Cannabis Advocates Encouraged by Policy Reform in the UK: Country Profile

Cannabis Advocates Encouraged by Policy Reform in the UK: Country Profile

The UK will allow doctors to prescribe medicinal cannabis products, but concerns over access abound.

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August 8, 2018
Melissa Schiller
International Legislation and regulation Medical News

The United Kingdom has taken a step forward in cannabis policy reform, announcing that specialist doctors will be able to legally prescribe cannabis-derived medicinal products later this year, but industry advocates say there is still a long way to go.

“We’re absolutely delighted with the fact that there has been some progress in the UK in the last few weeks,” Peter Reynolds, president of cannabis policy group CLEAR, told Cannabis Business Times. CLEAR was established in 1999 and campaigns for an end to cannabis prohibition for all purposes, making medical access a priority, Reynolds said.

This policy shift comes under the government of Prime Minister Theresa May, a longstanding prohibitionist, Reynolds said. The government was ultimately moved by two children, Billy Caldwell and Alfie Dingley, who suffer from severe epilepsy. Inspired by the children’s stories and the national headlines, the Chief Medical Officer was tasked to find evidence in support of the medical use of cannabis.

“What really sums up what has happened is that in 48 hours, the Chief Medical Officer responded to the government saying there is overwhelming evidence of the medical benefit of cannabis,” Reynolds said. “Of course, this evidence is not new evidence—it’s evidence that’s been around for years or decades, in most cases. That together with the media finally getting behind this issue is what’s forced their hand.”

The media in the UK, Reynolds said, has in the past supported the idea that cannabis causes mental illness, but has now started to see the other side of the story. “They’ve begun to see not just in children, but in older people, as well, that there are actually therapeutic benefits to cannabis.”

And while the legalization of cannabis-based medical products is certainly a welcome move to CLEAR, Reynolds said the UK still has a long way to go in cannabis policy reform. So far, it has not been determined what kinds of products will be available, who will be able to access them and whether a general practitioner will be able to prescribe them, he said.

“The most concerning thing is that in a number of reports that have been done by our government officials, they’ve started talking about what they call ‘grown cannabis,’” Reynolds added.

The government has warned that grown cannabis or “street” cannabis of unknown composition should not be available as a medical product, Reynolds said. And while CLEAR supports the idea that it is important to know the concentrations of cannabinoids in medical cannabis, the organization—and the UK at large—is concerned that herbal cannabis will be banned.

“The great worry of the moment is that it looks quite possible that what they’re going to try to do is retain an outright ban on herbal cannabis and keep herbal cannabis in Schedule I, whereas other cannabis products will be moved to Schedule II, which are the same schedules as you have in the States,” Reynolds said. “That’s the new battleground in the UK.”

The Medicines and Healthcare Products Regulatory Agency (MHRA), which is essentially the equivalent of the U.S. Food and Drug Administration (FDA), will need to decide what constitutes a medical cannabis product, and those products will be rescheduled as Schedule II, Reynolds said.

“So, it’s almost definitely the case that ‘herbal cannabis’—whole cannabis that is produced by people growing it at home—is still going to remain Schedule I, and what we have to push for is that herbal cannabis that is produced by a GMP-certified, properly regulated producer … will be moved to Schedule II,” he said. “That is the crucial issue at the moment.”

In the Netherlands, the Dutch government has contracted with Bedrocan to produce medical cannabis that it calls “standardized herbal cannabis,” ensuring that the cannabinoid and terpene content is consistent from batch to batch, Reynolds said. CLEAR would like to see the UK employ a similar system, he added.

“CLEAR’s position is that the gold standard in cannabis for medicine is vaporized, high-quality herbal cannabis,” Reynolds said. “The benefits it offers [include] efficacy, safety and most important of all, self-titration—you know exactly when you’ve had enough, and it doesn’t have all the disadvantages of edibles. It’s the best way of taking cannabis as medicine, so this is something that we’re pushing very hard on.”

Encouraging doctors to prescribe medical cannabis products will also be a challenge, Reynolds said. “There’s been a concerted attempt to demonize cannabis and indeed to frighten doctors who have taken any interest in it,” he said.

Initially, it was suggested that general practitioners would be able to prescribe the products for any condition they saw fit, but now the conversation has turned to only allowing specialists to prescribe cannabis products for a pre-defined list of conditions, Reynolds said.

Under UK law, no new laws are needed to legalize cannabis, he added. “The law that cannabis is covered by—the Misuse of Drugs Act—has within it all the effects and ability that one needs to introduce a fully regulated system, and not just for medical use—it could be a fully regulated system for adult-use, as well,” Reynolds said. “So, there’s no need for any laws to be changed—it can all be done by … what we call statutory instruments; just by an order signed by a minister.”

CLEAR is working with the Cannabis Trades Association, a group that focuses on the UK’s CBD market, to create a draft plan called the Cannabis Products Directive to regulate the cannabis market, including CBD products, which are a legal and fast-growing market in the UK.

“We already have the agreement of the MHRA and another important organization, the Food Standards Agency, to participate in sponsoring this Cannabis Products Directive to be put into the UK legislation, so that is really the hope or the ambition for the future,” Reynolds said. “That’s probably two years away yet.”

And while a lot of the regulations surrounding the program are still largely unknown, more information will likely roll out in September or October, Reynolds said, and CLEAR is encouraged.

“We’re absolutely delighted that there’s been a significant move,” Reynolds said. “It’s undoubtedly the beginning of the end of cannabis prohibition, but to begin with, it may still be very restrictive, and we’re waiting to see that.”

Top Image: © Horváth Botond | Adobe Stock

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