Medical cannabis panel is failing us, families tell Sajid Javid

This was the heading in today’s Times.

I wondered how broadly the access to medical cannabis would be under the new licensing system. Would it be broad enough so that people with chronic illnesses such as MS, Parkinson’s, Huntington’s disease and cancer could benefit? Not to cure their condition, but to ease symptoms and potentially extend life.

My fear was that the review would only recommend medical cannabis for cases of the rare form of epilepsy in children, such as Alfie Dingle and Billy Caldwell whose cases had extensive media coverage. Both had shown dramatic improvement by having access to the drugs they needed in other countries.

The outcome seems to be even worse than I had feared. Alfie had already been approved before the expert panel was set up, Billie’s licence was approved on the day the panel was announced by Sajid Javid. Only one other licence has been issued, because the panel requires very difficult conditions to be met.

Evidence must be provided of exceptional clinical circumstances. They are asked if the product has already been effective for the patient – since it is illegal here this would have had to be in another country. Not an option for many families. There should be evidence that no suitable medical product is available in the UK – but there are about 20 anti-epileptic drugs and it would take a long time to try them all without success. Medicinal cannabis would be cheaper and not harmful, but doctors and NHS trusts are fearful of accepting clinical responsibility for prescribing it and parents have been unable to obtain the medication without their support.

Rather than radical change in the availability of medical cannabis for many people it seems we have a system which blocks change for all but a trickle of exceptional cases. Why don’t we learn from the experience of other countries where it is legal?

As the world’s largest exporter of cannabis for medical and scientific use providing nearly half of the world total it seems hypocritical not to allow UK patients to benefit. At the very least we should be doing research into effectiveness for different conditions and optimal dosage. But pharmaceutical companies can only make money if they can manufacture a new formulation – there is no money in natural remedies. Universities don’t seem to be doing any meaningful research into medical cannabis. Why isn’t there a publicly funded body to investigate this and a range of other treatments which are not commercial money spinners but could help patients and save NHS money?

The Care Oncology Clinic is a private clinic researching a combination of repurposed drugs which seem to be helpful for cancer. Metformin, Atorvastatin, Doxycycline and Mebendazole. These are all licensed for other conditions but seem to be helpful in blocking the processes used by cancer cells. Searching PubMed, I found a drug, Memantine, which might be helpful in reducing the impact of neurocognitive decline after brain radiotherapy. But not enough research has been done on it, and there is no commercial incentive for it.

The NHS expensively sells us late stage cancer patients short. We need to fund research and gain acceptance for integrated oncology treatments in the meantime. Sadly, medical cannabis so far does not seem to be the door opener.