The Home Office’s recent promise to review policy on the medical use of cannabis has, as promised, been turned around quickly. Carried out by Professor Dame Sally Davies, it predictably brings good news and bad for patients who rely on cannabis for medicinal purposes.
The main takeaway from this “review of contemporary reviews” is the recommendation that the “whole class of cannabis based medicinal products be moved out of Schedule 1”.
This represents a limited but significant victory. Drugs in Schedule 1 are considered to have little or no therapeutic value and are therefore not available to be prescribed or held legally with a prescription. It is likely that cannabis based medicinal products will therefore be recategorised into Schedule 2, 3, 4 or 5, which make it legal to possess a drug with a valid prescription from a registered medical practitioner. Sativex, which uses a specific extract of cannabis and is prescribed for spasticity in MS, is currently controlled under Schedule 4.
However, the Dame’s review “does not consider the use of medicinal cannabis products for non-medicinal or recreational purposes, or where those wishing to provide cannabis based medicinal products are not registered medical practitioners”. It therefore does not address the right to grow.
In fact it rules the prospect out:
“Cannabis has many active chemicals and only cannabis or derivatives produced for medical use can be assumed to have the correct concentrations and ratios. Using other forms, such as grown or street cannabis, as medicine for therapeutic benefit is potentially dangerous. The evidence that cannabis and some of its derivatives can be addictive and harmful has been known for some time and is not disputed by recent science, so I believe the reasons it is a controlled drug in the UK stand.
“Because different forms of grown cannabis have different concentrations and ratios of THC, grown or street cannabis cannot safely be substituted for medicinal cannabis.”
Denying the right to grow obviously shows distrust in patients’ ability to self-medicate, and denies them the ability to medicate at a low cost.
However, back on the positive side of things, the report recognises that
“there is now conclusive evidence of the therapeutic benefit of cannabis based medicinal products for certain medical conditions and reasonable evidence of therapeutic benefit in several other medical conditions. This evidence has been reviewed in whole or part, and considered robust, by some of the leading international scientific and regulatory bodies, as well as the World Health Organization (WHO). As Schedule 1 drugs by definition have little or no therapeutic potential, it is therefore now clear that from a scientific point of view keeping cannabis based medicinal products in Schedule 1 is very difficult to defend. Moreover, I believe that it would not make sense to move cannabis and its derivatives out of Schedule 1 whilst leaving synthetic cannabinoids, which the evidence suggests have potentially greater therapeutic benefit and less potential for harm, in Schedule 1. I therefore recommend that the whole class of cannabis based medicinal products be moved out of Schedule 1.
“Moving these drugs out of Schedule 1 would allow them to be prescribed under controlled conditions by registered practitioners for medical benefit. In addition, moving the whole class of cannabis based medicinal products out of Schedule 1, will allow the evidence base on the therapeutic benefits associated with using this class of drugs to be improved through research, maximising benefits to patients.”
Given the particularly backward conservatism of UK politics, it is no surprise that the government is unmoved on recreational use and the right to grow. However, this was only Part 1 of the Cannabis Scheduling Review, and it recommends that the UK government should now carry out its own research to determine which kinds of medicinal cannabis are beneficial for different types of medical conditions.
The UKCSC will continue to make the right to grow a central demand of the legalisation movement.
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