British doctor and professor Michael Barnes said today that British patients cannot afford cannabis treatments, particularly children who are taking CBD (cannabidiol). Barnes spoke this morning to Congress CT-CANN23 – Clinical Trials on Cannabis, organized by BioEvents in London, and warned of “only four prescriptions for full spectrum oils” on the NHS (National Health System). Barnes said that the NHS essentially prescribes Sativex and Epidyolex, but "the isolates are not as effective as the whole plant". The doctor outlined the reality of medicinal cannabis in the United Kingdom and further questioned whether “will it be possible to carry out double-blind and randomized clinical trials with such a complex plant in chemical terms?”.
Since medical cannabis was regulated in the UK (UK), 25 patients have been prescribed cannabis, but only 110 doctors are currently prescribing cannabis derivatives, of which 99% are outside the NHS, in the private system. Around 400 doctors are trained in medical cannabis and are part of the Medical Cannabis Clinicians Society, founded by Michael Barnes to give clinicians the opportunity to share practical knowledge, develop transparent and independent guidelines, and lead the conversation as physicians in the medical cannabis industry. The UK medical cannabis market will, according to Barnes, have between 1.5 and 2 million patients, so only 1 to 2% will be enjoying the benefits of medical cannabis.
Michael Barnes spoke at the CT-CANN23 – Clinical Trials on Cannabis Congress at the Hilton Canary Wharf Hotel in London. Photo: Laura Ramos | cannareporter
“The average of treatments costs 300 to 800 pounds per person per month, and in children this value can be even higher”, warned Barnes, confirming that “most patients do not have the capacity to finance a treatment” [with cannabis] .
There are currently 23 private online cannabis clinics serving patients in the UK, but general practitioners (known in the UK as GP – General Practitioners and in Portugal as Médicos de Família) are not authorized to prescribe cannabis (unlike in Portugal) . According to Michael Barnes, in the UK cannabis is mainly used for pain (53%), disorders related to Anxiety and Post Traumatic Stress (39%), Multiple Sclerosis (3%), Attention Deficit (2%), Epilepsy (1%), Tourette (1%), Substance Use Disorder (1%), and, residually, for oncological and gastrointestinal diseases.
UK relies on cannabis imports
Around 34 British companies import cannabis through 4 importers. Barnes noted that there are 214 products available in the UK, of which only 3 are licensed. Of these, 84 are high-THC flowers, 34 high-THC oils, 10 flower types and 30 oils with balanced THC:CBD levels, 6 flower varieties and 34 high-CBD oils, and 6 isolated cannabinoids . Currently, there are still 5 growing companies coming into operation in the UK.
British physician Michael Barnes of the Medical Cannabis Clinicians Society at CT-CANN23. Photo: Laura Ramos | cannareporter
For the future, the British doctor highlighted the need to encourage cultivation in the UK, in order to ensure an efficient supply chain, in addition to resolving the issue of EU-GMP equivalence. As priorities, Barnes referred to the urgent need to train more doctors, more prescriptions through the NHS – since there are only 4 patients obtaining prescriptions for full spectrum derivatives -, and the authorization of prescriptions for general practitioners. “Most NHS prescriptions are for either Sativex or Epidyolex. Personally, I think it's immoral to have only these prescription possibilities”, he stressed.
The acceptance of the “real” evidence, which includes more than 4 cannabis studies to consider in the PubMed, in addition to making society aware of these therapies, there are other important factors to take into account, as currently around 60% of British people do not know that medical cannabis is legal in the country.
Michael Barnes also criticized the bureaucracy, saying that if we are waiting for clinical trials for all pathologies, with such a “chemically complex” plant, it will be difficult to guarantee patient access. “If cannabis is not used as a first-line treatment, then for conditions that 'conventional' medicines can no longer help, why not prescribe it? It is safe, if well prescribed, and works for many patients, around 80%. We will use it and learn as we go!”, he said, further calling for “cooperation” between all entities and “common sense”.
Around 71 countries currently have access to medical prescription cannabis, most of them in Western Europe.