As a result of a change in the law, on 1 November 2018 cannabis-derived medicinal products were placed in schedule 2 of the Misuse of Drugs Regulations 2001 (MDR). In simple terms, this provided official recognition in the UK that these products have a therapeutic value, enabling doctors to prescribe them.
However, as widely predicted both before and after the event, this has not resulted in open-season for the prescribing of medicinal cannabis. In fact, quite the opposite.
The NHS has set up a system to specifically monitor the prescribing of cannabis-based products and the first data is expected to be published by the end of March 2019. However, expect no surprises as it’s widely thought that no NHS prescriptions have been issued at all. This is because not only have large sections of the medical profession in the UK raised considerable concern over the efficacy and safety of cannabis-based products per se, but also the NHS interim guidance on issuing such prescriptions is hugely restrictive.
The guidance provides that even where a patient satisfies the prescribing criteria, only hospital consultants can issue a prescription. But even if you can find a sympathetic consultant, there is yet another hurdle. In most localities, cannabis-based products have been placed on the prescribing ‘grey list’, which means that they are not currently recommended for use. A consultant wishing to issue an NHS prescription for a ‘grey list’ product is required to seek approval from somebody with greater authority such as the Trust’s medical director. In reality then, not one but two people have to be persuaded to prescribe against the guidance.
Of course, the NHS is not the only source of prescription medicines. A doctor can issue a prescription privately; but whilst a consultant doing this can circumvent much of the red tape of the public sector, they are still faced with the interim prescribing guidance. Although strictly speaking the guidance is not binding upon them, as it is authored by professional medical bodies, it carries considerable ‘persuasive’ weight.
The reality is that even in the private sector, only a handful of prescriptions have been issued. However, even if you are one of the very few fortunate enough to get your hands on a prescription, there has been an even bigger problem – supply. The first batch of medicinal cannabis has only just arrived in the UK. Not only has it taken over three months since the change in the law for supplies to become available, but this first batch is tiny, comprising only enough cannabis to treat 30 patients for one month. One might almost think that they are not expecting a rush!
The only consultant who has so far put his head above the parapet to confirm he has issued private prescriptions for cannabis is Dr David McDowell, a pain specialist from Lancashire, in each case for a chronic pain condition.
Putting aside for one moment the difficulty in obtaining a private prescription, there is yet another huge problem – the cost. In the private sector you are not limited to paying only a statutory prescription charge (currently £8.80 per item unless you have a pre-payment card). It is thought that one month’s supply of medicinal cannabis on a private prescription will set you back a whopping £695!
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About the author
Leading Chronic Pain solicitor Richard Lowes co-founded the first legal team in the UK specialising in representing people suffering debilitating chronic pain conditions including CRPS, Fibromyalgia, Somatic Symptom Disorder, Myofascial Pain Syndrome and Neuropathic Pain. Richard is a popular speaker on the subject of chronic pain in litigation and remains an inveterate blogger. You may contact Richard direct at firstname.lastname@example.org