This article originally appeared on VICE UK.
The first bulk shipment of 800g of legal cannabis arrived in the UK from the Netherlands on Thursday. The shipment cleared UK customs on Friday morning, ending months of frustration for patients who have been legally prescribed the medicine, but could not find a pharmacy prepared to supply it. The medicine is now on its way to patients who are expecting their legal weed in the next 24 hours.
Doctors, carers, and patients, who say cannabis offers respite from conditions including chronic pain and multiple sclerosis, said the development is a major breakthrough, ending months of legal and procedural deadlock. "It's the first example of a real supply route being created,” said Henry Fisher of Grow Biotech, a cannabis start-up firm that imported the cannabis. “Up until this point there have been small, individual imports. This is now a genuine supply route. If they get a prescription, people can now get it fulfilled without waiting or a month to get it imported.”
Although medicinal cannabis was legalized in Britain in November 2018, patients say it has been almost impossible to access it due to a complex web of import laws, byzantine levels of bureaucracy, high costs, and a lack of clinical expertise among doctors. Individual prescriptions have been written for an unknown number of patients, generally by private doctors. But getting the drug into the UK has proven impossible for most. NHS trusts can't meet the high costs involved in importing the cannabis, and some have raised concerns over the drug’s efficacy, citing a lack of clinical data.
Some patients have managed to import a limited private supply, but today’s move marks the first bulk import into the UK, meaning a stock can be kept at a licensed facility for regular deliveries to a larger number of people holding valid prescriptions. The cannabis—containing high levels of the psychoactive substance THC, responsible for both the cannabis high and many medicinal effects—was grown by Dutch biotech firm Bedrocan under strict manufacturing and pharmaceutical standards in secure facilities in Netherlands.
The cannabis will cost around £700 [$902] per private patient per month per ounce. Illicit street cannabis can be obtained for around a third of that—albeit with unknown levels of THC, and no control over levels of fungicide or chemical residue from the growing process. Plus, there's always the risk of prosecution. The shipment will be stored at a pharmacy at an undisclosed location and delivered to patients either by licensed courier to their home or their local pharmacy.
One patient prescribed medicinal cannabis, who we'll call John, has been diagnosed with Crohn’s disease. The 32-year-old said cannabis brings rapid symptomatic relief from the bloating, pain, and gut inflammation the condition causes. “Without it, I can’t even get dressed on some days. “My clothes hurt my abdomen, and I can’t leave the house. After vaporizing cannabis, within 20 minutes I feel pain relief, and am able to go about my day."
John sought out a specialist consultant, who was able to issue a private prescription, in November 2018, when standard opiate medicines failed to stop his pain. He is now prescribed 1g of dried Bedrocan cannabis per day, which has a THC content of 22 percent. He is paying £695 [$895] per ounce or 28 grams of cannabis per month.
Dr. David McDowell, a chronic pain consultant, said the bulk import means patients can access the drug in a more reliable way. “When the regulations changed in November 2018, no one was prepared. It was one thing to assess the patient, but quite another to be able to get access to the medication. That is effectively where we have come to today. Patients can now get their prescriptions.”
In November 2018, the government legalized medical cannabis following the high-profile case of Billy Caldwell, a severely epileptic 12-year-old boy from Northern Ireland whose mother, Charlotte, illegally imported cannabis oil from Canadian firm Tillray in July 2018. The Home Office granted an exemption in the Caldwell case, and shortly after to another child with epilepsy, Alfie Dingley. It hurriedly drafted new reforms that patients, doctors, and pharmacists say paid only lip service to reform and left them no closer to using, prescribing, or delivering the medicine.
Currently, legal access to medicinal cannabis can only be provided to patients who have an "unmet special clinical need that cannot be met by licensed products”—and who have to consult a private consultant who can then prescribe cannabis as an “unlicensed special” —a complex import arrangement.
“Bedrocan cannabis is grown in controlled conditions in bunkers, from cloned cuttings,” said Dr. David Caldicott, senior lecturer at the faculty of medicine at Australian National University and author of the Australian Medical Cannabis Course. “It is consistent and each plant is identical. That means it is possible for clinicians to define and administer a dose. Other firms are producing similar products—and there is a great need for competition in these markets to ensure no firm has a monopoly.”
Cannabis is still unavailable as a licensed medicine in the UK, as it is in many EU states, Canada, and 33 US states. It's prescribed by specialists as an ‘unlicensed special’—a category of experimental drug that hasn't cleared standard medicine regulations—and can only be imported by firms licensed to do so. The medicinal cannabis market in the UK could be worth €115 [$129] billion Euros, analysts claim. From now on, that's a real possibility.
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