Coming only weeks after the Royal College of Physicians called for the decriminalisation of all drugs, members of the Royal College of Nursing have voted overwhelmingly in favour of lobbying for the legalisation of cannabis for medicinal use.
Whilst clinical studies on the efficacy of medicinal cannabis specifically for chronic pain have so far proved equivocal, many sufferers say they do find relief in cannabis, but they risk the ire of the criminal law in the process.
Nurses highlighted the seeming irrationality of the current position of cannabis when compared to legal painkillers such as morphine and fentanyl, which are members of the same family of drugs as heroin. Legalisation of cannabis, they argued would protect patients from disreputable dealers, prevent patients being treated as criminals and allow medical professionals to monitor them for any potentially harmful side effects.
A spokesman for the cannabis law reform campaign group, Clear, said “this is recognition by the people we all turn to in our most difficult times that cannabis is an extremely valuable medicine which science now proves to be both efficacious and safe.”
Groundswell of opinion
Some months ago we highlighted The Legalisation of Cannabis (Medicinal Purposes) Bill, which had been introduced before parliament, sponsored by Paul Flynn MP. That seemed to trigger a groundswell of opinion of which the votes of the Royal Colleges are the most recent confirmation.
However, although it wasn’t reported widely, Mr Flynn’s Bill was ultimately the victim of filibustering by a member of his own party; which meant that it was consigned to the legislative dustbin.
How does the UK compare internationally?
In January 2018, cannabis was legalised for medicinal use in Denmark for a trial period of four years and with medicinal cannabis now legal in large parts of the US, as well as in Peru, Chile, Uruguay, South Africa, Poland and Spain, among others, it seems that the UK is certainly bucking the trend.
History and Politics
In Victorian times, a doctor’s bag would carry a whole variety of now banned and highly restricted substances, including both cannabis and opiates, but over the years legislators set to work in restricting or banning their use, often for very good reasons. However, cannabis was still being used medicinally in the UK as recently as the early 1970s, when ultimately it was banned.
Fast forward to 1999, and a Select Committee of the House of Lords recommended that cannabis be available on prescription in some limited circumstances, although this recommendation was not accepted by the government at the time.
In 2002, the government announced that the medicinal use of cannabis might be allowed if clinical trials of the drug were successful. However, quite what clinical trials were being referred to was unclear and the statement seemed little more than an attempt to appease lobbying groups.
In January 2004, the government downgraded cannabis from a Class B to a Class C drug for all purposes, only for this decision to be reversed in May 2008.
It was not until 2010 that GW Pharmaceuticals were granted a licence to market the first, and to date the only, cannabis-based prescription medicine in the UK. Sativex contains cannabinoids and is used to treat spasticity in people with multiple sclerosis.
Certainly, both public and professional opinion seems to favour the greater liberalisation of the use of cannabis generally. However, successive governments seem unable to overcome the fear that such liberalisation potentially opens them to accusations of being ‘soft on drugs’, even when proposed legislation, such as that proposed by Paul Flynn, is limited to medicinal use.
But government caution is not without support among the medical profession. A spokesman for the Royal College of Psychiatrists has said recently “The legal status of cannabis and other drugs is a matter for government rather than doctors to decide. Cannabis carries significant mental health risks for some, including psychosis, depression and anxiety. We support medical use of NICE approved, cannabis products, following properly conducted independent research… Legalisation for recreational and medicinal use should be considered as distinct.” [Our emphasis]
And therein lies the problem – there is a lack of persuasive evidence that cannabis can effectively treat chronic pain and other symptoms. To highlight the point, a recently published research paper concluded that “public perception of the efficacy, tolerability, and safety of cannabis-based medicines in pain management and palliative medicine conflicts with the findings of systematic reviews and prospective observational studies conducted according to the standards of evidence-based medicine.”
In other words, anecdotal ‘evidence’ conflicts with the science. And whilst that remains the case, it is difficult to be critical of the government’s stance.