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Explained | How will Cannabis-based medicines be prescribed on the NHS?

The UK’s drug advisory board, the National Institute for Health and Care Excellence (NICE), this week released guidance for healthcare professionals on how and when to prescribe two Cannabis-based medicines.

These CBD-rich medicines were previously made legal in 2018,  but were only available through clinicians on the Specialist Register of the General Medical Council on a private patient basis.

This meant patients and their families required a spend of thousands of pounds a year to obtain a recurring prescription, while many chose to travel abroad for more cost effective access,

With both Sativex and Epidyolex approved for prescriptions on the NHS, it will be easier and cheaper for more people with specific conditions to explore a more holistic approach to healthcare.

Sativex

NICE advises that practitioners prescribe Sativex, a spray that contains CBD and THC, to treat spasticity in Multiple Sclerosis patients, but advise against it being prescribed for chronic pain, as they found no evidence for it being beneficial for people with long-term pain – another symptom of MS.

Epidyolex

Epidyolex has been approved by NICE for treating specific types of severe epilepsy. Doctors can prescribe the CBD-based solution to patients with Lennox-Gastaut syndrome and Dravet syndrome, both rare, life limiting types of epilepsy that are more prevalent among children.

Before prescribing to patients, NICE urges that practitioners take several factors into account.

  • The patient’s history with cannabis (medical or illicit)
  • Potential for dependence, diversion and misuse
  • Mental health history
  • Medical history, especially liver impairment, renal impairment, cardiovascular disease
  • Potential for interaction with other medicines
  • Pregnancy and breastfeeding

Many are welcoming the new steps toward embracing medicinal cannabis in the UK, but some believe the news does not stretch far enough.

Millie Hinton, from the pro-medical cannabis campaign End Our Pain, told The Guardian:

“This restrictive guidance is condemning many patients to having to pay for life-transforming medicine privately, to go without or to consider accessing illegal and unregulated sources”

It remains to be seen whether other forms of medical cannabis will be more accessible in the future, but for now many will be able to access both Sativex and Epidyolex on a more affordable basis than before, and without having to travel from their home country.

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