British Journal of General Practice - Cannabis In Primary Care

Dr Leon Barron and Dr Dani Gordon's editorial on Cannabis In Primary Care proposes that GPs are perhaps the best placed of all doctors to prescribe medical cannabis.

The reclassifying of cannabis to a schedule 2 drug in November 2018 was seen as a landmark moment for patients, indicating a shift in medical policy, and more importantly, attitude toward medicinal cannabis within the UK. Following a change in legislation and subsequent guidance from the Royal College of Physicians and the British Paediatric Neurology Association, the RCGP issued its own desktop guidance for GPs to enable informed discussions with patients around this subject matter.

Draft National Institute for Health and Care Excellence guidelines on cannabis-based medicinal products were released in August 2019, with full publication expected towards the end of this year.

Despite an increasing number of patients enquiring about medical cannabis, the reality is that it remains a contentious subject, generally poorly understood by doctors and largely unavailable for patients. The reasons are complex and multi-factorial and include there being a lack of physician education in prescribing; a lack of cannabis-based medicines available in the UK; a convoluted regulatory process in obtaining a medical cannabis prescription and suitable product; and the added fact that only GMC registered specialists may initiate a prescription.

Current UK legislation and practice guidelines which exclude GPs as primary first prescribers risks leaving GPs out of the conversation, despite the level playing field regarding the knowledge of cannabis medicines shared by both specialists and GPs alike. The authors propose that GPs are perhaps the best placed of all doctors to prescribe medical cannabis, as they do in most other countries where cannabis for medical purposes is now legal.

Read the feature in this month's issue of The British Journal of General Practice.