The law was changed on 1 November 2018 to allow clinicians on the General Medical Council’s Specialist Register to prescribe cannabis-based products for medicinal use (CBPM), where it is clinically appropriate and in the best interest of patients. Whilst the law does not restrict the conditions for which these products may be prescribed, interim guidance has been issued by the Royal College of Physicians, British Paediatric Neurology Association and Association of British Neurologists. The use of medicinal cannabis to treat post-traumatic stress disorder (PTSD) is not considered, as the interim guidance focuses only on areas where the evidence base is most developed.
The National Institute for Health and Care Excellence (NICE) has been commissioned to develop updated clinical guidelines on the prescribing of CBPM, the scope of which is limited to the management of chronic pain, intractable nausea and vomiting, spasticity and severe treatment-resistant epilepsy, areas where the evidence base is most developed. The guidelines will be published by October 2019. It will be based on the best available international evidence and will have been produced using NICE’s world-renowned process for identifying and assessing relevant studies and delivering such guidance. NICE is expected to consult on the draft guidance between 23 July – 20 August 2019. This guidance will be routinely updated to take account of emerging evidence.
An initial impact assessment ‘Rescheduling of cannabis-based products for medicinal use under the Misuse of Drugs Regulations 2001’ was published alongside The Misuse of Drugs (Amendments) (Cannabis and Licence Fees) (England, Wales and Scotland) Regulations 2018. A copy of this impact assessment is available at the following link:
This set out the approach that the Government proposed to take in assessing the costs and benefits of the change in the law at a population level, with regard to the rescheduling of CBPM. The analysis is limited to the five medical conditions where there is most evidence. These five conditions are multiple sclerosis – pain or muscle spasticity; chemotherapy-induced nausea and vomiting; severe treatment-resistant epilepsy in children - specifically Dravet Syndrome and Lennox-Gastaut Syndrome only; chronic pain in adults and appetite and weight loss associated with HIV/AIDS.
To further the evidence-base, the National Institute for Health Research has issued two calls for research in this area and is working with the industry and researchers to ensure that the evidence is developed in a way that will inform decisions on public funding. This research will be open to all good quality proposals covering any indication and disorders unresponsive to existing treatments.