No cannabis for pain, says NHS watchdog

Philip Etchells on the recent decision not to approve cannabis treatment for chronic pain conditions.

Philip Etchells
25th November 2019
The National Institute for Health and Care Excellence (NICE) has recently approved two cannabis-based medicinal products (CBMPs) to treat epilepsy and multiple sclerosis (MS). However, the watchdog has refused to recommend cannabis for chronic pain, among other treatment-resistant conditions, due to current research being “limited and of low quality”.

One reason NICE’s decision has been criticised is because the ruling only applies to the NHS in England. The announcement has not come with funding, meaning that access will depend on local NHS funding decisions. Genevieve Edwards, from the MS Society commented that they were “bitterly disappointed” with NICE’s verdict because “it means thousands of people with MS will continue to be denied an effective treatment”. Professor Mike Barnes, the chair of the Medical Cannabis Clinicians Society, also criticised NICE’s failure to acknowledge “alternative, valid sources of evidence” and claimed those in favour of medical cannabis were “excluded from the process and NICE committee”.

In 2018, the UK law on cannabis was amended, limiting cannabis medicine prescriptions to people under special circumstances and only done by specialist clinicians. Currently, just 18 NHS prescriptions have been provided since the legalisation of certain CBMPs last year. This change took place after the high profile case of 12 year old Billy Caldwell, who had his cannabis medicine confiscated by customs officials at Heathrow airport. His family had travelled to Canada to obtain the medicine for Billy’s life-threatening epilepsy because it was still illegal to prescribe it in the UK.

A positive outcome of the announcement is that by 2021, one neuropsychopharmacologist wants to produce Europe’s largest body of evidence for cannabis medicine. Despite disapproving of NICE’s refusal to endorse cannabis medicines, Professor David Nutt hopes to enrol 20,000 people suffering from various conditions in Project 21 - a study which has been backed by the Royal College of Psychiatrists. It will involve conditions shown to be susceptible to the drug, including chronic pain, anxiety, Tourette’s and PTSD, as well as epilepsy and MS. 

However, until more evidence is produced, criminality remains a very real issue for those who cannot afford private prescriptions, which can cost up to £3000. Hopefully, perceptions and laws about cannabis will change with the growing evidence because currently, many people are suffering or being criminalised for seeking out ways to treat their conditions.

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