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Medicinal cannabis may have been legalised, but that doesn’t mean it is easy to get

More guidelines for how doctors across the UK can prescribe medicinal cannabis will be published next week

Guidelines for how doctors across the UK can prescribe medicinal cannabis will be published next week by the Royal College of GPs due to mounting confusion over the new law. They will make clear that the only people able to prescribe cannabis are specialist hospital doctors – defined as having specialist knowledge and expertise, and being on the General Medical Council’s specialist register – and not GPs. Sources told i the RCGP guidelines will also cover the legality of use of the two forms of medicinal cannabis: Sativex, a mouth spray licensed in the UK for people with MS-related muscle spasticity that has not got better with other treatments, and Nabilone, which is prescribed for people to help with the side effects of chemotherapy. The short and long-term side effects that cannabis can have, as well as signposting to further resources for GPs, and for GPs to refer patients to, will also be included. The guidelines will make clear that for some conditions, for example chronic pain, evidence on the benefits of using medicinal cannabis is very low. The change in the law finally came after Home Secretary Sajid Javid listened to concerns from parents of children with conditions such as severe epilepsy, such as the mothers of Alfie Dingley and Billy Caldwell, whose conditions were causing up to 150 seizures a month. According to the Royal College of Paediatrics and Child Health and British Paediatric Neurology Association (BPNA), cannabis-derived medicinal products must be defined by three areas: they contain cannabis, cannabis resin, cannabinol or a cannabinol derivative; they are produced for medicinal use in humans; and they are a medicinal product. NHS guidelines NHS England has written to NHS clinicians twice setting out what the change to the law means and the local governance arrangements that need to be put in place. However, campaign group End Our Pain say the NHS guidelines are “so restrictive that hardly anyone will be able to get a prescription”. The group says “many thousands” of patients feel bitterly disappointed. “We don’t believe this is what the Home Secretary had in mind when he made the bold decision to re-schedule medical cannabis so that it could be prescribed following the high profile campaigns of Alfie Dingley and others. This is an outrageous situation” they add.

End Our Pain is helping 17 families, each with a child suffering from intractable epilepsy, who feel that they may now have to fundraise to go abroad to get the medical cannabis that has just been legalised in the UK. “This is as cruel as it is ridiculous,” the group says. The family of Jorja Emerson is one of those. This month, the two-year-old, from Dundonald, near Belfast, became the first child to be prescribed medicinal cannabis in the UK. Jorja was born with a rare chromosome disorder called 1q43q44 deletion syndrome. It causes developmental delay but is not life threatening. However, it has triggered stage 4 epilepsy and every seizure Jorja suffers – she has up to 30 a day – puts her life at risk. The Emersons fought for over a year to secure the landmark prescription. Jorja’s father Robin, 33, said the NHS “turned its back” on them and it was only a neurologist at the private Portland Hospital in London that agreed to help the family.

For the few

The NHS itself admits that “very few people” are likely to get a prescription for medical cannabis. Currently, it is only likely to be prescribed for children and adults with rare, severe forms of epilepsy, and adults with vomiting or nausea caused by chemotherapy. And it would only be considered when other treatments were not suitable or had not helped. Even if a patient does get accepted for Sativex, for example, its availability on the NHS is “limited”. The National Institute for Health and Care Excellence (NICE) does not recommend that NHS doctors prescribe Sativex, as it is not cost effective. Mr Emerson is paying £3,000 for a three-month supply of medicinal cannabis for Jorja. “It’s a lot of money, but it’s a choice between my daughter staying alive and dying,” he said. The cost of the drug, however, means it is not a long-term solution, and the Emersons blamed the bureaucratic nature of obtaining medicinal cannabis for further delays in getting the treatment. MPs on the the All-Party Parliamentary Group on Prescribed Use of Medical Cannabis are supporting Mr Emerson after he met with them in Westminster last week. Sir Mike Penning, who chairs the APPG, said: “Parents like Robin already have more than a head full, coping with the stresses and strains of caring for very sick children. The last thing they need is a long and tortuous process to actually get the medicine that’s been prescribed. This assault course of bureaucracy needs sorting out once and for all. “But in the meantime, if this prescription isn’t sorted soon I’m minded to ask a small cross party group of MPs led by myself and my co-chair Tonia Antoniazzi to go and get it from Canada and give it to Robin for Jorja.” Urgent debate Last month, Edinburgh West MP Christine Jardine called for an urgent debate to be held in the House of Commons over the rigid guidelines governing the prescription of medical cannabis. Among those supporting her call for the debate is Karen Gray, from Edinburgh, whose six-year-old son Murray suffers from severe epileptic fits. Ms Gray campaigned for medical cannabis to be prescribed on the NHS. She also lobbied to get Epidiolex, a medicine containing an ingredient from cannabis oil which she says has helped improve Murray’s condition. Ms Jardine said: “I’m urging the Health Secretary to use every available means to work with the NHS, the General Medical Council and the relevant professional bodies to see these guidelines reworked so that they more properly reflect the historic law change.” Ms Gray said the UK is “way behind” what other countries such as Canada, Holland and Spain are doing in this area of medicine. NICE has been commissioned to produce a clinical guideline – expected in October 2019 at the latest – on the prescribing of cannabis-based medicines for a range of clinical conditions. In the interim, the BPNA and the Royal College of Physicians (RCP) have been asked to develop guidance around prescribing of cannabis-based products which covers children with rare, severe forms of epilepsy, and people with vomiting or nausea caused by chemotherapy. An NHS England spokesperson said: “The new guidance will help individual medical professionals to use the available evidence to prescribe what is most effective for their patients and will not stop anybody getting the treatment they need. As set out by the Secretary of State, a second opinion service will give people access to a second clinical view if they disagree with their specialist’s recommended prescription.” The NHS is collecting data on the number of prescriptions for medicinal cannabis but told i it was too early to publish the information.

First adult

Carly Barton, a former fine art lecturer, is believed to be the first person in Britain to have been prescribed cannabis since its legalisation for medical use last month. The 32-year-old was left in constant pain after suffering a stroke in her twenties. She bought cannabis illegally to relieve the pain of fibromyalgia and is now thought to have obtained her first legal supply. The prescription came from David McDowell, a private pain specialist. Ms Barton said that it was still very difficult for NHS doctors to prescribe the drug. “It’s momentous that this has happened,” she said. “It’s the first prescription that was written since cannabis was made illegal since 1928. It’s made history, this bit of paper.” However, she cannot afford to buy a second batch of the cannabis, which is imported from the Netherlands. “The truth of the matter is that he’s given me a three-month supply that’s going to cost me £2,500. I’m going to blow all of my savings on this initial prescription, and after this three months is up I’m going to have to go back to being a criminal, breaking the law,” she said. Dr McDowell said: “Although doctors have been given the potential to prescribe appropriately where they think the patient would benefit, the practicality is that it is impossible for patients currently to get a prescription for medicinal cannabis.”

https://inews.co.uk/news/health/medicinal-cannabis-legal-doctors-prescribe-guidelines/

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Teagan Appleby from Aylesham home after receiving cannabis-based medication

A young girl with a severe form of epilepsy is back at home after receiving cannabis-based medication in a London hospital.

Teagan Appleby of Milner Crescent, Aylesham, had up to 300 fits a day but her life-threatening condition has now stabilised.

Doctors at the Evelina Childen’s Hospital have successfully treated the nine-year-old who was born with the rare condition Isodicentric 15, a chromosome abnormality that has led to Lennox-Gastaut syndrome, a form of acute epilepsy.

Wheelchair-bound Teagan was at the centre of a battle to receive cannabis-based treatment along with other severely epileptic children in the UK, which led to Home Secretary Sajid Javid announcing in October that cannabis could be medically-prescribed by neurologists and other specialists. It was legally allowed on prescription in the UK from November 1.

Teagan’s mum Emma has been backed by Dover and Deal MP Charlie Elphicke, who fought for the cannabis-based medication to be legalised, but the little girl’s treatment was further delayed by restrictive prescribing regulations imposed by the NHS and because of supply shortages.

The MP appealed to the chief executive of the Trust which runs Evelina Childen’s Hospital, after which Kent-based GW Pharmaceuticals was permitted to supply cannabis-based Epidiolex to medics treating Teagan.

But although Whitfield & Aspen pupil Teagan’s condition has improved, the youngster is still suffering from night-time seizures.

Her mum Emma wants her to be treated with THC – tetrahydrocannabinol, the strongest form of cannabis treatment.

Emma is hoping that THC will prevent all of Teagan’s seizures and allow her to return to school.

Charlie said: “It’s every parent’s worst nightmare to see their child in pain. Yet this is the awful reality Emma has faced for so long.

“I was struck by how hard Emma has to fight, day in day out, for her daughter – and at times what a lonely and exhausting battle that must be.

“Yet her love for Teagan shines through. She will not stop until Teagan gets the help she needs.

“I am determined to help. I will do everything I can to make sure the bureaucrats do not stand in Emma and Teagan’s way. Common sense must prevail.

“Teagan must be given every chance for a better life.”

https://www.kentonline.co.uk/dover/news/cannabis-oil-treatment-helps-teagan-195284/

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Woman at the centre cannabis growing operation claimed she was looking after exotic plants

A woman found at the centre of a cannabis growing operation at a Norwich home claimed she thought she was “looking after exotic plants”, a court has heard.

Svetlana Jarmalaviciene, 50, was found in the bedroom of a property in Alexandra Road, Norwich surrounded by cannabis, in various states of growth, worth between £3,800 and £5,000.

When police raided the house in August 2017 they found a number of plants and equipment linked to an cannabis-growing operation, including lighting equipment, electricity which had been abstracted and a false wall.

Chris Youell, prosecuting, said the defendant was found in bed with plants found next to the bed and in other rooms at the privately rented property.

In total officers found 18 potted plants of cannabis, thought to have a value of somewhere between £3,800 and £5,000, as well as others at various stages of growth in the property.

They also found cannabis, worth about £300, at her home address in St James Close, Norwich.

Mr Youell, who described Jarmalaviciene as the “custodian” of the plants said she was paid about £1,000 a month to look after what she described as “flowers”.

He said: “She was staying there for the purpose of carrying out cultivation of those plants, presumably in return for some payment of benefit.”

Jarmalaviciene was found guilty of production of cannabis and possession of cannabis following a trial after denying both offences, insisting that she believed she had been “tending exotic plants”.

Ian Fisher, mitigating, said Jarmalaviciene, who is from Lithuania and has two children worked in a restaurant over there but lost her husband in 2007.

He said she came over to this country in 2010 and got a job with Bernard Matthews where she worked until 2017 when she lost her job.

Mr Fisher said she “couldn’t find employment” and felt into rent arrears before this “opportunity” presented itself of being a “watch person”.

Judge Maureen Bacon said she accepted the defendant “was not the criminal mastermind behind this operation”.

On Thursday she sentenced her to a total of nine months imprisonment, suspended for 18 months. She was also ordered to do 150 hours unpaid work, pay £800 costs and a £140 victim surcharge.

https://www.edp24.co.uk/news/crime/woman-who-had-exotic-plants-in-norwich-found-guilty-of-cannabis-production-1-5818093

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High Times Cannabis Cup Amsterdam 2018

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Cannabis expo showcasing

13 Dec 2018

A cannabis expo showcasing the health, agricultural and financial benefits of cannabis has kicked off in Pretoria.
It comes just months after the private use of marijuana was legalised.
The expo is expected to conclude on Sunday.

Africa 

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Vid On Link

FACING FIRING SQUAD British designer faces DEATH PENALTY in Bali after being found with cannabis oil

The Sun

The 45-year-old man, named only as PMH, was reportedly arrested after receiving a package containing CBD oil from an address in Thailand

A BRIT is facing the death penalty in Bali after being accused of smuggling drugs into the country, Indonesian officials say.

The 45-year-old man, who has not been named, was collared after he received a package containing bottles of cannabis oil from Thailand, it is claimed.

The man appeared at a Bali police station on Thursday alongside four other foreign men accused of trafficking drugs.

His initials were given as PMH and he is reportedly a designer from England.

The other men paraded for the cameras were from China, Germany, Malaysia and Peru.

The man, who has only been identified as PMH, is reportedly a designer from EnglandAll five were arrested separately over the past fortnight and were made to wear orange jumpsuits and black masks during the press conference.

Indonesia has strict drug laws, and it routinely executes people convicted of smuggling or dealing.

Local media said the Brit was arrested after a package from Thailand was intercepted at a post office in Renon, Bali, on November 30.

Police claim the package was addressed to the British man, and an X-ray revealed that it contained two bottles with a yellowish, thick liquid, Merdeka reports.

The liquid, weighing over 30kg, was tested and it was confirmed to be cannabis, according to Balinese cops.

Officers said the package was sent by someone with the initials HP.

The 44-year-old Peruvian national, named as Jorge Rafael Albornoz Gammara, was arrested after he arrived at Ngurah Rai international airport from Dubai last week.

He was hiding 4.08 kilograms of cocaine inside the interior of his luggage, AFP reported.

Frank Zeidler, 56, of Germany, is accused of smuggling 2.1 kilograms of hashish inside his luggage on a flight from Bangkok.

Cui Bao Lin, 29, from China was arrested at the airport on Saturday with more than 200 ecstasy pills and more than 160 grams of ketamine found in his bag, police said.

Hamdi Izham Hakimi, from Malaysia, was arrested the same day with a bag containing nearly 15 grams of marijuana and 11 ecstasy pills, according to authorities.

https://www.thesun.co.uk/news/7971645/british-designer-death-penalty-bali-cannabis-oil/

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Meghan Markle’s first wedding had cannabis party bags

Though Meghan Markle’s first marriage certainly didn’t pan out, the wedding sounds like it was a blast. In an interview with Markle’s estranged father in the Daily Mail, it also sounds planned out to the final detail. All men were provided with white shirts to wear and the wedding turned into a party immediately following the 15-minute ceremony.

Each of the 100 guests were reportedly given a fabric gift satchel from the couple with a note and a plastic party bag of cannabis within. Thomas Markle said that it may not have been legal in Jamaica at the time, but that it was no big deal there. He also said that he gave his baggie away and didn’t smoke or think that Meghan did either.

That sounds like a hard sell though, because weed gift bags are pretty specific. Sure, she booked the same famous Jamaican Inn that’s hosted guests like Marilyn Monroe and Arthur Miller as well as James Bond writer Ian Fleming. Sure, she reportedly “micro-managed” it down to the last detail. But that also means she planned on handing out cannabis, no questions asked, and that makes it seem likely that Markle was at least once a fan of the herb herself.

In the UK, cannabis remains illegal for recreational use, but was recently given the green light on medical use for certain conditions. Marijuana is a very popular illegal substance there, and though it remains illegal, the United Kingdom is the biggest exporter of legal cannabis in the world.

GW Pharmaceuticals famously created the cannabis-based drugs Sativex and Epidiolex and the company calls the UK home. Despite the seemingly marijuana-themed facts of the country, cannabis remains a Class B drug in the UK, along with amphetamines, barbiturates, codeine and ketamine.

Maybe the now-Duchess will be a champion for further loosening of prohibition in the UK, but no one should hold their breath waiting. There’s a big leap between clever weed wedding party gifts (Meghan and Prince Harry gave out beige and blue totes filled with goodies that were certain to not include weed…) and being vocal on such a controversial subject while inhabiting such a public and royal role.

https://www.thegrowthop.com/cannabis-news/meghan-markles-first-wedding-had-cannabis-party-bags

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S.Africa eyes green shoots in local cannabis industry

Daily Mail

South Africa on Thursday held its first cannabis industry exhibition since the constitutional court ruled private, personal cannabis use was legal, attracting scores of entrepreneurs and consumers.

Although no smoking was allowed at the venue, hundreds of people attended the trade show including producers, manufacturers, brand owners, distilleries and brewers.

“It is an enormous opportunity and I don’t think people realise how big it is. If we look at the market, it is enormous when you look at what is happening in America and Canada,” said Steve Carver, 50, a director at U Can Grow Africa which sub-lets land for cannabis cultivation.

Another attendee Sifiso Pretorius, who has a licence to cultivate the plant, said the profits derived from cannabis based products were “unbelievable”.

“It’s a huge industry and its mainly export based, dollar based. The potential is huge,” he said.

The country’s top court decriminalised private use and cultivation of the herb in September, although it did not decriminalise the use of the drug in public — nor the offences of supplying or dealing.

From medicinal oils, dog treats and even pure hemp clothing, attendees were treated to a world of cannabis-derived products from the southern Africa region.

– ‘Make this industry viable’ –

Zimbabwean-born fashion business owner Haanes Swan, 25, who sells tailored hemp clothing, praised the cost-effective nature of the plant.

“The fabric is four times stronger than cotton and takes half the amount of water to grow.”

“Eventually we will grow hemp in Zimbabwe by the end of next year. We will be able to clothe people for almost next to nothing,” Swan said.

For others, the decriminalisation is a chance to cash in on the budding industry in a country where unemployment is stubbornly high.

“I wanted information about growing and cultivating because I want to do that myself. I’m quite happy with what I got because I know where to find seeds and everything else to start,” law student Amogelang Shadi, 24 said.

Dressed in Rastafari colours, director of the privately-owned Marijuana Board of South Africa, Rasta Sphesihle Madola, told AFP that the rasta community was also working with farmers and growers associations to profit from the plant.

“As we are rasta we are about the economy of cannabis, we know that it makes money in the world. We call on international investors to invest and make this industry viable,” Madola added.

The South African parliament now has just under 24 months to draft new laws that reflect the decriminalisation court order.

https://www.dailymail.co.uk/wires/afp/article-6493125/S-Africa-eyes-green-shoots-local-cannabis-industry.html

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