“Ireland has the most restrictive medical cannabis programme in the world”

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.

Peter Reynolds is an advisory board member of the Irish Medical Cannabis Council.

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.

Read more: HSE to offer first cannabis-based products on MCAP program from October

Peter Reynolds is president of CLEAR Cannabis Law Reform in the UK and an advisory board member of the Irish Medical Cannabis Council.