Image: a graphic showing the chemical structure of cannabis

Cannabis for MS on prescription: your questions answered

The Government has announced that cannabis can now be legally prescribed. We answer some of your questions about this news.

 

How will I be able to get cannabis to manage my MS?

On Thursday 1 November, the Government rescheduled cannabis-based medicinal products to make it legal to prescribe them. This means specialist doctors like neurologists can now prescribe unlicensed cannabis-based treatments grown to a certain pharmaceutical grade.

But even this type of cannabis can only be prescribed after all licensed treatment options have been considered. And GPs can't prescribe it, though they may be able to refer you to a specialist.

Guidance published for specialist doctors is very restrictive and discourages them from prescribing medicinal cannabis. So even if your doctor feels you could benefit from cannabis, they may find it hard to secure funding and permission from their hospital

We’ll be talking to NHS England to make sure this guidance is revisited urgently and they listen to people with MS.

Will I be able to get cannabis to manage pain?

Right now it looks unlikely. Guidance for specialist doctors recommends against prescribing medicinal cannabis for people with pain. We disagree with this recommendation. We believe evidence for cannabis helping with pain has been ignored.

Will I be able to get cannabis to manage muscle spasms?

Right now this is also unlikely. You might be able to access cannabis-based treatments for muscle spasms, but only once all other options have been considered.

And the guidance for specialist doctors says very little about spasticity in MS.

But what about Sativex, you can already get it?

There’s already a licensed cannabis-based treatment to manage spasms for people with MS – Sativex. But it's only officially recommended for use in Wales.

In other parts of the UK you can’t easily get it on the NHS because regulatory bodies say it costs too much. And for many people it’s too expensive to buy privately.

Will it be easier to get Sativex now?

Probably not. NICE and the pharmaceutical company that make Sativex would have to reach a new decision on costs. But it’s important to remember Sativex is only licensed to help people with muscle spasms and stiffness, not pain.

Evidence shows cannabis can also help with pain. That’s why we’re calling for NHS England to recommend medicinal cannabis for people with MS who have pain and muscle spasms.

What forms of cannabis are likely to become available?

Legally speaking, unlicensed medicinal cannabis can be prescribed if it passes a pharmaceutical standard called Good Manufacturing Practice (GMP). This is to make sure it passes safety standards and is made up of the correct compounds.

What about CBD?

Cannabidiol (CBD is one of the compounds that make up cannabis. You can buy it legally as a food supplement (because it's not the part of cannabis that gets you high).

For a doctor to prescribe it would need to be the GMP pharmaceutical standard. And right now there's no evidence that CBD alone works in treating MS symptoms.

What happens next?

The National Institute for Health and Care Excellence (NICE) have started consulting on long term guidelines for who should be able to access medicinal cannabis. We're not expecting it to be completed until next October 2019.

We’ll be working to make sure people with MS are involved in this process and the evidence for cannabis for medicinal use is properly reflected in guidance.

We'll also keep talking to neurologists, to understand what this means for people with MS.

Does cannabis really work?

Evidence shows cannabis for medicinal use can work for some people to relieve pain and muscle spasms in MS.