Epidyolex can be prescribed for patients with Lennox-Gastaut syndrome and Dravet syndrome (both rare forms of epilepsy).
There is some evidence medical cannabis can help certain types of pain, though this evidence is not yet strong enough to recommend it for pain relief.
Nabilone for chemotherapy patients
Many people having chemotherapy will have periods where they feel sick or vomit.
Nabilone is a medicine, taken as a capsule, that has been developed to act in a similar way to THC (the chemical in cannabis that makes you high). You may have heard it described as a “manmade form of cannabis”.
The National Institute for Health and Care Excellence (NICE) has published a clinical guideline on the prescribing of cannabis-based products for medicinal use in humans. This guidance was published in November, with further Technology Appraisals on use of Epidyolex® published in December 2019. These include recommendations for:
Advice produced by the Professional Organisations has now been superseded by issuing of the NICE guidance as outlined above
NHS England has commissioned and developed an e-learning training with Health Education England and the University of Birmingham, on cannabis and cannabis based products for medicinal use which all healthcare professionals can access.
This package includes the pharmacology of cannabis, legislation governing medical use and therapeutic areas and evidence for its use. The module will be updated as more information becomes available.
Cannabidiol oral solution (Epidyolex®) is a CBD product that has been through randomised controlled trials for two epilepsy syndromes (Dravets syndrome and Lennox-Gastaut syndrome). It has recently been approved for a European marketing authorisation by the European Medicines Agency (EMA) for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome. From 1 October 2019, Epidyolex® will be classified as a Schedule 2 controlled drug (CD) in the UK rather than being exempt from scheduling (an ‘Exempt Product’). This change is being made to reflect the trace levels of THC in the medicine. Prior to licensing, Epidyolex® was available through compassionate use and extended access programmes. These are now closed to new patients.
Deacon has written to every member of the cabinet to express the “abject despondency” parents feel due to the lack of access, after their hopes were raised by legalisation, with thousands of children enduring hundreds of serious seizures a month which it is hoped could be dramatically eased with medicinal cannabis.
She has received just one reply so far, from the foreign secretary, Dominic Raab, who, in a letter addressing her as “Bridget”, began by saying that cannabis use was detrimental to the mental and physical health of communities.
A Department of Health and Social Care spokesperson said: “We sympathise with those patients dealing so courageously with challenging conditions.
“Unless some kind of bespoke regulatory framework can be found that reduces barriers to access, the more risky scenario of unregulated self-medication with illegally sourced supplies will continue,” he said.
Prof David Nutt, the former government drugs adviser who is behind Twenty21, a large medical registry now providing free full-extract cannabis oil to patients in the UK suffering from a variety of conditions, to address the block on prescribing, said there was “mounting real-world evidence” of the efficacy of medical cannabis.