Talking to your GP about medical cannabis treatments
If you have not found licensed therapies to be effective in managing your current condition/symptoms and have been left suffering with a poor quality of life, you may wish to talk to your GP about medical cannabis treatments.
Many GPs in the UK have been naturally hesitant about recent changes in the law surrounding the use of cannabis-based medicinal products and may not be aware of the various options available to patients.
At present, the NICE guidelines only permit NHS reimbursement for chemo-related nausea, spasticity in MS and for a few rare childhood epilepsies. However, the prescription of cannabis-based medicinal products can be made for other conditions by a specialist medical practitioner (a consultant). If you are not eligible for medical cannabis treatments on the NHS and who wish to explore medical cannabis treatment for an unmet clinical need you currently have the choice of a number of private clinics. A simple Google search for medical cannabis clinics will give you a range of choices. The Primary Care Cannabis Network advocates for regulated and safe medical cannabis treatments to be freely available on the NHS.
We would encourage you to ask your GP for a brief referral letter outlining current unmet clinical need or to provide you with a summary of your medical notes relevant clinic letters from secondary care. Most clinics will not see you without the relevant medical records or a GP referral. Your GP in theory can prescribe follow up scripts for medical cannabis under the direction of a specialist although currently this is very unlikely to be approved through the NHS.
There are no barriers to medical cannabis treatment and any condition can be considered. Most prescriptions issued in cannabis clinics are currently to help improve quality of life for patients suffering with chronic pain, anxiety, PTSD, epilepsy and muscle spasm. Medical cannabis may also be considered to help patients wean off strong medications with unpleasant side effects such as high dose opioids.
Private cannabis clinics can be costly for patients although the price of monthly prescriptions has come down considerably over the past few months since the government allowed for the bulk import of medical cannabis.
Another option is to enrol within a clinical trial. Recent NICE guidelines on Cannabis Based Medical Products (CBMP) and the National Institute for Health Research have emphasised the need for further focussed research and clinical trials on the therapeutic value of CBMPs and outlined a number of priority areas including gathering data on CBD and THC for fibromyalgia or persistent treatment-resistant neuropathic pain, chronic pain in children and young people and for treatment resistant epilepsy.
Drug Science, an independent scientific body has launched Europe’s first and biggest national medical cannabis registry, called Project Twenty21.Twenty21 is currently in the process of enrolling 20,000 patients, creating the largest body of evidence for the effectiveness and tolerability of medical cannabis. If you have a qualifying condition, then access via Project Twenty21 may be an option for you. Treatment will available at be a capped cost but will restrict a doctor to prescribe only certain products. It is only available at the moment for those with pain and psychiatric conditions, like anxiety. There is information about Project Twenty21 on the Drug Science website.
As a patient you have the right to be involved in discussions and make informed decisions about who provides your care and treatment and it is a duty of your GPs to support you as much as they are able to, in decisions about your care. For private secondary care, it is not essential to have a letter of referral, however the British Medical Association believes it is best practice for patients to be referred for specialist treatment by their GP because they know their medical history and can provide advice on whether a referral is necessary.
It is a professional duty of GPs to keep up to date with advances in medicine and science and understanding cannabis based treatments and the Endocannabinoid system is no exception.
If your own GP does not feel he / she has enough about medical cannabis treatments we would encourage you to signpost to The Primary Care Cannabis Network. We are open to all GPs and free to register and offer up to date educational information and peer support.