Baroness Meacher is the chair of the All-Party Parliamentary Group for Drug Policy Reform and has a long history in social work and mental healthcare within vulnerable communities.
She is active in campaigning for widespread drug reform and regularly engages in debates on the subject of medical cannabis given her experience in helping people who were using it therapeutically.
MCN sat down with Meacher to discuss how she came to be aware of the remedial properties of the plant, cases of particular note she has been involved in, and how she is working to raise awareness and improve access to medical cannabis for British patients.
Your background in social work and mental healthcare led you to discover that cannabis has therapeutic benefits, what kind of conditions and symptoms did you find that people were often using it to treat?
When I asked patients why they were using cannabis when already suffering with a psychotic illness (I was convinced that it must surely be interacting with their pharmaceutical medication) they would reply: ‘It makes me feel human, and even if I experience more hallucinations it is well worth it because I feel alive.’
It was obvious to me that cannabis was very helpful in combating some of the negative symptoms of psychotic illness such as lack of libido, lack of feeling and lack of motivation; clearly cannabis was improving all of this. It is wonderful that people are now doing the research into the use of CBD as an antipsychotic medication. It’s very interesting.
In your opinion, to what extent is cannabis being used to address a previously unmet clinical need within vulnerable populations?
Cannabis is frankly perfect for the treatment of psychosis and its negative symptoms. The use of CBD is the priority, and that is where research is now focusing. I personally feel that perhaps certain people with psychosis could manage without many of the powerful antipsychotic medications they are being prescribed if they had access to CBD in addition to psychotherapy to help them to manage and deal with the symptoms.
If they were less anxious about the medications and responding negatively to them, then they may improve slightly anyway. I think it is a very interesting area of research.
In terms of mental illness in a broader sense, I know that people use cannabis to help them with depression and anxiety; I’m not an expert in those areas but there are so many people who find it valuable. Again, some robust research would be very helpful in those areas. In the meantime, it is my view that if patients are reporting that they feel better using medical cannabis products then NICE and the other regulatory bodies need to find ways of approving cannabis for people who are very vulnerable from depression and anxiety while better research is being done, because it clearly doesn’t appear to be doing adults any harm.
Are there any particular cases of note you can recall in which someone experienced substantial improvement or benefit as a result of using medical cannabis, or a particular incident which convinced you of its efficacy?
I have met so many people who were suffering terribly and whose lives have been completely transformed by cannabis. For example, Lara Smith comes to mind. She has major spinal conditions and was put on 34 different medications which did very little to alleviate her pain but caused unbearable side effects.
She decided to stop taking those and now exclusively uses cannabis, which alleviates her pain more effectively than anything else. I also met somebody on a television programme who suffers with Crohn’s disease; he was told he would die within six years and now 10 years on he simply takes cannabis and he’s absolutely fine.
Somebody very close to me suffers from PTSD and since using cannabis he has reported that it has helped him massively.
You have discussed how the need for research into how access to medical cannabis could reduce the burden on the NHS. What would need to happen in order for this research to be commissioned and how would it work? Do you think this is something that public and medical professionals would quickly support?
I think there would be a huge amount of support as research findings come out ever more strongly in relation to medical cannabis’ impact on all of the different conditions.
For example, Drug Science led by Professor David Nutt is going to make medical cannabis available to 20,000 people as a pilot scheme, in the course of which they will be looking at measuring the outcomes, the cost, the positive effects on symptoms, and so on. They are going to have a meeting with NICE to make sure that they will actually take the findings of this research very seriously.
I understand that NICE are also finally considering moving away from a requirement for research to be in the form of randomised controlled trials (RCTs), which of course are not helpful for cannabis in many ways. In my opinion, we simply need other forms of research. Drug Science are leading the way in this country in terms of breaking away from RCTs and using outcome measures and so on.
This, of course, has been done a lot in the USA and although NICE looked at more than 19,000 different research studies, they dismissed all but four of them because they were not RCTs. There really is enough research out there for a great deal of liberalisation in prescribing cannabis and this research is still ongoing, which is wonderful.
Do you feel that it will present a significant challenge if medical cannabis products have to be treated in the same way as other pharmaceuticals, which are typically very expensive and take a long time to reach the market?
I think it would be a disaster, quite frankly, if this country holds on to the requirement for RCTs. What is interesting is that the Queen’s speech includes The Medicines and Medical Devices Bill. This will change the requirement for such costly research studies in order to get new medicines into the market more quickly.
Even if this is only for a short period of time while more work is done, I think it is a potentially very exciting piece of legislation.
There is a burgeoning realisation that we are just too tough here. It is significant that 50 countries have approved medical cannabis and most of them have got thousands of patients being prescribed it, rather than merely tens; we are way behind.
Even though access to medical cannabis is technically possible in the UK, there is criticism surrounding the number of prescriptions issued and that they have been issued privately at a cost. What in your opinion are the largest barriers patients are facing in trying to access to medical cannabis, and how can this be addressed?
Medical resistance is huge. Many doctors were educated and trained at a time when cannabis was regarded as a dangerous and illegal drug. So, first and foremost their mindset needs to change. Even if that happens, they are being inhibited from prescribing cannabis-based medicines anyway and they are expected to take full risk and responsibility. They feel that this is a big problem because cannabis is in the ‘specials’ category and not just a standard medication they would usually prescribe.
The next problem is that only specialised consultants can issue medical cannabis prescriptions, and all of the forms and procedures this entails are incredibly time consuming and onerous; they simply don’t have the time to be doing this.
There are many barriers at the medical level, and then there are barriers in terms of securing licences for producers. We don’t yet have readily available licensed production of the medicines here, there is the rule that only one month’s supply can be imported at a time on a named patient basis, which is ridiculous and only serves to ensure that the cost is huge.
There are medical barriers, there are rule-related barriers, and of course the bureaucracy and extortionate cost. These are the things that have to change and change quickly to give patients access to medical cannabis.
How would you argue these issues should be addressed to improve access to medical cannabis?
There is already important work going on and there are wonderful people such as Professor Mike Barnes who has set up clinics and is also training other doctors. There are organisations like Drug Science who are doing wonderful work as well, so there are already developments on the medical side.
I am going to have a meeting with officials about all the rules and bureaucracy and to discuss what the government can do to free up the availability of medical cannabis. NICE had a meeting with me yesterday, they need to move and I’m sure they will; how quickly that will happen remains to be seen, but it will be as quickly as they possibly can.
NICE need to move to recognise medical cannabis in a more positive way and to provide guidance that will actually encourage doctors to prescribe.