When the UK government announced that cannabis was to be moved from Schedule 1 to Schedule 2 of the Misuse of Drugs Act, many patients and advocates across the country rejoiced. This change would essentially legalise the medical use of cannabis and some of the most vulnerable people across the UK would finally be able to access the medicine they needed from a legal source. Yet, almost five years on, the picture we see today is very different to the one many imagined.
Access to medical cannabis remains restricted to many people for many reasons. However, one of the most significant factors behind this ongoing problem is undoubtedly the prescribing rules for cannabis-based medicines. Under current legislation, general practitioners (GPs) are simply unable to prescribe medical cannabis. But why is this? And will it ever change?
Medical cannabis prescribing in the UK
While medical cannabis can technically be prescribed for any condition for which there is evidence of its potential efficacy, these prescriptions can only be approved by a specialist clinician who is registered with the General Medical Council (GMC). GPs can only support the prescription of medical cannabis through a shared care agreement.
Patients can receive a medical cannabis prescription from a specialist clinician through the NHS; however, this is very rare. In the vast majority of cases, prescriptions are granted by private clinics at a cost to the patient. While there are schemes to help with the cost of medical cannabis prescriptions, many are still priced out of accessing a potentially life-changing medication.
How many medical cannabis patients are there in the UK?
It’s hard to find an exact figure for how many patients have been approved for medical cannabis. What is clear is that the number of patients receiving medical cannabis prescriptions had been consistently on the rise over the last four and a half years. Recent estimates suggest that the number of medical cannabis patients in the UK may range from 21,000 to 32,000. But this is still barely scratching the surface.
It is currently estimated that around 1.8 million patients are still relying on the “illicit” market to source cannabis for medicinal purposes. This includes individuals who are using non-medical-grade cannabis to manage conditions for which there are recommendations for prescribing, such as treatment-resistant epilepsy and multiple sclerosis. Many experts believe that opening prescribing up to GPs as well as specialist clinicians would help to close this gap – and a new campaign is calling for just that.
The Protect Our Patients Campaign
The Protect Our Patients campaign, led by the Cannabis Industry Council (CIC), the Medical Cannabis Clinicians Society (MCCS), Volteface, and Maple Tree Consultants, is calling on the government to grant GPs the same prescribing powers as specialist consultants for cannabis-based medicines. With over 36,000 GPs across the UK, it is argued that such a move would make medical cannabis more accessible to the patients who need it, and there is evidence to support this claim.
Unlike their mainland counterparts, GPs on the Channel Islands can initiate medical cannabis prescriptions for their patients. Unsurprisingly, medical cannabis patient numbers are growing at a faster rate than in mainland UK.
General Practitioners are also able to prescribe cannabis-based medicines in Australia where medical cannabis approvals have soared to over 350,000 since 2019. For reference, the UK has over twice the population of Australia.
Are GPs open to prescribing medical cannabis?
It’s not just patients and advocates that want to GPs take on medical cannabis prescribing – GPs are open to the idea, too. According to a 2021 survey conducted by the Primary Care Cannabis Network (PCCN), 73% (of a sample of 1,000) of practising UK GPs are open-minded about prescribing cannabis to patients. Furthermore, more than two-thirds of respondents revealed that they are asked about medical cannabis by their patients at least every six months.
However, there remains some hesitancy among GPs when it comes to prescribing medical cannabis. The same survey found that less than one-quarter of respondents would currently be willing to take on the role of prescribing and overseeing medical cannabis treatment. This is likely due to a lack of education and training around medical cannabis and the endocannabinoid system among doctors in the UK, as many participants highlighted in their responses.
Another concern for GPs is the lack of licensed medical cannabis products in the UK. Currently, only three cannabis-based medicines are licensed: Sativex, Epidyolex, and Nabilone. However, there are many other unlicensed medicines available, including whole flower products, many of which are being prescribed at private clinics. But if more patients in the UK are to benefit from the legalisation of medical cannabis, more needs to be done to improve access.
Should GPs be prescribing cannabis in the UK?
According to a report by the Cannabis Industry Council, NHS waiting lists have now reached 7.4 million people, with estimates indicating this number could rise to 10 million by 2024. The NHS is currently under enormous pressure, and patients are suffering as a result. The NHS estimates that 34% of adults in the UK are living with some form of chronic pain, so it stands that a high percentage of those on the waiting list will be made up of pain sufferers, and will go on to be prescribed addictive opioids. Allowing GPs to prescribe cannabis would help to relieve the backlog, provide an affordable alternative medicine and reduce the risk of ongoing opioid addictions in patients, which creates a further burden on the already struggling healthcare system.
The Protect Our Patients campaign is calling for supporters to take action and get involved. Take a look at their website to learn more about how you can help