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UK: Legalise cannabis as treatment of last resort for MS, says charity
Thursday 27 Jul 2017
Ten thousand people with multiple sclerosis in the UK should be allowed to use cannabis legally in order to relieve their “relentless and exhausting” symptoms, experts in the disease have told ministers.
The MS Society claims the one in 10 sufferers of the condition whose pain and spasticity cannot be treated by medication available on the NHS should be able to take the drug without fear of prosecution.
The evidence on cannabis’s effectiveness, while not conclusive, is now strong enough that the government should relax the ban on the drug for MS patients who have no other treatment options, the society says in a report.
Doctors who treat MS patients have backed the society’s call, as have the Liberal Democrats and the Green party. Legalisation would ease “the extremely difficult situation in which many people with MS find themselves”, the charity said.
The society is calling for the first time for the 10,000 patients – one in 10 of the 100,000 people in Britain with MS – to be able to access cannabis without fear of arrest. It has changed its position after reviewing the evidence, consulting its medical advisers and seeking the views of 3,994 people who have the condition.
“We think cannabis should be legalised for medicinal use for people with MS to relieve their pain and muscle spasms when other treatments haven’t worked,” said Genevieve Edwards, the MS Society’s director of external affairs.
“The level of clinical evidence to support cannabis’s use for medicinal purposes is not conclusive. But there is sufficient evidence for our medical advisers to say that on the balance of probability, cannabis could benefit many people with MS experiencing pain and muscle spasms.”
The charity is also urging NHS bosses to make Sativex, a cannabis-based drug used by some people with MS, available on prescription across the UK so that patients who can afford it no longer have to acquire it privately, at a cost of about £2,000 a year. Wales is the only home nation to provide the mouth spray through the NHS.
Patients’ inability to access Sativex on the NHS in England, Scotland and Northern Ireland “has resulted in many people with MS turning to illegal forms of cannabis as an alternative. It’s simply not right that some people are being driven to break the law to relieve their pain and spasticity. It’s also really risky when you’re not sure about the quality or dosage of what you’re buying,” Edwards said.
Norman Lamb, the Lib Dem health spokesman, said: “This is the strongest proof yet that the existing law on cannabis is a huge injustice that makes criminals of people whose only crime is to be in acute pain. This draconian law is potentially opening anything up to 10,000 MS sufferers to prosecution, and underlines why the Liberal Democrats have braved a tabloid backlash to campaign for the legalisation of cannabis. It is about time the government listened to the science.”
One in five (22%) MS patients who took part in a survey by the society said they had used cannabis to help manage their symptoms, but only 7% were still doing so. A quarter (26%) of those who had stopped taking it said they had done so out of fear of prosecution. Another 26% of respondents had considered trying cannabis but had not done so for the same reason and also because they were concerned about the drug’s safety.
Doctors are divided over cannabis’s potential role in treating MS. Some are supportive while others are anxious about endorsing the use of a drug that can cause psychiatric problems. The Royal College of GPs said it was currently drawing up policy on the issue and could not comment. The Royal College of Physicians, which represents hospital doctors, said it had no policy on the issue.
Dr Willy Notcutt, a pain management specialist at the James Paget hospital in Norfolk, who has been treating MS patients for more than 20 years, said: “Every week I come across patients wishing to use cannabis to control their symptoms but who are unable to get proven drugs like Sativex from the NHS. Many patients seek illegal cannabis to get help. They can’t be sure of its origin but are being forced to commit a criminal act in order to obtain relief.”
Dr Waqar Rashid, a consultant neurologist at Brighton and Sussex University Hospitals NHS trust, said: “[Cannabis is] not a cure-all, and there are other treatments that should be tried first. But it makes sense for criminality not be a barrier to a treatment which could reduce the debilitating impact of symptoms and transform someone’s quality of life.”
Caroline Lucas, the Green party co-leader and its sole MP, said: “The MS Society’s new position is a big step forward, and recognises the fact that thousands of people with MS could benefit from the the use of medicinal cannabis. By rigidly sticking to criminalising cannabis the government drives MS sufferers to illegally acquire the drugs, thus putting themselves as risk of prosecution simply for searching for pain relief.”
The National Institute for Health and Clinical Excellence (Nice), which advises the government, has told the NHS not to prescribe Sativex for spasticity because it is not cost-effective.
The Home Office said: “This government has no plans to legalise cannabis. Cannabis is controlled as a Class B drug under the Misuse of Drugs Act 1971 and, in its raw form, currently has no recognised medicinal benefits in the UK.”
Case study: Steven Colborn, 55, from Seaham, County Durham
Imagine running a marathon while sharp pain darts up and down your legs. This is what multiple sclerosis feel like for me. When muscle spasticity kicks in my legs just twist and turn and bend back on themselves and it’s excruciatingly painful.
But three years ago I was offered a treatment that could help. During a regular appointment, a specialist nurse said they had managed to get a month’s supply of Sativex, a drug derived from cannabis, from the manufacturer.
The results were incredible. My muscle tension eased and I started to feel my legs moving better. I was able to get a good night’s sleep. I could exercise without getting as tired as quickly. For the first time in a long time I felt that I was managing my condition.
My month’s supply ran out and the drug wasn’t available free on the NHS. I was offered a muscle relaxer called Baclofen which hadn’t worked for me in the past.
I have been forced to pay for this drug myself. I can’t work any more so I rely on disability benefits. I have to save up a lot of money to be able to afford it – it costs £412 a month. Over the past four years I’ve only managed to buy about seven months’ worth.
I take Sativex but other people get similar relief from cannabis in its pure form. I don’t like taking this myself because of the narcotic effect, which you don’t get with Sativex. But for those it helps, it should be made legal.
I have had this illness for 36 years and every day I wake up and think ‘maybe there has been a breakthrough’. I know there will never be a cure, but I am just looking for a way to make things easier. Now I have been presented with something that offers me hope and the NHS say they cannot afford it. My question is: can you afford people like me getting worse?
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