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A case for cannabis: Why medicinal access and supply must be fixed

Now is the time to redress perceptions of medicinal cannabis in the clinical community, says an expert.



First Jamaican medical cannabis released in the UK

Nadeem Sarwar, CEO of digital pharmacy, Phlo Connect, explains why now is the time to redress perceptions of medicinal cannabis in the clinical community, and fix the barrier to access and supply.

For a long time, medical cannabis has been a topic of controversy within healthcare. Yet, while it continues to attract stigma in some quarters, awareness and attitudes have been shifting toward greater acceptance of its prescription and use. 

In November 2018, UK law changed to allow prescribing of cannabis-based products for medicinal use (CBPMs) in certain circumstances. For many people living with chronic conditions who had already encountered limited success with other prescription medicines, this change represented new hope for readily available access to an alternative option.  

Nadeem Sarwar, CEO of digital pharmacy, Phlo Connect

Nearly four years later, reality has not met expectations. Fast forward to 2022 and the total number of NHS prescriptions now stands at just three. 

Little progress has been made to help patients to access the medicine through the NHS and many who could benefit are still unable to access medical cannabis. An estimated 1.4 million people continue to use illegal, non-regulated cannabis from the black market to help manage medical problems, while thousands of others have resorted to private healthcare services instead. 

Whether through black-market or private prescriptions, the cost of medicinal cannabis in the UK is high, but for conditions where it has demonstrated clinical efficacy, use of medical cannabis could offer cost-savings when offset against conventional treatments and hospital admissions.  

What are the barriers to prescription? 

 Clearly there are obstacles to overcome. Unlike traditional pharmaceutical interventions, medicinal cannabis has been used in medical settings before undergoing scrutiny of its efficacy through clinical trials. Clinicians therefore often cite lack of evidence for hesitancy to prescribe.  

However many industry experts believe that these concerns are misplaced and ignore real-world evidence; case studies, observational data and valuable user feedback and experience available from tens of thousands of patient reports highlighting the therapeutic value of medical cannabis.  

Adding to clinician’s reluctance is a challenge around authorisation to prescribe. Currently, only clinicians on the General Medical Council (GMC) specialist register – which does not include GPs – can prescribe the medicine.

To address this, a review published by the BMJ in 2022 recommended the launch of a national pilot programme that would enable GPs, who make up 50 per cent of doctors in the NHS, to prescribe medicinal cannabis.[2]  

Taking a people-centred approach to medicinal cannabis 

Addressing both of these challenges requires a shift to a more person-centred mindset , mixing patient-reported outcomes with an evidence base drawn from larger studies.  

Experts have also suggested that existing National Institute for Health and Care Excellence (NICE) guidelines are too restrictive. Mike Barnes, a consultant neurologist and chair of the Medical Cannabis Clinicians’ Society said the guidance would make it more difficult for doctors to issue prescriptions for medical cannabis and advises that the guidance be reassessed by a new panel of leading academics, medical practitioners and cannabis experts from both the UK and countries where cannabis is already successfully utilised.  

Together, these changes would enhance NHS clinicians confidence when prescribing medical cannabis. There are lessons to be learned from overseas too; accredited educational programmes can help to overcome any barriers that may exist in clinicians’ knowledge and help to correct misperceptions and stigma.  

Nor is the access challenge centred solely on clinicians. It will be important to educate the general population so that patients are empowered to confidently discuss medical cannabis as a potential treatment option. With November 2022 seeing the very first medicinal cannabis patient conference in the UK, there are forward strides being made.  

How can we make access a reality for patients? 

UK based cannabis companies are also leading a new charge, securing investment to help to legitimise the medical cannabis industry as one that can deliver both social and economic returns, and help to meet domestic demands and while bolstering the economy.  

 The Leva Clinic is the UK’s leading online clinic supporting people living with chronic pain, specialising in a holistic approach to chronic pain management including personalised medical cannabis care plans. It is also part of Project Twenty21, the largest observational medical cannabis research project in Europe, gathering clinical and real-world data to assess the effectiveness of medical cannabis and develop a body of evidence to support future guideline updates.  

In a UK first, Phlo Connect has recently partnered with Leva Clinic to become the first digital pharmacy to deliver medical cannabis to patients’ homes. This collaboration is aimed at breaking down barriers to access by creating transparent digital pathways that provide digital prescriptions and keep both patients and clinical teams updated with the prescription and delivery status. 

Chronic pain doesn’t wait and according to Verus Arthritis, more than 34 per cent of UK adults are affected.4

Getting medication quickly, and knowing exactly where a prescription is in the process, gives patients a feeling of control, especially when chronic pain can affect so much of day-to-day life – getting the right medication fast, can feel like a real lifeline, which is why we’re prioritising secure, on-demand, same day delivery for people receiving support via The Leva Clinic.  

Thousands, if not millions of people are missing out on a potentially life-changing management option, alongside progress in research we know that providing safe, secure digital access to treatments like medicinal cannabis is non-negotiable. From patients, to providers, services and healthcare professional teams, everyone wins.   

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