Archive for the ‘Health’ Category
An ‘Expert Panel’ On Medicinal Cannabis Without A Single Expert On It?
Dr Michael McBride, Chair of the Cannabis-based Medicines Expert Panel
To be fair, the members of the expert panel are hardly a surprise. It’s the medical establishment writ large. The chairman, Dr John McBride, was, according to Charlotte Caldwell, “instrumental” in stopping Billy’s medicine being prescribed, despite the original prescription coming from a consultant neurologist specialising in paediatric epilepsy.
A government which has denied any medicinal value in cannabis for nearly 50 years needs ‘cover’ for its long overdue U-turn. Surely though, there needs to be at least one member of the panel who has some expertise in the subject? It’s doubtful that any of the members have ever seen a vaporiser or could tell the difference between weed, hash and a concentrate. They’d probably just call them all ‘skunk’.
Professor Dame Sally Davies, Chief Medical Officer
The intention is probably to turn ‘medicinal cannabis’ into a pill or a bottle of medicine, a nice square peg that these bureaucrats can slot into their square hole. Such servants of the status quo are incapable of considering that modern medicine might have anything to learn from traditional, plant-based medicine that has been used successfully for millennia, instead of barely a century of the simplistic, reductionist theory that they represent. Of course it shouldn’t be a matter of either/or, we should use the best of both theories because both have much to offer to the health of the nation.
It’s instructive that Professor Dame Sally Davies managed to find “overwhelming” evidence of the medicinal value of cannabis in about 24 hours flat. The evidence has been wilfuly ignored by every government and the self-serving individuals who have held the role of Home Secretary since 1971.
It’s astonishing though that in her review, delivered at lightning speed, she’s come up with this pejorative term “grown cannabis” yet seems enthusiastic about synthetic cannabinoids on which there is precious little clinical research and strong evidence of severe, even life-threatening side effects, totally different from the natural product.
Dame Sally writes: “Cannabis has many active chemicals and only cannabis or derivatives produced for medical use can be assumed to have the correct concentrations and ratios. Using other forms, such as grown or street cannabis, as medicine for therapeutic benefit is potentially dangerous.”
Where else does cannabis come from if it isn’t ‘grown’? It has to be synthesised in a lab. Why on earth would Dame Sally want to go down that route when no other jurisdiction enabling legal access to medicinal cannabis has done so? Bedrocan products are grown specifically for medical use and standardisation of “correct concentrations and ratios” is exactly what the company is focused on.
This is a clash between two different approaches to medicine which, as I say should be regarded as complementary, not contradictory but we cannot possibly move forward if the only ‘experts’ have no expertise!
To be fair, this is all unfolding at breakneck speed. Imagine Theresa May hovering in the wings, the hard line prohibitionist eager for any opportunity to kick this back into touch. As it stands, the expert panel will fail, it’s bound to. We have to give Dame Sally a chance to adjust to the new reality. With the assistance of Professor Mike Barnes, CLEAR will be keeping a close watch on progress and we will keep Dame Sally apprised. We have already written to her twice this week setting out our concerns and we will do so on a regular basis.
Dame Sally’s Caution On “Grown Cannabis” Does Not Bode Well For Access To Herbal Cannabis As Medicine.
Professor Dame Sally Davies
Great news all round! Professor Dame Sally Davies has, within a matter of days concluded that cannabis does have medicinal value and needs to be removed from schedule 1. No surprise really as the evidence is, as Dame Sally says, “overwhelming”. The simple fact is that our government has been deliberately ignoring it for years.
However, reading Dame Sally’s report yesterday I was immediately struck by her use of the term “grown cannabis” in a disparaging sense. I’m tempted to ask ‘where else does it come from?’ unless its synthetic and that is my second point of concern. I’m surprised by her apparent enthusiasm for synthetic cannabinoids on which there is precious little clinical research and strong evidence of severe, even life-threatening side effects, totally different from the natural product.
Professor Mike Barnes, CLEAR’s medical advisor, and I discussed the report this morning and while we both welcome it, we’re very concerned that access to raw herbal cannabis, specifically the Bedrocan product range, may continue to be refused.
In everything that I have learned over more than 30 years and great deal of practical experience working with patients, vaporised herbal cannabis is the gold standard for safety and efficacy. Bedrocan products are available in almost every other country in Europe. They can be prescribed and dispensed in the UK tomorrow and if this route is denied to patients there will be uproar. This is what patients want and need.
I defer to Mike Barnes in his expertise on the evidence but he agrees with me that vaporised herbal cannabis must be fundamental to the new arrangements. Oils are obviously more suitable for children and some conditions in adults but children will not be the majority of patients needing access and the pharmacology and titration of cannabis when taken orally is very different and nowhere near as effective.
It would suit the medical establishment and the continuing, moralistic, prohibitionst lobby if cannabis for medicine was all about products which are “derived from” or “based on”, not the dried flowers from the plant which is what we must have if this reform is to succeed. If so, this will mean that many, perhaps most, people will prefer to continue in the illegal market and that, in my view, would be a failure of this process that we are now engaged in.
Nick Hurd MP, The Times. ‘Out-of-date rules must not come before compassion for those who need medicinal cannabis’
Nick Hurd MP
This article by Nick Hurd MP, the Home Office Minister, is re-published from the Times of Friday, 29th June 2018.
It is the most significant recent government statement on cannabis.
“Out-of-date rules must not come before compassion for those who need medicinal cannabis
There are times when life presents a situation for which the status quo is no longer viable; when the case for compassion stands in direct challenge to the rules of the day. This is perhaps no better illustrated than in the case of two young boys and their need for a medicine current legislation does not allow within the UK.
The laws restricting access to cannabis-related medicine in this country have stood for decades. The highly emotive cases of Alfie Dingley and Billy Caldwell have brought home the urgent need to reconsider those rules.
It is impossible not to feel huge empathy for parents expressing their desperation at the difficulty of accessing a treatment they consider essential to the health and wellbeing of their children. I am very aware that behind those high-profile cases stand other families and individuals experiencing the same frustration at the current restrictions.
The home secretary and I are in the process of reviewing the case for rescheduling cannabis-related medicine. This review will be evidence led and should be completed in the autumn.
If medicinal and therapeutic benefits are identified, the intention would be to reschedule cannabis-related medicine as a treatment available through GPs. Whilst recent cases in the media have involved epilepsy this would be open to patients suffering from all illnesses where such treatment is identified to benefit them.
While we await this review, we are confined to working within the existing rules which require a licence. I am delighted that we were able to issue one on behalf of Alfie Dingley — the first ever licence for the long-term treatment of an individual using cannabis-related medicine in the UK.
However, this process took too long and I want to thank Alfie’s family and the clinical team for their patience in working with us to reach this landmark.
We have also issued an emergency licence to treat Billy Caldwell at the request of his clinical team at Chelsea and Westminster Hospital. I have assured Ms Caldwell that Billy will continue to have access to the medicine should his medical team request it and have made clear that we will do what we can to facilitate a long-term licence application for Billy.
We have worked intensively to put in place a much better route for clinicians to secure licences on behalf of their patients until a decision is taken on rescheduling. An expert panel of clinicians will advise Ministers on individual applications. I want to reassure those involved that we are determined to strip this process of any unnecessary bureaucracy. As such, any application can expect to receive a final decision within two to four weeks.
We also want to remove anxiety on fees and are committed to urgently reviewing the fees paid for licences that are awarded as a result of the advice of the expert panel.
The bottom line is that we do not want people to suffer needlessly because of rules and processes that no longer feel fit for purpose.”
A Quick, Easy Guide to The New UK Arrangements For Access To Cannabis As Medicine.
There’s already an awful lot of misunderstanding over the arrangements just introduced for medicinal cannabis and there’s no need for it because, to be fair, the government has been very clear.
There is an interim procedure which will be very, very difficult for most to achieve. You must have very strong support from your doctor and they, together with your local NHS Trust, must be prepared to put in a lot of work, form-filling and pay some substantial licensing fees. It’s all explained here. If you don’t understand it, don’t worry. Your doctor will and it’s only if he/she is prepared to pursue this path for you that you have any chance at all.
There also seems to be an idea that there’s a list of conditions for which cannabis will be available. There’s no truth in this at all. It’s up to your doctor and if they pursue this interim procedure, they will have to make the case why cannabis will work for you.
For most people, you are going have to wait until the autumn when cannabis will be re-scheduled and available on prescription from your GP. It will then be up to you to persuade your doctor. The biggest problem is likely to be that most doctors simply have no understanding of cannabis at all. Now would be a good time to start gathering together all the scientific evidence you can find about using cannabis to treat your condition(s).
Something is going to have to be done about introducing some training for doctors. Since December 2017, the Royal College of GPs has had a set of guidelines ready to issue to doctors but it’s been sitting on them. These were authored by CLEAR, clinical information by Professor Mike Barnes with methods of use and harm reduction information by Peter Reynolds. We are urging the Royal College to make these available to doctors immediately.
Initially the products available are likely to be the Bedrocan range but we expect some of the Canadian companies will quickly make products available. We also expect NICE to re-visit Sativex and reassess its cost-effectiveness. It must be time for some hard negotiation over the price. This is an opportunity for GW Pharma and Bayer to make a significant reduction which would be in their own long term interest.
Cannabis for Medical Use And How The Royal College Of GPs Is Letting Us All Down.
The last couple of weeks have brought an enormous breakthrough for those who need cannabis as medicine but with the release of the government’s interim measures for licensing, the difficulties of how this will work in practice are obvious.
Unless doctors are properly informed and educated about cannabis many patients are going to remain without any help and forced to continue in the illegal market.
The Royal College of GPs was supposed to have issued guidelines to all GPs by the end of 2017 but evidently politics have interfered. It seems that either there has been external pressure from government to hold back or there’s been internal wrangling with some senior doctors opposed to any information being released.
What is astonishing is that this directly contradicts a resolution of the RCGP Council last September when it resolved (unanimously according to reports) to publish guidelines on the use of cannabis as medicine. This raises very serious issues about the governance of the Royal College and also an ethical issue in failing to enable doctors to fulfil their professional duty to patients.
It was at the end of 2016 that CLEAR first wrote to all the Royal Colleges suggesting that guidelines on the use of cannabis as medicine should be considered. The letters went out from Professor Mike Barnes, CLEAR’s scientific and medical advisor. We referred to evidence that about a million people were already using cannabis for medical reasons and particularly the explosion in the use of CBD products. We acknowledged that clearly doctors couldn’t endorse the use of an illegal drug but certainly for CBD and because of the reality of what’s actually happening they needed to be properly informed.
Professor Nigel Mathers of the Royal College of GPs took up our proposal enthusiastically. Through 2017, Mike Barnes and Peter Reynolds of CLEAR attended a number of meetings at the Royal College and detailed plans were made. A formal proposal was put to the council, the ultimate governing body of the Royal College at its meeting in September and approved. It was agreed and announced that the guidelines would be on the college’s website by the end of the year. It was even reported in The Times.
Professor Mike Barnes, CLEAR Advisory Board
Mike Barnes produced the first draft which covered the endocannabinoid system and a summary of the clinical evidence including side effects and a risk/benefit analysis. Peter Reynolds contributed a section on methods of ingestion and harm reduction.
Professor Nigel Mathers finalised the guidelines to make them compliant with the Royal College’s standards. It was his last project before retiring from his position as Honorary Secretary.
Then everything stopped. Both Mike Barnes and Peter Reynolds followed up regularly but were fobbed off, given a variety of excuses until eventually six months had passed and we came to realise that there was a determination from somewhere to prevent publication despite what the council had agreed.
The extraordinary progress of the past few weeks leaves the Royal College stranded. It has let down doctors and through them their patients. It had every opportunity to be in front of these developments and to enable doctors to offer advice that patients are now clamouring for.
Mike Barnes said:
“It is a great pity that there has been this delay. Given the events of the last couple of weeks it is now really important that the RCGP lead the way and publish guidelines for their members, as the public will be asking more and more questions about the medicinal value of cannabis.”
Prejudice against and misinformation about cannabis has been rife for many years. At last that is changing and cannabis for medical use is going to be available legitimately in the UK. We remain ready to assist the Royal College in ensuring GPs get the information they need.
Letter To Nick Hurd MP, Home Office Minister, About Alfie Dingley’s and Billy Caldwell’s Urgent Need For Cannabis Medicine.
From: Peter Reynolds
Sent: 12 June 2018 10:16
To: ‘nick.hurd.mp@parliament.uk’
Cc: ‘Charlotte Caldwell’
Subject: Give Billy back his medication.
Importance: High
Dear Mr Hurd,
The Misuse of Drugs Act 1971 makes specific provision within it that the Home Secretary may licence any action under it that would otherwise be unlawful.
There can be no credible excuse whatsoever for refusing to licence Billy Caldwell’s and Alfie Dingley’s cannabis medicines when they have been proven to work under the supervision of senior doctors and the medicines themselves are produced by reputable, government regulated companies.
UK drugs policy is now the most regressive, backwards and cruel of any first world nation. Specifically on the medical use of cannabis it is evidence-opposed and causing great harm, far more harm than is prevented by a policy that is based on nothing but ignorance and prejudice.
It is nothing but an excuse to argue that all drugs must be properly tested. Cannabis is the oldest medicine known to mankind, it has been used safely and effectively for at least 10,000 years. Only in the last 100 years has this diabolical experiment of prohibition wreaked havoc across the world in exactly the same way as the prohibition of alcohol.
Cannabis contains around 500 molecules and it is impossible to regulate in the same way as a single molecule pharmaceutical product synthesised in a lab. Trying to force regulation of cannabis into the MHRA process is absurd. The MHRA was designed by the pharmaceutical industry for its products. It is run by people from the pharmaceutical industry. It is not fit for the purpose of regulating plant based medicines.
This is why in every jurisdiction throughout the word where there is legal access to cannabis, it is regulated by a special system separate from pharmaceutical products. This is the nettle that the UK government needs to grasp if it is to fulfil its responsibility.
In the meantime though you must ACT NOW for Billy and Alfie. Any further procrastination will amount to negligence and dereliction of duty for which you and other ministers will be held to account.
Yours sincerely,
Peter Reynolds
President
CLEAR Cannabis Law Reform
Lazy, Self-Serving, Incompetent MPs Decide To Blame Drug Consumers For The Consequences Of Their Failed Policies.
David Gauke MP, Justice Secretary
This is the latest propaganda and falsehood in the war on drugs. According to David Gauke MP who is the justice secretary, James Cleverly MP, Dr Sarah Wollaston MP and Cressida Dick , the Metropolitan Police Commissioner, it’s our fault, people who consume drugs, that their failed policies have created a gigantic criminal market which uses violence in its turf wars and takes no responsibility for the quality or safety of its products.
James Cleverly MP
Dr Sarah Wollaston MP
These arrogant fools expect to sit in their ivory towers, issue edicts as to what we may or may not put into our own bodies and expect us to comply as well-behaved, dutiful, worker drones.
Their first duty in government is to protect us and they are failing abysmally. They should be creating safe, regulated drugs markets where people can buy what they want in civilised conditions knowing that quality is assured, strength is known and proper labelling tells us exactly what we are getting. Instead they are doing exactly the opposite. They abandon all responsibility to criminal gangs and their hands are dripping in the blood of the violence and deaths that ensue.
All the arguments have been won. There is no doubt that way to minimise the harm of drugs is to regulate them and make them available under strict conditions in accordance with their potential for harm. At a stroke this will virtually eliminate the harms of the criminal market which are by far the most significant harms for drugs such as cannabis and MDMA. In known strength and quality the health harms of these drugs are almost insignificant. For dangerous drugs such as opiates, cocaine and alcohol, regulation should be much stricter, opiates probably prescription only but their health harms will be minimised and decent services can be put in place, funded by taxing legal markets, to help those who fall victim to them.
Cressida Dick, Metropolitan Police Commissioner
The war on drugs is actually a war on people who choose different drugs from the ones these arrogant and deluded politicians determine to be acceptable. This latest, vile denial of their responsibility for the highest ever rate of drug deaths and for the epidemic of drug-related violence is disgusting. It is a direct attack on the people they are supposed to protect. We must bring these tyrants down. Anyone who seriously espouses this idea that consumers are responsible for their failed policies is unfit to hold public office. It’s negligence, malfeasance and the most serious dereliction of duty.
Let’s Nail the Home Office’s Latest Smokescreen About Medical Cannabis
As the evidence and support for legal access to cannabis for medical use grows, so the Home Office adjusts and reframes its arguments in denial.
This should come as no surprise. The ‘hostile environment’ revealed by the Windrush scandal runs through the Home Office like a stick of rock. The culture of this department is defined by Theresa May and it reflects her character and personality. It is secretive, demands total control and micro management of everything it touches and whenever it is challenged it finds another excuse to maintain its iron rule. It is institutionally dishonest.
A Home Office spokeswoman said:
“We recognise that people with chronic pain and debilitating illnesses are looking to alleviate their symptoms. However, it is important that medicines are thoroughly tested to ensure they meet rigorous standards before being placed on the market, so doctors and patients are assured of their efficacy and safety.”
The truth is rather different. In every jurisdiction throughout the world where medicinal cannabis has been legally regulated, it is through a special system outside pharmaceutical medicines regulation. You cannot regulate a 500 molecule plant-based medicine in the same way as a single molecule synthesised in a lab.
Regulation by the MHRA is the final excuse, the last obstacle to a revolution in healthcare in the UK. We need an ‘Office of Medicinal Cannabis’ as there is in the Netherlands, or ‘Access to Cannabis for Medical Purposes Regulations’ as administered by Health Canada. Colorado has its ‘Medical Marijuana Registry Program’ and other US states have similar arrangements. Israel’s Ministry of Health has its ‘Medical Cannabis Unit’. In Australia, its equivalent of the MHRA, the Therapeutic Goods Administration, has established its own set of medical cannabis regulations.
Every other government that has recognised the enormous benefit that medicinal cannabis offers has come to the same conclusion: cannabis is a special case. It is far more complex but much, much safer than pharmaceutical products.
So next time you hear this, the last, lame excuse from a government ideologically opposed to this long overdue reform, treat it and them with the contempt they deserve. They prefer that people should continue in pain, suffering and disability than that they should do what science and medicine says is right.
The UK Government’s Latest Excuse About Medicinal Cannabis Is Yet Another Deception.
Nick Hurd MP, Home Office Minister
Nick Hurd MP, the Home Office minister, said again this week that as far as any consideration of cannabis for medical use is concerned, the government will “await the outcome” of the report on cannabis due from the WHO in 2019 “before considering the next steps”.
In fact, the results of an FOI request show that the UK government has refused to take part in the WHO committee which will “review cannabis and cannabis-related substances on their potential to cause dependence, abuse and harm to health, and potential therapeutic applications”. This despite the WHO issuing a questionnaire to the Department of Health and Social Care “designed to gather information on the legitimate use, harmful use, status of national control and potential impact of international control”.
Aside from the obvious concerns this raises, it is quite extraordinary considering that the UK is the world’s largest producer and exporter of legal cannabis.
Fundamentally the government’s postion on cannabis for medical use hasn’t changed since 1971. Those who follow the Home Office’s statements will have noticed gradual changes but they all seek to reinforce the fundamental premise that cannabis is a dangerous drug of abuse with no therapeutic benefit.
Recent ‘adjustments’, shall we call them, of the official position have dealt with the now overwhelming weight of evidence that cannabis does have very real and significant medical value. The response has been to caution that all medicines must go through the etablished system of testing for safety and efficacy.
This is a deception as well. As CLEAR revealed at the beginning of 2018, in every jurisdiction throughout the world where medicinal cannabis has been legally regulated, it is through a special system outside pharmaceutical medicines regulation.
Theresa May is ideologically opposed to the use of cannabis as medicine, it’s as simple as that. She won’t permit it to be properly considered, discussed or investigated and every time something forces a response, such as a parliamentary question or an enquiry even from a fellow Conservative MP, another deceptive excuse is conjured up.
Victoria Atkins MP, Theresa May MP. Both Have Family Interests In Cannabis For Medical Use.
CLEAR can further reveal that the Home Office’s public position on prospects for licensed cannabis medicnes is also a deception. The statement that has been published is “As happened in the case of Sativex, the Home Office will consider issuing a licence to enable trials of any new medicine…” We can’t name names just yet but we now have first hand knowledge that at least one publicly-quoted company with established cannabis production facilities in two other G7 countries has been refused permission by the Home Office even to apply for a licence.
The UK government’s stance on cannabis becomes murkier and murkier the deeper you look. The stench of corruption becomes overpowering when you consider that Theresa May’s husband’s company is the largest single shareholder in GW Pharmaceuticals and the husband of Victoria Atkins MP, the drugs minister, holds a licence to produce 45 acres of cannabis for medical use.
There Was Grenfell, Then The Windrush Generation And Now Theresa May Fiddles While Alfie Dingley Faces Death
When Will This Tyrant Be Overthrown?
The campaign to save Alfie Dingley’s life looked to have succeeded on 20th March when 108 MPs met Alfie and family at Parliament. That same day, accompanied by Sir Patrick Stewart, a petition of over 370,000 signatures was delivered to Downing Street and Theresa May herself met with the family and encouraged them that everything possible would be done to help. Originally, the Home Office were suggesting that they might issue a licence to allow a bespoke trial of medical cannabis but that changed to a suggestion that they would consider issuing a licence on a ‘compassionate basis’. They also indicated that they might issue the licence for Alfie within days rather than weeks.
Home Office Minister Nick Hurd MP appears to support the petition delivered to Downing Street. Today (3rd May 2016) the petition has gown to over 650,000 signatures.
A formal application for a licence was submitted to the Home Office on 16th April 2018 by Alfie’s GP and a consultant neurologist. This was raised at Prime Minister’s Questions two days later and once again Mrs May expressed sympathy and promised that the Home Office would look at it “speedily”.
Now, Hannah, Alfie’s mother, has been told that it could take up to four months for the application to be considered and even then no one can be certain what the decision will be.
Apparently this is because the medical cannabis oil needs to be ‘tested’, whatever that means. Is this a U turn to requiring a full clinical trial to be undertaken? If so, how can a clinical trial be undertaken on one boy with a particular form of epilepsy so rare that he is said to be one of only nine boys in the world? Clearly a clinical trial with the normal double blind testing is impossible. So what other form of ‘testing’ needs to be carried out?
The oil has already been tested on Alfie under the supervision of a consultant neurologist in the Netherlands. There, having experienced up to 30 seizures per day in the UK, after taking three drops of oil per day he had only two seizures in two months. The oil is made by Bedrocan, the Netherlands government official contractor for the production of cannabis for medical use and already complies with international standards for Good Manufacturing Practice (GMP).
The only conclusion that can be drawn is that this is yet more procrastination and deliberate delay by a government that is notorious for its inhumane treatment of many people. Theresa May has a long standing and well documented record of being opposed to any drug law reform and of dismissing the campaign for access to cannabis for medical use as ‘just an excuse to take cannabis’. With the sole exception of President Duterte of the Philippines, who is engaged in a murderous campaign of extra-judicial execution of suspected drug dealers, Mrs May is the only world leader still calling for the ‘war on drugs’ to continue.
After scandal after scandal after scandal it is difficult to see what will finally bring Mrs May down. In Britain, where the idea of democracy has become little more than a bad joke, it seems that infighting within the Conservative Party over Europe is a more likely reason for her downfall than the grave abuses of individuals for which she is ultimately responsible.
Let’s be 100% clear, the Misuse of Drugs Act 1971 makes specific provision for any action that would otherwise be unlawful under the Act to be permitted under licence by the Home Secretary. It would take a single stroke of Sajid Javid’s pen to save Alfie Dingley’s life and Theresa May could have ordered that months ago.
Famously, Mrs May is a practising Christian. Surely, there must be a special place in hell reserved for her.
Peter Reynolds 