Peter Reynolds

The life and times of Peter Reynolds

Posts Tagged ‘Royal College of General Practitioners

Royal College Of General Practitioners. Draft Council Paper – Cannabis For Specified Medical Indications.

leave a comment »

This is the document presented to the Council of the Royal College of General Practitioners (RCGP) on 22nd September 2017.  The proposal was approved.

 

 

 

APPG: https://drive.google.com/file/d/0B0c_8hkDJu0DRnBfdGRDRXBROUU/view
Barnes: https://drive.google.com/file/d/0B0c_8hkDJu0DUDZMUzhoY1RqMG8/view
MS Society (2017) Cannabis and MS: The Role of Cannabis in Treating MS Symptoms

Cannabis for Specified Medical Indications

Introduction

In the past year, there has been significant interest in the issue of legalisation of cannabis for medical purposes. The All Party Parliamentary Group on Drug Policy Reform made a recommendation in October 2016 that cannabis should be legalised for specific medical indications (https://drive.google.com/file/d/0B0c_8hkDJu0DRnBfdGRDRXBROUU/view). An accompanying report (the Barnes report:  https://drive.google.com/file/d/0B0c_8hkDJu0DUDZMUzhoY1RqMG8/view) summarised the current evidence for medicinal use and outlined the known side effects. This proposal now has all party support with over 100 MPs backing the plan.

Other countries have recently legalised, or are about to legalise, medical cannabis, including over half of the US states, Germany, Canada, Australia and Ireland, amongst several others. It has been estimated that over 1 million people use cannabis for medical reasons in the UK on a regular basis. A recent poll showed 68% of the public supported medical usage and only 12% were actively against (REF). A similar number of GPs also supported the concept in a poll published alongside the APPG report.

Some forms of cannabis are legally available, including Sativex for MS-associated spasticity. An important component of natural cannabis, Cannabidiol (CBD), is also legally available without prescription through health food outlets.

It is likely that GPs will be asked, by those with a variety of chronic conditions, for advice on the use of cannabis and related products. It is proposed that the RCGP works with a number of other organisations (including the MS Society) to produce a GP information booklet which offers balanced and reasonable advice on the appropriate use of cannabis, bearing in mind of course, that natural cannabis and the main psychoactive component, Tetrahydrocannabinol (THC), remain generally illegal.

The MS Society has recently reviewed its position on cannabis use as a medicinal treatment for people with MS (MS Society, 2017). The society believes that there is now enough evidence to assert that cannabis for medicinal use, if managed properly, could benefit around 10,000 people who suffer from pain and spasticity as a result of multiple sclerosis.

They want to see all licensed treatments derived from cannabis made available to people who need them. But until that happens they are calling on the UK government to legalise cannabis for medicinal use to treat pain and spasticity in MS, when other treatments have not worked. They believe that people should be able to access objective information about the potential benefits and side effects of using cannabis for medicinal purposes.

Furthermore, they believe it’s both unfair and against the public interest to prosecute people with MS for using cannabis to treat pain and spasticity, when other treatments have not worked for them (MS Society, 2017).

The Proposal

It is proposed that the RCGP works with a number of other organisations (e.g. MS Society, Newcastle University) to produce a GP information booklet which offers balanced and reasonable advice on the appropriate use of cannabis, bearing in mind of course, that natural cannabis and the main psychoactive component, THC, remain generally illegal.

The aim of the GP information booklet would be to offer balanced and reasonable advice on the appropriate use of cannabis.

The booklet would be short and concise (about 4 pages of A4). It will briefly cover the history of cannabis and outline the natural endocannabinoid system found in all humans. The different forms of cannabis and means of ingestion/inhalation would be outlined. It will also outline the current legal status as a Schedule 1 drug but also highlight the legally available varieties of cannabis (Sativex, Nabilone and CBD).

The medical evidence for different conditions will be given in a balanced way with a reasonable appraisal of existing evidence for those conditions with a good evidence base and for those conditions currently lacking in evidence.

It is important that the side effects will be carefully outlined. This would include the known short-term effects of the psychoactive component as well as a discussion of the potential and actual longer-term effects. This would clearly include the concern around triggering schizophrenia-like syndromes and the risks associated with cognitive problems, driving, dependency.

It will be important that the evidence is presented in a reasoned and reasonable, balanced way without any bias either for or against the legalisation argument.

NM, MB, PR
August 2017

Advertisements

Probably The Biggest Breakthrough Yet For Medicinal Cannabis In The UK.

leave a comment »

Peter Reynolds, President, CLEAR Cannabis Law Reform

Since the beginning of 2017, Peter Reynolds and Professor Mike Barnes of CLEAR Cannabis Law Reform have been working on a project that is about to come to fruition.  The Council of the Royal College of General Practitioners (RCGP) meets tomorrow, 22nd September 2017, to consider our proposal to issue guidelines to doctors on the use of medicinal cannabis.

Professor Mike Barnes, Scientific & Medical Advisor, CLEAR Cannabis Law Reform

As ever, the UK’s stubborn, anti-evidence government remains intransigent on permitting legal access to cannabis, even for medicinal use.  This despite an overwhelming tide of reform across the world and the reality that perhaps one million people in the UK are criminalised and persecuted for using a medicine that has been known to be safe and effective for many centuries, facts which modern science now proves beyond doubt.

However irresponsible and pig-headed government ministers may be, doctors have a responsibility to their patients, an ethical duty that transcends the grubby and corrupt politics that ministers subscribe to. Professor Nigel Mathers, Honorary Secretary of the RCGP with responsibility for its governance, has championed CLEAR’s proposal.  He recognises that while doctors cannot be advising their patients to use an illegal drug, the reality is many people already are.

Professor Nigel Mathers, Honorary Secretary, Royal College of GPs

So this is not just another report or a conference.  This is practical action at the point of delivery of healthcare.  If the proposal is approved by the RCGP Council, the guidelines will be drafted by Professor Mike Barnes, assisted by Peter Reynolds, with additional input from the MS Society and Newcastle University.

In due course, probably by the end of the year, a booklet will be available for download by all GPs from the RCGP website.  It will set out balanced and reasonable advice on the appropriate use of cannabis for specific medical indications. The guidelines will also cover harm reduction advice and provide a basic grounding in the scientific evidence and the endocannabinoid system.

If our government refuses to take such sensible steps to improve healthcare and protect patients, then we, campaigners and medical professionals, must do it for them.

 

Guidelines On Cannabis For Medical Professionals.

with one comment

rcgp-external-hq

In a new initiative, CLEAR’s scientific and medical advisor, Professor Mike Barnes, has written to the presidents of several Royal Colleges proposing the development of guidelines around the use of cannabis as medicine.

Professor Mike Barnes

Professor Mike Barnes

This is a tricky situation for doctors.  Surveys and individual reports from CLEAR members indicate that many doctors tacitly endorse their patients’ use of cannabis but clearly cannot recommend the illegal use of cannabis, however safe and effective it may be.

Professor Barnes’ letter refers to the recent APPG report, his own paper ‘Cannabis: The Evidence for Medical Use’ and says:

“…cannabis now has a reasonable evidence base for the management of chronic pain, including neuropathic pain, and the management of spasticity as well as in the management of anxiety and a use in nausea and vomiting in the context of chemotherapy.”

In conjunction with CLEAR, Professor Barnes has written to:

Royal College of Anaesthetists
Royal College of General Practitioners
Royal College of Paediatrics and Child Health
Royal College of Physicians
Royal College of Psychiatrists

His letter goes on to explain that about one million people are using cannabis as medicine:

“I do feel that doctors need guidelines to assist them when patients request advice on the use of cannabis…doctors should be properly informed about harm reduction advice and should be aware of the clinical evidence that is now guiding medicinal use in several other countries around the world.”

Our proposal is for an initial meeting to discuss the idea.  If one or more of the Royal Colleges is prepared to back this initiative, CLEAR will set up and fund a working group of clinicians and medical education specialists to develop a set of guidelines.