Peter Reynolds

The life and times of Peter Reynolds

Posts Tagged ‘Stephen Donnelly

Ireland’s Medical Cannabis Access Programme – One Mistake After Another

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Lorraine Nolan, Chief Executive, HPRA

Short of an outright ban, Ireland has the most restrictive medicinal cannabis programme anywhere in the world and it’s still not operational more than four years after it was announced.

What’s even worse, as demonstrated by the letter nine leading neurologists have sent to Minister for Health Stephen Donnelly (Irish Times, 9th August 2021), the four products that the Health Products Regulatory Authority (HPRA) have selected are unsuitable for the conditions they are supposed to treat.

The story of how this has unfolded is a lesson in how not to regulate medicinal cannabis, or, indeed, any medicine. The programme is the result of public demand based on increasing recognition of the value and safety of cannabis when used responsibly under medical supervision. But it has been sabotaged by an Irish medical establishment that is hostile to cannabis and officials who have refused to take expert advice, preferring the opinions of clinicians who know nothing about it.

The problems started right at the beginning with a report compiled by the HPRA early in 2017 described as from an ‘expert working group’, yet not one person in the group was an expert in cannabis. It’s not clear that any of them had any knowledge at all about the use of cannabis as medicine when they were appointed. 

Unsurprisingly the report is full of errors and misunderstanding.  It claims there is “an absence of scientific data” on the efficacy of cannabis and not enough information on safety. This is palpable nonsense. History records cannabis being used as medicine for more than 5,000 years and ironically, it was an Irishman, William Brookes Shaughnessy, who published the first scientific paper on it in a medical journal in 1843. Since then it has been one of the most studied medicines on the planet.  It has over 26,000 references on Pubmed, the foremost source for medical literature whereas paracetamol has around 12,000. California has had a medicinal cannabis programme since 1989, the Netherlands since 2001 and its use is now widespread throughout the world. Millions of people are using medicinal cannabis safely and effectively. There is a vast amount of information and evidence available.

The most glaring error in the report is the omission of pain as a condition for which cannabis should be available. Pain is the condition for which cannabis is most often used and is most effective. In 2020 the global medicinal cannabis market was valued at around $9 billion, this is expected to reach $47 billion by 2027 and over 60% of this is for treating pain. Yet the HPRA’s so-called ‘experts’ thought it best to leave it out.

The HPRA started work on MCAP in March 2017. Officials claim to have sought “solutions to the supply of products from Denmark, UK, Canada and further afield”, which has included at least some officials going on international trips. It has taken four years to select four products, one of which is for epilepsy in adults and the other three are, as anyone with any expertise will confirm, best suited to treating pain!

Responsibility for this situation lies squarely with the HPRA.  It is matched by its corresponding failure to facilitate a medicinal cannabis industry in Ireland. At least a dozen serious proposals have been presented offering multimillion euro investments in Ireland, promising the creation of hundreds of new jobs.  Professor David Finn at NUI Galway is one of the world’s leading researchers into cannabinoid medicines and even his participation has failed to galvanise the HPRA into action.

Medicinal cannabis is the fastest growing business sector in the world. It is coming to Ireland, irrespective of the negative and luddite attitudes that prevail amongst the establishment. What is clear is that public health, the Irish people and the Irish economy are missing out in a big way and many of the opportunities have now been lost for good.

Written by Peter Reynolds

October 20, 2021 at 5:46 pm

100 Days Since Health Minister Stephen Donnelly Promised To #talktovera

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Minister for Health, Stephen Donnelly TD

It was in late March.  The #talktovera hashtag had already been trending on Twitter in Ireland for several weeks when Vera Twomey received a text message from Stephen Donnelly promising that he would be in touch shortly.  100 days on and he hasn’t made contact at all.  A few days ago an official from the Department of Health (DOH) telephoned with some vaguely encouraging words but Donnelly himself has completely failed to honour his promise.

#talktovera is a campaign that has attracted the support of millions of people but the abuse the Twomey family has endured at the hands of politicians and officials is only the tip of the iceberg of Ireland’s self-destructive problem with cannabis.  It is an issue that highlights the division between a youthful, progressive electorate and a political establishment that is 20 years behind, confused between the repression of the Catholic Church and deep seated vested interests in medicine and the civil service.

Vera Twomey honoured at the 2018 People of the Year Awards

Vera’s remarkable personal effort, including walking in protest from Cork to Dublin, led to a special ministerial licence for her daughter Ava, enabling her to access medicinal cannabis that has undoubtedly save her life.  Now around 50 people in Ireland also benefit from a similar licence but funding of the medicine is a mess with no consistent or rational policy in place.  Ava is far more fortunate than others as the cost of her medicine is met by the state but only after her parents have to find €9500.00 every three months and then wait five weeks for it to be reimbursed.  This is an enormous burden for any working family and means they live in peril where illness or work problems could easily result in a serious threat to Ava’s life. #talktovera started as a straightforward and reasonable request to the health minister to discuss the matter and find a resolution.

Four years ago, largely as a result of the attention that Vera had brought to the issue, the Irish government announced its Medical Cannabis Access Programme (MCAP).  Not a single patient has yet been prescribed cannabis under its provisions and funding for it has has only just been announced.  It enables consultants to prescribe for just three conditions and they are restricted to just four products, all of which will be funded at source by the state. But none of the products used by the 50 people with a ministerial licence are included and on the face of it they were abandoned to continue finding the money themselves, with only a few, including Ava, ever getting it reimbursed.

This ridiculous state of affairs has transfixed Stephen Donnelly. He and his officials have failed to deal with the issue properly and the COVID-19 pandemic cannot be an excuse for something that needed only a few minutes of his time.  It does require the courage to grasp the nettle and cut through reluctant, stubborn officialdom and a medical etablishment that is way behind every other country in Europe in embracing the remarkable power that medicinal cannabis offers.

To be fair, Micheál Martin, the Taoiseach, has spoken directly to Vera on a number of occasions. He was always supportive of Vera’s initial campaign for Ava but his contact has been in a personal capacity and for some reason he has felt unable to instruct his health minister to deal with the matter. He could also have instructed DOH officials over Donnelly’s head but he hasn’t been prepared to do this either.

The reality is that in Ireland, on this issue, its political leaders are not in charge. The tail is wagging the dog.  Officials at the DOH and the Health Products Regulatory Authority (HPRA) are not in charge either.  They submit to a regressive, bigoted medical establishment that ignores best practice and evidence from around the world and is fundamentally hostile to cannabis.  They in turn submit to the powerful forces of gangsterism and organised crime that pervades Irish society, still, tragically, with significant paramilitary influence behind it.

I can attest to my own experience of Ireland’s self-destructive problem with cannabis.  Although I have now lived in the Republic for four years, before that while living in the UK, then still a member of the European Union, I have been trying to help Ireland develop a medicinal cannabis industry. I have learned that there are powerful forces resisting any progress with a calculated determination to procrastinate and prevaricate. As far back as 2015, I first approached the DOH with a proposal from one of the leading Canadian licensed producers to establish an Irish facility.  Since then, three further clients, each substantial international organisations, actively seeking to invest tens of millions of euros in Ireland, have walked away, frustrated by backwards, negative thinking, prejudice and bigotry.  Hundreds, perhaps thousands, of jobs have been lost and tens of thousands of Irish people are denied access to the medicinal cannabis that could improve their health.

The UK remains way behind where it should be in access to medicinal cannabis but as I work with clients in both countries, in comparison Ireland makes the UK look like Califiornia.  It’s pathetic the way that senior clinicians in the UK continue to resist the inevitable and the huge weight of positive evidence but Ireland is far, far worse. Some of it is to do with it being a very small country, a population of only five million, any one senior doctor who achieves professional and political influence can become immensely powerful.

Dr Ray Walley leads Irish doctors against cannabis

Dr Ray Walley, formerly president of the Irish Medical Organisation and prominent in health politics, runs the Cannabis Risk Alliance, a cabal of senior clinicians that promote 1930s ‘reefer madness’ ideas about cannabis. In 2019, to its eternal shame. the Royal College of Surgeons of Ireland invited Alex Berenson, a tabloid journalist and author of spy and conspiracy fiction, to address its members on his theories that cannabis causes violent crime and has no medical benefits. It’s hardly surprisng that when in 2017, the HPRA convened an expert working group to review the medical use of cannabis, its conclusions were about as negative as you would expect from ‘experts’ with zero knowledge of cannabis steeped in prejudice from all their colleagues. It would be funny, were it not so tragic, that the ludicrous conclusion of its work is that pain is now excluded from MCAP. It’s the condition for which millions of people around the world successfully use cannabis but according to these fools it doesn’t work in Ireland.

It’s absolutely clear that it’s these attitudes that control officials in the DOH and HPRA and have led them to frustrate any political will to support medicinal cannabis.  It’s the HPRA that has taken an absurd length of time to identify four products for MCAP that are actually a hopeless mismatch for the three conditons that it covers.  Ironically, the products selected would be more suited to treatment of pain which is, of course, excluded from the programme.  There is a suggestion that officials selected these products based on lobbying from their producers rather than their suitability.  I have seen no evidence for this but based on my other experiences, it makes sense.

The HPRA was also charged with setting up a licensing system for the cultivation of cannabis and production of medicines but to my first hand knowledge it has been dilatory to the point of negligence. Senior officials at HPRA have twice made promises to my clients on timings which they have reneged on, costing my clients substantial investments of time and money.

It is clear to me that there is institutional hostility towards cannabis in the DOH and HPRA and that this is fuelled by the prejudice and ignorance that pervades the medical establishment.  In the face of this, Taoiseach Micheál Martin, Health Minister Stephen Donnelly are impotent, useless and incapable of making any progress.

Irish drugs gangsters thank their customers for their continuing support

Then, to far more sinister effect and at the root of all this is the burgeoning criminal market in cannabis, the credible evidence that at least 10,000 Irish people are regularly accessing illicit cannabis to deal with their medical conditions, that probably half a million more are engaging with the gangsters to buy cannabis for pleasure and relaxation. Behind this is violence, misery, human trafficking and the massive cannabis cashflow that funds the even more dangerous trade in hard drugs by the gangsters and paramiltaries.

Cannabis could be a huge opportunity for Ireland in better medical treatment, new businesses, increased employment and a healthier and happier society. Instead it is a massive problem caused by weak politicians, incompetent officials, a corrupt medical establishment and violent orgainsed crime.  An Garda Siochana, the Irish police, are trapped in the middle but it’s the Irish people that are the real victims. And the weak, pathetic, hypocritical and cowardly health minister, Stephen Donnelly, still won’t #talktovera.

Written by Peter Reynolds

July 3, 2021 at 5:20 pm