05 Sep NICE’s Draft Guidelines on Cannabis Prove That Its Methods Don’t Work and It Is Causing Harm to Patients

The draft guidelines produced by the NICE committee are nothing short of ridiculous. There is a complete absence of common sense and an absurd failure properly to consider all the available evidence.

But it’s actually much more serious than this. It is now abundantly clear that this committee, its membership and its conclusions were only ever intended to delay, obfuscate and sabotage the reforms which were introduced in November last year because of a public outcry.

The selection of members of the committee is by any standards corrupt. The most highly qualified people have been deliberately excluded. Anyone publicly expressing support for the use of cannabis as medicine has been rejected whereas those selected have frequently expressed opposition. The inclusion of the ‘reefer madness’ advocate Professor Finbar O’Callaghan is both reprehensible and inexcusable. If the man had any ethical standards or conscience he would recuse himself. The committee is a confidence trick.

The medical establishment, the Home Office and all the various regulators, including the MHRA, the FSA and the Royal Colleges are all institutionally opposed to cannabis and they are doing everything they can to stop it reaching the people who can benefit from it. Cannabis, the more intelligent approach to medicine it both requires and inspires, threatens too many vested interests and the comfortable, self-satisfied and self-serving model of healthcare that prevails in Britain.

But if any NICE apparatchik or fat cat pharma supremo thinks they can stop cannabis they are fooling themselves. From right around the world the overwhelming weight of expert opinion and patient experience reveals that what is happening in Britain is merely delaying the inevitable. But in the meantime it is causing great suffering and unnecessary harm to patients. It is a scandal of the highest order and the people responsible for it must be called to account.

CLEAR has responded to the consultation on the draft guidelines in great detail. Without reproducing our line by line commentary, these are our three general observations.

1. The entire guideline is characterised by a failure to consider observational evidence and real-world experience. Cannabis is the oldest medicine known to mankind and failure to give substantial weight to real-world experience of its safety and efficacy is nothing short of absurd. Given its illegality over the past 100 years, the wild scaremongering about its recreational use and therefore the lack of formal clinical evidence, this is simply setting it up to fail. It is irresponsible in the extreme to fail to consider the enormous benefit at very low cost and the very few adverse events associated with illicit cannabis.

2. There is little evidence of potential for harm for cannabis for any medical condition. Given the enormous numbers using cannabis in its most potent form as a recreational drug and/or self-medicating (estimated at 250 million regular users worldwide) there are far fewer adverse events or incidents of harm than for common over-the-counter medicines.

3. The weight given throughout the guideline to the potential for harm of cannabis is wildly disproportionate. There is no evidence of any significant harm from cannabis when used as a medicine, especially when under the supervision of a medical professional. At least 10,000 years of human experience shows that cannabis is essentially safe. Seeking to evaluate its safety in the same way as a new, experimental medicine, synthesised in a lab for which there is no real-world experience is a fundamentally flawed approach. Unlike potentially dangerous or unsafe medicines, cannabis can and should be offered to patients on a ‘try it and see’ basis. Instead of being over-cautious, clinicians should welcome this approach and can be certain that it will benefit patients whether or not in proves effective in individual cases.