'It's Crazy' – Patients Say the UK's Medical Cannabis System Is Not Working

The production of medical cannabis in the UK has risen by almost 700 percent over the last five years. However, since the drug was legalised for medical use in 2018, there have been just three NHS prescriptions of cannabis oil. A private market is growing – with roughly 6,000 prescriptions issued – but many struggle to pay the expensive fees each month.

In its annual report, the International Narcotics Control Board (INCB), a UN body that regulates the trade in controlled drugs for medical use, estimated that the UK stockpiled almost 190 tons of medical cannabis – or 92 percent of legal global supply – as of 2019, after producing 320 tons, making it the world’s largest producer.

The huge increase in production is almost solely down to multibillion biopharma company GW Pharmaceuticals, whose licensed cannabis-based products are enjoying growing global demand after it became the first company in the world to receive marketing authorisation from any country for a cannabis-derived medicine in 2010. 

GW’s oral solution Epidyolex – an epilepsy medication made with CBD, the therapeutic compound of cannabis that doesn’t get you high – has driven huge growth since receiving FDA and European Medical Agency approvals, with sales worth £360 million last year.

Lily Temperton, from cannabis market consultants Hanway Associates, said GW Pharma had ramped up production in the UK to meet the increasing worldwide demand for licensed pharmaceutical cannabis products. “The true scale of their operations is unknown, but as GW is the only active commercial supplier, we can expect them to represent the vast majority of UK production,” she told VICE World News. 

Epidyolex and Sativex – a cannabis-based medicine for multiple sclerosis, which contains THC and is also produced by GW – are the only approved plant-derived cannabis-based medicines in the world, and have undergone rigorous testing proving their efficacy.

This allows the company, recently acquired by Jazz Pharmaceuticals, to enjoy what some observers have described as a near monopoly status in more than 40 countries which import the products (in 2017, GW said it is “not creating a monopoly. Rather, we are blazing a trail for any other CBD prescription medications that may follow.”)

Epidyolex is available to patients in the UK if a number of other treatment options have already been attempted. Both Epidyolex and Sativex have profoundly positive effects on many patients, but some experts believe that more simple preparations of unlicensed full extract cannabis oil – containing both THC and CBD, imported from the Netherlands and only available privately – can be more effective.   

Due to onerous regulations, no unlicensed cannabis medicine has ever been legally cultivated, processed and supplied in the UK, despite these products making up the bulk of UK patient prescriptions through private clinics. However, medical cannabis cultivators Northern Leaf were recently granted a licence in Jersey, indicating potential regulatory intent to expand the number of producers in the British Isles. 

In 2016, the UK produced 95 tons of legal cannabis and exported almost 68 percent of the world’s total medical weed, making it the world's largest exporter of medical cannabis products – until it was ousted by Canada in 2019, despite increasing its crop more than three times since then. But routes to access full extract cannabis oil containing both THC and CBD remain narrow and expensive. 

“I cannot always afford the cost of the prescription, but cannabis medicine is what works best for me, and importantly has the least harmful side-effects,” said Martin O’Neill, 40, who suffers debilitating pain from meshoma, a condition arising from serious hernia mesh surgery complications.

“It is absolutely crazy that I can get incredibly strong medicine, much of which I don’t want, given out for free on the NHS – but if I want to use cannabis medicine, which works best, then I have to pay hundreds of pounds a month,” he added. “Cannabis lets me live my life. But when this last five grams of cannabis runs out, that’s it – I’ve spent all my savings.”

Professor Mike Barnes, interim chair of the Cannabis Industry Council, said: “Despite having a reputation as a globally dominant medicinal cannabis producer, the UK is almost entirely unable to cater to the needs of domestic patients. As it stands, there are numerous restrictions on full medical access due to unclear governmental bureaucracy, a lack of medical education and restrictive guidelines from NICE and other regulatory bodies.”

In its report, in bold letters, the INCB scalded the UK: “The Board calls on the government of the United Kingdom, in view of its obligations under the international drug control treaties and bearing in mind its importance as a major manufacturing, importing and exporting country, to submit timely and reliable data to the Board.”

A Department of Health and Social Care (DHSC) spokesperson said: “We sympathise with every patient and every family courageously confronting life with hard to treat conditions. The government changed the law in November 2018 to allow specialist doctors to prescribe cannabis-based products for medicinal use where clinically appropriate and in the best interests of patients.

“We are considering what further action we can take with regard to broader access to unlicensed cannabis-based products, while giving immediate priority to resolving the supply of Bedrocan oils from the Netherlands, which many patients are receiving.”