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Cannabis

Unlicensed medicine

Legal Changes

Since 1 November 2018, doctors have been able to legally prescribe medical cannabis for patients who have exhausted conventional prescription medication to ease their symptoms and improve their quality of life.

Medical Cannabis

Cannabis-based products may provide relief for individuals who have previously attempted licensed medicines without success in meeting their clinical needs. When prescribed thoughtfully following a comprehensive assessment and under careful supervision, medical cannabis can emerge as a potential treatment option for patients grappling with various physical and mental health issues.

How does Medical Cannabis work?

The human body possesses an endocannabinoid system, crucial for maintaining internal balance and regulation, influencing functions such as sleep, appetite, stress response, and pain modulation. Within the cannabis plant, there are phytocannabinoids, a group of compounds that interact with the body’s endocannabinoid system to produce therapeutic effects. Notable cannabinoids include THC (tetrahydrocannabinol) known for its psychoactive properties, and CBD (cannabidiol) which is non-psychoactive and often associated with various therapeutic benefits. These interactions contribute to the potential efficacy of medical cannabis in addressing a range of health issues.”

CBD and THC

The medical cannabis plant contains hundreds of cannabinoids, but the two most extensively studied are THC and CBD. In many medical cannabis preparations, these cannabinoids are present in varying ratios. When eligible for medical cannabis treatment, the CBD:THC ratio is selected based on individual symptoms and medical history. Whole-plant treatments, incorporating both THC and CBD, are believed to have a more profound effect than their individual components. This synergistic phenomenon is referred to as the ‘entourage effect.

Dosing

Cannabis, like many other medications, follows the ‘start low, go slow’ dosing principle to control individual symptoms with minimal side effects. Incremental increases in dosage help mitigate risks and identify the optimal dose for your condition. It may take 3 to 4 weeks to feel the full benefits of medical cannabis and up to 12 weeks to establish a consistent dose. Throughout this period, regular follow-up appointments with your doctor are scheduled.

Formulations

Medical cannabis offers various administration methods. In the UK, the most commonly prescribed formulations include medical cannabis oils for oral use and medical cannabis dried flower for vaping. Oral cannabis oil, taken 2-3 times daily, provides continuous relief throughout the day. Vaping serves as an add-on for ‘breakthrough’ symptoms, offering a quick onset (within minutes) but with effects lasting only about 2 to 3 hours.”

Patients typically tolerate medical cannabis well, with side effects being relatively rare at low doses. Occasional side effects are more likely at higher doses or when combined with substances that enhance them, such as alcohol. Titration, or the gradual adjustment of dosage, is done until effective symptom control is achieved or until side effects arise. If you encounter any concerning side effects, it’s crucial to promptly discuss them with your doctor.”

Patients typically tolerate medical cannabis well, with side effects being relatively rare at low doses. Occasional side effects are more likely at higher doses or when combined with substances that enhance them, such as alcohol. Titration, or the gradual adjustment of dosage, is done until effective symptom control is achieved or until side effects arise. If you encounter any concerning side effects, it’s crucial to promptly discuss them with your doctor.”

cannabis uses

Side effects

Patients typically tolerate medical cannabis well, with side effects being relatively rare at low doses. Occasional side effects are more likely at higher doses or when combined with substances that enhance them, such as alcohol. Titration, or the gradual adjustment of dosage, is done until effective symptom control is achieved or until side effects arise. If you encounter any concerning side effects, it’s crucial to promptly discuss them with your doctor.”

Travelling

When traveling, be aware of potential restrictions on bringing or taking cannabis in and out of your destination country. Cannabis is highly regulated, and even with a doctor’s prescription, it may be illegal in some countries. Consult www.gov.uk/travelling-controlled-drugs for specific guidance before traveling with cannabis.

Driving

This medicine may cause drowsiness. Refrain from driving until you understand its effects. Do not drive if you experience sleepiness, dizziness, difficulty concentrating, impaired decision-making, or blurred/double vision. Avoid alcohol consumption. For additional information, visit www.gov.uk/drug-driving-law.”

Dosing

Orally administered cannabis oil has a gradual onset of effects compared to inhaled cannabis. Take your first dose as advised by your doctor, preferably on a day when you can stay at home until you understand how the medicine affects you.

Storage

Once at home, your product should be safely stored as indicated by the patient information leaflet and out of the reach of children or pets. Always follow directions for storage on your Medical Cannabis label as this may change depending on the product you have been prescribed. To avoid leaking, products should always be stored upright with the lid securely tightened.

cannabis drug

Frequently asked questions

Medical cannabis is suitable for individuals in the UK who have tried other medications for their condition without success or have an intolerance to analgesics. According to current UK law, it is considered a last-line treatment option, recommended only after exhausting all other licensed and off-label medication alternatives.

While there are no specific licensed indications for medical cannabis treatment, it is frequently considered as a therapeutic option for individuals experiencing chronic pain conditions. These may include neuropathic pain, characterized by nerve damage or malfunction, fibromyalgia, a disorder associated with widespread musculoskeletal pain, and multiple sclerosis spasticity, involving muscle stiffness and spasms. In our clinic, we explore the potential benefits of medical cannabis for patients dealing with various forms of chronic pain, always taking into consideration individual medical histories and symptoms.

Many Medical Cannabis products are full-spectrum plant extracts. This means it contains not only THC and CBD, but also minor cannabinoids, terpenes and other plant compounds. Treatments which include the whole plant – a combination of THC and CBD – are thought to have a better effect than just the individual components. This is known as the entourage effect.

Medical Cannabis is an unlicensed medicine and needs to be initiated by a consultant on the GMC specialist register within their area of expertise, in the management of chronic conditions.

Medical Cannabis, being an unlicensed medicine, requires initiation by a consultant on the GMC specialist register, specializing in the management of chronic conditions. Regarding dosing, the ‘start low, go slow’ approach will be employed. Your medical cannabis dose will be gradually increased over a period of a couple of weeks until an effective dose is reached. The titration process will be discussed thoroughly with your doctor, typically taking place over a period of, for example, 2 to 4 weeks. This gradual adjustment aims to minimize side effects and ensure an optimal and well-tolerated dosage for your specific needs.

While using medical cannabis, particularly due to the presence of THC, it’s crucial to refrain from driving or engaging in activities such as operating machinery while the intoxicating effects persist. The legal limit for THC in the blood is 2 micrograms per litre. It’s noteworthy that THC can remain detectable in the blood for days after the immediate effects have worn off, as it is stored in fat cells. This implies that one could surpass the legal limit even when feeling unimpaired. To ensure compliance and facilitate communication with authorities, it’s advisable to carry a copy of your prescription at all times.”

There is a diverse range of Medical Cannabis products available in the UK, and their selection should be guided by your doctor or specialist. Some individuals may need to experiment with various products or utilize a combination for optimal treatment. Many Medical Cannabis products are full-spectrum plant extracts, encompassing cannabinoids (predominantly THC and CBD), along with minor cannabinoids, terpenes, and other plant compounds.

It’s important to note that over-the-counter CBD products are typically derived from hemp, which contains high levels of CBD and minimal other cannabinoids, terpenes, and flavonoids. Many believe that these additional components are crucial for the full medical benefits of the plant, known as the entourage effect.

CBD-based products available from health food stores and other outlets usually contain small amounts of CBD. These products are not currently regulated and are not recommended for medical purposes due to their variable composition and lack of oversight.

While medical cannabis encompasses a broad range of cannabinoids and plant compounds, over-the-counter CBD products are typically derived from hemp. Hemp, rich in CBD but low in other cannabinoids, terpenes, and flavonoids, may lack the full spectrum of components believed to contribute to the plant’s medical benefits, known as the entourage effect.

CBD-based products available from health food stores and other outlets often contain minimal CBD. Notably, these products are not currently regulated, and their composition varies widely. As a result, they are not recommended for medical purposes due to the potential lack of consistency and oversight in their production.

Recreational cannabis typically features high levels of THC, minimal CBD, and an increased risk of adverse effects. Batch-to-batch variations in THC/CBD ratios can result in unpredictable effects.

In contrast, medical cannabis is exclusively used for treating medical conditions under the supervision of a medical professional, often through a prescription. All available products in the UK must adhere to Good Manufacturing Practice (GMP) standards. These medical cannabis products have a known composition, including precise levels of THC and CBD. This ensures consistency, allowing doctors to make informed prescribing decisions based on the patient’s specific needs.

Typically, medical cannabis is considered as a treatment option after patients have encountered challenges, such as failing to experience benefits or facing unacceptable side effects with licensed medicines. It is often explored when other conventional treatments have proven ineffective or intolerable, making medical cannabis a potential alternative for those facing difficulties with standard medications.

Continue taking all other medications unless instructed otherwise by your prescribing clinician.

If you wish to stop your medical cannabis, discuss it with your doctor. Some patients may experience side effects upon discontinuation, but these are typically short-lived, lasting only a few days.

It is not recommended that you drink alcohol whilst on medical cannabis. Both alcohol and cannabis can reduce one’s ability to think rationally, a combination of both increases the risk of impairment.