Royal College Of General Practitioners. Draft Council Paper – Cannabis For Specified Medical Indications.
This is the document presented to the Council of the Royal College of General Practitioners (RCGP) on 22nd September 2017. The proposal was approved.
APPG: https://drive.google.com/file/d/0B0c_8hkDJu0DRnBfdGRDRXBROUU/view
Barnes: https://drive.google.com/file/d/0B0c_8hkDJu0DUDZMUzhoY1RqMG8/view
MS Society (2017) Cannabis and MS: The Role of Cannabis in Treating MS Symptoms
Cannabis for Specified Medical Indications
Introduction
In the past year, there has been significant interest in the issue of legalisation of cannabis for medical purposes. The All Party Parliamentary Group on Drug Policy Reform made a recommendation in October 2016 that cannabis should be legalised for specific medical indications (https://drive.google.com/file/d/0B0c_8hkDJu0DRnBfdGRDRXBROUU/view). An accompanying report (the Barnes report: https://drive.google.com/file/d/0B0c_8hkDJu0DUDZMUzhoY1RqMG8/view) summarised the current evidence for medicinal use and outlined the known side effects. This proposal now has all party support with over 100 MPs backing the plan.
Other countries have recently legalised, or are about to legalise, medical cannabis, including over half of the US states, Germany, Canada, Australia and Ireland, amongst several others. It has been estimated that over 1 million people use cannabis for medical reasons in the UK on a regular basis. A recent poll showed 68% of the public supported medical usage and only 12% were actively against (REF). A similar number of GPs also supported the concept in a poll published alongside the APPG report.
Some forms of cannabis are legally available, including Sativex for MS-associated spasticity. An important component of natural cannabis, Cannabidiol (CBD), is also legally available without prescription through health food outlets.
It is likely that GPs will be asked, by those with a variety of chronic conditions, for advice on the use of cannabis and related products. It is proposed that the RCGP works with a number of other organisations (including the MS Society) to produce a GP information booklet which offers balanced and reasonable advice on the appropriate use of cannabis, bearing in mind of course, that natural cannabis and the main psychoactive component, Tetrahydrocannabinol (THC), remain generally illegal.
The MS Society has recently reviewed its position on cannabis use as a medicinal treatment for people with MS (MS Society, 2017). The society believes that there is now enough evidence to assert that cannabis for medicinal use, if managed properly, could benefit around 10,000 people who suffer from pain and spasticity as a result of multiple sclerosis.
They want to see all licensed treatments derived from cannabis made available to people who need them. But until that happens they are calling on the UK government to legalise cannabis for medicinal use to treat pain and spasticity in MS, when other treatments have not worked. They believe that people should be able to access objective information about the potential benefits and side effects of using cannabis for medicinal purposes.
Furthermore, they believe it’s both unfair and against the public interest to prosecute people with MS for using cannabis to treat pain and spasticity, when other treatments have not worked for them (MS Society, 2017).
The Proposal
It is proposed that the RCGP works with a number of other organisations (e.g. MS Society, Newcastle University) to produce a GP information booklet which offers balanced and reasonable advice on the appropriate use of cannabis, bearing in mind of course, that natural cannabis and the main psychoactive component, THC, remain generally illegal.
The aim of the GP information booklet would be to offer balanced and reasonable advice on the appropriate use of cannabis.
The booklet would be short and concise (about 4 pages of A4). It will briefly cover the history of cannabis and outline the natural endocannabinoid system found in all humans. The different forms of cannabis and means of ingestion/inhalation would be outlined. It will also outline the current legal status as a Schedule 1 drug but also highlight the legally available varieties of cannabis (Sativex, Nabilone and CBD).
The medical evidence for different conditions will be given in a balanced way with a reasonable appraisal of existing evidence for those conditions with a good evidence base and for those conditions currently lacking in evidence.
It is important that the side effects will be carefully outlined. This would include the known short-term effects of the psychoactive component as well as a discussion of the potential and actual longer-term effects. This would clearly include the concern around triggering schizophrenia-like syndromes and the risks associated with cognitive problems, driving, dependency.
It will be important that the evidence is presented in a reasoned and reasonable, balanced way without any bias either for or against the legalisation argument.
NM, MB, PR
August 2017
We Should Encourage Peter Hitchens In His Bombastic Ways.
Peter Hitchens clearly doesn’t realise what a turn off his rude, boorish behaviour is to 90% of people who watch him on TV. Of course, to the small minority who agree with him, it’s very effective rabble rousing just like an Islamist fanatic or a hard right hatemonger. That’s exactly how he looks to most people and really we should encourage him to do more of the same.
Peter’s performance on BBC Sunday Morning Live followed a pattern all too-familiar to those who understand his tactics. Through such occasions his tone becomes increasingly strident, he interrupts everyone repeatedly, complains that no one has read his book, throws in a wild and dishonest claim about cannabis and mental health, then goes into full tantrum mode complaining he’s never allowed to finish his point.
He was accompanied today by David Raynes, the retired-in-disgrace, ex-customs officer who is well trained in Hitchens’ techniques. With a career one step up from a security guard, he now holds himself out as some sort of scientific and medical expert and has a ready made reefer madness story to add in while partnering with Hitchens on the interrupting, talking over and hectoring of other guests.
The moderation of the debate by Sean Fletcher was weak, ineffectual and really rather pathetic but I do sympathise. Hitchens is a Machiavellian, calculated subverter of debate and only the very strongest can handle him.
But it’s clear that nowadays he digs himself deeper and deeper the more hysterical he becomes and the angrier he is, the more the weakness of his arguments is exposed. Carry on Peter, you’re doing our job for us now.
Probably The Biggest Breakthrough Yet For Medicinal Cannabis In The UK.
Peter Reynolds, President, CLEAR Cannabis Law Reform
Since the beginning of 2017, Peter Reynolds and Professor Mike Barnes of CLEAR Cannabis Law Reform have been working on a project that is about to come to fruition. The Council of the Royal College of General Practitioners (RCGP) meets tomorrow, 22nd September 2017, to consider our proposal to issue guidelines to doctors on the use of medicinal cannabis.
Professor Mike Barnes, Scientific & Medical Advisor, CLEAR Cannabis Law Reform
As ever, the UK’s stubborn, anti-evidence government remains intransigent on permitting legal access to cannabis, even for medicinal use. This despite an overwhelming tide of reform across the world and the reality that perhaps one million people in the UK are criminalised and persecuted for using a medicine that has been known to be safe and effective for many centuries, facts which modern science now proves beyond doubt.
However irresponsible and pig-headed government ministers may be, doctors have a responsibility to their patients, an ethical duty that transcends the grubby and corrupt politics that ministers subscribe to. Professor Nigel Mathers, Honorary Secretary of the RCGP with responsibility for its governance, has championed CLEAR’s proposal. He recognises that while doctors cannot be advising their patients to use an illegal drug, the reality is many people already are.
Professor Nigel Mathers, Honorary Secretary, Royal College of GPs
So this is not just another report or a conference. This is practical action at the point of delivery of healthcare. If the proposal is approved by the RCGP Council, the guidelines will be drafted by Professor Mike Barnes, assisted by Peter Reynolds, with additional input from the MS Society and Newcastle University.
In due course, probably by the end of the year, a booklet will be available for download by all GPs from the RCGP website. It will set out balanced and reasonable advice on the appropriate use of cannabis for specific medical indications. The guidelines will also cover harm reduction advice and provide a basic grounding in the scientific evidence and the endocannabinoid system.
If our government refuses to take such sensible steps to improve healthcare and protect patients, then we, campaigners and medical professionals, must do it for them.
This Time What’s On The Side Of The Bus Is True.
And can be backed up with solid facts and evidence.
My Resignation From The Conservative Party.
From: Peter Reynolds
Sent: 31 August 2017 11:20
To: ‘Chris Loder’ <chairman@westdorsetconservatives.org.uk>
Cc: ‘LETWIN, Oliver’ <oliver.letwin.mp@parliament.uk>; ‘Antony Stanley’ <agent@westdorsetconservatives.org.uk>
Subject: My resignation from the Conservative Party
Dear Chris,
After the disastrous handling of the EU referendum result, the ludicrous decision to appoint one of the most incompetent and out-of-touch ministers as prime minister and her farcical election performance, I have been wrestling for some time as to whether to renew my membership. The Conservative Party is now far divorced from its fundamental principles of liberty and small government and Mrs May is an authoritarian bigot stuck in some 1950s delusion of what Britain is today.
Following her ridiculous announcement last night that she intends to stay on as leader I am now tendering my resignation forthwith. She has no mandate, no respect and in my view is held in utter contempt throughout the country. It is also self-evident that all other minsters are too weak, cowardly and neurotic about their own jobs to do anything to stop her.
Mrs May failed consistently over six years at the Home Office. She is a Remainer and should never have been permitted to lead the party or the country after the referendum result. Mrs May and all ministers failed entirely to plan for a leave vote and they have dithered, waffled, dodged and tripped up again and again, achieving absolutely nothing in the period since the result.
Brexit was a huge opportunity for the UK but the Conservative Party has wrecked it and damaged Britain irreparably in the process. If I had my way Mrs May would be led in chains out of Downing Street and placed in stocks in Parliament Square to endure the humiliation she so richly deserves.
I refer you to my article ‘Has There Ever Been A Worse UK Government Than This?’ which has produced the biggest response to anything I have ever written about politics in more than 30 years of journalism. It well sums up the tragic and diminished state in which she leaves our country.
https://peterreynolds.wordpress.com/2017/08/06/has-there-ever-been-a-worse-uk-government-than-this/
Yours sincerely,
Peter Reynolds
The Daily Telegraph Misrepresents ‘Skunk’ Cannabis Mental Health Cases With Figure of 82,000. True Figure is 1,600.
Martina Lees
Two almost identical articles were published in The Daily Telegraph on 11th and 12th August 2017
Does smoking skunk trigger psychosis? And if so… why aren’t we doing more about it?
In both articles, journalist Martina Lees wrote that:
“…hospital admissions with a primary or secondary diagnosis of drug-related mental and behavioural disorders have more than doubled over the past decade, to almost 82,000 a year. Most are believed to be cannabis-related.”
This is a combination of wildly misleading manipulation of data and brazen falsehood.
Hospital Episode Statistics are maintained in great detail by the NHS using a system of coding called ICD10 – a medical classification list by the World Health Organization (WHO). containing codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.
The specific code for ‘mental and behavioural disorders due to use of cannabinoids’ is F12. For the past 11 years, ‘finished admission episodes’ (FAE) for F12 have averaged 973, so the claim that most of the 82,000 are cannabis-related is simply false. (Unless of course, Ms Lees is going to claim she made a mistake.)
So where does the extraordinary figure of 82,000 come from (the exact figure is 81,904)?
Firstly, it is for all illicit drugs or ‘drug misuse’ including the following ICD10 codes:
F11 Mental and behavioural disorders due to use of opioids
F12 Mental and behavioural disorders due to use of cannabinoids
F13 Mental and behavioural disorders due to use of sedatives or hypnotics
F14 Mental and behavioural disorders due to use of cocaine
F15 Mental and behavioural disorders due to use of other stimulants, including caffeine
F16 Mental and behavioural disorders due to use of hallucinogens
F18 Mental and behavioural disorders due to use of volatile solvents
F19 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances
Secondly, the figure is not just for primary diagnosis but for secondary diagnosis. So the primary reason for one of these cases might be a broken leg or any other medical condition. The secondary diagnosis might be that the person was high on speed or any of the drugs mentioned. The primary diagnoses for all these codes adds up to about 8,000 FAEs but the figure is inflated ten-fold by the inclusion of secondary diagnoses. Why do this? Why have the figures been presented in this way? With what purpose?
If the whole premise of her article is about the mental health effects of cannabis, why does Martina Lees use this massively larger figure for all illicit drugs when the specific figure for cannabinoids is easily available? And if the purpose of the article is to investigate the effect of cannabis on mental health, why look at secondary diagnoses – except that it handily inflates the figure ten-fold?
Three other important points about this data:
1. ‘Finished admission episodes’ is not the same as people, its caseload, so those 1606 cases in 2015-16 almost certainly includes cases where the same person has been admitted more than once.
2. ‘Cannabinoids’ includes synthetic cannabinoids such as Spice and anyone with any knowledge of current affairs will know how problems with Spice have exploded in recent years. It is a fact that Spice is much more harmful to mental health than cannabis so the increase in F12 FAEs in recent years is almost certainly explained by this.
3. I’m not a believer in always comparing any data about cannabis with equivalent data for alcohol but it is worth noting, to put these figures into perspective, in 2015-16 the number of FAEs for mental and behavioural disorders due to use of alcohol was 44,491. As there about 10 times more people use alcohol regularly than cannabis, that means anyone is nearly three times as likely to be admitted for ‘alcohol psychosis’ as ‘cannabis psychosis’.
I have written to Martina Lees asking her to comment on this data and explain why she has used it in such misleading fashion.
“Britain Has A Problem With British Pakistani Men Raping And Exploiting White Girls.”
Speak It Loudly And Do Not Be Deterred By The Politically Correct Appeasers.
Weak
Correct but then Cowardly
Jeremy Corbyn, who I had come to admire and respect despite our political differences, disgraced himself and his party when he failed to support the courageous MP, Sarah Champion.
She should not have resigned for speaking the truth. To do so was cowardly and unforgivable. She compounds the abuse and betrayal the victims have already suffered, both from the abusers themselves and from those in positions of authority who failed to protect them because of fear of offending the wicked principle of political correctness.
The inescapable logic is that, based on the evidence, these vile, sub-human, individuals from the Asian/Pakistani/Muslim culture are raised in an environment in which women of their own background behave in a very discreet, reserved fashion and when they see troubled, vulnerable girls from the white, British culture behaving in a way they regard as improper, they consider them to be worthless and have no compunction at all about exploiting them and sexually abusing them in the most disgusting fashion.
These crimes are some of the most repellent and unforgivable that it is possible to commit and they stem directly from the Asian/Pakistani/Muslim culture where these monsters have failed to integrate into British society. As I assume most of them are British born, I think a heavy responsibility falls on their parents who, having been welcomed to this country, have failed to raise or integrate their children into British society and have maintained what from a British perspective are perverted, medieval values that have no place here.
These crimes are rooted in racist attitudes from these Asian/Pakistani/Muslim scum and they disgrace all the other decent people from that culture who are upstanding members of our society.
It is NOT racist to call out these crimes for what they are. In fact the greater offence to morality is to fail to call them out or to equivocate, excuse or try to deflect the blame.
This Is Arthur Daley, The New Ram On The Farm.
I call him that because he’s wearing a camel-coloured coat with black collar and trilby. See the likeness?
He’s arrived just in time to settle in for the Autumn shagfest when he’ll be expected to do his duty day after day until the winter sets in.
Blackberrying In August In Torrential Rain.
Surely it’s too early for blackberries? The hedgerows near me have been brimming with fruit since July. I’m easily collecting a couple of pounds on every hour’s walk.
As for the rain, it’s par for the course these days. The way the jet stream has been behaving the last few years it’s becoming normal and I predict an Indian Summer. Come September when the lunatics return to the asylum at Parliament we’ll all be sweltering in the sun.
Follow all the weather forecasts you want. I can give you a money back guarantee you won’t get a more accurate prediction.
The Shame Of Drugs Minster Sarah Newton MP.
Sarah Newton is MP for Truro and Falmouth. Since July 2016 she has been Parliamentary Under-Secretary of State at the Home Office. Her responsibilities include drugs and alcohol.
During last month’s drugs debate Mrs Newton caused uproar in the House of Commons when she said she “would not agree that alcohol is the most dangerous drug” and that “alcohol taken in moderation is not a harmful drug”.
Both these statements are, of course, directly contradicted by a vast quantity of scientific evidence and many MPs corrected her dreadful mistakes as they spoke in the debate. Mrs Newton demonstrates very clearly the standard of knowledge, evidence and probity that prevails in the Home Office. It is locked into a policy of deliberately misleading both Parliament and the public on drugs and has been so for at last 50 years. Mrs Newton is the just the latest MP prepared to sell their soul and integrity for ministerial office.
Her shame is compounded by the photograph above from March 2017 which shows her endorsing and supporting the work of the Portman Group, the alcohol industry’s shadowy lobbying organisation which works relentlessly to minimise controls on alcohol and public perception of the harms it causes.
There can be no doubt that this is a form of corruption. Mrs Newton, along with the home secretary, Amber Rudd MP and her predecessor, Theresa May MP, is engaged in misleading the public, encouraging use of the most dangerous drug of all while misinforming about the less harmful alternatives such as cannabis.
Peter Reynolds 