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GPs go forth

Doctors not prescribing medical cannabis due to lack of knowledge

Doctors are not prescribing medical cannabis due to a lack of knowledge on the topic, MPs have been told.

Specialist doctors have been able to prescribe medicinal cannabis to patients whose clinical needs cannot be met by licensed products since 1 November.

The change in law - which saw cannabis-derived medicinal products being rescheduled as schedule 2 drugs - followed a review that found evidence that medical cannabis has therapeutic benefits.

But experts told Health and Social Care Committee members last month that patients have struggled to access the drug because doctors 'do not understand the nature of cannabis'. 

Speaking before the committee, Medical Cannabis Clinicians’ Society interim chair Professor Mike Barnes said: 'The main barrier, to be honest, is education. There are bureaucratic barriers, but I think they can be overcome. I think most doctors do not want to prescribe because they do not understand the nature of cannabis. They do not understand what dose to give or in what format to give it.' 

'The second barrier is the guidelines. I am sure that the Royal College of Physicians and the British Paediatric Neurology Association felt they were doing a good job in providing those guidelines. Personally, I think they are too restrictive, rather negative and focused on double-blind placebo-controlled studies, as we have heard, so I think producing guidelines that are a little bit more balanced is necessary,' he added.

Committee member Dr Philippa Whitford said doctors have also been reluctant to respond to patient requests due to the personal financial risks they take when prescribing unlicensed drugs. 

She said: 'One of the problems is licensing, and the issue of doctors prescribing unlicensed drugs and the personal financial risk they have to take. I have signed the form many times myself and it has very scary wording. Surely, regardless of getting through the NICE process, getting it licensed would be the key step.'

Last year, Pulse reported that the Home Office instructed a GP to stop prescribing cannabis oil to a 12-year-old boy despite being effective against his severe and uncontrollable epilepsy.

Meanwhile, a Pulse survey revealed that GPs had seen a significant increase in the number of patients requesting medicinal cannabis.

Readers' comments (5)

  • Wow
    Medicinal cannabis pressure group says doctors are not prescribing enough medicinal cannabis.

    In next weeks edition:
    Sugar lobby says sugar is a good source of energy. And oil lobby says fast cars are super-cool.

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  • Seen a lot of cannabis users needing expensive anti-psychotic medications. Good luck if they have an accident and you have prescribed it-the irresponsible blame culture will blame the prescriber and not the one that drove dangerously.

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  • I would advise correcting the source of the quote to the fact that Doctors are declining to prescribe cannabis absolutely BECAUSE they DO have knowledge of it's effects.
    Cannabis is a dangerous drug with long-term, severe, and ssometimes delayed psychiatric side effects, that also contains carcinogens and reduces libido and testosterone levels and reduces virility.
    It is a poison. and a highly addictive one!
    We are being urged to drastically reduce prescriptions for heroine. same should apply to cannabis!

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  • David Banner

    GPs can’t prescribe these products, and the indications for specialists are extremely narrow.

    And long may this continue. We were told 20 years ago that strong opiates would only be used in extreme cases of chronic pain. Ditto 10 years ago with gabapentinoids.

    But now we are overwhelmed by a massive population hooked forever on both these drugs. Once the brakes come off medical cannabis the demand will go through the roof (many of whom will most certainly NOT have chronic pain), and our King Canute ability to limit it laughable.

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  • Vinci Ho

    (1) Fact , many of our patients made enquiries about cannabis oil ( preparations already available in health food shops) . But have we asked the question ‘Why?’ seriously? The bulk of these patients are suffering chronic pain and mental symptoms rather than neurological conditions. Academics need to look at further than concentrating in a parochial view of searching for another ‘magic bullet’.
    (2) Cannabis is currently a Class B drug concerning illegal possession as per Misuse of Drug legislation .
    But Cannabis derived medicinal products have been moved to Schedule 2 for therapeutic use and hence , easier for licensing .
    The dual classification system ( Class and Schedule) is by all means , necessary but is also a potentially confusing concept for the public . Trying to explain to a layman( even to ourselves)about this can be challenging.
    (3) Cannabis is a heterogeneous mix of many chemical compounds . Predominantly, Tetrahydrocannabinol (THC) is perceived as the ‘bad guy’ and Cannabidiol(CBD) is the good one . Exactly how they work on our central nervous system remains unclear
    Research evidence is still overall limited as it was difficult to carry out trials liberally when these products were in the category of Schedule 1. Now , perhaps , is a better opportunity for more studies to explore the usefulness of these drugs .
    (4) Further complication( and hence , confusion) on this matter is the fact that products containing less than 0.2% of THC can be sold freely as so called cannabis oil in these shops I mentioned above . Immediately, after the Home Secretary announced reclassifying cannabis derived medicinal products to Schedule 2, many patients of mine asked me why I could not give them cannabis oil on prescriptions . One can see the lack of clarity to the public could easily feed a form of populism .
    (5) The simple conclusion that these medicinal products were not prescribed due to doctors’ lack of knowledge is rather callous and out of touch with the complex reality . The truth is the knowledge about the efficacy and safety of these products/medicine is not well established yet and it certainly requires more research evidence .

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