In the UK, cannabis is still an illegal substance. While the penalties aren't as heavy as they once were, being caught in possession of cannabis can lead to severe consequences.  Cannabis had been downgraded from a Class B drug to a class C drug in 2004 by the Labour government. Then in 2009, it was raised back again to a Class B drug against the advice of the ACMD.

However, as each day passes, more and more studies and organisations are opening the door to medicinal cannabis use in the UK. Here are a few examples. 

Project Twenty21

Project Twenty 21 was set up to provide eligible patients access to Cannabis-based treatment monitored by Drug Science. The findings will hopefully provide evidence for NHS funding where the benefits out way the potential risks. 

Drug Science was formed by a committee of scientists with a passionate belief that the pursuit of knowledge should remain free of all political and commercial interests. Project Twenty21 was founded in 2010 by Professor David Nutt following his removal from his post as Chair of the Advisory Council on the Misuse of Drugs (ACMD). Professor Nutt was sacked by the then Home Secretary Alan Johnson due to a lecture Professor Nutt gave at Kings College London.

He criticised the lack of evidence for the current classifications of drugs in the UK. 

 Professor Nutt cited the following; 

"You are 20 times more likely to get lung cancer if you smoke tobacco than if you don't. That's the sort of scaling of harms that I want people to understand. There is a relatively small risk for smoking cannabis and psychotic illness compared with quite a substantial risk for smoking tobacco and lung cancer."

This was not the first time Professor Nutt had clashed with a Home Secretary; the then Home Secretary Jacqui Smith was not happy when Professor Nutt published his paper on risk perception concerning MDMA and horse riding. Professor Nutt claimed that the risk is greater for people who ride horses than people who take MDMA. Professor Nutt was working on evidence-based information.

This did not go down well with the then Home Secretary and other politicians, culminating in Professor Nutt's removal from his Chair position 

To access medical treatment with Project Twenty21, you have to fit the criteria listed below:

• Anxiety Disorder
• Chronic Pain
• Multiple Sclerosis
• Post Traumatic Stress Disorder
• Substance Use Disorder
• Adult Epilepsy
• Attention Deficit Hyperactive disorder

As well as a history of at least two licenced medications, both of which must have been prescribed and proven to be ineffective at managing the condition.

All of this information must be documented in a medical summary from the GP practice. Treatment will initially start with you and a specialist doctor from Project Twenty21 at an approved cannabis clinic. Once a prescription is approved, the pharmacy will contact you for payment before your medication is sent to your house.

Get Medical Cannabis with Project Twenty21 - drugscience.org.uk

Cancard + 

What is the Cancard?

Cancard is a card designed with doctors' help, backed by senior representatives of the Police Federation, and made for patients. Despite Cannabis medicines becoming legal in 2018, patients unable to afford a costly prescription are stuck in limbo. Cancard aims to bridge the gap between patients, doctors, and the police. The card allows the police to exercise discretion by understanding that the patient caught in possession is medicating for their condition.

Does this mean I'm legal now I have a Cancard? 

No. The laws concerning the possession and supply of cannabis have not changed. However, what has changed is the lengthy discussions with police forces on how to identify legitimate patients. The police can now use discretion if you own a Cancard. The card proves that you are legally entitled to a cannabis prescription and are only in contravention of the Drugs Act because you can't afford one. 

What does the BMA think of the Cancard?

In April of 2021, a warning was sent to GP's from the British Medical Association (BMA), stating, "The BMA and RCGP have said they do not support a scheme to provide ID cards for people who qualify for a legal cannabis prescription." In the statement, the BMA went on to say, "they support the use of cannabis-based products for medicinal use in humans under the supervision of specialist clinicians or prescription of MHRA-authorised licenced products by doctors who have the necessary clinical experience. But they could not support the use of the Cancard, 'nor the suggestion that the UK registered GPs sign a declaration confirming a diagnosis for the card to be issued.' 

Carly Barton, the creator of Cancard, said the verification process had been designed with a medical working group of eight doctors that included GPs. She also stated 'The feedback from GPs so far has been incredibly positive. It is very much being seen as a harm reduction tool for their patients to feel less stress over possible criminalisation simply for maintaining their health." 

The NHS and prescribed cannabis

The NHS website Medical cannabis (cannabis oil) - NHS (www.NHS.UK) states, "Very few people in England are likely to get a prescription for medical cannabis. Currently, it is only likely to be 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)

Due to the NHS's view on cannabis and the many risks that they list, the NHS is very reluctant to prescribe cannabis for:

• Decreased appetite
• Diarrhoea
• Feeling sick
• Greater weakness
• Dizziness
• Feeling tired
• Feeling High
• Hallucinations
• Suicidal thoughts

Although ironically, if we look at Benzodiazepines and specifically Diazepam, drugs one can obtain through the NHS, the risks listed on the patient leaflet are as follows:

Uncommon (may affect up to 1 in 100 people)

• Respiratory depression (very slow and/or shallow breathing). Rare (may affect up to 1 in 1,000 people)

• Respiratory arrest (cessation of breathing)

• Unconsciousness

• Jaundice (yellowing of your skin or the white of your eyes). Very rare (may affect up to 1 in 10,000 people)

• Anaphylaxis (severe allergic reaction) with symptoms such as sudden wheezing, swelling of your lips, tongue and throat or body, rash, fainting, or difficulties to swallow. Other side effects: Very common (may affect more than 1 in 10 people)

• Drowsiness. Common (may affect up to 1 in 10 people)

• Fatigue

• Confusion

 • Loss of coordination of muscle movements (ataxia) and other movement disorders, tremor. Uncommon (may affect up to 1 in 100 people)

• Muscle weakness

• Memory loss

 • Difficulty in concentrating

• Balance disorders

• Dizziness

• Headache

• Slurred speech

• Stomach and intestinal problems such as nausea, vomiting, constipation, diarrhoea

• Increased salivation

 • Allergic skin reactions in the form of itching, skin redness and swelling and skin rash.

Rare (may affect up to 1 in 1,000 people)

• Mental side effects such as excitation, agitation, restlessness, irritability, aggressiveness, memory loss, inappropriate behaviour, delusion, rages, psychoses, nightmares or hallucinations. May be or become serious. These side effects are more likely to occur in children or the elderly.

• Decreased alertness

• Depression

• Emotional withdrawal

• Insomnia (problems sleeping)

This is a pervasive list of side effects for a medication that the NHS will prescribe as a muscle relaxant and more widely used to treat anxiety and depression.

Will medicinal cannabis ever be regulated in the UK?

Today we're seeing a lot more adulterated cannabis, vapes, and edibles that are Synthetic Cannabinoid Receptor Agonists (SCRA's) or Spice as they're called on the street. Would it not be wise for the BMA to recognise the legitimate use of cannabis to treat illnesses rather than people self-medicating with cannabis products that have not gone through any formal testing, come with no harm minimisation information, and are sold on the street? 

This month I had a conversation with someone who has purchased cannabis from three different dealers in the Midlands and the South of England. All have been tested to show the presence of SCRA's (for more information on SCRA's, see Blog - The Dangerous World of Synthetic Cannabinoids - Home Drug Testing Kits - EZTestKits.com ) 

The concern here is that as more and more weed is being adulterated, this is becoming normalised. Users are requesting this type of cannabis over your non-adulterated weed. This is going to increase the risks and the dangers to you, the smoker. 

The need to test your cannabis is increasing day on day. Cannabis products have gone through a rapid change over the years, including edibles and vapes alongside your traditional bud. The need to home test your cannabis is more prevalent today than it has ever been. 

General advice would always be to source your cannabis from a reputable dealer, someone you know and trust. Look and examine your cannabis. Does it smell right? Is there a chemical smell to it? How does it fee? If it's not right, then trust your instincts. No drug is safe, but you can be safer.