Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.

Join

Subscribe or Register

Existing user? Login

Medical cannabis

Pharmacists must take the lead on medical cannabis

The legalisation of medical cannabis has offered a chance to put pharmacy at the forefront of health and patient care, where it belongs.

hand giving prescription bag of cannabis to patient

Source: JL / The Pharmaceutical Journal

The home secretary Sajid Javid has announced that medical cannabis can be prescribed for patients from 1 November 2018; however, pharmacists should not expect to be deluged with prescriptions immediately. Unlike the scenes in Canada, where cannabis was decriminalised completely on 17 October 2018, there will be far stricter controls in the UK. 

The drug has not been legalised. The regulations are clear that only cannabis-based medical products will be moved into Schedule 2 of the Misuse of Drugs Act 2001 regulations, meaning that possession, supply and procurement is authorised for pharmacists. Before this happens, the Department for Health and Social Care and the Medicines and Health products Regulatory Agency need to agree on a clear definition of what constitutes a cannabis-derived medical product, so they can be given marketing authorisations and prescribed. 

Consultants will be able to prescribe cannabis-derived medical products as ‘specials’ and patients will be able to get access to them through clinical trials of a new medical product but, apart from that, any other form of cannabis will be illegal.

There is only one cannabis-related medical product approved in the UK — Sativex, manufactured by UK-based firm GW Pharmaceuticals. This was licensed almost ten years ago for treating spasticity in multiple sclerosis, but has not really made a mark after the National Institute for Health and Care Excellence (NICE) refused to recommend its use on the NHS on cost grounds. Epidiolex, also manufactured by GW Pharmaceuticals, has been approved by the US Food and Drug Administration for use in the United States and is passing through the European Medicines Agency authorisation process. But because it contains virtually no tetrahydrocannabinol (THC) — the main psychoactive compound in cannabis — it is exempt from scheduling regulations.

This dearth of licensed medical cannabis products is not likely to last long. At this year’s Pharmacy Show, held on 6–7 October 2018 at the NEC Birmingham, the number of stalls touting cannabis-related products was rivalled only by Falsified Medicines Directive ‘solutions’. Returning delegates at the show were heard to compare the situation with the ubiquitous vaping sales force present a few years ago. 

There are various forms of cannabis oils legally available in the UK that do not include THCs, and the Cannabis Trades Association estimates that as many as 250,000 people currently use them. Even Hollywood actor Gwyneth Paltrow, also known for her staunch advocacy of ‘wellness’, has said she sometimes uses cannabidiol (CBD) oil to help her sleep. 

The publicity around the Billy Caldwell case is likely to drive sales of CBD oils, but the public is entirely confused about what they can and cannot buy, or get prescribed, and what does or does not work for their condition.

The widest-reaching source of information on the subject is probably the internet and its main providers are entirely unregulated online sellers. NICE guidance on medical cannabis is not expected until at least October 2019, meaning that healthcare professionals will be none the wiser about indications, dosing or precautions when prescribing medical cannabis. This presents a real opportunity for pharmacy to take the lead on how these medicines are introduced in the UK.

In Canada, medical cannabis has been available since 2001. Initially only patients with a terminal illness, or another serious medical condition could receive it, but the law was relaxed over time and 269,000 Canadians were using medical cannabis by the end of 2017. The drug has now been legalised for recreational use in the country, but both the medical and pharmacy professions were opposed to its use at first. Professional bodies, including the Canadian Medical Association (CMA), even lobbied against its prescribing and dispensing and, consequently, the government allowed patients to buy medical cannabis directly from the producer, cutting out pharmacists completely.

This is not true for healthcare bodies in the UK. The Royal Pharmaceutical Society has been very supportive of the rescheduling of medical cannabis and is working on guidance for pharmacists. The regulations have been written in such a way that pharmacists will be the sole supplier. There is an opportunity here for pharmacists to develop the expertise to educate others on the effective use of the various forms of medical cannabis and fill the knowledge vacuum that currently exists as new cannabis-based medical products come on to the market. This change has offered a real chance to put pharmacy at the forefront of a new and exciting development in patient care once again.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205633

Readers' comments (1)

  • UK pharmacist already taking the lead in providing balanced information on cannabidiol (CBD) to veterinary professionals and pet owners. https://caninearthritis.co.uk/cam-conversation-with-andrea-tarr-from-veterinary-prescriber-about-cannabidiol-cbd-use-in-dogs-with-osteoarthritis/

    Unsuitable or offensive? Report this comment

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Paediatric Drug Handling

    Paediatric Drug Handling

    Written for new pharmaceutical scientists, this book provides a background in paediatric pharmacy and a comprehensive introduction to children's medication.

    £33.00Buy now
  • Physicochemical Principles of Pharmacy

    Physicochemical Principles of Pharmacy

    This established textbook covers every aspect of drug properties from the design of dosage forms to their delivery by all routes to sites of action in the body.

    £48.00Buy now
  • Introduction to Pharmaceutical Calculations

    Introduction to Pharmaceutical Calculations

    Introduction to Pharmaceutical Calculations is an essential study aid for pharmacy students. The book contains worked examples and sample questions and answers.

    £33.00Buy now
  • Minor Illness or Major Disease

    Minor Illness or Major Disease

    This established textbook helps you differentiate between minor illnesses which can be safely managed in the pharmacy, and major diseases.

    £43.00Buy now
  • MCQs in Clinical Pharmacy

    MCQs in Clinical Pharmacy

    Four practice tests, each with 80 practice-oriented MCQs. Assess your knowledge of clinical issues, evaluative and analytical skills.

    £25.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Supplementary images

  • hand giving prescription bag of cannabis to patient

Jobs you might like

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.