Minister for Health launches new online information repository on Medical Cannabis
The Minister for Health Simon Harris today (Tuesday) published a new online repository of information on medical cannabis on the Department of Health’s website.
The repository provides detailed information for doctors and patients on the existing Ministerial medical cannabis licence scheme, the Medical Cannabis Access Programme currently under development, and relevant legal and policy overviews on wider medical cannabis issues.
Commenting on the launch of the repository, Minister Harris outlined the goal in publishing this information:
“While the potential of cannabis is not yet fully established, there is considerable interest in the use of cannabis for medical purposes among the clinical community, members of the public and others.
The significant work that has been undertaken to date by the Health Products Regulatory Authority (HPRA), the Medical Cannabis Expert Reference Group, and my Department, to advise on and facilitate access for clinicians wishing to prescribe medical cannabis for their patients, has been extremely important and so I am pleased that this vital information will now be publicly available to all. Further developments over time will be added to the repository so it is maintained up to date.
I hope that the information contained in this repository will allow the conversation around medical cannabis to develop and proceed in an informed manner, but always based on the best clinical and scientific information available.”
The Minister acknowledged the changing international attitudes towards medical use of cannabis, most recently Canada, however confirmed that he will continue to act with care when dealing with cannabis:
“As Minister for Health, the safe treatment of patients remains my top priority. Cannabis remains a controlled substance in many jurisdictions due to its potential for public harm. This repository of information will provide a clearer position on the possible benefits but also the precautions and potential risks of cannabis as a medical treatment and will allow doctors to make an informed decision in the best interest of their individual patients.”
The information on medical cannabis is available on the Department of Health website.
Notes to the Editor
There is considerable public interest in the use of cannabis for medical purposes. While the therapeutic potential of cannabis is clearly of interest and potentially promising, the quality of the evidence reported thus far is limited for many indications, and as a result clinicians, researchers and patient advocacy groups consistently cite the need for formal clinical trials to evaluate the benefits and risks of treatment. Media reports often refer to a growing body of evidence regarding the effectiveness of cannabis. However, the HPRA report ‘Cannabis for Medical Use — A Scientific Review’ concluded that the available scientific evidence finds, at best, a moderate benefit for cannabis in a small number of conditions and conflicting evidence, or no evidence at all in a large number of other medical conditions.
Recently published clinical trial data on the effectiveness of certain cannabis-based medicines in certain epilepsy syndromes and in spasticity associated with multiple sclerosis as well as media reports regarding anecdotal potential benefits of cannabis-based products for various medical conditions has led to demands from members of the public, some political representatives, and some medical bodies to be allowed to access cannabis for medical use. Internationally, several countries have access models in place for cannabis for medical use.
Current Ministerial licence scheme for access to cannabis for medical use
Under the Misuse of Drugs Acts 1977 – 2016, it is open to the Minister for Health to consider granting a licence for access to medical cannabis-based preparations for named patients, where this course of treatment has been endorsed by the consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time. To date Ministerial licences have been issued for the treatment of seven individual named patients with unmet medical needs.
Medical Cannabis Access Programme (Under Development)
Separate to the Ministerial licence scheme, on the 10th of February 2017 the Minister published the Health Products Regulatory Authority (HPRA) report, “Cannabis for Medical Use – A Scientific Review‟. On foot of this report the Minister announced his intention to establish an access programme for medical cannabis-based treatments for the following medical conditions;
- Spasticity associated with multiple sclerosis;
- Intractable nausea and vomiting associated with chemotherapy;
- Severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications.
Dr Mairín Ryan, from HIQA, was appointed to Chair an expert reference group, who were tasked with the development of operational, clinical and practice guidelines for the access programme. The clinical guidelines are contained in the online information repository.
The HSE has been asked to establish and maintain a Register to facilitate the programme and work is continuing on the drafting of secondary legislation to underpin the access programme. The particulars of the programme and the legislation will be finalised once appropriate cannabis product supplies have been established.
Availability of cannabis products that are of an appropriate quality standard and are affordable to patients is a critical aspect in establishing the access programme. Without a domestic supply of product, the programme cannot operate. The Department is working intensively on finding solutions to the supply of appropriate products for Irish patients, to be dispensed in Ireland and remove the need to travel abroad to source a supply.
In the meantime, medical practitioners wishing to prescribe medical cannabis for individual patients are advised to review the guidance on applying to the Minister for Health for a licence information on which is available in the repository.
THC and CBD
The two active components of cannabis that are of current medical interest are tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC is the principal psychoactive constituent of cannabis. Under the Misuse of Drugs legislation, products containing THC are strictly controlled and possession is unlawful except under licence.
CBD is also derived from cannabis; however, as it is not psychoactive, it is not controlled under the Misuse of Drugs legislation. CBD oil is often marketed as a food supplement and it has been reported that a number of Irish patients are accessing CBD oil from high-street shops or online. However, it should be noted that CBD oil is not authorised as a medicinal product in any country and any such products on the market are not currently subject to the same level of quality assurance and control as is required for medicinal products and medicinal claims cannot be associated with their use.