The NHS policy on medical cannabis is crazy, and cruel
Why approve a drug you won't prescribe?
‘Ros, you have MS.’ (Oh God. You’d think after seventeen years I could type it a bit more easily. Never mind.) ‘Your daughter has epilepsy.’ (Also true.) ‘You’ve just made a podcast about cannabis and you haven’t mentioned either of those things! Why on earth?’
Fair. Throughout the making of this episode, a huge elephant loitered in the house. I averted my eyes from it, for a couple of reasons. Firstly, I am not a doctor. More Jam Tomorrow is about history and politics, not medicine. Who am I to assert how much cannabis can help with either of these neurological conditions?
In case you were wondering, since I was diagnosed, my cannabis consumption has consisted of one – ONE – gummy (split in half), offered by a friend who’d been in the US. I used to share the odd joint, but I got pregnant soon after my diagnosis and breastfed for a decade after that. (This is not a boast; I’m just odd.)
But now the elephant is increasingly agitated. When Ian Dunt mentioned in his MJT interview that lots of people were obtaining cannabis through private prescriptions, the elephant became impossible to ignore. There is something the creature doesn’t understand. Why, when cannabis has been approved for nearly seven years, does the NHS so rarely prescribe it? The BBC reported last year that only five people had received an NHS prescription. If, as David Nutt wrote in the British Medical Journal, many clinicians still believe it is too risky to prescribe, why was it approved in the first place?
Decriminalize marijuana : yes [on Proposition] 19 (1972). It failed. Cannabis is now legal in California. Library of Congress
Like most people with MS, I sometimes have neuropathic pain and spasms. So far they have not been bad enough or lengthy enough for me to ask for a prescription. In any case, I know that the first-line treatment is a drug called gabapentin, which I took for several years in the hope it would help my migraines. Coming off it was an agonising process that I simply could not bear to repeat. Yet a specialist (and specialists are the only clinicians allowed to prescribe cannabis; GPs are not) can only prescribe Sativex when the standard options have been tried, and failed.
The MS Society says:
You can talk to your doctor about getting Sativex, but this can depend on where you live. The NHS in your specific region might not pay for it, or prescribers might decide not to give it to people. A doctor anywhere in the UK can give you a private prescription for Sativex. But this costs over £500 for a month’s supply.
Some clinics claim to be offering private prescriptions for less than that. But making it so hard to obtain a prescription drug – and thereby forcing patients who are in pain to pay huge sums for it – is iniquitous. Many people with MS are on a low income because they cannot work. Their only alternative is to break the law and risk joining the 140,000-odd people prosecuted for cannabis possession each year.
The Department of Health says a wider rollout will only be possible when cannabis can be proven to be safe. Yet codeine, which is also a class B drug, is available over the counter at pharmacies. Ritalin is class B too, and available on prescription. Cannabis seems to exist in a strange no-man’s-land; safe enough to approve, but not to prescribe; dangerous enough to ban recreationally, but not to police in a meaningful way, as the bloke smoking it outside my local Sainsbury’s last week can attest.
Who knows? Maybe the whole mess makes more sense if you’re stoned. It’s defeated my mental processes. And one day, I fear, it’s going to make me even angrier.
More Jam Tomorrow: Cannabis is out now. If you like my work, you can tip me at Ko-fi.com.