On November 1, medical cannabis became legal in the United Kingdom, as promised in July. Home Secretary Sajid Javid issued an announcement detailing the rationale for this change, which is that cannabis medicine should be available to treat severe epilepsy and other serious ailments.

Javid said:

Having been moved by heartbreaking cases involving sick children, it was important to me that we took swift action to help those who can benefit from medicinal cannabis. We have now delivered on our promise and specialist doctors will have the option to prescribe these products where there is a real need. I’m grateful to the expert panel–who have been considering cases in the interim–and to those who’ve worked hard to bring about this change at the earliest possible opportunity.

The expert panel Javid refers to is the Advisory Council on the Misuse of Drugs (ACMD), which recommended that cannabis be rescheduled. Similar to the United States, marijuana in the United Kingdom has been listed as a drug with no medical value. In the UK, however, the government has acknowledged that “there is evidence to show the therapeutic benefit of cannabis-based medicines for some conditions.” This statement from Professor Dame Sally Davies, the country’s chief medical officer, prompted the ACMD and Javid to issue a plan to reschedule medical cannabis.

What will be authorized?

One remaining issue is what kind of medical cannabis will be allowed. In a letter dated September 11, the ACMD recommends that the government “continue working on refining the definition of [cannabis-derived medicinal products (CDMPs)] to include appropriate standards so that only those products which meet those standards are available to be prescribed.”

The letter outlines three paths toward acceptance of a CDMP: First, a product may be listed if it is a “‘special’ unlicensed medicinal product that is for use in accordance with a prescription or direction of a specialist medical practitioner,” alternatively, a product may be used as part of a clinical trial, and third, a product may be authorized by the Medicines and Healthcare products Regulatory Agency.

According to the ACMD, current definitions of medical cannabis are too broad, and it recommends that a new definition be found. The letter lays out implementation recommendations that include accurate labeling of THC and CBD content, prohibition of smoking medical cannabis, training medical providers on proper prescription methods, publication of the outcomes of clinical trials, a clear and effective method of communicating news and information on medical cannabis to the public, and finding ways to encourage drug companies to bring cannabis-derived medicines to market. Currently, only one drug is approved: Epidiolex, which made by GW Pharmaceuticals. In the United States, the drug was recently approved to treat two types of severe epilepsy.

The government clearly intends to take a careful approach to medical cannabis. Most doctors will not be able to prescribe it, and only those with “exceptional clinical need” will be eligible. It seems likely that the first medicines to be licensed will be oils for topical or oral administration and whose manufacturing quality control is equal to that of other prescription medicines. The government also issued this reminder: “The Home Secretary has made it clear that today’s announcement does not pave the way towards legalising cannabis for recreational use. The penalties for unauthorised supply and possession will remain unchanged.” Nevertheless, the rescheduling of cannabis medicine in the UK is a promising sign that a government is willing to consider the evidence that cannabis-based medicine is effective in treating some medical conditions.

What do you think? What conditions will most likely be eligible, and what medicines will be licensed? Leave a comment below.

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