Findings in a new report from drug policy think tank Volteface has revealed that 99% of people who use cannabis medicinally in the UK do so illegally due to failings. Doctors are now calling for cannabis to be treated like any other medicine.
Since the legalisation of medical cannabis in the UK in 2018, around 15,000 people are being prescribed through private clinics. However, although cannabis can be prescribed for a wide range of conditions such as MS, fibromyalgia, endometriosis and a range of gastrointestinal diseases, only three prescriptions have been dispensed on the NHS.
Despite being available legally, there are also still 1.8 million people in the country using cannabis for medicinal purposes who are accessing their medicine on the illicit market.
Read more: Brexit – the perfect opportunity for UK to be centre of European cannabis
Volteface’s new report, entitled ‘Known Unknowns’, has now revealed persistent failures in the provision of cannabis-based medicines since legalisation, making a series of recommendations to address the problems it identifies with the current model of prescribing.
The organisation has said these failures are leaving people with chronic illnesses no choice but to risk criminalisation by using drug dealers instead of doctors.
A total of 41 doctors were interviewed for the report, which highlights key issues that need to be resolved including efficacy, research, knowledge and accessibility.
Known Unknowns sets out three key reasons why medical cannabis is currently so
under-prescribed in the UK:
- A lack of specific and suitable evidence of efficacy, with many clinicians expressing a desire to see more evidence in the form of Randomised Controlled Trials before feeling confident in prescribing.
- An ineffective system of governance was highlighted, with many doctors expressing a lack of support in terms of the practicalities of the prescribing process.
- Hesitations around the uniqueness of cannabis as a medicine, compared to man-made pharmaceutical products.
Author of the report and Head of Operations at Volteface, Katya Kowalski, said: “It is clear that medical cannabis does not fit neatly into the healthcare system. In order to see this change and become mainstream, we have got to see a broadening of choices for clinicians to prescribe outside of the cannabis clinic model. Nowhere else in medicine do we see single-drug clinics.
“From my research, this is a major barrier within the medical community, something we need to see addressed in the sector, to truly broaden confidence amongst clinicians to prescribe more widely, in turn, expand patient access.”
Known Unknowns
The report highlights a critical lack of understanding about cannabis-based medicines among doctors.
The report found that the vast majority of clinicians lacked support and understanding in the form of guidance, information and clear protocol around the practicalities of the prescribing process.
Additionally, the report found that stigma towards cannabis amongst clinicians and clinical bodies is a further barrier, as decades of prohibitionist policy has naturally coloured views towards cannabis within the medical profession.
These preconceived notions towards cannabis have prevented it being fully embraced as a legitimate medicine and exacerbated concerns amongst clinicians.
Making improvements
The report says that a drive to expand private prescriptions will lead to an expansion of medical cannabis use more widely.
It argues that once it is regularly prescribed in the private sector and the health benefits are seen by clinicians, NHS provision is likely to improve as a result of pressure applied to NHS trusts, along with the wider acceptance of the medicinal uses for cannabis.
Looking at how improvements can be made going forward, the report also explores existing solutions and innovative steps currently being taken in the industry. It highlights data, research and industry insights from leading medical cannabis organisations.
Recommendations in the report include:
- Mainstreaming cannabis prescribing in clinicians’ daily practice.
- Open up communities of practice for clinicians to access medical cannabis information.
- Collecting evidence across sectors.
- Launch a clinician-centred campaign.
- Consider cannabis as per other medicines.
- Conduct more RCTs to supplement the knowledge base.
Commenting on the findings Arjun Rajyagor, Chief Operating Officer at Sana Healthcare who was interviewed for the report, commented: “The use of cannabis for medicinal purposes remains a contentious issue and despite the law change, relatively few patients have received medicinal cannabis on prescription in the UK. Known Unknowns is an important and timely report that offers insight into why we must focus on the perceptions and concerns faced by practising clinicians.
It’s clear we need evidence-based research to increase confidence in prescribing and offer a way forward that will help provide solutions to the barriers of access to medicinal cannabis. That’s why we’ve developed Script Assist; a new, innovative platform to support clinicians to prescribe independently, streamlining the process and providing supporting data. I believe this is a significant step in addressing many of the issues outlined in the report.”
