Legalising medicinal cannabis has led to people getting carried away with what they believe it could treat, England’s Chief Medical Officer has warned.
Dame Sally Davies spoke in Parliament yesterday to say she has concerns about the safety of cannabis-based medicines.
She called for more clinical trials to test the safety and effectiveness of the drugs, and said doctors mustn’t cut corners.
Cannabis-based medicine was legalised in the UK in November and is only available to a limited number of patients – mainly children with severe epilepsy.
But the previous illegality of the medicines means clinical trials haven’t been done in the past, so evidence of how well they work, and for what, is thin on the ground.
Dame Sally Davies, the British Government’s chief adviser, said she has concerns about the safety and effectiveness of medicinal cannabis and warned there are ‘no shortcuts’ to prescribing it
Dame Sally has been the Government’s chief medical adviser since 2011.
Speaking to the health select committee yesterday, she said doctors were rightly hesitant to dish out cannabis-based drugs without good evidence from clinical trials.
In the highest profile cases of the children who prompted the law change, they had already been taking the medication illegally before it was allowed.
‘I think we have opened a Pandora’s box and there is a belief that it works for many conditions,’ Dame Sally said. ‘I do have concerns about safety.’
Various benefits of cannabis-based medicines are widely claimed but not well proven.
People claim they help epilepsy, chronic pain, depression and PTSD, multiple sclerosis, and even – controversially – cancer.
Mothers of children with severe forms of epilepsy say they have found their children have far fewer seizures when treated regularly with cannabis oil.
But Dame Sally warned the chemical THC, which makes people high when they smoke weed, has links to depression, schizophrenia and brain development problems in young people.
She called for more in-depth trials to be done to find out how the drugs actually affect patients who take them.
And private companies set to profit the most from selling the drugs should help to fund them, she said.
‘Randomised control studies, properly done, are the way to go forward,’ Dame Sally said. ‘It would be great if the industry would make a contribution to this.
‘I really hope we can do the trials, because without those, how can we help the patients?’
Campaigners yesterday marched to 10 Downing Street to hand in a petition signed by 578,000 people calling on the Government to review prescribing guidelines for medicinal cannabis products and make them less ‘restrictive’
Campaigners, pictured with Labour MP Tonia Antoniazzi (left), said even thought medical cannabis has been legalised it is still too difficult for the parents of epileptic children to access
But clinical trials take a long time and desperate parents insist the ‘clock is ticking’ for their epileptic children who could be helped by the drug.
ACCESS TO MEDICAL CANNABIS ‘APPALLING’ SINCE LEGALISATION
A university professor last month said access to medicinal cannabis had been ‘appalling’ since it was legalised in November.
Professor Mike Barnes, from Newcastle University, claimed in February only six patients had been given prescriptions – and none of them were on the NHS.
Since November 1 2018, specialist doctors in the UK have been able to legally prescribe unlicensed marijuana-based products containing THC, which is what makes users ‘high’.
Despite the law change, the British Paediatric Neurology Association’s guidelines do not recommend the prescription of medicinal cannabis that contains THC.
‘The situation is appalling,’ Professor Barnes said in The British Medical Journal.
‘Not one patient has benefited from a cannabis prescription on the NHS.
‘The legislation has had no impact on the health of people due to the lack of education of the medical community and overcautious guidelines produced by the Royal College of Physicians and the British Paediatric Neurology Association.’
Dame Sally said: ‘Without an evidence base, we cannot license these drugs and move them into whatever turns out to be their rightful place in medicine.
But when asked if the process could be ‘streamlined’ to allow patients quicker access to the products she said: ‘There is no shortcut, we have to find out how it works and what the impact is.’
Campaigner Peter Carroll, who represents at least 16 families lobbying Parliament to get access for their severely epileptic children, said waiting to compile more evidence would be ‘unforgivable’.
Speaking on behalf of the campaign group, End Our Pain, Mr Carroll said some children suffered from 300 seizures a week.
He told the committee: ‘How can we tell these children they have to wait four or five years?… That is unforgivable. These prescriptions can and should be written now.’
Families of children with severe epilepsy handed a petition with 578,000 signatures to 10 Downing Street calling for the guidance on prescribing medical cannabis to be reviewed.
Organised by End our Pain, the petition said that despite medical cannabis being rescheduled, guidance issued Royal College of Physicians (RCP) and British Paediatric Neurology Association (BPNA) was ‘so restrictive that almost no one will get access to medical cannabis’.
It is supported by Hannah Deacon, whose son Alfie Dingley was the first person in the UK to receive a permanent medical cannabis licence and went on to be granted the first NHS prescription issued after the UK law change.
Campaigners from the End Our Pain group hold photos of their relatives outside 10 Downing Street yesterday. They want access to medical cannabis, which is believed to reduce seizures in children with severe forms of epilepsy, to be easier to access
Billy Caldwell, pictured with his mother, Charlotte, suffers from severe epilepsy which Ms Caldwell found was eased by cannabis oil which she had to obtain illegally. Billy’s was one of the landmark cases which convinced the UK Government to change its mind on the legal status of cannabis medicines
THE DIFFERENCES BETWEEN THC AND CBD
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are both derived from the cannabis plant.
Together, they are part of the cannabinoid group of compounds found in hashish, hash oil, and most strains of marijuana.
THC is the psychoactive compound responsible for the euphoric, ‘high’ feeling often associated with marijuana.
THC interacts with CB1 receptors in the central nervous system and brain and creates the sensations of euphoria and anxiety.
CBD does not fit these receptors well, and actually decreases the effects of THC, and is not psychoactive.
CBD is thought to help reduce anxiety and inflammation.
Speaking at Parliament, Miss Deacon said she could not stand back and let other children suffer after seeing the ‘wonderful change’ medical cannabis had had on Alfie.
She said that since the prescription, her seven-year-old son had gone from being in hospital 48 times in one year to just one hospital admission in a year.
Parents Matt and Ali Hughes from Norwich said the ‘clock was ticking’ for their 20-month-old son Charlie who suffered from as many as 100 seizures a day.
‘His rare form of epilepsy stops the brain from developing. If we can stop the seizures by getting cannabis oil we can give him a chance to develop.
‘It could completely change his outcome and give him a better quality of life,’ said Mrs Hughes.
Other families said they have been reduced to criminality by spending thousands of pounds to bring the drug into the UK from Holland to help their children.
But Alette Addison, head of pharmacy development and regulation at the Department of Health and Social Care, told the select committee that without an evidence base doctors will not be confident prescribing the drugs.
She also denied that the current guidance was too restrictive, insisting it was based on the ‘best international evidence available’.
She added: ‘Doctors are only going to be confident in prescribing, signing that form, if they have the evidence base to do so, and it’s not there at the moment.’
THE LANDMARK CASE OF BILLY CALDWELL
Billy Caldwell’s mother Charlotte (pictured together) had seven bottles of cannabis oil confiscated at Heathrow Airport customs, prompting a row over cannabis oil
Cannabis oil was thrust into the limelight when epileptic boy Billy Caldwell’s mother had seven bottles confiscated at Heathrow Airport customs.
The 12-year-old sparked a row over the medicinal status of the oil, prompting the Home Office to step in and grant his mother Charlotte an emergency licence for the product that was calming his seizures, which contained THC.
Billy’s bottles were confiscated on June 11 after Ms Caldwell brought them in from Toronto.
On the back of the cases of Billy and fellow epileptic boy Alfie Dingley, six, Home Secretary Sajid Javid called for a review into medicinal cannabis.
In a major shift of policy, he announced in July that some products containing the drug would be available on prescription in the UK from the autumn.
On the back of today’s change to the law, Ms Caldwell said she wept with joy.
‘For me what started off as a journey which was about the needs of my little boy actually turned into something, proved to be something, a lot bigger,’ she told Sky News.
‘It proved to be the needs of a nation.
‘Medicinal cannabis gave me back my right as a mummy to hope, but the most important thing medicinal cannabis has done is given Billy back his right to life.
‘Only relatively recently did our Government and country really start to appreciate just how many wee children and people of all ages were affected by the difficulties associated with accessing medicinal cannabis.
‘But it became clear it wasn’t just about what was perceived to be a small number of very sick children and that medicinal cannabis could make a life-changing or life-saving difference to more than a million people.’
Although thrilled by the law change, Ms Caldwell hopes regulations will be expanded to allow more people to benefit from cannabis-based treatments.
‘This is new ground for everybody. We did in a few days what successive UK governments failed to do in more than half a century and made medicinal cannabis legal,’ she said.
‘Then, as now, politicians didn’t realise the complexities involved.
‘There’s a wide range of conditions, each of which can only be treated by certain forms of medicinal cannabis.’