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Should Cannabis be considered more seriously as a form of medication in the United
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Dissertation on medical use of cannabis in the uk
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Should Cannabis be considered more seriously as a form of medication in the UnitedKingdom?
Ella Douthwaite
In the United Kingdom, cannabis is rarely medically prescribed; only for children and adults
with forms of epilepsy, adults with nausea or vomiting as a side effect of chemotherapy and
for patients suffering from spasms and muscle aches caused by Multiple Sclerosis. Medical
Cannabis (and cannabis oils), (National Health Service, 01 November 2018) I would like to
evaluate how effective medical marijuana is as a treatment for each of these conditions. The
drug was legalised only recently in 2018 as a final resort. Authors of Sage Journals believe
that “There is a need to maximise both clinical research and patient benefit, in a safe,
cautious and ethical manner, so that those patients for whom cannabis is shown to be
effective can access it.” Medical Cannabis in the UK: From Principle to Practice (Sage
Journals, 2020) This statement is accurate because we know that people are accessing
marijuana regardless of the law to ease their symptoms, it is important for services to take
the time to research so that cannabis users have all the accurate information to make an
informed decision.
Currently there is only one treatment used for treating two kinds of epilepsy (Dravet
syndrome and Lennox-Gastaut syndrome, both rare and difficult to treat) that is cannabis
based; ‘Epidyolex’, containing pure CBD (Cannabidiol, which is an ingredient in cannabis
and doesn't cause the ‘high’ effect.) “Epilepsy is a condition that affects the brain and causes
frequent seizures” Overview, Epilepsy (National Health Service, 2020) Epilepsy can be a
significant burden to somebody's quality of life as it causes stiffness, uncontrollable muscle
jerking and collapsing as just some of the symptoms.
Dravet Syndrome affects 15,000 people in the UK, it is a form of epilepsy which also causes
a range of learning disabilities and conditions directly related to the disease such as autism
and ADHD (attention deficit hyperactivity disorder). What is Dravet Syndrome (Dravet
Syndrome UK, Date Unknown) As mentioned previously, Lennox-Gastaut syndrome is
another condition that is difficult to treat. Lennox-Gastaut syndrome only occurs between 1-5
in every 100 children diagnosed with epilepsy, Patients may experience ‘drop seizures’
(Atonic and tonic seizures) where the child literally drops to the ground. Atypical absence
seizures are also common meaning that the patient appears ‘vacant or blank’ Lennox-
Gastraut Syndrome (Epilepsy action, 2020) If no other treatment helps, cannabis products
could massively benefit a patient.
The evidence review provided by the National Institute for Health and Care Excellence
(NICE) shows a strong positive result from the use of Epidyolexlex as a treatment of
epilepsy. The research states that 600,000 people in the UK that are diagnosed with
epilepsy are taking a form of antiepileptic drug; 30% of those people’s epilepsy is drug
resistant. The researchers had concluded that the criteria they were looking to achieve
would be a 50% reduction in seizures in patients; adverse events would also be considered
during the trial. As a summary of evidence, the use of cannabidiol on patients suffering with
Dravet Syndrome saw in favour of CBD in studying the reduction in frequency in total
seizures and the study of total seizures. Therefore, despite a favouring of placebo when
testing total adverse events, the drug’s overall result is positive. Furthermore, when testing
, the same dependents on Lennox-Gastaut syndrome, CBD was favoured in all positive tests,
achieving the 50% reduction rate goal.
We can be confident in the accuracy of these results as NICE are deemed a dependable
and trustworthy source which has been proven to have consistency in their guidelines and
research. The actual reliability of the experiment was scientific and authentic because NICE
chose to only manipulate cannabis as a variable which ensures a fair test. The researchers
also collected detailed qualitative data covering the participant’s age groups and their
specific epilepsy type whilst also ensuring consistent monitoring was completed. Cannabis-
based medicinal products (National Institute for Health and Care Excellence, 2019) NICE
guidelines update team.
However, the same organisation, in 2019, stated that they did not recommend the use of
medicinal cannabis (epidyolex) on children with epilepsy due to a lack of knowledge of the
long term side effects. The BPNA (British Paediatric Neurology Association) recommends
only using this medication on the following basis’ 1) ‘have an epilepsy that does not respond
to conventional licensed anti-epileptic medications 2) have not responded to the ketogenic
diet or who are not suitable for the ketogenic diet 3) who are not candidates for epilepsy
surgery; this makes the number of suitable candidates very small. Cannabis oil for epilepsy
(Epilepsy society, date unknown)
On the contrary, if we consider more external sources, we learn that “three double-blind
randomised controlled trials of pure CBD in children and young people with these syndromes
has shown a greater reduction in monthly seizures compared to placebos. There was also a
greater reduction in drop seizures in people taking CBD compared to those on a placebo”
Cannabis oil for epilepsy (Epilepsy society, date unknown). The patient or patient’s
parent/guardian should evaluate both arguments when considering whether this treatment
would be suitable for them but, after reliable testing, the positives tend to outweigh the
negatives in these trials and the drug produces advantageous benefits in treating epilepsy
well.
In the United Kingdom, ‘Sativex’ (nabiximols) is the cannabis based drug used to treat
Multiple Sclerosis. This is the only drug that is legally licensed to treat spasticity (spasms or
muscle stiffness) in the UK. Cannabis, (MS society, date unknown) Multiple Sclerosis affects
the spinal cord and brain, this condition can be painful and debilitating as it can cause issues
with vision, leg movements, sensation and balance. Overview, Multiple Sclerosis (National
Health Service 2018) Sativex is used for patients who’s side effects are intolerable and
resistant to other treatments.
This treatment is an oromucosal treatment spray (mouth spray) which contains THC or delta-
9 tetrahydrocannabinol and CBD or cannabidiol. The patient's prescriber would inform on
how many sprays to take as it is dependent on the patient, however the number of sprays
would be increased each day until maximum dose is given. Sativex (nabiximols), (Multiple
Sclerosis Trust, 2019)
In November 2019 NICE approved the use of Cannabis based products for the treatment of
intractable nausea or vomiting, spasticity and severe treatment. However, it was not
recommended to be used to treat chronic pain. The recommendations for treating spasticity
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