Why is the NHS slowing down medical cannabis? Blame data

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"I think we opened a Pandora's box," said Dame Sally Davies, chief medical officer in England, at a parliamentary committee on medical cannabis earlier this month. Noting that little is known about the health benefits of marijuana, Davies cautioned about its potential dangers. And she is not alone in her concerns.

Since Secretary of State for the Interior Sajid Javid introduced a bill in November 2018, only a few NHS doctors have apparently prescribed cannabis to patients, despite strong demand from advocacy groups.

In this vacuum of cannabis, private clinics could be the first major legal sellers in the country. Costing £ 200 for an appointment and between £ 600 and £ 700 per month for a prescription, these clinics, the first of which opened in Greater Manchester earlier this month, are expected to meet the needs of budding patients left behind. NHS.

Does the NHS refuse valuable medicines or do private clinics distribute dangerous drugs? "It's believed that cannabis is effective in many conditions," says Davies. "In the meantime, what is the impact of taking it for an extended period? We know [THC, a cannabis chemical] has an impact on the brain and causes depression, schizophrenia, brain development problems in youth and adolescence. If a pregnant mother took it, I would be very worried.

THC, short for tetrahydrocannabinol, is the main psychoactive compound in cannabis. When consumed, it binds to the cannabinoid receptors of the brain, badociated with memory, coordination and perception of time, thus causing hypertension. The sentiment is attractive enough to make cannabis the most commonly used illicit substance in the world. But research shows that prolonged consumption can have less than doping effects. A recent study linked THC-rich cannabis strains to psychosis and even estimated that half of all cases of psychotic disorders for the first time in Amsterdam could be avoided if the potent drug was not available.

But such studies are often based on recreational "street" varieties, which have been pushed to high THC levels due to prohibition and consumer demand. Medical cannabis is rather rich in CBD, the "miracle molecule" that has been hailed by many users as a cure for everything from chronic pain to cancer. Although it is a legal drug in many countries, claims badociated with the CBD can lead many to question its true benefits.

"There is plenty of evidence for the utility of chronic pain, epilepsy, chemotherapy during chemotherapy, as well as anxiety, PTSD, and sleep," says Mike. Barnes, neurologist. He is also clinical director of the new cannabis specialty clinics and testified in the recent parliamentary debate, inviting the panel to consider the CBD's existing database.

"Cannabis can be a good cure for many conditions such as fibromyalgia, appetite stimulation, Crohn's disease and cancer," he says. "Of course, we need more evidence about the type of cannabis, the dose and the format that best suits each situation, but the doctor has enough evidence to seriously consider a prescription. If this doctor refuses to prescribe it, then he should call in a cannabis expert.

Although more evidence is needed to properly convince the NHS, many studies support Barnes' claims. Among many revelations, research has shown how cannabis can help reduce drug dependence, relieve anxiety, suppress inflammation, treat autism spectrum disorders, and even increase sperm count.

It also seems to help with epileptic conditions. After all, it's the difficult situation of two boys with severe epilepsy who started the conversation about cannabis in the UK last summer. And after receiving the drugs temporarily, the seizures in children would have gone from 150 a month to zero.

It has also been shown that some studies on CBD resulted in undesirable side effects, such as a loss of appetite and diarrhea. But when it is bombarded with examples where it helps, it's hardly surprising that advocates of medical cannabis may be frustrated by the reluctance of the NHS.

"Davis said we had to wait three or four years before we could receive this type of high quality data. How do you explain it to a parent? "Said Peter Carroll, founder of the End Our Pain campaign, which aims to expand access to medical cannabis for children with epilepsy. Speaking alongside Professor Barnes, Carroll confronted the parliamentary panel in the story of a mother who had illegally purchased cannabis-based products to heal her child. "The child has improved dramatically," he said. "So it's his randomized controlled trial. And his own NHS doctors said, "We're seeing an improvement," and then they said, "But we will not prescribe it."

"I think we need to take a broader view of the evidence here, because there is a point where many anecdotal stories rely on a body of evidence," he continued. "And it seems absurd to me that we have to wait three, four or five years for these trials to happen while there are currently real cases."

Randomized controlled trials mentioned by Carroll are the gold standard for clinical drug testing. In these trials, two groups are studied, one with the drug, the other with a placebo, without knowing who they were administered. But any resulting medication can take years to become available.

"You have to think about what is happening in the context of the NHS, the NHS culture, the revered nature of the NHS," says Steve Moore, who runs the Center for Medical Cannabis, a think tank with the goal of making it more accessible. climbing clinical trials on cannabis. "People are asking for things quickly right now, but I think they have to realize that it will work at the pace of the NHS." Last summer, Moore led the campaign to grant Billy Caldwell, one of the boys living with epilepsy, his cannabis oil.

While these leads are initiated, those who can afford them can choose not to adhere to the state structure and enroll in private clinics. Two more of them are expected to open in Birmingham and London later this year. Others will undoubtedly continue to supply cannabis on the black market.

"I really hope we can go to court," said Davies as she concluded her testimony in Parliament. "Because without them, how can we help patients? And that's why we are all here.

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