Cannabis

Baroness Meacher Excerpts

Thursday 7th September 2017 Grand Committee

Asked by

[Baroness Meacher]

To ask Her Majesty's Government whether they plan to invite the Advisory Council on the Misuse of Drugs to review the evidence supporting the rescheduling of cannabis to Schedule 2 or 4.

[Baroness Meacher (CB)]

My Lords, chronically sick patients with constant severe pain and other symptoms have suffered for far too long, reliant on prescribed medications that are sometimes ineffective and with intolerable side-effects for many people.

I remind noble Lords, if they will forgive me, of the case of Faye, whose experience was so brilliantly articulated in the Daily Mail on 2 May. At the age of 27, Faye was diagnosed with crippling rheumatoid arthritis. She describes the side-effects of conventional drugs as,

“more disruptive to daily life than the disease itself”,

which is saying something with rheumatoid arthritis. Faye recognised that prescribed drugs are fine for some people, but not for her. Having never used an illegal drug, and rather fearful, she found cannabis, and very slowly came off her prescribed medications. What was the result? She stopped feeling sick all the time—imagine a life of feeling sick all of the time. Now, two and a half years later, taking only cannabis, Faye says that her quality of life is now 98% of what it was before the diagnosis. She works full-time. Not only is this absolutely wonderful for Faye but it is saving the NHS thousands of pounds a year in medications, consultant appointments, GP appointments and so forth.

Under our drug schedules, as all noble Lords in this Room know, cannabis is listed as a dangerous drug with no medicinal value. In reality, of course, cannabis is safer than many prescribed medications and there is growing evidence of its medicinal value for a remarkable list of conditions. Our schedule is simply wrong and should not remain as it is. We need to inject some urgency into the situation. It is unnecessary and in my view cruel for these patients to suffer another two, three or even more years of agonising, sleepless nights and pain-stricken days or risk arrest to get hold of cannabis, which they tell us is the only effective medication with minimal or no side-effects.

For the first time, the UN is on our side and on the side of our Government should they wish to undertake some reform. The United Nations Office on Drugs and Crime—the UNODC—at the UN General Assembly Special Session on Drug Policy in April last year, made it clear that evidence-based public health policy is here to stay, and that treatment without stigma should be the driver of drug policy. This was a most important statement from the UN body at the centre of international drug policy. After 60 years of drug policy dominated by the notion of a “war on drugs” and the ludicrous aim of creating a drug-free world, the UN is at last asking member states to consider a pragmatic, realistic approach. From now on, countries need clear objectives—how remarkable: let us have some objectives—such as reducing addiction and harm in the consumer countries, and reducing violence and corruption in the producer and transit countries.

If the world is to follow the UNODC lead, countries need to evaluate policies and introduce those for which there is an evidence base. This brings us directly back to medicinal cannabis. We have sufficient evidence worldwide to know that cannabis has very significant medical properties. As I have said, we can no longer justify its Schedule 1 status. At its last meeting, the World Health Organization’s expert group agreed that the widespread acceptance of medicinal cannabis means that the WHO’s insistence on its having no medicinal value appears incongruent, particularly as it relies on 80 year-old data. I believe that is actually progress.

Our own Medicines and Healthcare products Regulatory Agency, the MHRA, determined last October that products containing cannabidiol—CBD, a derivative of cannabis—are indeed medicines and can be prescribed. How can we say under Schedule 1 that cannabis has no medicinal value when, according to our regulatory body, a part of it does? We cannot. We are fortunate to have Ministers in the Home Office who understand the evidence. A blog by the Home Office Minister Sarah Newton in April stated that the Government’s view is that cannabis should be subject to “the same regulatory framework” as other potential medicines, subject to approval from the MHRA.

The big question—this is very important—is whether the MHRA can accept a special status for cannabis, an inexpensive weed with such valuable medical properties. If cannabis is put through five or 10 years of double-blind random controlled trials, it will finish up so expensive that it will be ruled out from the NHS by NICE. Sativex is a good example. My fear is that Epidiolex, for children with specific strains of severe epilepsy, may also be priced out of the NHS market in another three years’ time when the lengthy trials finally come to an end. It is impossible to overestimate the urgency of treatment for these epileptic children, who suffer severe brain damage with hundreds of seizures every single day. Their brains are being destroyed and that damage will not be reversed.

Another tragedy that we really need to think about in relation to Epidiolex is, I understand, that GW Pharmaceuticals, which has spent £20 million on these trials, now realises that another cannabinoid would be more effective for these children with severe epilepsy than the cannabinoid upon which those £20 million-worth of trials were based. It cannot repeat them all, so a suboptimal medicine will be put to the MHRA for approval. There is something terribly wrong here and I would be grateful if the Minister would meet me to talk about the need to consider a safe—it must be safe—but less costly process of trials for cannabis medicines than is required at present.

Columbia Care, a well-respected company providing reliable, dosable cannabis, may provide an answer. Its products are superior to those accepted in the Netherlands and Germany and may provide a model of trials acceptable to the MHRA. There are other reputable companies providing good-quality cannabis products to Israel and elsewhere. Already 28 US states, 11 European countries and the whole of Latin America recognise that cannabis is a medicine. More states and countries join that list every year. The illegal status of cannabis has undoubtedly discouraged research into its medicinal properties. Oxford University, however, will be funded to the tune of £10 million by Kingsley Capital Partners to investigate our own endocannabinoid system. It is our own system that explains the extraordinary powers of cannabis. I will not go into this but in the meantime Professor Mike Barnes’s report, commissioned by our APPG for Drug Policy Reform, has reviewed all the international data and showed beyond doubt that cannabis is indeed an effective medicine for a number of conditions.

In conclusion, I appeal to the Minister to request the ACMD, under the leadership of its excellent chair, Dr Owen Bowden-Jones, to review the evidence for the Schedule 1 status of cannabis and to make recommendations as soon as possible. The UK will then be prepared to respond quickly to the WHO review. I hope that the ACMD will consider the regulations we would need to support a revision of the cannabis schedule. Obviously, a good set of regulations would be extremely important. Again, I hope the Minister will respond to the urgency of the need for reform for these patients.

--- Later in debate ---

[Baroness Williams of Trafford]

I noted the noble Lord’s mention of Bedrocan. I had not heard of it and I am very willing to look into that specific drug. There are of course many drugs available in other parts of the world that are not necessarily available here and vice versa. I will write to him on that point. I will also take up the point about Alfie separately.

[Baroness Meacher]

May I thank everybody who has spoken so effectively in this debate? So many powerful points were made and we have managed to avoid duplication, amazingly. It just shows how many points one needs to make in relation to this—

[Baroness Vere of Norbiton (Con)]

My Lords, there is no right of reply in this debate.