parents to black market

There is currently only one consultant who specialises in paediatric epilepsy prescribing cannabis in the UK

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Paediatric epilepsy

Experts have warned that the lack of paediatricians willing to prescribe cannabis medicines in the UK is reaching crisis point, leaving children’s lives at risk and forcing parents to turn to the illicit market.

The lack of pediatric neurologists willing to prescribe medical cannabis in the UK is forcing parents to turn to desperate measures, according to several campaigners and clinicians in the industry.

There is currently only one consultant who specialises in pediatric epilepsy prescribing cannabis-based medicines in the UK and actively taking on new patients.

As there are no pediatric prescribers currently enrolled in Project Twenty21, parents and carers don’t get the costs of their prescription subsidised, costing them around £2,000 a month.

“It’s the children that changed the law and suddenly they’ve been forgotten about,” says Matt Hughes, co-founder of Medcan Support, a UK charity aiming to educate and support parents in accessing medical cannabis. “I see it as pediatric access in crisis because I can’t see it getting any better.”

Parents of children with epilepsy

Through Medcan Support, Hughes is contacted by dozens of parents of children with epilepsy, who are willing to do anything to access cannabis – even turning to illicit means.

“A lot of parents aren’t transparent about using it illegally, but we know there are some,” Hughes continues. “Those who want access are going to use cannabis wherever the source and currently, they are left to the CBD market or the illicit market, where there’s no clinical oversight.”

While Hughes is careful not to disclose much, there are reports of parents giving children Rick Simpson Oil, which is po

tent in THC, known to cause seizures if taken in too high of a dose and without enough CBD to counteract its effects.

Parents: Cannabis activist Matt Hughes and his family

Matt Hughes, with his partner Ali, and son Charlie.

“Parents are trying to do this on their own,” he says. “We shouldn’t be having to give this type of advice, we’re almost taking the role of the clinician having to draw on our own experiences, but everyone’s different which is why we need that clinical expertise.

“Cannabis can cause seizures if you get the dose wrong, it’s not like pain and other conditions where if it doesn’t work then it’s not life-threatening.”

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Dr Adelaida Martinez, a former consultant at the Portland Hospital for Women and Children in London, and one of the few who has been prescribing for children with intractable epilepsy retired in October. She wrote to Health Secretary Sajid Javid in a public letter, outlining her concerns for these patients, who without access to this medication would be left “fighting for their lives”.

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”.

Many blame the current crisis on guidelines from the British Paediatric Neurology Association (BPNA) guidelines, which they say prevent doctors from prescribing cannabis-based medicines and “deny children safe treatment”.

Fifty clinicians signed an open letter to Mr Javid, outlining their concerns about the guidance, which state that the body does not recommend the prescribing of products containing THC due to a “lack of evidence of safety or efficacy.”

The BPNA also states that you must be a paediatric neurologist to prescribe, but this is not based on law and is not supported by national guidance, according to the Medical Cannabis Clinicians Society (MCCS), which authored the letter.
“Our concern is that what appears to be a deeply entrenched and dogmatic position on this subject from the BPNA is effectively denying sick children access to an efficacious and safe medicine that may well reduce or even stop their seizures and immeasurably improve their quality of life and reduce their chance of death,” the letter stated.

“It is deterring private prescriptions and is playing a part in the almost total block on NHS prescriptions. This block in turn is forcing many very vulnerable families to have to fundraise thousands of pounds a month to source the medicine privately.”

Desperate parents

It is understood that earlier this year the BPNA referred one doctor who was prescribing cannabis medicines to the General Medical Council (GMC) on the basis that he was a paediatric rheumatologist rather than a paediatric neurologist. The case was dropped following review and no further action will be taken.

The MCCS letter included a statement from the GMCs independent medical expert who was quoted during the review as saying the BNPA position is “probably not in the best interests of children”.

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However, as cannabis-based medicines remain unlicensed by the MHRA, without the support of the BPNA and other bodies such as NICE, clinicians don’t feel comfortable prescribing, explains Hughes.

“There are many unlicensed medications that are prescribed for epilepsy, but because that’s common practice, clinicians have the confidence to do it,” he says. “As cannabis is so new and there’s the stigma attached to it, doctors are leaning on NICE guidelines and if something were to go wrong, they’re on their own. I know there are some who would be willing to prescribe but they don’t want to be held responsible.”

This is having a knock-on effect on the ability to collect the “robust” evidence of the safety and efficacy, which regulatory bodies have repeatedly called for.

“Everyone is saying that we need more robust evidence, but we’re not going to get any evidence if there’s no one prescribing,” adds Hughes, who through Medcan Support is planning a new study of around 60 patients, as it is limited to the number of children which are currently prescribed for.

“We can only grab the data from the current patient cohort at the moment.”

Earlier this year a study by Drug Science showed that there is a 96 per cent chance of a child significantly improving after prescription of full-spectrum cannabis. The MCCS, Medcan Support and other organisations across the industry are calling for this real-world evidence to be taken into account and to treat individual patients on a case-by-case basis, rather than relying on randomised control trials (RCTs) which are not suited to full-spectrum cannabis.

Parents: Portrait photo of Dr Lewis

Dr Evan Lewis

Dr Evan Lewis, director of the Neurology Centre of Toronto, and a specialist in pediatric epilepsy argues that this evidence is already out there.

“There is evidence now to support cannabis in epilepsy, that details a clear mechanism of action in terms of the endocannabinoid system and its role physiologically,” he tells Cannabis Health. “There’s certainly good theory behind how cannabis works in the brain and what the effects are in terms of epilepsy, from very good robust clinical research that’s been done in randomised control trials.

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“Drug-resistant epilepsy is defined by a child who has seizures and has tried two medications or more. The research and data show that the chance of success for a third medication is less than three per cent. At that point, in my opinion, cannabis should be considered as an option.”

He continues: “Cannabis has a unique mechanism of action compared to the other drugs, so it’s very possible once you hit the drug resistance stage that underlying epilepsy may be due to an imbalance in the endocannabinoid system (ECS) or it may be that the ECS can be supplemented by cannabis to help prevent seizures.”

Dr Lewis is currently carrying out a review of research into the effects of THC, which has so far indicated that the long-term use of cannabis may not affect cognitive functioning. He advocates for clinicians to take a ‘harm reduction’ approach to their practice.

“From my perspective, parents are going to do it anyway, so when a practitioner refuses to prescribe that’s the worst-case scenario. Those individuals will source the cannabis from somewhere else, probably illegally and then nobody is taking care of these children,” he says.

“It’s the duty of the practitioner to send parents and patients to those resources, knowing that, in all likelihood, they’re going to source that cannabis and get it themselves. To push parents away or ignore parents is actually doing harm.”

Medcan support

Hughes has encouraged clinicians to speak to experts at Medcan Support and the MCCS to educate themselves on the existing research and access advice. He also called on the 60 existing medical cannabis prescribers in the UK to support pediatric specialists in prescribing.

“The lack of access to cannabis prescriptions is a harm that needs to be removed from our healthcare system,” adds Dr Lewis.

“The tide has shifted so much that whether it sits well with them or not, it is now a duty for clinicians to learn about this. Learning can mean educating themselves on resources and where to send patients or becoming a prescriber themselves, but there’s no room on that spectrum for doing nothing.”

Cannabis Health contacted the BPNA for comment but did not receive a response.

 

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