Following the launch of Cancard in the UK, Nancy Cross, Analyst at Lightning Health talks about the positive impact the launch may have on individuals carrying medicinal cannabis

In 2018, cannabis-based medicinal products (CBMPs) for medicinal use were rescheduled into Schedule 2 of the Misuse of Drugs Regulation, meaning that they can be prescribed medically subject to controlled drugs requirements. Since then, physicians on the General Medical Council (GMC) Specialist Register with a special interest in the indication being treated, have been able to choose to prescribe medicinal cannabis-based products where there is an unmet clinical need. If individuals are eligible to receive a prescription through NHS England, they will pay the standard co-payment of £9.35 per prescription from 1st April 2021 [1,2]. 

Due to the rescheduling of CBMPs, patients with a range of indications are now, in theory, eligible for a prescription through the NHS [1]. In practice however, very few patients are receiving NHS commissioned prescriptions for unlicensed CBMPs despite the new legislation. To date, very few specialist doctors have elected to be on the Specialist GMC Register; this is likely to be associated with persisting stigma combined with a lack of education around the benefits of medicinal cannabis. As such, few patients have access to specialist physicians that are able and willing to prescribe CBMPs, and reimbursed access is extremely limited. 

Select individuals may be able to access CBMPs through the private healthcare system in the UK however, the costs of private prescriptions are prohibitively expensive for many and patients often resort to using illicit sources of cannabis. The ethical debate in the medicinal cannabis community focusses on inequity of access to CBMPs based on an individual’s financial resources and the inability to access therapy privately leaves many patients with the fear of being prosecuted for self-medicating with these products. 

In November last year, the Cancard was launched to tackle these issues, with the aim to “unofficially decriminalise” medicinal cannabis in the UK. The Cancard, devised by a stroke patient and cannabis user, is a holographic photo ID card that individuals can carry if they have a ‘qualifying condition’ for which they are eligible for a medicinal cannabis prescription, but they cannot afford it (privately). Cancard Ltd. have worked with healthcare professionals, policy makers and senior police officers, and guidance has been issued to all forces in the UK to give police the confidence to use their discretion when dealing with individuals carrying cannabis for medicinal reasons. The card also comes with a stop–and–search guide, a helpline for legal advice and resources for solicitors to ensure that patients are empowered in their decision to self-medicate with cannabis and are protected from prosecution [3,4]. Last week, The Times reported that nearly 20,000 people living with a range of conditions are using the Cancard and 96% of cardholders who have been stopped by police have not seen confiscation of their personal supply of cannabis or any criminal charges [5]. 

Although there is no change in the legality of carrying cannabis without a prescription, this is an important and welcome step in changing attitudes towards medicinal cannabis and reducing the fear and emotional distress of patients who cannot afford a prescription.   

References

[1] Department of Health and Social Care (2018). Available at: https://www.england.nhs.uk/medicines-2/support-for-prescribers/cannabis-based-products-for-medicinal-use/  

[2] NICE (2020). Available at: https://bnf.nice.org.uk/guidance/controlled-drugs-and-drug-dependence.html  

[3] Cancard. Available at: https://www.cancard.co.uk/ 

[4] Medical Cannabis Network (2020). Available at : https://www.healtheuropa.eu/cancard-uk-medical-cannabis-card-launched-today/104214/ 

[5] The Times (2021). Available at: https://www.thetimes.co.uk/article/cannabis-card-allows-20-000-pain-sufferers-to-avoid-arrest-vnf0znr3n 

Article published 31 March 2021.