Medical Cannabis: Recent Developments

According to the NHS, medical cannabis, also known as medicinal cannabis, is “a broad term for any sort of cannabis-based medicine used to relieve symptoms”. The cannabis plant contains more than a hundred different chemical compounds called cannabinoids, some of which are the active ingredients in prescription medicines. The most well-known cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD).

Under the Misuse of Drugs Act 1971, cannabis (as well as most cannabinoids) is a controlled drug. Prior to September 2018, cannabis-based medicinal products could only be accessed through the granting of an individual licence. Following a review by the Chief Medical Officer and the Advisory Council on the Misuse of Drugs, the Home Office announced that from 1 November 2018 cannabis-based medicinal products would be rescheduled under the relevant regulations, meaning they could be prescribed by doctors on the Specialist Register of the General Medical Council.

Cannabis use for medicinal purposes is allowed in several countries and territories across the world. These include the Netherlands, Canada, France, Germany and some US states. In the Netherlands, for example, cannabis for medicinal purposes is available with a physician’s prescription and can be prescribed by all doctors.

In December 2018, the House of Commons Health and Social Care Committee launched an inquiry into issues around medicinal cannabis. The committee stated that while the rescheduling of cannabis for medicinal purposes had been “widely welcomed”, there had been a “failure” to communicate what this would mean “in practice”. In September 2019, the Government responded to the recommendations set out in the committee’s report. These included providing clearer information on availability and building the evidence base.

New National Institute for Health and Care Excellence (NICE) guidelines were published in November 2019 on the prescribing of cannabis-based products. The guidance recommends specific cannabis-based products in the treatment of intractable nausea and vomiting and for spasticity in Multiple Sclerosis (MS), but not for the treatment of pain. The guidelines did not recommend these products for severe treatment-resistant epilepsy, however NICE made research recommendations in this area.