Medical cannabis is a broad term for any sort of cannabis-based medicine used to relieve symptoms. Cannabis is a flowering herb also known as hemp. Medical cannabis has been legal to prescribe in the UK since 1st November 2018.
Many cannabis-based products are available to buy online without prescription, but their quality and content are not known. There's a good chance they will contain the psychoactive ingredient Tetrahydrocannabinol (THC) which makes you high, but may not be safe to use. Hence, they may be illegal and potentially dangerous.
The other main therapeutic ingredient of cannabis is Cannabidiol (CBD). Some products that may claim to be medical cannabis, such as "CBD oil" or hemp oil, are available to buy legally as food supplements from health stores but there's no guarantee these are of good quality or provide any health benefits. They tend to only contain very small amounts of CBD, so it's not clear what effect they would have if any.
Some cannabis-based products are available on prescription as medicinal cannabis. However, these are only likely to benefit a small number of patients.
Endocannabinoid System (ECS)
Cannabis binds to our Endocannabinoid System, a neurotransmitter system that is contained throughout the human body. We have natural endocannabinoid receptors (CB1 and CB2) which are found in the nervous and immune systems, and elsewhere. There are natural ligands (ions or molecules) that bind to these receptors (anandamide and 2-AG). The ECS is known to have a wide range of effects. The phytocannabinoids found in the cannabis plant are thought to work through the ECS, as well as and other neurotransmitter systems. There is increasing information available about the science of the ECS.
Sleep and insomnia – there's an improvement of short-term outcomes in those with obstructive sleep apnoea syndromes, fibromyalgia, chronic pain, and multiple sclerosis. These are the diagnoses in which studies have been undertaken so far, so it's likely to help with sleep disturbance in other conditions. Preparations containing at least some THC seem to be most effective in most people for sleep, based on the evidence so far.
Anxiety – according to the Medical Cannabis Clinicians Society (MCCS) there is some evidence for the use of a CBD product for anxiety states. The MCCS recommends that a CBD prescription is considered before every licenced anti-anxiety medication has been tried, although licenced product categories should be prescribed first. Medical CBD products for anxiety are extremely well-tolerated and have a good safety profile.
Post-traumatic stress disorder (PTSD) - there are many preliminary positive studies for the effective use of medical cannabis in the treatment of
Pain - CBD is a powerful antioxidant with anti-inflammatory effects on joints, improving pain and stiffness. CBD also has an analgesic effect by reducing pain perception in the brain.
Good quality medical cannabis is made under EU Good Manufacturing Practice (GMP) and the product is validated with an independent Certificate of Analysis (COA).
Can I get a prescription for medical cannabis?
Currently, it's being prescribed for the following conditions:
children and adults with rare, severe forms of epilepsy
adults with vomiting or nausea caused by chemotherapy
people with muscle stiffness and spasms caused by multiple sclerosis (MS)
It would only be considered when other treatments were not suitable or had not helped. However, there are no restrictions regarding specific conditions where medical cannabis can be prescribed.
Is medical cannabis safe?
The risks of using cannabis products containing THC are not yet clear. Hence, clinical trials are needed before they can be used.
"Pure" products that only contain CBD do not carry these unknown risks linked with THC, but in reality, most products will contain a certain amount of THC, as in nature.
The main risks of THC cannabis products are:
psychosis – there is evidence that regular cannabis use increases your risk of developing a psychotic illness such as schizophrenia
dependency on the medicine – although scientists believe this risk is probably small when its use is controlled and monitored by a specialist doctor
Generally, the more THC the product contains, the greater these risks are. Cannabis bought illegally off the street, where the quality, ingredients, and strength are not known, is the most dangerous form to use.
What are the side effects?
After taking medical cannabis, it's possible to develop any of the following side effects:
a behavioural or mood change
feeling very tired
If you experience any side effects from medical cannabis, report these to your specialist medical team. You can also report them through the Yellow Card Scheme.
CBD and THC can affect how other medicines work. Always discuss possible interactions with a specialist. CBD can also affect how your liver works, so your GP would need to do a blood test to monitor your liver function regularly.
How do I get a prescription?
You cannot get cannabis-based medicine from a GP – it can only be prescribed by a specialist doctor as a Controlled Drug (CD).
Dr Iqbal Mohiuddin would be happy to discuss with you all the other treatment options first, before considering a cannabis-based product.
A prescription for medical cannabis oil would only be given when it was believed to be in your best interests, and when other treatments had not worked or were unsuitable. This would be prescribed at a low starting dose initially and steadily increased to a therapeutic level to avoid any side effects. Private prescriptions would be provided monthly after medical review.
The private CD prescription, the supply of monthly cannabis medication from the pharmaceutical company, and its home delivery would cost £240. This could only be prescribed after a medical assessment for suitability first. I have also registered with Project Twenty21, Europe's first and biggest national medical cannabis registry, which was launched by Drug Science on 7th November 2019. Certain patients with certain health conditions may be suitable research subjects for enrolling onto this registry, entitling them to discounted rates for medical cannabis.
Get in touch with us today to discuss your best treatment options. Complete our Pre-assessment form and call Pam on 0800 779 7800 to book a specialist consultation with a Consultant Psychiatrist.
Please remember that possessing cannabis is still illegal, whatever you're using it for. That includes medical use unless it has been prescribed for you.
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