Global interest in medical cannabis is booming as legal restraints on production and use are eased and, despite the COVID-19 crisis, this acceleration has continued.
In the UK, following high profile coverage of cases involving children with intractable epilepsy, medical cannabis has been available lawfully in limited circumstances since 1 November 2018. Opinion is divided as to whether this change in the law represents an important step forward or a missed opportunity; there is a body of highly respected medical opinion on each side.
Some UK clinicians want to prescribe more freely. A growing body of public opinion says there are some areas where time-consuming and lengthy trials are unnecessary, most notably for conditions where the drug has been shown to alleviate symptoms. For these, some experts argue a new set of prescribing rules need to be formulated. The medical cannabis industry and a range of campaign groups also want speedier and cheaper access. But regulators and the medical establishment, with an eye to drug disasters such as the Thalidomide scandal, and the current US opioid crisis, urge caution. They want tangible evidence of safety and efficacy in the form of large-scale clinical trials.
This report sets out some of the thorny ethical, regulatory and legal hurdles the UK faces in terms of medical cannabis. It also touches on recent developments in the UK relating to cannabidiol (CBD) and includes thoughts from experts and campaigners, both in the UK and abroad, on how one might approach this new and rapidly-expanding field of medicine. The medical cannabis market is expected to keep developing quickly in 2021 and beyond, despite the inevitable hurdles raised by the Covid-19 pandemic and resulting global recession.
We would like to take this opportunity to thank our experts: Dr Leon Barron (Executive Committee Member – The Medical Cannabis Clinicians Society, Founder – The Primary Care Cannabis Network), Karine Cousineau (Director, Government Relations and Sustainability, The Green Organic Dutchman), Hannah Deacon (a founding member of the MCCS and Campaigner), Professor Andrew Goddard (President of the Royal College of Physicians), Eoin Keenan (Content & Communications Director, Prohibition Partners), Dr Inbar Maymon-Pomeranchik (founder of BioDiligence Partners), Dr Barry Miller (Chair of the Medicines Advisory Group the Royal College of Anaesthetists Faculty of Pain Management), George McBride (Chief Executive Officer, Hanway Associates), Marcus Stuttard (Head of the AIM and UK Primary Markets at the London Stock Exchange), Melissa Sturgess (Chief Executive Officer of Ananda Developments), Nick Tulloch (Director of Fetlar Capital), and Marion Zammit (Head of Medical Cannabis Activity at Malta Enterprise).
Medical cannabis and CBD in the UK
There are growing calls for wider access to medical cannabis, but a lack of hard evidence surrounding its safety means many doctors are unwilling to prescribe without randomised controlled trials.
A view from the professional bodies
With cost and safety issues looming large, moving forward will require a range of different approaches – from alternatives to traditional trials, to the involvement of the pharmaceutical industry.
Opportunities for investors
Companies are putting the pieces in place to benefit once the industry does take off, although legislation and regulation means UK investors remain cautious.
International models
Several countries have loosened restrictions on medical cannabis, offering the UK lessons in terms of its approach to research, manufacturing and access.
Report summary
There is worldwide demand for medical cannabis, and growing calls to make it more widely available in the UK. But some doctors urge caution and more medical trials.
