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Communication
So near yet so far: why won’t the UK prescribe medical cannabis?
  1. David Nutt1,
  2. Steve Bazire2,
  3. Lawrence D Phillips3,
  4. Anne Katrin Schlag4
  1. 1 Faculty of Medicine, Imperial College London, London, UK
  2. 2 NHS, Redditch, Worcestershire, UK
  3. 3 Department of Management, London School of Economics and Political Sciences, London, UK
  4. 4 Drug Science, London, UK
  1. Correspondence to Professor David Nutt; d.nutt{at}imperial.ac.uk

Abstract

Although cannabis-based products for medicinal use are now legal in the UK, it is still challenging for patients to gain access, and only very few National Health Service prescriptions have been written to date. This paper attempts to make sense of why the UK lags behind so many other countries which also have legalised medical cannabis. From consulting with parents and patients, prescribers, pharmacists and decision-makers it seems that there are a series of distinct barriers to prescribing that need to be overcome in order to improve patient access to medical cannabis in the UK. These include concerns about the perceived lack of scientific evidence. To alleviate these concerns, we highlight the importance of patient-centred approaches including patient-reported outcomes, pharmacoepidemiology and n=1 trials, which can contribute to the development of the evidence base for medical cannabis. We hope that this paper will help policymakers and prescribers understand the challenges to prescribing and so help them develop approaches to overcome the current situation which is detrimental to patients.

  • public health
  • qualitative research
  • statistics & research methods
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors DN is the guarantor and developed the initial manuscript. LDP and AKS developed the section on concerns about perceived lack of evidence, and the importance of n=1 trials. SB wrote the pharmacy perspective, and the suggested guidance for area prescribing committees. All authors reviewed the manuscript and agreed on the final submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AKS is a paid researcher for Drug Science, a charity that receives unrestricted educational donations from several sources including some companies that manufacture or distribute medical cannabis products.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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