Peter Reynolds

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BBC Horizon to Ramp Up Discredited Kings College ‘Skunk Scaremongering’

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Dr Marta di Forti. Scientist or Skunk Scaremonger?

Tonight’s BBC Horizon is going to follow the long-established BBC policy of overstating and exaggerating the potential harms of cannabis.

From clips already released it is clear the programme is to promote as gospel truth the hysterical scaremongering and fanciful statistical projections coming from Dr Marta di Forti at King’s College London’s Institute of Psychiatry. This so-called scientist and her colleagues base all their conclusions on profoundly unscientific methods, false assumptions, bizarre statistical trickery and the misuse of the tabloid term ‘skunk’ as if it actually means something.

This is the way the BBC has always operated – to support the false narrative of the establishment about cannabis, to demonise it, to minimise if not ridicule its medicinal benefits and to cherry pick evidence and biased opinion to support its case.

Anyone with any real knowledge of cannabis who has spent any time properly reseraching the evidence will know that Dr di Forti’s projections and claims are ridiculous.  This is a British phenomenom.  It occurs nowhere else in the world.  Every other nation’s media, scientific and medical community takes a balanced and realistic view and recognises that cannabis is largely benign and for 99% of people, 99% of the time is harmless.  Perhaps most instruictive is that virtually nowhere else in the world will you hear the word ‘skunk’ used by real scientists.  Originally the name of a specific strain of cannabis it is now merely a scary word used to frighten people and it has no specific or defined meaning.  Its use is, in fact, the very opposite of science.

But don’t take my word for it. In a devastating critique of di Forti’s latest 2019 study, read the words of leading scientists from Australia and the Netherlands as they dismantle di Forti’s wild overclaiming and statistical trickery: High-potency cannabis and incident psychosis: correcting the causal assumption

Written by Peter Reynolds

August 28, 2019 at 10:29 am

New NHS ‘Cannabis Clinic’ Announced as Kings College, Institute of Psychiatry Joins the ‘Green Rush’.

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Dr Marta di Forti: “Cannabis-induced psychosis is a crisis which cannot be ignored”.

Mail on Sunday, 30th June 2019. NHS is forced to open Britain’s first clinic for cannabis psychosis to treat addicts of the mind-altering drug

Daily Telegraph, 30th June 2019. NHS opens first ever cannabis clinic as mind-altering ‘skunk’ fuels psychosis among users

Daily Star, 30th June 2019. First NHS clinic for weed addicts launched to treat cannabis-induced psychosis sufferers

The Times, 1st July 2019. NHS opens its first clinic to treat cannabis psychosis

Dr Di Forti, Professor Murray and their colleagues at the King’s College Institute of Psychiatry live in a bubble that is not replicated anywhere else in the world. The fantastic and frightening statistics that they publish are achieved through the use of complex, esoteric algorithms that generate theoretical projections which are regularly challenged by every other research team across the world working on the same subject.

Nevertheless, in the UK their theories are accepted as fact. Vigorously promoted by the King’s College press office, dutifully sensationalised by the Daily Mail and rarely challenged by other mainstream media, they are part of the anti-cannabis mythology which has a stronger foothold in the UK than any other country in the world.

Despite their best efforts, repeating the same or similar studies over many years, there is no evidence that cannabis causes psychosis, merely observational studies that show some people who are diagnosed with psychosis have used cannabis. Similar studies also show an association with drinking milk, energy drinks, using a skateboard, playing computer games or living in areas with heavy traffic pollution.

Research conducted at the Universities of Bristol and Cardiff, validated by further work at University of York, shows that the risk of a diagnosis of psychosis correlating with cannabis consumption is about 1:20000. See: https://www.sciencedaily.com/releases/2017/04/170420132334.htm By comparison the risk of being struck by lightning in a lifetime is 1:3000. See: https://news.nationalgeographic.com/news/2004/06/0623_040623_lightningfacts.html. This puts the risk into proper perspective and explains why nowhere else in the world, including where far more potent varieties of cannabis are legally available, is this a problem of any significance.

A few unfortunate souls will need treatment for psychosis where cannabis, probably with other substances, has been a component factor in their illness but the risk of this is infinitesimally small and compared to the panoply of other substances, activities and experiences we indulge in, completely irrelevant to 99% of people.

This clinic is another example of the skilled PR operation which enables Kings College to continue repeating this research year after year without ever discovering anything new or useful. It’s also clear that they want their share of the ‘green rush’ of huge investment funding going into cannabis as legalisation continues its unstoppable and very welcome roll-out across the world.

Legally regulated cannabis will result in a safer, happier, wealthier world for everyone and far better protect those very few people who are vulnerable rather than leaving the market under the control of gangsters.

Written by Peter Reynolds

July 1, 2019 at 11:28 am

Letter to the Irish Independent, 22nd June 2019. ‘Let’s look at the evidence when it comes to cannabis’

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Peter Reynolds of CLEAR confronts the reefer madness of Irish psychiatrist, Professor Patricia Casey.

See her original column: ‘Dangers of sleepwalking into legalisation of cannabis use’

In response to Patricia Casey (Dangers of sleepwalking into legalisation of cannabis use’, 15th June 2019), how much longer must we be berated by the sort of arguments that Professor Casey puts forward? At best her column is disingenuous and misleading.

The ‘Cannabis Risk Alliance’ was directly contradicted by another group, similarly qualified, just a few days later and by the overwhelming weight of medical and scientific opinion around the world.

Research shows the risk of mental illness with cannabis is one in 20,000. By comparison the risk of being struck by lightning is one in 3000.

Medical cannabis is not “use of cannabis of the CBD variety”. Bedrocan, the leading EU medical cannabis supplier has three products with THC content of 22%, 13.5% and 14%. It’s clear Professor Casey simply doesn’t understand the subject.

Cannabis has been used as medicine for more than 5,000 years and doctors around the world now prescribe it with enormous benefit to patients. Some 99% of Irish doctors have not been educated in the endocannabinoid system, through which cannabis works. In other countries, medical cannabis has special regulations. Trying to regulate a 500 molecule medicine in the same way as single molecule pharmaceutical product is impossible.

Professor Casey is wrong about the Netherlands. By separating the cannabis market from hard drugs, the rate of heroin addiction is one-sixth that of Ireland. So talk about a ‘slippery slope’ and a “softening up process” is simply mischievous.

I agree that government must be careful of vested interest groups but these include doctors funded by pharmaceutical companies. Psychiatrists only see people with a problem and are blind to the benefits that 99% of people experience.

Can cannabis be misused and cause harm? Yes. Is the risk as great as with alcohol or tobacco? No. Is it any more than with coffee, bacon or chocolate? Not really. It really is time we acted in accordance with the evidence and not on scaremongering which verges on hysteria.

Peter Reynolds

 

 

Written by Peter Reynolds

June 22, 2019 at 4:10 pm

Doctors Are Frightened Of Cannabis. It Challenges Conventional Medicine And Threatens Their Status.

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Professor Andrew Goddard and Professor Finbar O’Callaghan at the Health and Social Care Committee, 26th March 2019

The British medical establishment is behaving like a spoilt child that doesn’t understand the rules of a new game.

The irony is that it’s actually a very old game that went out of fashion just a century ago despite thousands of years of practice. The wisdom accumulated across those many years has been dismissed by simplistic, reductionist, allopathic medicine and its return is being driven by patients – real benefit that real patients experience in real life, surely the most important criterion of all.

The doctors responsible for drafting the medicinal cannabis guidelines from the Royal College of Physicians and the British Paediatric Neurology Association have failed patients.  Either through error or design they have overlooked the evidence of safety and efficacy that is widely available.  They say there is ‘no evidence’ when what they mean is there is no evidence that suits them.  For some reason they regard medical practice in Canada, the USA, the Netherlands, Germany, Spain or Israel as not applicable to the UK.  Their guidelines are not based on evidence but on the disregarding of evidence and they are merely the opinion of doctors who have no experience of cannabis at all.

These doctors who expect their ill-informed opinions to be treated as scientific fact are directly opposing the doctrine of ‘do no harm’.  They stand by while scores of young children suffer life threatening seizures, while hundreds of thousands in chronic pain are offered only highly toxic, addictive and dangerous opioids.

Their arrogance, stubborness and self-serving preference for lengthy clinical trials from which they earn fat fees is both damaging quality of life and putting health at risk for millions of us.

Since Finbar O’Callaghan and Andrew Goddard gave evidence to the Health and Social Care Committee, over three months ago, neither of them, nor any of their colleagues in their ivory towers, have done anything effective to improve access to cannabis as medicine.  They have decided that their opinion counts above everything else.  They have no interest in what patients have learned from experience, sometimes over many years. They choose to ignore the expertise of thousands of doctors from other countries.  They will consider the benefits of cannabis only on their terms.  They continue to wildly exaggerate the possible harms and side effects and their position is fixed, stubborn and intransigent.

It was notable in the two professors’ evidence that they preferred only to talk about cannabidiol, where they could refer to the evidence of clinical trials. They didn’t want to discuss full spectrum cannabis at all.  Why is it that physicians are so risk averse when surgeons are lauded and idolised for the most perilous use of the knife? They will slice into flesh only millimetres away from vital organs, remove sections of the brain which could kill or paralyse with the slightest error. Yet unbelievably, O’Callaghan actually does recommend slicing into a child’s brain rather than to administer a tiny dose of a very low potency version of a drug which 250,000,0000 people worldwide consume regularly with very few problems.

It’s all about ignorance and fear. O’Callaghan, Gardner and 99% of British doctors have received no education at all in the endocannabinoid system through which cannabis exerts its therapeutic effects and this challenges their status. In our culture, doctors have been treated as infallible, almost as Gods, never to be questioned, only to be obeyed. So a medicine that works, that is safer than virtually all the pills you can buy over-the-counter and has powerful, benefical effects for very wide range of conditions is a real threat to doctors’ status. It shakes their world and so they are eager to disparage it, exaggerate its risks, diminish its efficacy.

This is the real issue with cannabis. It gives medicine back to the people, literally for those who grow their own, and with it a great deal of the power and prestige that the medical profession has held over us.

Of course more and more doctors are opening their minds and learning.  It’s the establishment that’s the problem, as it so often is in British life.  It’s those at the top of the Royal Colleges, the professional institutions and the NHS bureaucrats at the intersection between money and medicine. These are the people that stand in the way of the most inexpensive, multi-purpose, safe, effective, easily tolerated medicine that we have.

 

Ignorant Doctors Bring Shame On Their Profession With Foolish Words on Cannabis

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What is it in these British Isles that has resulted in a medical establishment that uses prejudice, scaremongering and specious argument to object to the medical use of cannabis?

The astonishing ignorance that pervades the medical profession on this subject is demonstrated once again by a ridiculous letter in today’s Irish Times.  In a display of hubris, arrogance and plain stupidity, these people who assume they are due our respect, have conflated the issues of medical and recreational use in the most  destructive and confusing way.  These doctors are fundamentally failing in their duty to ‘do no harm’ both in undermining progress towards use of cannabis as medicine and in not providing this medicine to their patients immediately.

The sheer stupidity of the argument advanced by these doctors is breathtaking. They object to progress towards medical availablility by promoting the old chestnut of cannabis in recreational use causing psychosis. Their point is entirely irrelevant, it has nothing to do with medical use. It is no different from denying morphine to patients to control the most severe pain, following an operation, severe injury or at end-of-life, because some people use heroin as a recreational drug. It is a shameful, illogical, irrational and deeply cruel argument that shoud rest heavily on these doctors’ consciences.

And the psychosis argument is nothing but scaremongering anyway.  The evidence clearly shows that the risk of cannabis use correlating with a diagnosis of psychosis is one in 20,000.  As the National Geographic reports, the risk of being struck by lightning in one’s lifetime is merely one in 3,000.

The letter then descends into further evidence-free scaremongering, again totally irrelevant to the use of cannabis as medicine. The risks of cannabis are vastly and dishonestly exaggerated by doctors who clearly have no real idea what they are putting their names to.

It’s a disgrace that this letter has been composed and submitted to the Irish Times and the doctors’ new campaign group, the Cannabis Risk Alliance, is a fraud.

Shame on these quacks who have brought their profession into disrepute and stand in the way of providing proper medical care to their patients.  This must be the final nail in the coffin of unquestioning respect and belief in doctors.  They have shown beyond doubt that they do not deserve to be held in such high regard.

 

Written by Peter Reynolds

May 21, 2019 at 1:02 pm

The Desperate Rearguard Action the British Medical Establishment is Fighting Against Cannabis

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Professor Finbar O’Callaghan

This Arrogant Man Must Face Tough Questions About his Stance on

Cannabis, his Financial Interests and his Breathtaking Hypocrisy.

Professor Finbar O’Callaghan introduced himself at the recent oral evidence session of the Health and Social Care Committee in these terms:

“My name is Professor Finbar O’Callaghan and I am here as president of the British Paediatric Neurology Association which is the association which represents all paediatric neurologists in the UK. I’m also a consultant paediatric neurologist at Great Ormond Street, an epileptologist and professor of paediatric neuroscience at UCL. I have a particular interest in epidemiology and clinical trials and in particular running clinical trials in childhood epilepsy.”

It’s hardly surprising then that in such a pre-eminent position, his opinion on the use of medical cannabis in paediatric epilepsy is regarded as if it had the force of law amongst doctors.  But I point you to his final sentence and his declared adherence to the doctrine and close involvement in the multi-million pound industry of clinical trials.

Note that Professor O’Callaghan is now becoming the medical establishment’s poster boy in opposing the prescription of cannabis as medicine.  He is now disparaging its use for fibromyalgia in adults, something he is no more qualified about than a junior medical student.

Clinical trials cost tens of millions of pounds (at least) and their primary purpose, at which they do not always succeed, is to ensure the safety of experimental medicines, usually single molecule drugs, synthesised in a laboratory, which may be highly toxic.  All such trials are financed by the pharmaceutical industry with the intention of gaining a licence (known as a marketing authorisation) to enable them to sell their medicines at what are invariably huge prices. The businesses and people involved in the clinical trials process earn vast amounts of money and have a vested interest in ensuring that the regulation of all medicines follows this route.

All clinical trials are conducted under the auspices of the Medicines and Healthcare products Regulatory Agency (MHRA), a government agency which is directed, managed and staffed almost exclusively by people who used to work in the pharmaceutical industry. They all continue to benefit financially from the self-reinforcing, self-regulating and self-serving medical establishment which is built on the pharmaceutical industry and its invention of clinical trials.

Clinical trials are the medical establishment’s ‘kool aid’.  They are a panacea for doctors’ ethical and clinical decision making.  If anything goes wrong, even the most horrendous, catastrophic results, if a doctor has prescribed a medicine which has been through the clinical trials procedure, they can wash their hands, disavow any responsibility and move on to their next ‘doctoring-by-numbers’ appointment.  Increasingly, doctors make very few real decisions. Their actions are all pre-determined by protocols and drugs created and approved by the medical establishment.

So cannabis really doesn’t fit into this system and for Professor O’Callaghan unless any medicine goes through a clinical trial in the specialty which he behaves as if he owns – childhood eplipesy, it will never be good enough to get his endorsement and will therefore be shut out of normal practice and very difficult if not impossible for patients to access.  It is, in fact, a ‘stitch-up’.  A term the Professor will understand as he advocates slicing into a child’s brain in a surgical procedure before trying whole plant cannabis as a medicine.

Note that cannabis is not an experimental medicine, nor a single molecule drug, synthesised in a laboratory, nor is it highly toxic.  It consists of around 500 molecules, is synthesised in a plant and has been in widespread use, we know beyond doubt, for at least 10,000 years.  Currently it is in regular use by 250,000,000 people worldwide as a recreational substance.  In modern times it has been in use as a medicine in Israel since the early 1990s, California since 1996, in Canada and the Netherlands since 2001.  There is no evidence of any significant problems or side effects at a population level, none whatsoever where it is used as a medicine under medical supervision. The only evidence of any significant negative effects is where it is used in extremely potent form as a recreational substance by children and even then the numbers involved are tiny.

This is why in every jurisdiction throughout the world where cannabis for medical use is legally permitted, it is through a special system outside pharmaceutical medicines regulation. Every other government that has recognised the enormous benefit that it offers has come to the same conclusion: cannabis is a special case. It is much, much safer than pharmaceutical products. 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.

None of this fits into Professor O’Callaghan’s model.  His career and his income is founded on clinical trials and specifically in childhood epilepsy, regardless of the facts of actual experience in thousands of patients, he is going to do everything he can to prevent its use except on his terms.  He has a glaring and outrageous conflict of interest and the failure of any other doctor to point this out simply demonstrates how powerful is the medical establishment and its mafia-like control of our healthcare system.

In his written submission to the Health and Social Care Committee, O’Callaghan had the audacity to attack Professor Mike Barnes, based on a scurrilous article in the tabloid Mail on Sunday, for his “significant financial interests in the cannabis industry”.  He also attacks everyone else who has any knowledge or experience in the area, denigrating them as “experts” (in inverted commas).  O’Callaghan’s hypocrisy is breathtaking and it is time the sycophantic, uncritical reporting of his opinions was highlighted. I have no doubt that he is an “expert” but he is not the only one and there are paediatric neurologists in Canada, the Netherlands and elsewhere whose knowledge and experience of prescribing cannabis vastly exceeds his own.  He needs taking down a peg or two in the interests of children – and now adults – whose care he is interfering with.

Cannabis as medicine has never gone away, despite the best efforts of vested interests and the medical establishment to kill it off. After almost a century of being demonised by governments, the media and every quack on a mission, whether qualified or not, it is here to stay. This doctrine of pharmaceutical drugs, clinical trials and ruthless suppression of empirical knowledge has only been around for that same 100 years.  Modern, reductionist medicine has great deal to offer but so does the wisdom of ages and the plants that have long helped us cure, heal and maintain our health.  They can co-exist and we must put aside arrogance and self-interest in order best to serve the people.

 

Written by Peter Reynolds

April 7, 2019 at 5:11 pm

A CLEAR Response to the Institute of Psychiatry’s Latest Cannabis and Psychosis Scaremongering

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Dr Marta di Forti

The Insititute of Psychiatry is today announcing its latest study on the links between cannabis and psychosis – ‘The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study’.

For many years, its leading lights Professor Sir Robin Murray and Dr Marta di Forti have published study after study attempting to show a causal link between cannabis use and psychosis.  They have never managed to achieve this and despite concerted efforts, the link cannot be described as anything more than extremely tenuous.  The number of people that may be affected is infinitesimally small, while hundreds of millions of people worldwide consume cannabis regularly without any ill effects.

Every year in the early spring Dr di Forti and Professor Murray publish their latest study on the subject. It’s always interesting to see the latest iteration of their work although all the studies are remarkably similar

Cannabis is a psychoactive substance so clearly it can have an effect on mental health.  We know from at least 10,000 years of human experience that for most people this is a beneficial effect.  The number of people that suffer negative effects is difficult to quantify but we can be certain that it is very small. Research published in the journal Addiction shows that in order to prevent just one case of psychosis, more than 20,000 people would have to stop using cannabis. http://onlinelibrary.wiley.com/doi/10.1111/add.13826/full

This level of risk must be compared with other risks to give it any meaning. For instance, if the risk of a diagnosis of psychosis correlating with cannabis use is 1 in 20,000, the risk of being struck by lightning in one’s lifetime is about 1 in 3,000. This puts the risk into a realistic perspective.
https://news.nationalgeographic.com/news/2004/06/0623_040623_lightningfacts.html

It’s also important to understand that this latest study does nothing to show that cannabis actually causes psychosis, only that there is an association or correlation with cannabis use.  There may be other correlations which may or may not be much stronger.  For instance the populations studied may also use tobacco, drink wine, eat spicy food, live in a city centre or exercise regularly or not at all.  Similarly it cannot be shown that any of these factors are the cause of psychosis.

It is also interesting that the study deems an average of 14% THC to be high potency cannabis.  Throughout the USA and Canada, average THC content now exceeds 20%, sometimes as high as 35% and there is no reported increase in rates of psychosis.

Finally, it has to be said that Dr di Forti is well known for her theoretical projections about cannabis use which can be quite alarmist. Thankfully, they have never been reflected in actual healthcare records and the number of cases of psychosis correlating with the use of natural cannabis in the UK remains very low, no more than a few hundred.  There are many, very much more risky activities to be concerned about.

What is certain is that the way safely to manage the risks of cannabis, even though they are so low, is in a legally regulated environment. In this case products are labelled so that the content is known, quality is maintained to a standard avoiding contamination and impurities and if anyone does experience problems they can seek help without having to confess to a crime. Age limits can also be enforced ensuring that children do not have the easy access to cannabis that they have, for instance, in the UK.

Written by Peter Reynolds

March 20, 2019 at 10:27 am

What Is The Matter With Doctors About The Use Of Cannabis As Medicine?

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In the UK, most doctors, and the medical profession as a whole, are ignorant and bigoted about cannabis.

Their ignorance is not entirely their own fault.  For 50-odd years, since cannabis tincture was last available from UK pharmacies, they have been subject to the same relentless tide of propaganda from the Home Office, successive governments, the tabloid press and rabble-rousing politicians as the rest of society.  Many still regard cannabis as a dangerous drug consumed by degenerates that almost inevitably leads to mental illness.  The idea that it could be a safe and effective medicine which offers real benefits in a wide range of conditions is regarded as laughable.

However, there is no excuse for such laziness amongst a profession that regards itself as scientific.  And this is the charge – indolence, carelessness and laziness – that needs to be laid at those doctors at NHS England, the Royal College of Physicians and the British Paediatric Neurologists Association, that are responsible for the disgraceful ‘guidelines’ published two weeks ago.

Throughout Europe, Israel, Canada and the USA there are thousands of doctors who have made the effort to learn about cannabinoid medicine.  They have had to make extraordinary effort to do because even the most basic science is still rarely taught.  The endocannabinoid system is on the syllabus of very few medical schools, anywhere in the world, despite the fact we now know that it is the largest neurotransmitter network in the body and affects almost every aspect of our health and all medical conditions.  This is a dreadful indictment of the medical establishment but particularly of doctors in the UK, very few of whom have made any effort at all.

So while, to a degree, the ignorance can be forgiven, the bigotry cannot. It is cowardice. These doctors prefer to cover their own backs, protect themselves and prefer an absurd level of caution to doing what is in their patients’ best interests.  The incredibly low risk attached to cannabis in any form, at any age and particularly when under medical supervision, is simply overlooked.

Yes, the medical profession is known to be ‘conservative’ but in the case of cannabis this is an excuse.  Yes, we live in an increasingly litigious society but any truly professional doctor would not be cowed by such fear when the evidence is widely available, if they could be bothered to look. And what is this ‘conservatism’ of?  Modern medicine is barely a century old.  It is new in the history of our species and while the reductionist approach has brought great benefit and made huge advances, it is at the expense of thousands of years of human experience which has been dismissed as valueless.

These doctors may feel that the reforms have been foisted on them with no consultation and little notice but this is not a political game, it affects the lives of millions, from the youngest baby to the oldest, most senior citizens.  These doctors are failing in their professional duty.  For too long they have enjoyed being regarded with ultimate respect, rarely being questioned or challenged by their patients but those days are gone.  Most of the population is now far better informed than ever before, largely because of the internet and although this may cause doctors some problems, they have to learn to live with it.  They have to respect their patients, parents and carers and recognise more than ever before that healthcare is about co-operation, about working together. They have to come down from their ivory towers and start delivering truly patient-centred medicine.

 

Written by Peter Reynolds

November 13, 2018 at 4:57 pm

The Medical Establishment Shows Its True Colours On Cannabis. A Betrayal of Patients.

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NHS England has today published what it describes as prescribing guidance – ‘Cannabis-based products for medicinal use: Guidance to clinicians‘.

The actual guidance is buried within a mountain of bureaucratic doublespeak and requires downloading PDFs from the Royal College of Physicians (download here) and the British Paediatric Neurology Association (download here). In both cases, aside from chemotherapy-induced nausea, the guidance amounts to ‘do not prescribe’. This is a travesty of the intention of these reforms and demonstrates how the medical establishment is more interested in protecting its self-interest than in helping patients gain the benefits of cannabis as medicine. Cowardly and scared are the two words which best sum this up.

It’s no surprise that doctors in the UK are ignorant about the use of cannabis as medicine. They have been subject to the same relentless torrent of reefer madness propaganda from government and media as the rest of society. They have been prevented even from learning about the endocannabinoid system by the authoritarian policy of prohibition and any doctor in the UK who has any experience of cannabis as medicine will have been in breach of professional ethics as well as the law.

But it’s deeply disappointing that the authors of these documents have made no effort to understand the excellent work that is being done by medical professionals in other countries.  The Royal College of Physicians and the BPNA will be a laughing stock across the world in the many more enlightened and educated jurisdictions where patients are gaining great benefit. But of course, this isn’t a laughing matter. In fact, these two so-called professional bodies are making it a tragedy.

Clearly, what is in the best interests of patients is that we must bring in expertise from overseas.  There are eminent doctors abroad who will be glad to step in, particularly in private practice, and pick up this baton which the NHS has fumbled and dropped in the most clumsy fashion.

This is a huge opportunity for those in private medicine who can set aside these cowardly excuses and make the most of the new regulations for patients who are fortunate enough to be able to afford it.

For the average Briton with chronic pain, Crohn’s Disease or an epilpetic child this is a kick in the teeth from the profession that is supposed to care for them.

Written by Peter Reynolds

October 31, 2018 at 6:14 pm

Cannabis Advocates Really Need To Stop Accusing Doctors of Being Bribed By Pharmaceutical Companies.

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There may well be some doctors who are corrupt and there are still, despite much improvement, serious questions over the relationship between pharma companies and doctors but the idea that every member of the Faculty of Pain Medicine who signed that letter to the Times is taking bribes is ridiculous.

The real reason is ignorance and that’s not an attack on doctors, it’s a reason.  They have been subject to the same relentless torrent of reefer madness propaganda from government and media as the rest of society.  They have been prevented even from learning about the endocannabinoid system by the authoritarian policy of prohibition and any doctor in the UK who has any experience of cannabis as medicine will have been in breach of professional ethics as well as the law.

CLEAR has been working with some of the very few enlightened doctors since way before the cause of cannabis as medicine became fashionable.  Working with members, their MPs and doctors, we have organised lobbying of ministers and MPs over more than the past 10 years. In several instances we had doctors, both GPs and consultants, contact the Home Office to enquire about obtaining a licence for a specific patient.  In at least three instances these doctors were then contacted by Home Office officials who warned them off using threats and intimidation.  Shocking but completely true.

It is and it always has been government – stupid, prejudiced, bigoted and self-opinionated politicians – who have prevented access to cannabis, even in the face of overwhelming evidence.  This means that there has been no education at all and doctors are as poorly informed as everyone else. They’re also, and understandably, worried, even scared.  They don’t understand cannabis, many will not even have heard of the endocannabinoid system and they are concerned about being sued, professionally disgraced, losing their job and now of being swamped by patients demanding cannabis about which they know nothing.

Of course, it was thoroughly stupid to assert in the letter that “the evidence suggests that the prescribing of cannabis (containing the psychoactive and addictive tetrahydrocannabinol component) will provide little or no long-term benefit in improving pain and may be associated with significant long-term adverse cognitive and mental-health detriment.”

There is no reasonable interpretation of the evidence that supports this. THC can be addictive in a very modest sense but the withdrawal symptoms and negative effects are trivial compared to those from opioids which doctors prescribe readily and frequently.  There is excellent evidence from many sources that cannabis containing THC and CBD benefits pain and while there may be some cognitive and mental health effects, to suggest they are significant or even come remotely close to those from opioids is false and in opposition to the evidence.

I repeat, doctors aren’t saying this because they are bribed by pharmaceutical companies, it’s because they have no idea what they are talking about.

The urgent requirement now is medical education.  It is amazing how radical the new regulations are and many people still don’t seem to realise how far the government has gone.  They go much further than we at CLEAR had even dared to dream and the definition of cannabis-derived medicinal product (CDMP) is very broad.  When we were consulted on it by the Department of Health and MHRA we never thought they would accept all our recommendations.  They enable the prescription of every form of cannabis, including flower, oil and concentrate, provided they meet quality standards.

So the problem with the law is gone. Literally, it is all over. It is absolute and total victory. Now two big problems remain. Education is the first but this is being addressed.  NICE has acted commendably fast to start recruiting a panel to advise on prescribing guidelines and Professor Mike Barnes, CLEAR’s scientific and medical advisor has already developed a series of introductory online training modules. Early in November his Medical Cannabis Clinicians Society launches and this will be an important forum for the future.

The second big problem is supply.  Where are the CDMPs to come from?  Sativex falls into the definition and this was GW Pharma’s big opportunity to act responsibly and imaginatively.  The possibility still exists that it will substantially reduce the absurd, rip-off price that it has been charging for Sativex since 2010.  If it had the imagination it could very easily turn over some of its production to unlicensed CDMPs for which there is now a ready market. I fear that it is wedded to licensed products only, hugely expensive and, in my judgement, unnecessary clinical trials and very high prices for its end products.  If so, then I will be selling my shares.  I admire the company for its courage, innovation and high standards but if it does not seize this opportunity then I believe it is failing in its duty to shareholders and also to Britain, which let’s remember has gifted it a privileged and unique opportunity in the world.  Fail now to provide for the needs of UK patients and that amounts to betrayal.

So for now the only possible sources of supply that meet the definition will be Bedrocan in the Netherlands and some of the Canadian licensed producers. US companies cannot export.  Neither can the Israeli companies and they would also face a thoroughly deserved boycott of their products even if Netanyahu was to issue export licences.  Bedrocan can barely meet demand from its existing customers and there is talk of it having difficulties with a ceiling on its export licenses. Only some Canadian producers meet the required GMP quality standards and they too are facing shortages as they also supply the recently legalised recreational market which is seriously short of product.

So the Home Office has to act and start issuing domestic production licences and it has to do so immediately.  Whether it will, remains to be seen.  Its drugs licensing department is a shambles, staffed by officials who do not even understand the law they are supposed to administrate, who regularly give different, contradictory answers on different days and exceed their lawful authority as a matter of course.  If there is a ‘hostile environment’ for immigration in the Home Office, for drugs licensing and cannabis production it has been hostile but also aggressive, paranoid and stupid ever since the Misuse of Drugs Act 1971.

The urgent need is for prospective British cannabis producers to mobilise their MPs and for immediate pressure to be brought on the Home Office at the highest level.  Sajid Javid has shown he can act decisively.  Expanding domestic cannabis production is the inevitable next step in what he has already achieved.  He must act now.

So the future in the UK for those who need cannabis as medicine is brighter than could ever have been imagined.  The next steps are challenging but nowhere near as difficult as the campaign to reform the law that CLEAR has fought for nearly 20 years.  Don’t blame doctors, continue to blame the government and hold their feet to the fire until they act on medical education and cannabis production as they must.