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UK: Medicinal cannabis on prescription

Discussion in 'Health News and Research unrelated to ME/CFS' started by Sly Saint, Jul 27, 2018.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    This is being reported in a lot of places.
    Here is Sky News:
    "
    Senior doctors will be able to prescribe cannabis-based medicines in the UK later this year after the government agreed to ease a ban.

    Home Secretary Sajid Javid announced the decision while admitting the current law is "not satisfactory".

    It follows recent high-profile cases in which children with severe epilepsy were initially denied access to cannabis oil to control seizures."
    https://news.sky.com/story/medical-cannabis-to-be-legalised-on-prescription-in-uk-11449687

    and the BBC:
    "
    Specialist doctors in the UK will be able to legally prescribe cannabis-derived medicinal products by autumn, the home secretary has announced.

    Those that meet safety and quality standards are to be made legal for patients with an "exceptional clinical need", Sajid Javid said.

    As it is a devolved matter, it will require legislative change before it is enforced in Northern Ireland.

    Legalisation follows high-profile cases involving severely epileptic children.

    Many had previously been denied access to cannabis oil.

    Others forms of cannabis will remain illegal."
    "
    'Exceptional circumstances'
    Mr Javid's decision was made after the chief medical officer for England, Prof Dame Sally Davies, and the Advisory Council on the Misuse of Drugs said patients with certain medical conditions should be given access to the treatments."

    https://www.bbc.co.uk/news/health-44968386
     
    adambeyoncelowe likes this.
  2. NelliePledge

    NelliePledge Moderator Staff Member

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    8,699
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    keeping it tightly controlled as the Drs have to apply to expert panel for approval
     
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  3. MeSci

    MeSci Senior Member (Voting Rights)

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    Last edited by a moderator: May 19, 2021
  4. hellytheelephant

    hellytheelephant Senior Member (Voting Rights)

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    Her Drs were happy to prescribe Fentanyl...but not medical cannabis. Crazy!:banghead:
     
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  5. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Is it crazy?

    Fentanyl is well established as having an analgesic effect and for acute problems like dislocations seems not unreasonable.

    For whatever reasons there does not seem to be good evidence for analgesic efficacy of cannabis products - or at least not sufficient evidence for good risk/benefit to make them widely available.

    We complain about BPS and Lightning people and bleach enthusiasts recommending treatments with poor evidence base. Surely the same applies here?

    I would not take too literally a lot of these stories in the media either. It is very unclear to me what actually happened in this case.
     
  6. Mij

    Mij Senior Member (Voting Rights)

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    My ex-financial advisor swears by his prescription cannabis oil to treat his back pain. He was barely able to walk. He was able to get off all his pain meds years ago. His only side-effect is the munchies and gaining a few lbs.
     
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  7. Trish

    Trish Moderator Staff Member

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    I think it's worth proper studies being done on the use of medical cannabis for pain relief, and there is also at least anecdotal evidence of efficacy for otherwise uncontrollable epilepsy and for some symptoms of multiple sclerosis. If it weren't for the social use and consequent classing as illegal in most places, it would probably have been properly researched by now.
     
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  8. voner

    voner Senior Member (Voting Rights)

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  9. rvallee

    rvallee Senior Member (Voting Rights)

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    Cannabis works very well for some types of pain, not at all for other types of pain. As many painkillers do. And there are specific strains that achieve those effects. The poor quality of pain research is in part to blame for this, but there is no question that it is effective. If anything it's an indictment of how bad medical research is that there is still controversy over this, just as bad as medicine's complete and total denial of horrible withdrawal from antidepressants.

    The problem is 100% on medicine and down to poor research quality being the norm. It's frankly absurd at this point that this still remains controversial, shows how evidence is entirely irrelevant in EBM. It's evidence that people accept that is relevant, the quality or accuracy makes no difference until science settles things with actual evidence.
     
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  10. Mithriel

    Mithriel Senior Member (Voting Rights)

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    They ran trials of cannabis for MS in my area but the results were not fantastic. In the real life situation, there was a lot about cannabis for MS twenty years ago and many of the people I knew had tried it and the chocolate bars but if it had worked that well everybody would be taking it now.

    There are still the chocolate bars around but the results seem to be about the same as B12 injections, not an overwhelming effect.
     
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  11. oldtimer

    oldtimer Senior Member (Voting Rights)

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    I thoroughly researched the best CBD (cannabidiol) and spent a fortune on it. I have all types of pain and got no relief whatsoever. I didn't even feel more relaxed. Big disappointment.
     
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  12. MeSci

    MeSci Senior Member (Voting Rights)

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    I've tried cannabidiol too, and found it unimpressive.

    Much better is real cannabis.
     
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  13. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    Can we argue that though?

    Maybe the three biggest illegal drugs are based on opium, cocaine and marijuana.
    Modifications of, and synthetic analogues of, morphine and cocaine have been central to pharmacology for decades. There is a vast range of opioids. Cocaine analogues have been basic to local anaesthesia. Because they work.

    I agree with @Mithriel that if cannabis was such a useful analgesic not only would it have been researched, it would have been known to Muhammad ibn Musa al-Khwarizmi and friends 1000 years ago. It would have been known to those of my college friends who partook of the weed on a regular basis.

    Maybe one particular minor alkaloid in cannabis is analgesic but even so I find it surprising that this has not been identified years ago. A number of plants have several alkaloids with different effects and this tends to be well researched.
     
    Last edited: May 19, 2021
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  14. Binkie4

    Binkie4 Senior Member (Voting Rights)

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    When I was diagnosed with polymyalgia and prescribed prednisolone, my Consultant said he would prefer to prescribe me cannabis but it wasn't allowed.

    The prednisolone has proved to be "a complete disaster", the words of another Consultant who treats me for a different condition and he has written to my GP about the problems caused. It has been impossible to get an appointment to look at this during covid but I hope to see my polymyalgia Consultant soon.

    Am I right in thinking that medical cannabis can be prescribed if it is in my best interests? I am still taking prednisolone for the pain to the detriment of another condition. I have been prescribed other painkillers but they are insufficient.

    I need to hear what the Consultant suggests. I would like to know if cannabis is an option since prednisolone is worsening another condition, also hard to treat.
     
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  15. Mij

    Mij Senior Member (Voting Rights)

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    Cannabidiol is being researched by a clinical-stage company (STERO Biotechs) in Israel for inflammatory diseases and now COVID by enhancing therapeutic effects of steroid treatments, lowering dosage needed in steroid treatments and side effects.

    The company has 2 ongoing phase II clinical trials for Chron's D in Israeli hospitals and more trials this year on various indications.
     
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  16. rvallee

    rvallee Senior Member (Voting Rights)

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    Yes, cannabis has bans on research that opioids and cocaine do not. It was forbidden in every country to do any research at all until recently. Same with psychedelics. Cocaine and opioids research is strongly controlled but not forbidden.

    And what goes on in US drug policy goes on in the rest of the world, so there was an effective global ban on cannabis research, still in effect for the most part.
     
  17. lunarainbows

    lunarainbows Senior Member (Voting Rights)

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    I looked into this a while ago for my pain. I think the current NHS rules is that while Hospital specialists can prescribe if they think there is sufficient proof of efficacy for cannabis for that particular condition, in reality they don’t really prescribe because they tend to follow NICE guidelines. And NICE guidelines say it can only be prescribed for MS, for children with certain types of epilepsy or for nausea related to chemotherapy. the specialist would really have to build an evidence based case that it would help you, and be willing to “go out on a limb” for you. Not many are willing to do that. I remember reading very few, or no, new cannabis prescriptions had been issued on the NHS for some time.

    I did consider going private (I found a clinic run by neurologists and pain doctors and other specialists who have seen cannabis help their patient (for many conditions). One has a bursary scheme so if I ever went, I’d apply to that). These too can only prescribe in very specific circumstances - for example for pain they require you to have tried at least 3, or 5? pain medications beforehand, the consultant needs to build a case I think and details of it all are sent off to some directory. Then if it really worked - I would ask to get it prescribed on the nhs and try to build a case. I think it would still be extremely difficult to get it prescribed on the NHS or find a doctor willing to do that, which is why I’m keeping it as a last resort for now if all other pain meds fail. (the doses taken for pain are much lower than the doses taken for epilepsy so it costs much less than for epilepsy. I don’t know what the doses for your condition are).
     
    Last edited: May 19, 2021
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  18. Binkie4

    Binkie4 Senior Member (Voting Rights)

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    @lunarainbows - thank you for that full answer which should help me on my way forward.

    As well as the pain, what is really concerning me is the damage caused by the prednisolone to another health condition. I really want to hear what the prednisolone Consultant has to say about this and what he suggests.
    As regards cost, I have read of it costing several hundred pounds a month? Do you know if this is the case if it is prescribed on the NHS?​
     
  19. lunarainbows

    lunarainbows Senior Member (Voting Rights)

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    An NHS prescription should be free (if on benefits and eligible), or the usual NHS prescription charge (£9.35). The several hundred pounds should only be for private prescriptions as need to pay the medication costs. And yes I think for pain, when I looked into it, costs were around £150-£300 a month. it’s a lot cheaper than for epilepsy, as epilepsy requires much higher dosages so can run into the thousands. I think most conditions that are treated privately are at costs similar to pain.

    I think one of the reasons they prescribe cannabis, in the private clinics at least (but don’t see why they can’t build a similar case on the NHS), is that people often can’t tolerate the side effects or other effects of the medication they’re currently on and need a last resort, or need an alternative (like pain meds, or epilepsy meds, or other meds with side effects and issues).
     
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  20. Jonathan Edwards

    Jonathan Edwards Senior Member (Voting Rights)

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    I find that quite hard to believe. Is it really the case?
    I have been aware of research into cannabis derivatives for things like nausea over a period of about 40 years.

    And since all the medical students were regularly researching it at the weekend and not reporting any particular effects on pain I am more tempted to think it does not work.

    And I don't understand this argument. If the research is poor and we do not have reliable evidence then the question remains surely - by definition?
     
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