Doctors should be able to prescribe medical cannabis, Home Office adviser concludes

Doctors should be allowed to prescribe medical cannabis to patients who need it, the second stage of a Home Office-ordered review has concluded.

Home secretary Sajid Javid asked the Advisory Committee on the Misuse of Drugs (ACMD) to give a verdict on rescheduling marijuana after relaxing rules was recommended by England’s chief medical officer earlier this month.

The “short-term” advice from the Committee agreed there was sufficient evidence of benefits of cannabis in treating conditions like epilepsy.

Relaxing current schedule one restrictions would help patients and enable more research into its benefits. it said.

“The ACMD advises that clinicians in the UK should have the option to prescribe Cannabis-derived medicinal products that meet the requirements for medicinal standards to patients with certain medical conditions,” its chair Dr Owen Bowden-Jones wrote.

It had been asked to recommend whether the change should occur within three weeks, but in its letter to Mr Javid the ACMD said the government should first put in place a system for classifying medical grade cannabis products.

There are issues with the variable "composition, effectiveness and purity" of current cannabis products on the market.

“It is important that clinicians, patients and their families are confident that any prescribed medication is both safe and effective,” Dr Bowden-Jones added.

Only products that have been deemed suitable by the Department of Health and Social Care (DHSC) and the Medicines and Healthcare Products Regulatory Authority (MHRA) promptly "should be given medicinal status," he said.

Completing these new standards in a “timely manner” will allow doctors to quickly begin prescribing products which meet the standards and allow it to complete a longer-term review on exactly where cannabis products should be reclassified, the ACMD said.

It noted there were “a number of internationally available products” that could meet this definition.

These would be pharmaceutically-produced products, which could include cannabis oils prescribed in the high profile case of 12-year-old Billy Caldwell, who uses cannabis to treat his rare form of epilepsy. However, it would not cover grown leaf cannabis.

Currently all cannabis products are schedule one of the misuse of drugs regulations, meaning they legally have no therapeutic benefit. Heroin (diamorphine) and several cocaine-derived products are schedule two.

The Home Office was forced into the current review of drug laws after cancelling Billy Caldwell’s prescription, which helps treat his severe form of epilepsy. His mother Charlotte travelled to Canada to get new stocks of the medication, which is illegal in the UK because it has a higher level of THC – the psychoactive compound that causes cannabis’ high.

His medicine was confiscated at customs and when Billy’s seizures returned the Home Office granted an emergency license and ordered the current review.

The ACMD recommendations says new cannabis products must be backed with long term safety evidence from clinical trials. These have previously been difficult to conduct and it adds that the issues around effective research apply to other schedule one drugs as well, such as LSD, and wider reform should be considered.

It also says new regulatory measures will be needed for doctors and pharmacists to prevent medications with a high potential for recreational abuse being sold on the black market.

Home Secretary Sajid Javid said he was "grateful for the review and to the Advisory Council on the Misuse of Drugs for their short-term advice on scheduling."

He added: "I am carefully considering both recommendations and will make a decision shortly.”