With the publication of new regulations yesterday, it is now clear how cannabis will be available on the NHS starting on 1st November 2018.
Only consultants will be able to prescribe cannabis and it will be entirely up to each consultant to make a decision about individual patients. The definition of cannabis-derived medicinal products is sufficently wide that both oils and herbal cannabis manufactured to GMP (Good Manufacturing Practice) standards will be available.
There is very little explanation included in the regulations but the intention is that prescribing guidance will be developed over time by NICE (National Institute for Health and Care Excellence). The regulations prohibit smoking cannabis for medical use but if your consultant decides it is appropriate for you, they will be able to prescribe herbal cannabis for vaping. Apart from Sativex, all cannabis products are unlicensed medicines described as ‘specials’, so your consultant is supposed to consider licensed medicines first.
There are no restrictions on which conditions cannabis can be prescribed for. Again, it will be up to your consultant to decide.
So this is marvellous news. It is a fundamental breakthrough and its impact will be enormous but it will take time for it to start working effectively.
The law is no longer an obstacle. The biggest problem now is that very few consultants have any knowledge of cannabis at all and most are probably going to be very reluctant to prescribe. For the best part of a century, doctors, just like the rest of society, have been subject to a relentless flow of propaganda and false information about cannabis. Changing this with medical training, helpful prescribing guidelines and overcoming unjustified prejudice and fear are the new challenges we face.
To begin with, a lot of people will be disappointed because their consultant will be unwilling to prescribe. The first thing you can do about this is ask your GP to refer you to a different consultant but it may be some time before understanding develops and consultants are sufficiently informed. Almost certainly there will be more resistance to prescribing herbal cannabis and it will be easier to get oil.
As ever, the best thing to do is gather evidence on the use of cannabis for your condition(s). If you are well informed and prepared then you can help to educate your consultant. There is now an enormous amount of evidence available online. Just be careful to use proper scientific information and avoid the miracle cures and exaggeration that is still widespread.
Whilst not everyone will immediately be able to get the medicine they need, we are now on the correct path. Instead of politicians imposing their ignorant opinions on you, your doctor will now be making the decisions and that is the way it should be. In time the right to prescribe will be extended to GPs. For now the truly wonderful news is that we are no longer engaged in a battle with the law. What it’s about now is patience and education.