The recently released draft NICE guide for prescribing cannabis-based drugs is more restrictive than the initial position of the NHS. It only recommends prescribing nabilone, a synthetic drug containing THC, for chemotherapy-related nausea and vomiting, and explicitly states that no cannabis product should be prescribed for chronic pain, unless it is part of a clinical trial. However, NICE has recommended that further research be conducted to examine the clinical and cost-effectiveness of CBPM in fibromyalgia or treatment-resistant persistent neuropathic pain in adults, chronic pain in children and young people, CBD for severe treatment-resistant epilepsy, THC in combination with CBD for severe treatment-resistant epilepsy, CBPM for spasticity and intractable nausea and vomiting. Due to the lack of sufficient evidence, very few patients have been prescribed CBPM through the NHS.
As a result, many patients have turned to the private health sector, which is not subject to the same financial restrictions as the NHS. Private specialists, doctors and doctors at medical marijuana clinics should only prescribe when there is a clear and unmet clinical need. The list of conditions suitable for prescribing CBPM may be broader and include chronic pain, fibromyalgia, neurodegenerative diseases, migraines, PTSD, and anxiety. The Cancard is a credential that can be shown to a police officer to indicate that the person is using cannabis for medical reasons.
Before applying for a card, the applicant must receive a diagnosis from their doctor showing that they have one or more of the medical conditions that qualify for medical cannabis in the United Kingdom. Any CBPM that is supplied to patients in the UK must be approved and authorized by the Medical Health Agency (MHRA) and the Home Office, and meet strict criteria such as good manufacturing practice (GMP). Chronic pain affects up to half of cancer patients during treatment, and a prescription for medical cannabis could help control it without or with opioids. It can also help improve sleep so that the patient experiences less mental confusion and fatigue the next day.
All medical cannabis and medical cannabis products are considered unlicensed medicines, also known as specialty products. It is important to note that searching for medical cannabis privately will entail a cost not only for consultation and follow-up treatment but also for the CBPM themselves which can amount to more than 1000 pounds a month. The doctor does not need to recommend cannabis or favor it as a medical treatment; he only needs to declare that the patient has the medical condition or conditions in question. In effect, this means that if the medical specialist prescribing it believes that there is sufficient evidence of the effectiveness of cannabis as a treatment for a particular condition he can prescribe medical marijuana.
The country's medical authorities have long stated that they have been slow to expand access to medical cannabis due to a lack of research into its safety and effectiveness. All of which should mean that in the near future it will be easier to obtain a prescription for medical cannabis both through the NHS and in private clinics.
Conditions That Can Qualify for Medical Cannabis in the UK
Associated with Pain:
- Arthritis
- Back and neck pain
- Complex Regional Pain Syndrome (CRPS)
- Ehlers-Danlos Syndromes (EDS)
- Endometriosis
- Fibromyalgia
- Joint pain
- Musculoskeletal pain (MSK)
- Neuropathic pain or nerve pain
For Neurological Conditions:
- Autism Spectrum Disorder (ASD)
- Alzheimer's disease
- Cluster headaches
- Epilepsy
- Functional Neurological Disorder (FND)
- Migraines
- Motor Neurone Disease (MND)
- Multiple Sclerosis
- Muscle spasms
- Parkinson's disease
- Tourette's syndrome
- Tremors
- Stroke
For Psychiatric Conditions:
- Agoraphobia
- Appetite disorders like Anorexia
- Attention Deficit Hyperactivity Disorder (ADHD)
- Generalised Anxiety Disorder (GAD)
- Insomnia or sleep disorders
- Major Depressive Disorder (Depression)
- Obsessive-Compulsive Disorder (OCD)
- Panic disorder
- Post-Traumatic Stress Disorder (PTSD)
- Social anxiety disorder or social phobia
- Substance Use Disorder
For Gastrointestinal Conditions:
- Crohn's and ulcerative colitis
- Irritable Bowel Syndrome (IBS)
Associated with Cancer:
- Cancer-related anxiety
- Cancer-related appetite loss
- Cancer-related depression
- Cancer-related pain
- Chemotherapy-induced nausea and vomiting
For Palliative Care:
- Palliative care pain
- Palliative care anxiety
Some Other Conditions:
- Chronic Fatigue Syndrome, or ME
- Restless legs syndrome
