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UK Medicinal Cannabis Impasse – ‘Companies Won’t Invest In Clinical Trials; Medics Only Want Clinical Trials’

A WORLD-LEADING cannabis professor says the UK is caught in a depressing Catch-22 with companies unwilling to invest in clinical trials and medics unwilling to rely on real-world patient data.

The current impasse in the UK medical cannabis system has seen pitifully low numbers of NHS parents prescriptions written, delegates at Prohibition Partners Live heard.

Professor David Nutt, the UK’s former Drugs Czar who was sacked for his outspoken views, told on-line attendees there’s little sign of any progress.

Professor David Nutt.

Consequently, Prof Nutt and colleagues at Drug Science have launched Project 2021; it aims to recruit 20,000 patients by 2021 and has so for had interest from over 7,000 people.

This will rely on first-hand patient data in the same way other jurisdictions have allowed their cannabis medication to ‘evolve organically’.

He said: “Cannabis has evolved as practitioners have explored its potential by developing databases, getting a lot of patient feedback and developing a medicine. This is a different way to the traditional one, and the patients are key to this.”

The UK currently has two licensed cannabis medicines Sativex and Epidyolex, developed after Randomised Controlled Trials (RCT) by GW Pharmaceuticals. The National Institute for Health and Care Excellence (NICE) had initially deemed these drugs too expensive.  

‘It Would Be Stupid And Pointless’

He continued: “We have set a high-cost bar which makes it hard for companies to undertake multi-centre, large-scale clinical trials for cannabis – this has effectively eliminated all research into cannabis. 

“Companies won’t invest in that level of research because they cannot patent the products. Why spend tens of millions on an RCT for indications, which you can’t patent and NICE won’t reimburse? It would be stupid and pointless.”

When the UK changed its law to allow for cannabis prescriptions in 2018, following the cases of youngsters Billy Caldwell and Alfie Dingley, he felt like it was case of ‘job done’ but says it has been anything but.

Drug Science subsequently established a Medical Cannabis Working Group which involves patient groups, academics and industry with the aim of developing research and policies.

Patients on the Project 21 scheme pay £150 a month, and are prescribed for a limited number of conditions including pain, MS, PTSD, anxiety, and Tourettes with patients reporting back on the outcomes on the quality of life.

Interviewed by Jonathan Nadler, Managing Director of the Lyphe Group, Prof Nutt recounted the history of cannabis describing it as one of the oldest known medicines.

Queen Victoria used it for period pains and her doctor Sir Russell Reynolds wrote the definitive medical text in the Lancet in 1890, describing how it can be used for wide range of medical disorders.

In 1971, Britain fell into line with the prohibitionist US view that cannabis had no medicinal value, and it took until 2018 for that to change.

Prof Nutt, a Neuropsychopharmacologist at Imperial College, London, added: “Many doctors have spent the last 40 years vilifying cannabis as a dangerous drug that leads to psychosis and causes dependence. 

“So getting them to change from their prohibitionist position is challenging and difficult.”

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