We sit down with Cannabis Access Clinics UK to discuss the current climate of the United Kingdom's medicinal cannabis industry, and what the future holds for the UK.
There are a lot of eyes on the United Kingdom at the moment, following Boris Johnson's election in December last year, and the fulfillment of his campaign promise to "get Brexit done" on January 31st this year.
As a result of these seismic shifts, uncertainty now looms over the region, surrounding the UK's trade relations with Europe, whether or not Brexit will actually occur, and for some, how all of this might affect the UK's cannabis landscape. In order to gain a better insight into the climate in the United Kingdom, we decided to touch base with Dr. Samuel Murray, the General Manager of Southern Cannabis Holdings Europe, which operates Cannabis Access Clinics UK.
Following the UK's withdrawal from the European Union, as led by Boris Johnson, the now fissured regions are looking onward to trade negotiations in March. On whether or not this will impact the cannabis industry, Dr. Murray believes not.
"If anything, moving out of this Brexit-limbo the UK has been in for the past few years has improved sentiment. What the industry needs most is clarity, and we're finally starting to get this. Opportunities are opening up for experienced operators from outside of Europe."
This post-Brexit clarity may be just what the doctor ordered when it comes to the UK, where medicinal cannabis prescriptions have famously struggled. On his prognosis of the UK cannabis industry's future, Dr. Murray is optimistic.
"There's a lot of excitement in the UK at the moment, but also frustration from patients who have struggled to get access to affordable treatment following the reclassification of cannabis in 2018. Private specialist clinics have begun seeing patients in 2019, and this will likely be the main pathway for patients to access treatment in 2020."
This gravitation towards private specialist clinics, according to Dr. Murray, is the result of several barriers to entry that UK patients face when seeking out medicinal cannabis medicines. These barriers include "high costs of treatment and import delays," as well as a lack of information on the part of General Practitioners.
"GP education is a big hurdle. While GPs can't currently prescribe medical cannabis in the UK, they are the first point of contact for patients with chronic conditions that haven't responded to conventional licensed treatments," Dr. Murray said.
"Many GPs aren't aware of the potential benefits cannabis-based products can have, and are uncomfortable offering advice on the topic, or providing a referral and unfortunately the opportunity for quality of life improvement is lost, simply due to this lack of education. The endocannabinoid system still isn't something that's taught in medical school."
Though the lack of cannabis information doesn't lay solely with medical practitioners, as many UK citizens remain unaware that medicinal cannabis is even available.
"There's still a lack of knowledge in the UK. Most UK citizens I speak to are unaware that medical cannabis is legal, and plenty of doctors are unaware as well. Those that are aware that is legal are often unsure of what it's used for, outside of a few very high profile childhood epilepsy cases."
Interestingly, Dr. Murray mentions, while the medicinal cannabis industry struggles in the UK, the CBD, or cannabidiol supplement industry is "booming." The Guardian estimates that 1.3 million UK consumers spend £300m a year on cannabidiol products, a number which Leafly predicts will skyrocket up to £1 billion annually by 2025 – as much as the rest of the UK's herbal supplement markets combined.
Though this atmospheric rise of CBD prompts a "dire necessity for sensible regulation," according to Dr. Murray, as quality control surrounding CBD supplements is practically non-existent.
Currently, due to both these barriers to prescription and a general unawareness surrounding the industry, Dr. Murray estimates that cannabis prescriptions in the UK are in the "hundreds" in total, which lags drastically behind even Australia's monthly medicinal marijuana prescriptions. Currently, 3,000 Australians are approved for cannabis medicines per month, on track to reach 50,000 patients by the end of this year.
Though Australia's increasing success with medicinal cannabis is precisely something Dr. Murray wishes to replicate, having contributed to it himself:
"I'm an Australian trained doctor that has prescribed medical cannabis to approximately 500 patients in Australia, working at Cannabis Access Clinics Australia. I also completed my MBA at Cambridge, graduating in 2018. I moved back over to the UK in April 2019 to take on the role of General Manager of Southern Cannabis Holdings Europe, which operates CA Clinics UK. I've been driven by trying to replicate in the UK the fantastic quality of life improvements I've seen in so many patients in Australia."
Dr. Murray sees things changing in the UK cannabis landscape over the coming years, with patient numbers moving from hundreds to thousands this year, and by 2021, he anticipates UK patient numbers will grow to tens of thousands.
"Anyone that I talk to in the UK about medical cannabis is very interested and open to learning more cannabis and the industry. The stigma that I thought may have existed when entering a new market really isn't there."
Suitable patients are prescribed cannabis medication that can be filled at a pharmacy, just like any other medication.Dr. Samuel Murray, General Manager of Southern Cannabis Holdings Europe
Furthermore, Dr. Murray's work with Cannabis Access Clinics aims to attract more patients to the UK's struggling market.
"Cannabis Access Clinics offers patients across that UK access to specialist doctors that prescribe medical cannabis to patients in need. These are typically patients with chronic conditions that have already tried all available conventional, licensed therapy and have run out of options."
"Cannabis Access Clinics is also recruiting for CACOS UK, an observational study in conjunction with Applied Cannabis Research that will track the progress of 500 patients who undergo cannabis-based treatment through the clinic."
No Pain, All Gain
When it comes to medicinal cannabis, whether it be in the UK or elsewhere, there are a handful of primary conditions for which patients are prescribed cannabis products. Epilepsy and seizures are the best known medical conditions that cannabis can assist with thanks to products such as Epidiolex and Sativex, both of which are registered drugs produced by GW Pharma.
Though these aren't the only conditions cannabis can help with, as Dr. Murray reports that "cannabis is most commonly prescribed for symptomatic relief of chronic pain, nausea and vomiting, insomnia and some mental health conditions." Of these ailments, chronic pain may assist the largest market according to the doctor.
No drug or medication is without risk, but I don't think any doctor, even the most opposed to cannabis would argue that cannabis is anywhere near as dangerous as opioids. Dr. Samuel Murray, General Manager of Southern Cannabis Holdings Europe
"Chronic pain really is a huge burden on the health system and the wider economy in general. The NHS estimates as high as 1 in 5 adults suffering from chronic pain. Unfortunately, patients often end up on highly addictive opioids, at no fault of their own without many other options."
"The majority of patients I've treated are highly motivated to reduce their opioids, have often tried and failed before, and are just looking for some extra help to support this. When prescribed as an adjunct, with support from the patient's regular GP, I've seen patients succeed in reducing and ceasing opioid painkillers. Though of course, anecdotal evidence isn't enough and more research is needed to prove this conclusively."
While the United Kingdom is undoubtedly going through teething issues when it comes to medicinal cannabis, they aren't unlike the ones Australia faced up until very recently, and with people like Dr. Samuel Murray at the helm, it's looking like the UK is in good hands.
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