Can private GPs prescribe these products?
Under amendments to the Misuse of Drugs Regulations only “specialist medical practitioners”, defined as those listed on the General Medical Council’s specialist register, are permitted to prescribe unlicensed cannabis-based products.
Anybody else who did so would be breaking the law.
What should GPs do if a patient asks for one of these products?
GPs should explain that they cannot prescribe the drugs.
If they believe that the patient may meet the very narrow definitions laid down by NHS England, which include the lack of any licensed product that would meet the patient’s needs, they could refer the patient to a specialist.
Many people claim cannabis eases chronic pain. Are they excluded?
NHS England says that the evidence is insufficient to recommend cannabis-based drugs for pain and that, lacking such evidence, they should not be prescribed.
The Royal College of Physicians says that there has been limited evidence of effectiveness in some studies of palliative care patients but notin others.
Results of Sativex trials in this indication are equivocal. For long-term neuropathic pain, a Cochrane review in March 2018 concluded that potential benefits were outweighed by the risks, and a systematic review published in 2015 reached the same conclusion.
A disappointing outcome?
For patients with chronic pain, yes, especially as the review by England’s chief medical officer that underpinned the recent law change cited among its “conclusive or substantial” evidence claims that cannabis-based medicines were effective for chronic pain.
Genevieve Edwards of the MS Society said:
“The guidance published appears to ignore the clear evidence provided by the chief medical officer. For this change to have a real impact, everyone who could benefit must be given access in a safe, responsible, and fair way, with specialist doctors properly supported to make decisions around prescribing.”
Does the legal change go too far or not far enough?
Taken together, the change in the status of cannabis-based medicines and the NHS England rules represent a minimalist…