THE medical profession must learn from the way Covid-19 vaccines have been subjected to real-world efficacy trials – and adopt a similar pathway for cannabis, says one of the UK’s leading cannabis practitioners.
Professor Mike Barnes, Chair of the Medical Cannabis Clinicians Society, was speaking on day one of the Prohibition Partners’ Live three-day conference.
On the Cannabis Europa stage Prof Barnes participated in a debate on UK medical cannabis prescribing entitled: Is There a Doctor in the House? Patient Access to Medical Cannabis.
Prof Barnes said: “November 2018 was potentially an excellent day with the law change, but in reality only three NHS prescriptions have been written for children. There’s no reason why NHS clinicians cannot prescribe.”
With Covid Real World Data Finds Traction
He said one of the fundamental reasons for this is the ‘stigma’ still prevalent towards cannabis medicine in the ‘upper echelons of the medical profession’.
The main reason for this is that the bodies which provide the guidelines to clinicians continue to adhere to the mantra that all medicines need to be funnelled down the pharmaceutical route and undergo a double-blind placebo controlled trial, he said.
He argues it is inappropriate to treat a plant – ‘especially one like cannabis, with its 140-plus cannabinoids, 200 terpenes and numerous flavonoids – as a single molecule’.
And he continued: “It just doesn’t work. You need to look at real world evidence and there is a huge amount of data from observational studies.
“Now, with Covid real-world data is finding some traction that is meaningful. With the success of the vaccines they are looking at real-world data and saying ‘this is fine’.
“But when it comes to cannabis it is not fine. They want to put it back into a pharma box and cannabis does not fit in pharma box.
“NICE are constrained by their own regulations and that is how they look at it, but if they looked at the real-world data there is overwhelming evidence.
“I’m not one of those who says that cannabis is a cure for all – in any remote sense but for certain indications there is a lot of hard evidence.”
165m People Using Cannabis Every day
This panel was hosted by Richard Hurley, Features and Debates Editor at The British Medical Journal along with Dr Rebecca Moore, a Consultant Psychiatrist, also of The Medical Cannabis Clinics and Bradley Moore CEO & Director at PPLive sponsor Global Cannabis Applications Corp.
When cautioned by Mr Hurley on the pitfalls of relying on observational data with its potential for ‘all kinds of bias and flaws’, Prof Barnes fired back.
“You are in danger of going down the pharmaceutical route. You mustn’t forget that there are something like 165 million people in the world using cannabis every day of their lives.
“That is a huge amount of safety data. Somebody on the (UK) Health Select Committee 18 months ago said this might be the next Thalidomide. What complete and utter rubbish – millions of people have used it for thousands of years and we would know if it were the next Thalidomide.”
“A doctor’s concern has to be two things; firstly, safety, and I don’t think there is any concern on any parameter that cannabis is a safe medicine, it doesn’t kill people – unlike opioids.”
Lack Of Prescribing Is Immoral
“The other parameter is whether it works? We know it works on a real-world basis for a lot of people, not everybody – something like 80% of people prescribed for pain it has an effect, something like 80% of the people prescribed it for epilepsy it has an anti-convluscant effect.”
“We know it is working and we know it is safe. It’s not the first line. It’s for people who have reached the end of the road with other drugs, and in that situation I think it is verging on the immoral not to try something that we know is safe and we know that works, all because it hasn’t jumped through a pharmaceutical of double-blind placebo controlled study.”
“Intellectually, there cannot be much of an argument left against cannabis, but there clearly is, and I just don’t understand that.”
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