Governments are legalizing medical cannabis. Why is it so hard for patients to access?

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Governments are legalizing medical cannabis. Why is it so hard for patients to access?

 

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Patients deserve faster access to safe medical cannabis. Legalization is not enough – governments and businesses need to work together to reduce barriers and lessen patients’ reliance on the illicit market.

Catherine Jacobson is Vice President, Regulatory & Medical Affairs at Tilray.

Not long after medical cannabis was legalized in the UK last year, a woman from Northern England approached me to ask how she could obtain a cannabis-based medicinal product (CBMP) for her husband with terminal pancreatic cancer.

 

He was in tremendous pain and traditional pain medications had not worked. He wanted to try a CBMP to find out if it might alleviate some of his suffering – the therapeutic potential of CBMPs for pain has been well documented – and she asked how she might gain access to the medicines.

I explained the process to her: find a specialist willing to prescribe the CBMP, submit that prescription to the regulator for approval, locate a pharmacy willing to receive the medicine, find a licensed importer willing to apply to the Home Office for an import permit, and submit the import permit to our company, Tilray. We would then apply for an export permit and expedite the shipping to a pharmacy for dispensing. At best, it would take 3 months.

Sadly, the lengthy process took more time than her husband had. He died four months later, without having had the chance to try a medicine that might have reduced pain in his last months. More than a year after legalization in the UK, millions of patients still face the same arduous path to access. Similar burdensome processes exist in the majority of the 41 other countries that have legalized medical cannabis in some form.

 

This problem is largely the result of legal access being granted before CBMPs are put through the traditional drug approval process, which is overseen by health regulatory agencies. In many countries, politicians have acted on intense demand from patients, moving quickly through legislation to legalize medical cannabis. In others, courts have ruled access to medical cannabis as a patient right. Regulations have struggled to keep up.

 

There is no precedence for providing access to a medicine without first receiving approval from a country’s health regulatory agency. This has resulted in confusion at every level: doctors, patients, regulators, policymakers, and the public. So much misinformation is circulated on all fronts that it can be hard to tease out the critical issues, the evidence from which to make informed decisions about this complex topic and, most importantly, how to generate the right evidence to guide policy and regulations.

The therapeutic potential of CBMPs has been well documented, though a discussion about the level of evidence that should be required for specific medical conditions is still necessary. Multiple studies by leading scientists around the world have shown that CBMPs are generally safe or safer than other drugs approved for conditions such as pain and epilepsy. For any drug that is being prescribed, the doctor goes through an individual risk/benefit analysis for the patient. In the case of CBMPs, while the specific benefits may still be under debate, the risks are comparatively low.

 

Yet, regulations and standards set by the medical community are failing patients. This year, Tatterton & Walker1 reported that over 87% of respondents from children’s hospices in the UK know that their patients are receiving illicit cannabis preparations but cannot provide legal CBMPs. According to a survey conducted by the UK’s largest medical cannabis advocacy organization, United Patients Alliance, 72% of patients turn to the illicit market for a product to treat their symptoms. A recent YouGov Poll estimates that 1.4 million people in the UK alone may be obtaining cannabis through illicit means to treat medical conditions.

This estimate is not surprising given the hurdles of access to legal, pharmaceutical cannabis products via prescription in the UK. Not only does obtaining illicit cannabis from drug dealers pose safety risks to patients, they also don’t receive the medical supervision they need and deserve.

There are solutions. We need to build a new cannabis-specific approach that safely serves patients while mitigating the risks to public health. Industry, government, and healthcare professionals all have a role to play.

 

Companies must continue to ensure doctor and patient confidence. This could be done by ensuring that their medicines meet pharmaceutical-grade global product quality standards based on guidelines set by the leading standard-setting body for medicines, the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) or are manufactured under Good Manufacturing Practices (GMP).

Regulators must develop medical regimes that get CBMPs to patients in a time frame that matters and allow doctors the flexibility to prescribe the medicines. Creating a new process that speeds up approvals for CBMPs while working with the industry to develop real time patient registries to generate data on treatment, effectiveness, problems, and cost, will be critical.

 

A new regulatory approach is needed for several reasons. First, CBMPs do not contain novel chemical entities; rather, they are composed of the generic active ingredients, Cannabidiol (CBD) and Tetrahydrocannabinol (THC), that have been therapeutically used by humans for millennia. Second, cannabis-based medicine is personalized; not only does individual tolerability vary greatly, but the data to inform definitive clinical trials on a specific dose of a specific drug product for a specific indication does not yet exist. And finally, requiring costly and lengthy clinical trials – and placing the burden of the investment squarely on industry – will result in significant price increases. This reduces the likelihood that the drug would achieve cost coverage by the national health insurance agencies and increases the probability that patients will continue to turn to the illicit market.

 

Finally, we all need to work together to better understand and address public health concerns about less restricted access to CBMPs, such as recreational use in youth, impaired driving, and addiction potential. These should be driven by reliable and robust data collection programs. We also need to make a clear distinction between therapeutic use of CBMPs and adult (recreational) use of cannabis. While the global debate on ending prohibition continues, it should not come at the expense of patients suffering today.

The time has come to move the discussion about the therapeutic use of CBMPs from one steeped in historical stigma around cannabis to a rational one based on data and common sense.

 

https://www.euractiv.com/section/health-consumers/opinion/governments-are-legalizing-medical-cannabis-why-is-it-so-hard-for-patients-to-access/

 

Bongme 

 

Legalisation of cannabis IS a fool’s crusade

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Legalisation of cannabis IS a fool’s crusade

 

ON Monday, Times commentator Clare Foges wrote an admirable rebuttal to the LibDems’ much-vaunted cannabis legalisation policy, and took the whole legalisation case by the horns. 

Though the self-confessed dope smoker Jo Swinson is unlikely to become PM, Foges points out that she could become a power broker. She has a point – if the LibDems are addicted to anything, it is to their defining but barmy idea that normalising drug use will make it OK. We are also, as Foges sets out in her article, ‘drifting on the tides of fashion towards a dangerous destination’.  Debunking the legalisers’ brave new world of dope was never more urgent.

It’s not just political pressure but commercial too. And they are prepared to spend money to get their way. Earlier this year I attended a conference The Spectator hosted for commercial cannabis hopefuls and political lobbyists which was misleadingly subtitled ‘Understanding the impact’. Forget that – there wasn’t a dissenting voice on the platform. It was all about when and why, little about why not. But for Peter Hitchens and David Raynes in the audience no hard questions about the social and health impact of Big Dope would have been posed. For a window into the world of the alternative ‘health’ entrepreneurs and city analysts who can’t wait to exploit this drug and whose attitude is ‘I’m all right, Jack’, this was chilling.

 

Foges also tackled the perception that to be against legalisation is to be in favour of the status quo. There are few of us however who are satisfied with its blind eye default.

She dealt with the standard arguments against legalisation explaining that ‘losing’ the war on crime doesn’t mean we stop prosecuting it. She reaffirmed too that potency is higher than ever before; that study after study has found a clear association between the high levels of THC which most present-day cannabis contains and serious mental health problems, particularly schizophrenia and psychosis. 

 

But she went further, highlighting hospitalisations and how ‘those tormented by devils today tend to seek sanctuary in the local A&E, where admissions for psychosis have been rising’. An omission in this otherwise tour de force was any mention of the gulag of over-subscribed secure mental health units. Psychiatrists have called them cannabis dependency units, and they are populated largely by irreversibly damaged young male psychotics, betraying the fact that this is not an equal opportunities illness. Young men are the main victims of cannabis. Importantly she did turn to what Peter Hitchens has made his personal crusade which is to report and question ‘the third link in the chain: cannabis use; mental health problems; violent crime’. 

Most journalists have carefully avoided the unpalatable (to drug liberalisers) fact of the extraordinary number of brutal crimes in which the assailant had a history of heavy use. Not so Clare Foges.

 

Many have been documented on a website called Attacker Smoked Cannabis to which Foges refers and whose curator says: ‘Once one learns the characteristics of violence committed by cannabis smokers — frenzied, savage, sustained, unprovoked – such violence becomes easy to spot. A young father violently killing his child? A victim stabbed ten, 20, 50, 100 times? . . . Such crimes used to be rare in the UK and Ireland, if they happened at all. In 2019, there were more than two dozen before Easter.’ 

She highlights, too, a book called Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence by the former New York Times journalist Alex Berenson which ‘shines a light on the data in states that have legalised cannabis’. The author, she reports, ‘calculated a 35 per cent rise in murders from 2013 to 2017 compared with a 20 per cent rise nationally’ in the four states that changed their laws from 2014 to 2015: Alaska, Colorado, Oregon and Washington.

 

Foges’s article was one of the most comprehensive reviews of the impact of cannabis liberalisation by a journalist in recent years. Her conclusion, after weighing the evidence, that legalisation is no liberation but the reverse, was hugely welcome, as I wrote to the Times in response. 

For those readers not behind the paywall, I wrote:

‘Clare Foges’s warning against the momentum building for cannabis legalisation is timely and welcome. The flawed thinking behind the Lib Dem proposal needs spelling out. Most fundamental is the deceit that cannabis “harms” have derived from its prohibition, not its use. The reverse is the case. There has been a phoney war on drugs in the decades since the Misuse of Drugs Act, with the de facto decriminalisation of cannabis use, a laissez-faire police policy and an absence of meaningful criminal sanctions. Contrary to received opinion, in places such as Colorado and now Canada, cannabis use has risen and so too have harms, not least among children. The black market continues to thrive. Any idea that the huge public health and safety costs of this brain-changing (too often irreversibly) drug would be diminished by the official sanctioning of cannabis, or that its commercial exploitation and the legalisation of weaker strains would make cannabis use safe or protect children, is simply fanciful.’

 

 

https://www.conservativewoman.co.uk/legalisation-of-cannabis-is-fools-crusade/

 

Bongme 

Glasgow to get cannabis oil cocktail bar with unique new boozer coming to Tabac on Mitchell Lane

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Glasgow to get cannabis oil cocktail bar with unique new boozer coming to Tabac on Mitchell Lane

 

GLASWEGIANS are set to get a brand new cocktail bar – with a twist.

A trendy new bar is to open within Tabac on Mitchell Lane, which previously held Panther Milk – the city’s ‘hidden bar’.

 

Glasgow Live reports it will be given a new lease of life as a cannabis oil bar.

The man behind it all, Marco Lazzurri, told them: “We have been working on the cocktails for a while now, experimenting with sugar gomme or drops to infuse the drinks with CBD oil.

 

“I decided to give the old Panther Milk venue a new layout too, in the style of a grow room, and a neon sign of a hemp leaf will mark the spot where the old Panther Milk sign was, inviting people in.”

CBD does not have the same psychoactive effects as the cannabis plant from which it’s extracted, although it has become popular recently for a variety of uses.

It’s not yet clear when the new bar will open, but it is hoped it will be sooner rather than later.

We told recently how a Scottish store has been bombarded with offers after promoting bottles of Buckfast and MD2020 decorated with Rangers and Celtic colours.

 

Ali’s Grocers in Denny have been swamped since running a Facebook competition for a Old-Firm branded tonic wine hamper earlier this month.

On Friday, one lucky punter will scoop the boozy bundle – but it’s the store that has really hit the jackpot.

Abid Ali – who co-owns the shop with his dad Mohammed, 54 – says they have been struggling to keep up with demand.

 

https://www.thescottishsun.co.uk/fabulous/5003885/glasgow-cannabis-oil-cocktail-bar-tabac/

 

Vid On Link

 

Bongme 

 

Cannabis is ‘medicine, not a drug’ says dealer who ran one-man marijuana racket from his Manchester flat.

Cannabis is ‘medicine, not a drug’ says dealer who ran one-man marijuana racket from his Manchester flat. The judge REALLY didn’t agree

 

Nathan Doyle represented himself in court, said he wasn’t a danger to society, and talked about ‘the Rastafarians and the Hindus’

 

A drug dealer who ran a fake ”medical marijuana” racket in Britain as a front to smuggle thousands of pounds worth of cannabis into the UK for profit has been jailed for four and a half years.

 

Nathan Doyle, 34, used the dark web and cryptocurrency to order a string of consignments of cannabis from Canada – claiming he wanted to offer the drug to those who needed it for pain relief.

Doyle had the drugs delivered to his home on Brackley Avenue, Hulme .

 

He also set up his own PO Box account to have cannabis, and THC, a potent form of cannabis oil, sent to a company location on Deansgate .

 

Manchester Crown Court heard that UK Borders Agency first intercepted a package of drugs addressed to Doyle, at Coventry Airport in 2015.

When inspected by officers it was found to contain 16g of cocaine, with a value of £800.

In September 2016, a package of 130g of cannabis destined for Doyle’s home, and worth £1,300, was uncovered by the Borders Agency.

In May 2017, another package of cannabis with a value of £1,800 from Canada addressed to Deansgate, was intercepted.

And in June 2017, the Canadian Borders Agency intercepted a 140g consignment of cannabis worth £1,4000 bound for Doyle at his PO Box.

 

Officers from Greater Manchester Police visited the company where Doyle had set-up the PO Box address.

They discovered a parcel had just arrived for Doyle containing 14g of individual foil packages of class B drug “shatter” – a highly potent form of THC cannabis oil.

 

Doyle was arrested on Monday 8 August, 2017 on suspicion of importing class A and B controlled drugs.

 

When searching his address, officers found evidence that the packages had been emptied into glass jars and that he had been extracting the THC oil from herbal cannabis.

A large quantity of smell proof pouches, snap bags, jiffy bags and large letter stamps were also discovered, suggesting that Doyle was supplying the drugs in the same way that he is importing them.

Police also uncovered £5,000 worth of cannabis and a ready to grow magic mushroom kit – which had been imported from Amsterdam – and a small jar of magic mushrooms.

A fifth package arrived while he was being interviewed. It contained 250g of herbal cannabis with £5,000 hidden inside a boxed spiral slicer.

 

In court Doyle appeared unrepresented and said: “I’m a medical cannabis user – I’m not a dangerous substance user and I’m not a danger to society I’m a vulnerable adult. 

“I was a homeless alcoholic thanks to my father’s bad example and I also had a serious head injury – the only thing that has ever had any medical benefit for me is cannabis.

“I’m not a danger to society – it is a danger to me and I can’t accept this as fair.  I just want to use cannabis as medicine like the Rastafarians and the Hindus have for thousands of years.  It is medical, herbal. It is not man made. Cannabis is a medicine not a drug.”

 

But sentencing, the judge Mr Justice William Davis told him: “The notion that you were bringing in medical cannabis for medical purposes isn’t borne out.

“You illegally brought into this country quantities of cannabis and it was apparent from what was found at your home that this was a regular thing.

“You told the jury in your evidence that you did what you did in a way that made sure you hid from the law and you used cryptocurrency in order to be discrete. You told the jury you were trying to avoid detection and you knew it was against the law.

“Your case was you were only bringing in cannabis to give to fellow sufferers of a variety of illnesses. But I conclude that you were not engaged in a medical exercise – it was for profit. The various consignments indicate to me they were importations for profit.

 

Detective Chief Inspector Terry Crompton, of GMP’s City of Manchester division, said: “Nathan Doyle thought he was above the law and beyond detection.

“During this operation we monitored him closely as he carried out his illegal activities from his home address and the city centre.

“I would like to thank the officers in this case, as it is thanks to all of their hard work that this man is behind bars.

“I hope this sentencing sends a clear message that we will relentlessly pursue those who import drugs and we go to great lengths to bring them to justice.”

Doyle, of Brackley Avenue, Hulme, was sentenced to four years and six months for possession of class A drug psilocybin, importation of cocaine, and three counts of importation of cannabis.

 

He was also sentenced for importation of THC, possession with intent to supply cannabis and production of class B drug THC.

 

https://www.manchestereveningnews.co.uk/news/greater-manchester-news/cannabis-medicine-not-drug-says-17320937

 

 

UK DRUG LAWS – An Addiction to Hypocrisy

UK DRUG LAWS – An Addiction to Hypocrisy

 

Crime reporter Duncan Campbell sets out what the various political parties are promising on drugs for the next Parliament – but puts the likelihood of reform at close to zero.

 

Lenny Bruce. Remember him? Never heard of him? He was one of the greatest and bravest comedians of the last century who was hounded to his death in 1966 by the police and the courts over his drug use.

 

Not long before he died he suggested that cannabis would soon be legal in the United States “because the many law students who now smoke pot will someday become congressmen and legalise it in order to protect themselves”.

It didn’t quite happen like that.

 

But, Lenny might be gratified to know that, in 2019, there are now 11 US states in which the use of cannabis is legal. But what about the UK?

 

Three generations of British students have grown up since the 1960s and many of those now in Parliament have at least “experimented with” – the favoured words for a politician’s drug use, God forbid “enjoyed” – cannabis. But we are still far behind those US states and Canada and many of our European neighbours in attitudes towards prohibition.

 

Yet, disputes over drug supply are seen as the prime cause in the knife crime afflicting our inner cities. 12% of those in our overcrowded jails are serving time because of drug offences and children as young as 10 are being used as couriers to dodge the police.

 

Will next month’s General Election change anything for any of them? 

 

The Green Party and Liberal Democrats have been the most outspoken and radical when it comes to drug policy.

 

The Greens have said they intend to “end the war on drugs, which has trapped hundreds of thousands of people into lives of crime and treat drug addiction as a health condition, not a crime”. In its manifesto, the party cites Portugal as an example to be followed and state that the Misuse of Drugs Act 1971 and the Psychoactive Substances Act 2016 should be repealed and a pardon granted for anyone previously convicted of possession or small-scale supply of drugs. The Greens would make cannabis, labelled according to laboratory-tested strength, available to adults.  

 

The Liberal Democrats favour the legalisation of cannabis, which they claim could bring £1.5 billion in duty and savings through sales in licensed shops to over-18s. Those figures, of course, like all the other figures tossed around by all parties at election time, are as close to reality as the old claims made by prosecuting counsel in court cases back in the 1960s as to the value of what the police or Customs and Excise had seized.

 

Meanwhile, Nicola Sturgeon’s Scottish National Party would seek the immediate devolution of drug laws “to allow us to better tackle the public health emergency we face”. Distinct from legalisation, it backs decriminalisation. 

 

The Labour Party, probably aware that such a position would prompt a furious Gone To Pot! headline in the Sun, has tiptoed around the issue saying in its manifesto that “a Labour Government will establish a Royal Commission to develop a public health approach to substance misuse, focusing on harm reduction rather than criminalisation”.

 

Plaid Cymru also favour a commission, albeit not a royal one. 

 

Over the years, members of the Conservative Party have – somewhat reluctantly – shared their experiences with drugs. “I think I was once given cocaine, but I sneezed and so it did not go up my nose,” said Boris Johnson back in 2005. “In fact, I may have been doing icing sugar.” Yes, yes, Boris. A couple of years later, in a GQ interview, he admitted trying cocaine and cannabis at university, saying it “achieved no pharmacological, psychotropic or any other effect on me whatsoever”. More’s the pity. 

 

During this year’s Tory leadership campaign, Michael Gove told the Daily Mail that he “took drugs on several occasions at social events more than 20 years ago. At the time I was a young journalist. It was a mistake. I look back and I think, I wish I hadn’t done that”. Whether he meant being a young journalist or taking drugs was “a mistake” is not entirely clear – if you read what he has written recently you might think the former was the graver error – but we get the gist. 

 

However, the Conservative Party’s manifesto barely mentions the subject bar a paragraph which must have been tapped in at the last minute by a jobsworth after someone said “Oh, shouldn’t we do something about drugs rather than just overfilling the jails and pretending that we’ll get 20,000 more bobbies on the beat?” This is the party’s contribution: “Drug addiction fuels crime, violence and family breakdown – and new dangerous substances are driving an increase in deaths from drug abuse. We will tackle drug-related crime and, at the same time, take a new approach to treatment so we can reduce drug deaths and break the cycle of crime linked to addiction.” Whatever, as Churchill might have said.  

 

It is just over a month since the House of Commons’ Health and Social Care Committee published a report which encouraged the Government to consult on the decriminalisation of drug possession for personal use. The committee pointed out that the UK has some of the highest drug death rates in Europe, particularly in Scotland, and recommended a “radical change in approach to UK drugs policy, moving from the current criminal justice approach to a health approach, with responsibility for drugs policy moving from the Home Office to the Department of Health and Social Care”.  

 

But, what are the chances of this recommendation and the whole issue of drug policy surfacing during this election? Close to zero.

 

Still, at least one old familiar addictive British substance is guaranteed to be freely available in Parliament over the next five years: hypocrisy.

 

https://bylinetimes.com/2019/11/27/uk-drug-laws-an-addition-to-hypocrisy/

Police storm cannabis store in Basingstoke

Police storm cannabis store in Basingstoke

 

POLICE officers have been seen storming a shop in Basingstoke this afternoon. 

 

Vedas, a store that sells cannabis oil, is currently shut as police search the premises. 

 

Witnesses described watching as a police car and van descended on Church Street at around 1.30pm and entered the shop.

 

The store only opened last month by Basingstoke-resident Fraser Bracey.

 

The premises’s website advertises CBD-infused cakes, coffees and teas as well as oils. 

 

Last month, the Gazette reported how Vedas’ shop owner Fraser Bracey first came across CBD when his late grandfather was diagnosed with throat cancer.

Speaking at the time, he said: “He was my idol and I was looking into alternative treatments for him and I stumbled across CBD.”

 

Fraser then discovered the benefits of the oil himself after suffering from post-traumatic stress disorder (PTSD) following an operation.

 

The 26-year-old said: “I had an appendix operation however I bled quite badly after, I lost nine pints of blood whilst awake.”

Afterwards, Fraser suffered with PTSD, which affected his sleep and caused him to sweat excessively.

 

He decided to try CBD because the product had helped relieve his grandfather’s symptoms, and believes it has cured him of PTSD, saying: “I couldn’t go back to work. I had lot of physical symptoms and flash-backs to being in hospital. It was a tough time.”

 

Inspired by the benefits of the product, Fraser decided to set up a business selling CBD and has just opened a new café in Church Street, Basingstoke. 

 

Vedas CBD has items for sale with CBD including sweets, chocolate and tea, as well as offering shots of CBD in coffee.

 

He hopes the café will offer people interested in using the product somewhere to come and ask questions before buying it, as well as a social space to enjoy it.

 

He also wants to reassure customers that the products sold in the café are safe, explaining: “There’s no regulation in the industry and there are different ways of extracting the oil. We only deal with products that have been CO2 extracted rather than using things like alcohol which isn’t as safe.

“Bottles of CBD can be expensive so we want people to try it before they buy a bottle so offer shots in coffee.”

 

Fraser, who used to sell life insurance, said his new job is so rewarding when he sees the reported benefits of CBD for customers, explaining: “It was almost like it was meant to be going through the PTSD and now I do something I love that can help others.”

 

https://www.basingstokegazette.co.uk/news/18063887.police-storm-cannabis-store-basingstoke/#comments-anchor

Trinidad And Tobago Moves To Decriminalize, Establish Cannabis Economy

Trinidad And Tobago Moves To Decriminalize, Establish Cannabis Economy

 

Two bills were introduced last week in Trinidad and Tobago’s House of Representatives that could change the landscape of marijuana regulation across the several islands that make up the Caribbean country.

 

Attorney General Faris Al Rawi introduced the Cannabis Control Bill and the Dangerous Drugs (Amendment) Bill Friday. Following Jamaica’s example and the establishment of a CARICOM Commission on Marijuana Regulation, the goal of the legislation is to reduce penalties for possession and consumption and fire up a legal industry.

 

The Dangerous Drugs (Amendment) Bill would allow people to possess up to 30 grams of cannabis or 5 grams of cannabis resin without facing legal actions. Possession of up to 60 grams or 10 grams of resin would mean a fixed fine of $739 without arrest, conviction or imprisonment.

 

The Cannabis Control Bill would establish a national Cannabis Authority that can grant licenses for cultivators, laboratories, processors, retail distributors, importers and transporters.

 

The country’s attorney general told Parliament that Trinidad and Tobago could save up to $100 million by ending cannabis prohibition, saving the unnecessary costs of cannabis-related incarceration and judicial hours.

 

Between 2010 to 2018, 3,429 individuals were held in prison for cannabis-related charges in the Carribean nation, with average spendings of between $2,217.25 to $2,956.34 per month per person, according to a CannabisWire report.

 

The proposed legislation would also allow citizens to grow up to four cannabis plants at home, but only allows for male plants, which do not produce THC — the active compound that produce a psychoactive effect.

This part of the legislation has led activists to push for changes in the bill and push for full legalization of the plant.

 

Attorney General Al-Wari said the bills are expected to pass the House floor, which is held in majority by the People’s National Movement party.

 

https://www.benzinga.com/markets/cannabis/19/11/14890119/trinidad-and-tobago-moves-to-decriminalize-establish-cannabis-economy

Labour manifesto: defining ‘appropriate prescription of medical cannabis’

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Labour manifesto: defining ‘appropriate prescription of medical cannabis’

 

Cannabis Patient & Advocacy Support Services (CPASS) have said they are encouraged by Labour’s manifesto pledge to ‘progress the clinically appropriate prescription of medical cannabis’.
However, CPASS believes the actual details are scant, leaving the door open for multiple interpretations as to what a ‘clinically appropriate prescription of medical cannabis‘ would actually be.

 

CPASS has emphasised that it is important to look at this issue in a wider context.

A recent survey conducted by YouGov on behalf of CPASS concluded that 1.4 million people in the UK are using cannabis to treat chronic health conditions with homegrown or illicitly procured cannabis. They are doing this as an alternative to prescribed medicine from their doctor.

Dr Daniel Couch, Medical Lead, Centre for Medicinal Cannabis, said: “For the first time we have reliable, representative data regarding the number of people in Britain using cannabis as a medicine.

 

“Over a million people are using cannabis illegally to relieve their symptoms. The findings are astounding and present a national challenge.”

Defining an ‘appropriate prescription of medical cannabis’
Ann Keen, Chair of CPASS and Fellow of Queen’s Nursing Institute, pointed out that: “These figures demonstrate the vast number of patients in the UK with chronic and debilitating diagnosed conditions who feel they have no choice but to expose themselves to all the risks of accessing a medicine that works from the criminal market.

“Controlled, safe but innovative solutions must be explored as soon as possible”.

These risks include but are not limited to; the risk of being arrested and prosecuted for cultivation of cannabis; risk dealing with criminals to source their medicine; risk of exposure to adulterants within the cannabis (moulds, fertiliser residue or other chemicals); risk of taking their treatment into their own hands and away from trained clinicians; risk to mental health to those who are sensitive to high THC ‘street’ cannabis and; risk of being alienated from society due to the fact they perceive an ‘illegal drug’ to be a better way to treat their condition than prescribed medicine.

 

All these risks can be directly attributed to the legal status of cannabis and not inherent to cannabis itself, which has proven to be of great benefit to patients when administered by health professionals, as shown by data emerging from medicinal cannabis programmes from around the world, from Australia to Uruguay.

CPASS note that the next thing to consider is, what conditions are people using cannabis to treat? This will help Labour and other parties understand how people are using cannabis to bring symptomatic relief to a broad spectrum of conditions.

Research from United Patients Alliance Patient Survey 2018 identified the following conditions people were treating with cannabis: pain, depression, anxiety and insomnia being the top four.

 

Any ‘clinically appropriate prescription of medical cannabis’ would surely take this data into account?

Integrating medical cannabis into health services
CPASS says that the final question is how to best integrate medicinal cannabis into a robust health service such as the NHS when there are little clinical trials demonstrating the efficacy of cannabis as a treatment.

 

This is the reason such a blockage exists today. Despite medicinal cannabis being legal now for over a year in the UK only 18 people have received a prescription via the NHS, according to a freedom of information request from the week of 18 November. This figure appears to be 1,399,982 prescriptions short.

To find an answer to this CPASS recommends that the UK should look to Denmark.

Denmark has a high-quality health service, not too dissimilar to the NHS. They also found themselves in a situation where patients were taking it upon themselves to treat their conditions with illicit cannabis. Denmark approached the issue by taking the wider social context into account to come up with a solution.

The pilot so far appears to be a success proving popular across the board with politicians of all parties.

Jane Heitmann, a Danish politician and MP for the Liberal party, said: “It has been an interesting journey to pass legislation concerning the Danish pilot scheme.

“All parties of the Danish Parliament were in agreement. For the time being hundreds of patients and MD’s have experience with either using or prescribing medicinal cannabis, which is a far greater number than expected.”

 

Danish doctors, who are supported by education material on medicinal cannabis, are able to prescribe cannabis for any condition if they feel it will help the patient. They are left to determine the appropriate treatment including the dose.

These patients are then monitored in an ongoing research programme that will help the Danish health service to understand how effective cannabis is as a medicine and what, if any, are the risks associated.

Dr. Julie Moltke-Huitfeldt, Danish doctor, said: “Since January 2018 we have almost 10,000 prescriptions for over 3,000 patients.

“The scientific research that has been initiated since 2018 — including several RCTs — is another sign that doctors are taking it seriously and trying to achieve the data we need to be able to prescribe medicinal cannabis in the future.”

 

After two years of the programme, there have been no reports of adverse effects which is a very encouraging signal. The doctors get the support and freedom they need, the patients get access to safe medicinal cannabis and the health service gets the data it requires. At the same time pressure is taken off politicians and police to justify the enforcement of unpopular laws. You could say that everyone is a winner.

 

A tailor-made solution for the UK

Jon Liebling, Co-Founder of CPASS and a medical cannabis patient himself concludes: “Now that we know that there are 1.4 million patients in the UK accessing illicit forms of cannabis to help treat their diagnosed medical conditions, doctors must understand that any decision not to prescribe a quality, standardised cannabis based medical product (CBMP) for a patient is a decision to send their patient back to the illicit market for a medicine of unknown strength or quality and exposing them to all associated risks.

“This must play a part in any clinically appropriate decision.”

CPASS is dedicated to helping find solutions for the millions of Britons who could benefit from medicinal cannabis and central to this is a dialogue with policymakers on how to enable this change.

 

The organisation encourages all British political parties to consider an approach similar to that of Denmark and read this policy proposal put together by distinguished UK doctors on behalf of the Centre for Medicinal Cannabis.

The proposal is a tailor-made solution for the NHS based on the Danish pilot programme.

 

Jon Liebling 
CPASS co-founder, and
Bill Griffin
CPASS Patient Advisory Board
cannpass.org

 

https://www.healtheuropa.eu/labour-manifesto-clinically-appropriate-prescription-of-medical-cannabis/95267/

 

Bongme

I’m 11 weeks pregnant and smoke cannabis daily – it stops me feeling so sick and I’d consider an abortion otherwise EXCLUSIVE

hi

 

 I’m 11 weeks pregnant and smoke cannabis daily – it stops me feeling so sick and I’d consider an abortion otherwise
EXCLUSIVE

 

Sun

 

A PREGNANT mum smokes cannabis every day to beat morning sickness, despite experts warning her baby is at risk of being born prematurely and has a higher chance of suffering cot death.

Sammy Warnes, 30, suffers from hyperemesis gravidarum, severe morning sickness including chronic nausea and vomiting, which is the same illness Kate Middleton endured throughout all three of her pregnancies.

 

 

But Sun medic Dr Carol Cooper warns Sammy should stop – explaining that while research into the impact of smoking marijuana while pregnant is limited, the dangers include increased risk of stillbirth, low birth weight and premature birth.

Dr Cooper told Fabulous Digital: “Cannabis has long been recognised to help nausea in patients having chemotherapy, by working directly on the vomiting centres in the brain. It also works on the gut to slow it down.

“So perhaps it’s no surprise to find many mums-to-be turning to marijuana for morning sickness.

“There’s very little research into its use in pregnancy, but studies so far suggest that smoking weed can trigger premature labour and interfere with the baby’s growth in the womb. It may also raise the risk of cot death.”

 

“Research using rats shows that marijuana affects the kind of proteins and fats that make up the brain, and that could have serious far-reaching results on their offspring, especially their learning and memory.”At the moment, I think it’s unwise for any pregnant woman to use marijuana. We just don’t know enough about the risks to the baby.”

Current NHS guidelines on smoking tobacco while pregnant warn the risks are very real.
Babies exposed to tobacco smoke in their mum’s womb are on average 8oz lighter than other newborns.

“They are more likely to have problems keeping warm and are more likely to get infections,” the NHS advises.

On top of this Sammy is risking legal problems – police can issue a warning or on-the-spot fine of £90 if you’re found with cannabis.

 

 

Sammy suffered terrible morning sickness with her daughter Arabella, now three, and was given strong medication to help.

Hyperemesis gravidarum differs from standard morning sickness because the nausea and vomiting is prolonged and so severe – some women are sick 50 times a day and Kate Middleton was even hospitalised.

Sufferers may lose weight and become dehydrated because they are sick so often, and can experience low blood pressure when standing up too.

Unlike normal morning sickness it doesn’t always gets better by 16 to 20 weeks.

Mums with hyperemesis gravidarum can be treated with anti-sickness drugs, vitamins B6 and B12 and steroids, or a combination of these, none of which have any ill effects on the baby.

However, some may be too nervous to take medication – or be ill-informed about new treatments – for morning sickness. In part this is due to the Thalidomide crisis in the 60s, which saw babies born with birth defects after their mums took the drug during pregnancy.

 

Sammy claims the medication she was given posed a risk to her unborn baby and also didn’t work well.

After weeks of sleepless nights and chronic vomiting, Sammy, from Leeds, researched herself and found a puff or two on a joint every day helped.

Her symptoms disappeared totally at 25 weeks, and Arabella was born fit and healthy.

After falling pregnant again her sickness returned but was “10 times worse”, and so Sammy is once again ignoring medical advice.

“I’ve had no choice but to take it. It worked so well last time,” she said.

“This time the sickness was 10 times worse and I was considering having a termination.”

The NHS says between one and three in every 100 pregnant women suffer from hyperemesis gravidarum, with The Telegraph previously quoting a study which suggested 1,000 women a year terminate pregnancies because of it.

 

Sammy, who spends £10 every three weeks on cannabis and gets her supply from the internet, is unconcerned about the risks with her habit.

The former catering worker is due in May next year and told Fabulous Digital: “All the warnings are to do with smoking tobacco.

“The experts are in no position to say that will happen because the only testing they’ve done is on rats.
“In that respect they know as much as me.
“There’s no real link between it because it is under-researched.

 

“The thing is the prescription drugs [for sickness] do more damage.

“There’s risk of birth defects so they’re quite scary to be fair.

“One of them was making my body do random movements. That stuff panics me.

“[Cannabis has] actually saved both me and my baby’s life.

 

It got to the point where I was seriously considering an abortion.

“This time round has been 10 times worse.

“I’ve had to give my job up because I just couldn’t do anything.

“With just two puffs a day I’m able to be a parent to my daughter.

“I can do normal things like go to the shops, take her to nursery and just be a mum.

“Beforehand I was just being sick or waiting around to be sick. I was just knackered.

“People will say ‘Oh she just wants to be a druggie’ but it’s not that at all.

 

 

I don’t get high off it. It’s a couple of puffs with a minimum bit of baccy.

“There needs to be a conversation about this so other women know there’s something out there that can help them.

“Unless you’ve been through it you don’t really get it.”

 

When Sammy began suffering severe morning sickness while pregnant in 2015, doctors prescribed her Domperidone – a drug used to relieve nausea and vomiting – but she claims the symptoms only temporarily disappeared for 20 minutes.

She decided to Google any alternative ways to combat her illness when she was 10 weeks along as she was being sick 10 times a day. Sammy was hospitalised and on a drip at around 14 weeks due to dehydration, with the mum was so ill she couldn’t eat or drink.

She discovered several forums suggesting cannabis as a solution, she claims.

Sammy, who had experimented with the drug as a teenager, said: “I wanted to see if there were any old-wives tales or old fashioned tips that would help me out.

“Then I found quite a few forums on women using cannabis to stop their morning sickness.

“I was so desperate I thought I’d give it a go.

“I was a bit nervous when I first did it but I was reassured by all the things I read on the forums.

 

As soon as I took it the symptoms just went away.

“It wasn’t just a case of me feeling sick the whole time. I couldn’t do anything at all.

“It was amazing – it helped me get out of bed in the morning.

“It literally worked straight away. I just couldn’t believe it.

“I didn’t tell my midwife as to be honest I didn’t want to cause unnecessary stress.

“It was to medicate my body, not to get stoned. I’m not abusing it or trying to get blazed.”

Sammy claims her first daughter, who arrived in June 2016, weighing a healthy 6lb 2oz, is healthy both mentally and physically.

 

 

After discovering she was pregnant again in August this year, she hoped her chronic morning sickness wouldn’t make a return.

But six weeks in her hyperemesis gravidarum came back and she was signed off work.

Sammy said: “I was put on the tablets again but the same thing happened.

“The sickness would disappear for about 20 minutes but then I’ll be back to hugging the toilet all day.”

Despite the taboo surrounding smoking cannabis, Sammy said she has both the support of her friends and family.

She said: “I smoke it in my back garden in the mornings.

“My family are very anti-drugs and when I told them they initially kicked off. But when I told them the full story, they were like, ‘If it works for you that’s fine.’

 

 

“My partner is really supportive. He noticed the difference straight away. My half-siblings are supportive too. They have family members who use it to treat cerebral palsy and cancer.

“I’ve never told a midwife because I know I’ll get stick.”

“Now I can do a food shop, do the house cleaning and take my little girl to nursery,” she said. “When you can’t do that and you have that extreme sickness it’s just awful.

“The tablets have side effects of birth defects. That is known. My little girl is fit and healthy and is getting along fine at nursery.

“I’d rather just take a couple of puffs of weed. There are thousands of women doing the same.

“But there isn’t a conversation about it because they are scared their midwives will grass them up to social services.

“I want to speak out because there is something out there which can help other women.

“There’s chat about cannabis being used as medicine for chronic illnesses.

“I just want to help and tell other women.”

 

While Sammy may want to spread her message, the warning from doctors is clear – smoking during pregnancy puts babies in grave danger and substantially increases the risk of stillbirth and cotdeath.

This young mum was driven to the brink of abortion with severe morning sickness – that made her vomit 90 times a DAY.

Meanwhile this mum-to-be suffered extreme morning sickness – causing her to vomit 20 TIMES a day.

 

https://www.thesun.co.uk/fabulous/10399659/mum-smokes-cannabis-pregnant/

 

Photos and 4 Comments

 

Bongme 

‘Hippy crack’ leaves man BRAIN DAMAGED: 26-year-old suffers ‘decreased consciousness and confusion’ after inhaling two litres of laughing gas every WEEK for six months

hi

 

‘Hippy crack’ leaves man BRAIN DAMAGED: 26-year-old suffers ‘decreased consciousness and confusion’ after inhaling two litres of laughing gas every WEEK for six months

 

Daily Mail

 

A 26-year-old Dutch man got brain damage after using ‘hippy crack’ laughing gas.

The patient, who has not been named, went to A&E confused and in and out of consciousness, and had been vomiting for several days.

His family revealed he had been using two litres of the popular recreational laughing gas – nitrous oxide – every week for six months. 

Doctors ran tests and found the chemicals in his blood were off balance as a result, causing potentially life-threatening problems.

It had led to toxic-metabolic encephalopathy, a condition where the brain’s function is impaired causing mood changes, seizures, and muscle weakness.

After being treated in intensive care, the young man was discharged but his confusion as well as visual hallucinations remained for three months.

Doctors warned laughing gas can be perceived as a harmless way of getting high. But growing evidence is showing its damaging effect on the brain and body.

 

A 26-year-old Dutch man got brain damage after using 'hippy crack' laughing gas.

 

 

People normally inhale nitrous oxide (N2O), a colourless gas, through a balloon. It is illegal, but easily available to youngsters.

Just one balloon can lead to a lack of oxygen to the brain – people have died this way. 

Heavy regular use of N2O can lead to a deficiency of vitamin B12 and to a form of anaemia, with vague symptoms of weakness, shortness of breath, and fatigue.

 

Doctors led by Marissa Ginette Danielle Vive, at Haaglanden Medisch Centrum, wrote this story in BMJ Case Reports.

 

They said the man had gone to hospital with sudden onset of confusion after days of vomiting.

Upon physical examination, he ‘appeared intoxicated and was vomiting repeatedly’.

In the following days, his mental state kept changing. Sometimes he was completely unresponsive, while other times he was aggressive and spat at staff.

After tests were ran, medics found the man had hyperammonaemia – when there is excess of ammonia in the blood. It is dangerous because it can lead to brain injury and death.

It explained why the man was suffering with life-threatening encephalopathy – disease or damage to the brain.

Encephalopathy is when electrolytes, hormones, or other chemicals in the body become off their normal balance.

Symptoms of encephalopathy – sometimes permanent – include seizures, trembling, difficulty speaking, concentrating or remembering things, mood swings and muscle weakness.

The patient had consanguineous parents – meaning they were related when they had their child. Therefore, it was initially suspected the hyperammonemia was due to an underlying disorder – but this was ruled out.

Eventually, doctors concluded the cause of the hyperammonemia was a vitamin B12 deficiency.

Earlier tests had in fact revealed the man had low vitamin B12 – triggered by the overuse of nitrogen oxide.

 

N2O affects vitamin B12 levels by interfering with chemical pathways in the body, the doctors said.  

After B12 suppletion and therapy to reduce the amount of ammonia in the blood, the man stopped going in and out of consciousness.

‘He was transferred from the intensive care unit back to the medical psychiatric care unit,’ the doctors wrote.

‘Although his consciousness improved, he remained confused with visual hallucinations, an attention deficit and dysphoric mood. 

‘These psychiatric sequelae diminished over the course of three months. Hereafter, the patient reported having no residual complaints.’    

Dr Vive and colleagues revealed hyperammonaemia induced by vitamin B12 deficiency has not previously been reported in medical literature. 

This, they said, may be because if a patient who uses N2O has an altered mental state, it may be assumed it’s because other drugs or alcohol.   

Vitamin B12 deficiency can also cause nerve damage in the hands and feet, or problems with the immune system because the chemical can prevent white blood cells forming properly. 

The high N2O gives can lead to hallucinations and dizziness, as well as exacerbating the effects of other drugs or alcohol. Both could raise someone’s risk of an accident. 

Empty silver canisters of N2O have become a common sight outside clubs across the UK and even in the streets.

It is illegal, however loop holes make the gas easy for adults to buy. It is still widely available because it’s used by chefs to make whipped cream.

The Royal College of Nursing said in May ‘the law is not working’ as a deterrent for those inhaling N2O.

Around half a million people aged between 16 and 24 has used N2O in the last year, according to the Government. 

Officials estimate there have been an average five deaths per year since 2014. 

 

https://www.dailymail.co.uk/health/article-7726907/Hippy-crack-cause-BRAIN-DAMAGE-Man-26-left-confused-vomiting.html

 

18 comments

 

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