While the UK medicinal cannabis market shows evidence of a promising future for healthcare and the economy, it is still in its infancy when compared with other countries.
James Leavesley, chief operating officer and Brady Green, head grower at Midlands-based cultivator Dalgety, discuss how these other markets operate, and what insight this can give the UK.
In July 2001, the Canadian government became the first country to legalise medicinal cannabis, making it available to people with physician-documented evidence of a severe health problem that could not be managed using conventional therapies. Now, 18 years on, while Canada remains a leader in the market, there are more than 40 countries who have joined a movement to make medicinal cannabis legal using varying regulations and processes.
Looking at where Canada’s thriving medicinal cannabis market is in 2023, it is hard to imagine how it started out and the obstacles it encountered. Brady recalls the lack of insight, the competition with the illicit market and the ‘grey area’ of regulation that led to companies having to evolve several times.
For this reason, progress has been slow to get the industry to where it is now – but Brady believes the UK is starting in a good position.
“The UK medicinal cannabis market is hugely exciting for someone like me, who saw firsthand how Canada had to navigate its way without any real information – now we have a whole library,” Brady said.
“Canada’s industry started with people being able to grow medicinal cannabis for themselves, but then this became harder to control. New regulations made it more commercial, and with fewer producers it was easier to regulate. And similar to the UK, this was kept largely away from public knowledge for security, which I think was right at that stage.
“The market grew rapidly from there and competition was fierce, with new startups occurring regularly. But I think it’s easy to look at Canada now and compared to the UK, it appears very open and accessible – but this has taken time to build and there was still a stigma attached until recently. But the UK has the advantage of all the lessons learned, so it’s not like starting from zero. It has also given us the opportunity to enforce early education for the healthcare sector, government and the public, so that we can overcome some of the misinformation out there.”
Prioritising experience and quality
James said: “A large part of the reason we decided to have someone on board with experience of the Canadian market is because it is the most advanced nation in this area. Therefore, we had the best chance of engaging with someone who had worked at a higher standard and on a large scale, as well as being legitimate – understanding regulations and processes.
“Growing medicinal cannabis is both a science and an art, which Brady exemplifies. There has to be consistency from the strain to make it a reliable and regulated medicine, but unlike a lab, we are dealing with a living product that requires care and nurture too. We have plenty of scientific experts on our team, but we also needed someone who understood the nuances of horticulture, especially in controlled environments.
“Brady has a real passion for his work and has previously looked after large scale operations, and worked under tight regulations. His expertise has meant our first crop has an incredibly high yield, which is positive both from a business and a medicinal perspective.”
European insight and access
Looking closer to home and our neighbours in Europe, it has been interesting to see the growth of the medicinal cannabis market. Estimates suggest sales will reach more than €516 million by the end of this year.
James said: “At the forefront of the industry is Germany, with a large number of suppliers and intense competition. The high level of access and support for use of medicinal cannabis is something we would be keen to see replicated in the UK.”
Since 2017, under German law, every doctor is permitted to prescribe cannabis-based drugs, including cannabis flowers, extracts and individual cannabinoids. Under certain conditions, health insurance companies must cover the costs of therapy. According to the law, health insurance companies may only be allowed to refuse a request for reimbursement in exceptional cases.
“From our research, we know the average medicinal cannabis user in the UK is a 55-year-old, middle class, white female,” James added.
“While this statistic focuses on what the current market is showing, we know that this is not reflective of the diverse patient profiles out there. It’s therefore important that the UK focuses on opening this up and not reinforce negative stereotypes on people who are struggling to get access to medicinal cannabis.”
A consistent theme for all medicinal cannabis markets is the process of managing the stigma around it, making a clear distinction from the pesticide-infused black market, which is unregulated and highly dangerous for users. By encouraging more understanding about the benefits, it is hoped a shift in attitude can be achieved.
“As soon as people start to see beyond the stigma with medicinal cannabis, they are opened up to an incredible realm of health and economic benefits,” James said.
“Almost 40 million opioid prescriptions were given out in the UK last year, to deal with the rising number of patients facing severe chronic pain. This includes highly addictive ingredients such as morphine, tramadol and fentanyl. For 90% of these patients, these drugs are ineffective and for those that do use them, as tolerance levels are heightened over time, patients must be prescribed larger doses causing negative side effects.
“Painkillers are considered fairly normal in most British households, whereas medicinal cannabis still carries negative connotations – this ultimately comes down to education and is something we and many other countries are working towards changing. In the USA, there have been studies that suggest states where medicinal cannabis has been legalised, there has been a significant drop in opioid use, so there is potential for change.”
As well as Dalgety’s drive to make medicinal cannabis more accessible, having a domestic cultivation and distribution for the UK would also mean a greater consistency within the supply chain.
“Bringing medicinal cannabis production to the UK pharmaceutical market would allow for greater consistency for patients, similar to what other markets are able to offer currently,” James added. “Instead of relying on imports for prescriptions, we would be able to supply our own, UK-grown products and provide greater transparency of cultivation and manufacturing processes for both patients and regulators. And similar to other markets, the UK economy would reap the benefits of this, rather than UK patients spending hard-earned money on imported products.”
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