So near yet so far: why won’t the UK prescribe medical cannabis?

Nutt, David; Bazire, Steve; Phillips, Lawrence D.; Schlag, Anne Katrin

doi:10.1136/bmjopen-2020-038687

Cited by 40 publications

(31 citation statements)

References 14 publications

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“…What is holding the UK back? The reasons are multifactorial and complex 6. But one thing stands out: the resistance of the medical profession to endorse this new treatment paradigm.…”

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confidence: 99%

Why doctors have a moral imperative to prescribe and support medical cannabis—an essay by David Nutt

Nutt

2022

BMJ

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“…What is holding the UK back? The reasons are multifactorial and complex 6. But one thing stands out: the resistance of the medical profession to endorse this new treatment paradigm.…”

mentioning

confidence: 99%

Why doctors have a moral imperative to prescribe and support medical cannabis—an essay by David Nutt

Nutt

2022

BMJ

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“…Equally, as has been proposed by others, the voice and experience of consumers needs to be incorporated into the way health professionals prescribe and the way regulatory authorities facilitate the provision of medicinal cannabis to patients. 54 Addressing these factors is essential for safe and effective prescribing in contemporary medical practice.…”

Section: Discussionmentioning

confidence: 99%

Implementation of medicinal cannabis in Australia: innovation or upheaval? Perspectives from physicians as key informants, a qualitative analysis

2021

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Objective We sought to explore physician perspectives on the prescribing of cannabinoids to patients to gain a deeper understanding of the issues faced by prescriber and public health advisors in the rollout of medicinal cannabis. Design A thematic qualitative analysis of 21 in-depth interviews was undertaken to explore the narrative on the policy and practice of medicinal cannabis prescribing. The analysis used the Diffusion of Innovations (DoI) theoretical framework to model the conceptualisation of the rollout of medicinal cannabis in the Australian context. Setting Informants from the states and territories of Victoria, New South Wales, Tasmania, Australian Capital Territory, and Queensland in Australia were invited to participate in interviews to explore the policy and practice of medicinal cannabis prescribing. Participants Participants included 21 prescribing and non-prescribing key informants working in the area of neurology, rheumatology, oncology, pain medicine, psychiatry, public health, and general practice. Results There was an agreement among many informants that medicinal cannabis is, indeed, a pharmaceutical innovation. From the analysis of the informant interviews, the factors that facilitate the diffusion of medicinal cannabis into clincal practice include the adoption of appropriate regulation, the use of data to evaluate safety and efficacy, improved prescriber education, and the continuous monitoring of product quality and cost. Most informants asserted the widespread assimilation of medicinal cannabis into practice is impeded by a lack of health system antecedents that are required to facilitate safe, effective, and equitable access to medicinal cannabis as a therapeutic. Conclusions This research highlights the tensions that arise and the factors that influence the rollout of cannabis as an unregistered medicine. Addressing these factors is essential for the safe and effective prescribing in contemporary medical practice. The findings from this research provides important evidence on medicinal cannabis as a therapeutic, and also informs the rollout of potential novel therapeutics in the future.

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“…Medical cannabis does not lend itself to traditional RCTs and an increasing alternative evidence base is building up. Various international databases, comprising 1000 s of patients are by now showing the emergence of patterns of evidence of efficacy (Nutt et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Medical cannabis and epilepsy in the UK – A qualitative analysis of the carers’ perspective: “We're asking for quality of life for our children”

Schlag

Zafar

Nutt

2021

Drug Science, Policy and Law

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Despite the legalisation of cannabis based medicinal products (CBMPs) in the UK in November 2018, today there remains a scarcity of NHS prescriptions, and many patients continue to face unsustainable financial costs to acquire their medicines. Following on from our previous quantitative study highlighting the effectiveness of CBMPs to treat severe intractable childhood-onset epilepsy, for the present study, we used a narrative, open-ended approach to interview parents/carers of these patients. 11 families were interviewed to understand their current situation in more depth, and to contextualise the previous findings. Although these families have found CBMPs to be the most effective treatment for their child’s condition, access to these medicines remains severely restricted, causing serious challenges in their day-to-day life. Participants discussed a broad range of issues associated with medical cannabis. These included the regulation and policy surrounding medical cannabis, the anger and desperation related to these policies, and the benefits and harms of it. Evidently, the benefits of medical cannabis for these patients far outweigh any associated risks. Many of the issues raised in our study go beyond the science of medical cannabis per se. Rather, they are political issues, related to the wider issue of trust and power in society, and associated challenges of the doctor and patient relationship. The findings highlight the importance of including patients in decision-making about their medical plans and the value that should be given to their reported outcomes and wishes. We conclude by offering implications for further research and for policy making so that these families, and others like them, can finally receive the medications they so urgently require without crippling financial costs.

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So near yet so far: why won’t the UK prescribe medical cannabis?

Cited by 40 publications

References 14 publications

Why doctors have a moral imperative to prescribe and support medical cannabis—an essay by David Nutt

Why doctors have a moral imperative to prescribe and support medical cannabis—an essay by David Nutt

Implementation of medicinal cannabis in Australia: innovation or upheaval? Perspectives from physicians as key informants, a qualitative analysis

Medical cannabis and epilepsy in the UK – A qualitative analysis of the carers’ perspective: “We're asking for quality of life for our children”

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