Scotland: Private Clinic Starts Rolling Out Legal Cannabis to Patients

The Sapphire Medical Clinic in Stirling has just become Scotland's first private establishment where people can get prescription medical canna if they are dealing with conditions such as chronic pains. The Stirling clinic got the green lights in March for its canna program, and hundreds of people have inquired so far. The clinic provides unlicensed medicinal cannabis for people with health conditions that do not meet the harsh criteria that need to be met to obtain cannabis-based drugs under the NHS.

So far, only three products have been licensed by the UK-wide Medicines and Healthcare products Regulatory Agency (MHRA), including Sativex that targets MS patients with severe spasticity, Nabilone which targets patients receiving chemotherapy for nausea, and Epidyolex for rare childhood forms of epilepsy.  In Scotland, only Epidyolex can be prescribed by the NHS. (Whether parents were able to supply this medicine in the wake of Brexit, that's another question.) 

Many other cannabis products are unlicensed but can be obtained privately. Patients can only be prescribed medical cannabis if other treatments have failed to treat their health condition. A team of clinicians assess the patient before they are sent the drugs from pharmacies by courier. Heather (not her real name), a healthcare professional in her mid-50s, is one of the first Scottish patients to have now received unlicensed medical cannabis from the clinic in Stirling. 

She told BBC Scotland's The Nine that, for a decade now, she has had arthritis and neuropathic pain, and opioid medication she has been subscribed to previously hadn't quite helped. "Acute pain is pretty miserable and affects your whole life, your whole outlook. Some days I can't even manage buttons," Heather said.  "There's so much I could be doing with my family that I am not ready to do, and I can't do, because of chronic pain," she said. For the past month, Heather has been vaping dried cannabis flowers and taking oil containing THC, the drug's primary psychoactive agent. For her first batch of medicine, she has paid about £100.

In the US, medical cannabis is regularly prescribed to patients for the treatment of anxiety, depression, nausea and appetite loss, as well as various chronic pain conditions.

"Because it is such a low, carefully-controlled dose, it is slowly building up to affect the actual pain receptors themselves," Heather said. "It feels as though those senses are being dulled in areas where I have got pain. Rather than feeling totally high, I haven't felt any side effects of that of the cannabis medication. "To me, I see it as a trial at the moment. There is certainly anecdotal evidence that it helps people. But I want to know if it is going to help me and my quality of life," she said.

The 2018 law change moved cannabis from schedule 1 under the Misuse of Drugs Regulations 2001 - which devalued cannabis of its therapeutic qualities - to schedule 2, enabling doctors to prescribe it in certain situations. Sapphire's chief pharmacist Carl Holvey told the BBC the patients they see either don't qualify for NHS medications or the treatments had been judged not cost-effective. He said in cases of chronic pain, for instance, there was "good clinical evidence" to demonstrate that cannabis was effective.

"But when the assessment was done, the cost of the medicines was far too high for the NHS to cover," he said. "We are working to gather real-world evidence and clinical data to support the use of these medicines. "Hopefully the data will be used by the authorities to develop the knowledge base to show these medicines are effective - and cost-effective - so they can be used on the NHS," he said.

For the moment, the UK remains to be one of the world's biggest CBD exporters, a fact that contradicts how medical cannabis is used at home.  Officially, less than 3,000 patients are prescribed medical pot across the island, and most of those prescriptions are considered private.  Recent analysis has shown that should the UK improves its regulation on medical cannabis, the market could skyrocket at a value of £2bn. The market would open up an estimated 100,000 job opportunities and would revamp the access of 1.4 million people who could benefit from readily available cannabis medicine.