So near yet so far: why won’t the UK prescribe medical cannabis?
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  • Published on:
    Failure to disclose competing interests
    • Bobby P Smyth, Clinical Associate Professor Department of Public Health & Primary Care, Trinity College Dublin, Dublin 2, Ireland.

    Dear Dr Aldcroft,

    It seems that the authors of the BMJ Open publication entitled "So near yet so far: why won’t the UK prescribe medical cannabis?". BMJ open, 10(9), e038687 have omitted to include important information regarding their affiliations and potential competing interests.

    The paper discusses "medical cannabis". It writes enthusiastically about Project 21 a project led by an organization called Drug Science in collaboration with the cannabis industry. Later in the article it again discusses Drug Science, stating:- "Especially for clinicians it is essential to be able to find non-biased educational programmes, highlighting the need for accredited training to be made available. Drug Science is currently offering free online teaching courses on medical cannabis..."

    The lead author (DN) gives just one affiliation, i.e. Imperial College. Given that Prof Nutt is the founder and director of Drug Science it seems remarkable that he has neglected to clearly state this ( ). While he has many affiliations, surely the one which is most relevant in this paper is Drug Science, given that he is writing about Drug Science? As presented, it is made to appear that this is some sort of independent endorsement of an organization by a university professor.

    AKS does appropriately acknowledge her work with Drug Science as a "competing...

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    Conflict of Interest:
    None declared.
  • Published on:
    A Different Perspective
    • Tylah Gibson, Nursing Student The University of The Bahamas

    To the Editors,

    I have read your article, “So near yet so far: why won’t the UK prescribe medical cannabis?”, and I found it rather informative as well as intriguing. I am from The Bahamas and we, too, have yet to legalize cannabis for medicinal use. I am writing this letter to give my perspective on the legalization of cannabis for medicinal as a nursing student, from a country that still holds the ways in which first world countries do things, very closely.

    Personally, I am in favor of the legalization of cannabis for medicinal as well as recreational use. There have been recent talks in our country by the Prime Minister about the legalization of the hemp industry for economic benefits. In a national address by Prime Minister Minnis (2020), he called the laws about cannabis “outdated” and stated that “there are potentially many opportunities for creative Bahamian businesspeople to get involved in this new industry”. With the Prime Minister speaking publicly about this topic, it gives the country hope that legalization may occur in the future.

    I mentioned being in favor of the legalization of cannabis got recreational use as well because, as a future nurse, it is my duty to be culturally aware. In March, it was reported by Jones (2020) that the Rastafarian Royal Ambassador Priest, Rithmond McKinney, expressed that “the Rastafarian man was being oppressed and being victimized over the years; and stereotyped over the years for the use of cannabis, a...

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    Conflict of Interest:
    None declared.
  • Published on:
    The Need of Medical Cannabis

    This response is a written reflection on the article “So near yet so far: why won’t the UK prescribe medical cannabis?" by Nutt D, Bazire S, Phillips LD, et al . Published on the 8th of July 2020. Upon careful discretion of this article, I can say that it is extensively informative in reference to the importance of medical cannabis and, the issues faced in the UK pertaining to the access of said medication. It was a very interesting read and a timely article in itself. Based on the information you provided stating that in a year a minuscule amount of NHS prescriptions where issued and less than 100 to private providers. One can perceive that even though medicinal cannabis is legalized it is not being prioritized, maybe to retain a level of control.
    Further on it is stated that, “statements such as insufficient evidence of efficacy or it is too dangerous are common and used even in the face of personal evidence of patients CBPMs work and, in many cases can be life changing and tolerated.” because of the high level in which cannabis use is stigmatize, many refuse to receive positive information in relation to medicinal cannabis, hence I do agree with the point the article is trying to make. This positive information is refused by many, simply because of the lack of knowledge in relation to medicinal marijuana having little to no THC whereas recreational cannabises has high levels of THC resulting in a lot of negative side effects. In another article by Kev...

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    Conflict of Interest:
    None declared.
  • Published on:
    Resistance to evidence other than RCTs is fuelled by senior clinicans' financial self- interest
    • Peter J Reynolds, Medical Journalist and President of CLEAR CLEAR Cannabis Law Reform

    There are no case reports anywhere in the world of patients receiving cannabis under medical supervision coming to any significant harm. There is no doubt that cannabis is safe as a medicine. Those opposed to it, usually with vested financial interests, are trying to undermine use of CBPMs with spurious claims of harms caused by smoking cannabis in its most potent form as a recreational drug.

    The senior clinicians responsible for drafting the guidelines, from the Royal Colleges and other professional bodies, are the same people who have failed to provide up-to-date medical education on the endocannabinoid system, through which cannabis exterts its therapeutic effects. These same people are also responsible for running and supervising the clinical trials that pharmaceutical companies use to prove the safety and efficacy of their new products. For this they receive very substantial fees and long-running sponsorship for their institutions. The conflict of interest is obvious, yet is being entirely overlooked.

    I fully support Prof Nutt's analysis but suggest that senior clinicians responsible for drafting guidelines do not wish to consider other forms of evidence as they are not in their financial self-interest.

    In summary there is no evdience of any harm in the medically supervised use of CBPMs and substantial evidence of great benefit. Failing to prescribe in such circumstances is unethical, irresponsible and may actually be 'doing harm...

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    Conflict of Interest:
    None declared.