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Medical Cannabis Clinicians' Society publishes guidance for prescribers

New guidance has identified conditions for which it says there is strong or weak evidence of efficacy of medical cannabis treatment.

Guidance for the prescription of medical cannabis has been issued by the by the Medical Cannabis Clinicians’ Society (MCCS) and the All-Party Parliamentary Group (APPG) for Medical Cannabis under Prescription.

Published on 20 March 2019, the guidance identifies conditions for which it says there is “conclusive or substantial”, “moderate”, and “limited” evidence of efficacy of medical cannabis treatment — as well as those for which it says there is “no conclusive evidence”.

In the conclusive category, the guidance lists spasticity, pain, chemotherapy-related nausea and vomiting, and epilepsy. It says there is currently no conclusive evidence for efficacy in a range of conditions, including behavioural control in dementia, depression and cancer.

The MCCS recommends that “given that there are few doctors familiar with cannabis medicine, a specialist does not refuse prescription based on their own lack of understanding but seeks to work with an expert cannabis physician”.

To date, there have been no recorded NHS prescriptions for the drug and only a handful of private prescriptions since medical cannabis products were rescheduled in November 2018.

Speaking at a House of Commons Health and Social Care Select Committee evidence session on medical cannabis on 19 March 2019, Mike Barnes, chair of the MCCS, said the guidance was “broader” than the current guidance from the Royal College of Physicians and the British Paediatric Neurology Association.

“This [MCCS guidance] explains a bit more about the background to cannabis generally [and] explains some of the terminology. At a fairly high level, it goes through some of the evidence for the other conditions that may be considered,” Barnes told MPs.

The MCCS describes itself as an “academically independent not-for-profit” group which is “open to any clinician with an interest in cannabis as a medicine”.

The APPG for Medical Cannabis under Prescription defines its purpose as to “secure legislation for access to natural cannabis for medical purposes in the UK under prescription from a medical professional”.

Asked at the evidence session, by Paul Williams, MP for Stockton South, whether there were any competing interests behind the guidance, Barnes said that “we had some support from European Cannabis Holdings (ECH) simply to print [it], but it’s totally independent. I wrote most of it”.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206324

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