24 Sep Access Medicinal Cannabis. Stage 1

bedrocan-flosThis is the first in a series of articles that will set out, in detail, our best knowledge to date of how to access legal medicinal cannabis.

The law against the medicinal use of cannabis is cruel, irrational and has no basis in any evidence. It must be overturned and the only effective way to do that is through due process. All forms of protest have been shown to be ineffective. The only way to defeat this policy is to seize control of it and force change.

We have learned from research, from consulting with lawyers, doctors and scientists but most of all from experience. What we explain is current best practice. This is your best chance if you need access to medicinal cannabis now.

The steps involved in this process are really very simple:

1. Obtain prescription from UK doctor.
2. Apply for personal import licence.
3. Make arrangements with a Dutch or Belgian pharmacy.
4. Collect medicine and declare at customs with supporting documents

Of course, each stage is a minefield and depends on the individual. Each case really needs individual guidance which is available from CLEAR for those prepared to invest the considerable time, effort and financial risk which is involved.

This advice and guidance is, of course, offered entirely at your own risk. You must make your own assessment of the risks involved. My opinion is that the worst that can happen is that you lose your medicine and the cost of the trip – but that is my opinion, you have to choose to take the risk yourself.

Stage 1

The most important stage and the foundation to everything that follows is a prescription written by a UK doctor. The only herbal medicinal cannabis products available to prescribe are produced by Bedrocan BV, the Dutch government’s official producer of medicinal cannabis.

Bedrocan – 19% THC, 1% CBD

Bedrobinol – 12% THC, <1% CBD

Bediol – 6% THC, 7.5% CBD

Bedica – 14% THC, <1% CBD

All these products are unlicensed in Britain. Herbal cannabis is listed in schedule 1 of the Misuse of Drugs Regulations as having no medical use but this is false and inaccurate. Since Sativex (nabiximols) was placed in schedule 4 in April 2013 this statement has become legally unsustainable because Sativex is pharmacologically identical to herbal cannabis. This false distinction will be challenged in the courts in due course.

All doctors, whether they be GPs, juniors, registrars or consultants have ‘prescribing rights’. They are entitled under common law to prescribe any licensed or unlicensed medicine as they see fit. On unlicensed medicines, the General Medical Council’s (GMC) Prescribing Guidance states:

“…you may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.”

If your doctor tells you that he/she is not allowed to prescribe a Bedrocan product for you that is incorrect. This issue has also arisen with doctors saying they are not allowed to prescribe Sativex. Again that is incorrect, any doctor may prescribe Sativex. Of course, it may well be that your CCG, PCT or health authority has said it will not fund Sativex prescriptions and currently we know of no authority that will fund Bedrocan prescriptions. Therefore your prescription for Bedrocan will be on a private prescription in respect of which your doctor takes no orders from anyone.

N.B. We are currently investigating an EU directive which may force your CCG, PCT or health authority to reimburse the cost of a Bedrocan prescription but this may be a long way away at present.

It is important to recognise that if your doctor prescribes an unlicensed medicine then he/she takes full clinical responsibility for the consequences and may not be covered by his/her professional indemnity insurance. The same applies if prescribing a licensed medicine for an unlicensed purpose, e.g. prescribing Sativex for any condition other than spasticity in MS. This is very important to bear in mind when trying to persuade your doctor to prescribe what you need. Convincing him/her of the safety of Bedrocan is of vital importance.

Persuading your doctor to prescribe a Bedrocan product will depend largely on his/her knowledge of cannabis. Your relationship with your doctor will also be crucial and the longer he/she has known about your use of cannabis and has seen its beneficial effects, the easier it will be. You may have to accept that getting a prescription will not happen straightaway. It may require a process over time of demonstrating that it works for you.

An initial meeting with your doctor will determine how much persuasion is going to be necessary and how much work and research you are going to have to do to present your case. It may be a good idea to show your doctor a redacted copy of one of the prescriptions already obtained from other UK doctors.

The two principal factors that your doctor will need to consider are safety and efficacy. On safety, there is a vast amount of information available on the CLEAR website, the UKCIA website and via a Google search. On efficacy, then you must research the evidence for your particular condition(s). As well as those sources just mentioned, try Granny’s List, an extraordinary collection, more than 1000 pages of links to information on medicinal cannabis.

The prescription may be written on an NHS prescription form but it should be headed ‘Private Prescription’. It may also be written on a private prescription form, a letterhead or a sheet of plain paper with the doctor’s stamp. It must include the following information:

  • Doctor’s name, address, telephone and email
  • Patient’s name, address and date of birth
  • Product name (use the Bedrocan name, do not use the word cannabis)
  • Percentage dronabinol (the International Nonproprietary Name (INN) for THC) in numerics and words
  • The dosage in numerics and words (usually 2g per day)
  • The total amount of the prescription in grams in numerics and words
  • Doctor’s signature

N.B. We have information that some Dutch pharmacies will not accept a prescription if it is handwritten. We are investigating this and will advise accordingly.

Example B. Redacted Bedrobinol prescription Example B. Bedrobinol Prescription (ID Details Redacted)

Example A. Bedrobinol Prescription (ID Details Redacted) Example A. Bedrobinol Prescription (ID Details Redacted)