Monthly Archives: December 2019

Patient Frequently Asked Questions Medical Cannabis

Patient FAQs

In this article, we answer some of the questions we get asked most often at The Medical Cannabis Clinics. If you have any further questions, please don’t hesitate to contact us via our social media channels on LinkedIn, Facebook and Twitter.

Before prescription:

What is the cost of an appointment?

At The Medical Cannabis Clinics, the initial consultation is £150, where you’ll speak with a doctor.

A follow up appointment with one of our specialists costs £65, with these taking place after three weeks and then once per month for three months after the patient receives the medication. This is to monitor the patient’s progress and to make any necessary adjustments to treatment. 

If there are no problems within the first three months, then it may be decided that follow up appointments should be continued as half an hour phone conversations costing £50 each.

How much should treatment cost per month? 

This depends on the specific product prescribed by the specialist, but a rule of thumb is to budget between £500-£800 per month.

Can I take my medication on holiday?

In this case, rules vary depending on the country you are travelling to. As such, the patient will need to check with the relevant authorities for their destination and get written approval. It should be noted that there is significant legal risk in travelling to some countries with any cannabis based product, so patients should approach taking their medication abroad with caution. 

What happens if a GP won’t refer me to the medical cannabis clinics?

You can self refer by booking a consultation with one of our specialists. You will then need to allow us access to your GP summary, and you will need to book an appointment with our private GP before you see a specialist. It should be noted that there is an extra cost for this.

How can I self refer?

Please see the answer above.

What CBD to THC ratio will I receive?

There are various products available with differing ratios dependent upon the condition being treated. In general, the rule of thumb our specialists take with dosing is to start low with the THC content, monitor the patient’s response to this and then increase this ratio as necessary.

Can I take medical cannabis medication if I’m pregnant?

No, pregnancy is an absolute contraindication – we will not be able to provide medical cannabis for anyone who is pregnant.

 

Once you’ve had your appointment:

Can I get my medical cannabis in my local chemist?

No, this is highly unlikely as there are only a handful of specialist chemists that can supply medical cannabis products. At your appointment, you will be given details of where you can source your medication.

How do I take my medication?

At The Medical Cannabis Clinics, we provide medical cannabis products that you can take in capsule, oil or vape formats.

Can I drive after taking medical cannabis?

Like any other medications that may cause impairment, it is recommended that you do not drive or operate a vehicle if you feel impaired at all. You can contact you physician for further advice on this matter if you are unsure of what steps to take in this situation.  

 

Aftercare:

What kind of aftercare will I receive at The Medical Cannabis Clinics?

Following your appointment with us, you will be provided with an aftercare document. 

History of Medical Cannabis Use

History of medical cannabis use

Cannabis is believed to have pre-dated humans and was almost certainly one of man’s first medicines.

DNA studies suggest the plant evolved somewhere around 20 to 25 million years ago, as DNA fossil records suggest it diverged from its closest relative Humulus or hops 27.8 million years ago. Fossil pollen for cannabis is sparse and points to the northeastern Tibetan Plateau as a centre of origin.

Its first known use as a food and for psychoactive potential was around 6,000 years ago, according to ancient Chinese texts.

It may have originated around China – certainly central Asia – and spread westward from there. All the old-world cultures used it, including the Scythians who took it from Siberia into China, India and Mesopotamia.

In India, cannabis has been used for many thousands of years, including as part of the spring festival of colours, Holi. It was also used in ancient Egypt, as a medicine, particularly for pain, epilepsy, eye conditions and as an anti-anxiety drug.

Hebrews used it in ritual ceremonies and as a simple medicine, while ancient Romans and Greeks used it in food, wine and as a surgical analgesic. It was also used to treat tumours, childbirth complications, headaches and as a muscle relaxant.

Various civilisations have banned it over the centuries, including the Muslim cultures of ancient Egypt, and in France during the Napoleonic era. Nevertheless, by the 19th Century, its use as a medicine remained largely popular. 

William O’Shaughnessy, an Irish physician working in India for the British East India Company, noticed local doctors using cannabis extract for a range of medical problems.

He became the first to publish on the use of cannabis in modern medicine and used it himself to treat patients in his hospital in Kolkata.

One of his early descriptions involved a baby girl with infantile convulsions. He commented: “The child is now in the enjoyment of robust health and has regained her natural plump and happy appearance.” This echoes with the childhood epilepsy cases that have helped to bring cannabis medicine to the fore today.

O’Shaughnessey brought cannabis seeds to Britain, helping cannabis medicine to become used by doctors in the UK. Somewhat questionably, he is reported to have suggested that Queen Victoria used cannabis for menstrual pains.

In the late 1800s to early 1900s, cannabis use started to dwindle, largely because of the development of new synthetic medicines such as aspirin, barbiturates and antibiotics. While not falling out of favour, the advent of modern drugs marginalised its usage.

By 1925, governments concerned about the international trade in opium began convening conventions designed to put international restrictions on the use and trade of opium. 

At one such conference, in Geneva in 1925, an Egyptian delegate bloviated that hashish, a cannabis product, was at least as harmful as opium and should be put in the same category of restriction. With no counter argument  offered, from that point onwards cannabis was labelled as a drug of equal danger and risk of addiction as opium and other narcotic agents.

In 1930, another obstacle for cannabis medicine’s progress emerged in Harry Anslinger. He was the first Commissioner of the Federal Bureau of Narcotics in the United States and had a fixation on cannabis. He spent many years in his role as commissioner demonising the drug. Some of his reasons were simply racist, and he latched on to the anti-Mexican and anti-black mood of the times.

Anslinger teamed up with famous newspaper magnate William Randolph Hearst, who produced a number of anti-cannabis newspaper articles. Anslinger was the man behind the now well-known films Reefer Madness, and Marijuana!, which had the tagline ‘weird orgies, wild parties and unleashed passions’.

The global problems with narcotics continued after the Second World War, and in 1961 this led up to the United Nations Single Convention on Narcotic Drugs, which still included Cannabis.

Cannabis was placed in its most restrictive level – Schedule 4 – which contained those drugs viewed as most dangerous, with high abuse potential and limited or no therapeutic value. As a result of the 1961 convention, most of the countries in the world had to put into place their own regulations to restrict the use of Cannabis. 

In the UK, this resulted in the Misuse of Drugs Act in 1971. Cannabis was classified as a Class B substance, a class that defines the penalty for possession and intent to supply. Even now, possession alone can carry a penalty of up to five years imprisonment with an unlimited fine. Intent to supply can carry a prison sentence up to 14 years with an unlimited fine, which compares to much lesser sentences for crimes such as brawling, grievous bodily harm and death by dangerous driving.

This essentially remained the picture until very recently. Several decades of outright prohibition suddenly gave way in November 2018, when a surge of publicity around the epileptic conditions of young patients like Alfie Dingley and Billie Caldwell created enough political pressure to effect changes. 

Cannabis was rescheduled to a Schedule II substance, enabling medical prescribing. This was a remarkable revolution for the substance, and while huge obstacles remain in establishing the necessary degrees of evidence for its approval for broader application by national regulators, after a long and tumultuous history, the future for medical cannabis looks positive. 

The Difference Between CBD & THC

The difference between CBD & THC

CBD and THC are two of the cannabis plants’ main cannabinoids, and are probably the two cannabinoids in the plant that you’re most likely to have heard of before. But what’s the distinction between these two cannabinoids, and how can they be useful as medical treatment? Read on to find out more. 

CBD

With the explosion of the CBD market in the past few years, with CBD seemingly being added to wellness products of all kinds and touted as a miracle product across the board, it’s not shocking that many people remain confused about what CBD actually is and what it does. 

CBD, or cannabidiol, is one of the most prevalent cannabinoids in the cannabis plant. It is also the most common non-psychoactive cannabinoid, meaning its use won’t result in a high as seen with THC use. 

CBD primarily works by binding to the endocannabinoid system and activating other neurotransmitter systems like the adenosine, serotonin and vanilloid receptors.

In terms of the substance’s effects, CBD is most well-known for its anticonvulsant qualities. For instance, GW Pharma’s Epidiolex, a product licensed in the US for the treatment of childhood-resistant epilepsy, is constituted of 99.9% pure CBD.

CBD has also had its supposed anti-anxiety effects highly publicised by the media in our ever-anxious modern world, with multiple news outlets widely recommending use of the substance to combat mental health issues. 

Aside from the substance’s popularised anti-anxiety effects, CBD is also believed to have potent analgesic and neuroprotective properties. 

Another interesting characteristic of CBD is that it tends to counteract the psychoactive effects often associated with THC. This may come as a comfort to many seeking to alleviate their symptoms without the use of high-inducing THC, as it’s now generally understood amongst medical professionals that a relatively small amount of THC can be cancelled out with a comparatively large amount of CBD. 

However, despite this promising balancing effect, in each case of prescription, the THC/CBD ratio of the medicines being recommended should be clearly understood, particularly as manufacturers tend to produce several CBD/THC varieties.

THC

THC, or tetrahydrocannabinol, is a psychoactive cannabinoid that is highly prevalent in the cannabis plant. In general, it tends to constitute between 12 and 20 percent of the dried content in some strains of cannabis and can constitute up to 25 to 30 percent of the cannabis plant’s content in more potent varieties.

The high typically associated with recreational cannabis use can be attributed to this cannabinoid due to its psychoactive qualities that occur when THC binds to CB1 and CB2 receptors. The known psychoactive side effects of THC include disorientation,euphoria, paranoia and hallucinations. 

However, while many may be concerned about these side effects, it should be noted that few medical conditions require THC use over and above the use of CBD, so often, patients will start on a CBD-rich or balanced product rather than a high THC one. Typically, medical professionals recommend that patients using a product containing THC should ‘start-low and go slow’ with dosing, as this reduces the risk of any of the adverse side effects stated above.

A high is not all THC is known for though. THC is also known to have many useful medicinal properties. Specifically, we know THC has analgesic and anti-inflammatory properties, is a muscle relaxant and has anti-nausea effects. 

At The Medical Cannabis Clinics, our GMC registered specialists will identify the appropriate cannabis medicine care plan and products for patients following a comprehensive assessment which includes an in-depth evaluation of the main symptoms being targeted, current medications, pattern of symptoms and lifestyle factors such as safety-sensitive occupations. They will also monitor and adjust the medication on a regular basis to ensure the best effect with fewest side effects. There is also a carefully designed process in place to monitor patients’ wellbeing, with follow-up appointments after a week and then every month, for three months after receiving a prescription.

To book an appointment with one of our specialists click here

The Training Domino Effect Medical Cannabis

The training domino effect

“Doctors at the moment are not prescribing… the main reason in my view is a lack of education. Doctors have never been trained in cannabis medicine or the endocannabinoid system and they need the confidence that comes from training” – Professor Mike Barnes

Professor Mike Barnes, an instrumental player in paving the way for the legalisation of medical cannabis in the UK, thoroughly understands the importance of the prescription process. As the man responsible for obtaining the U.K’s first permanent medical license for Alfie Dingley, a young epilepsy sufferer who previously experienced up to 500 life-threatening seizures a month, his call for more doctors to be trained should not be ignored. 

At The Medical Cannabis Clinics, we truly understand the importance of training doctors to prescribe medical cannabis products. And importantly, we realise that not only is this training rewarding for the doctors in the short-term as they see their patients’ conditions improve immeasurably through this treatment, but it’s also rewarding in the long term, as the provision of training acts as the first step in a domino effect of larger positive change in society as a whole. This may sound like a reach, so let us explain how this domino effect works. 

Currently in the UK, the prescription of medical cannabis is at a stalemate as doctors remain in the dark about how medical cannabis can help patients and how they can prescribe in a safe and efficient manner. Once doctors receive the training they need however, they will be able to understand how cannabis based medicines work in a variety of cases and so will be able to prescribe for patients with confidence. 

The first knock on effect after training is obviously the treatment of patients in need – with this treatment being appropriate for patients with a variety of pain-related, psychiatric and neurological conditions. This is perhaps the most rewarding step for patients and doctors alike as you realise that once the stigma of cannabis-based treatment is overcome, remarkable results and improvements in previously resistant conditions can be seen. 

With the benefits of cannabis medicine becoming apparent as patients’ symptoms and conditions improve following adherence to carefully considering dosing regimes, word-of-mouth will convey the efficacy of this form of medicine, leading to more doctors realising cannabis’ medical benefits. 

As more doctors eventually start prescribing in this way then, this form of medicine will become far less taboo and more normalised, which in time may lead to healthcare advisory bodies allowing the prescription of medical cannabis for a wider range of conditions that currently remain without alternative, non opioid-based treatment options.

And as the medicine is accepted as an appropriate form of treatment for a number of conditions, the price of such cannabis-based treatment will drop, making it far more accessible for patients who desperately need to find solutions to their treatment resistant illnesses.  

With all this in mind, it becomes clear that training doctors is about far more than just prescribing for patients in the short-term. Through learning to prescribe with The Academy of Medical Cannabis and The Medical Cannabis Clinics, doctors are in fact contributing to a far larger and far more important societal and industry-wide domino effect that will have an impact on patients with a number of conditions and will help to eradicate years of stigma about a treatment that can effectively help so many who previously had no other viable treatment options.   

To learn how to prescribe cannabis-based treatment for patients in need, sign up to The Academy of Medical Cannabis’ training courses here, where you’ll not only learn how to prescribe but where you’ll also join our peer-to-peer network of experienced prescribers and get patient access through The Medical Cannabis Clinics.

5 things you need to know before buying CBD

5 things you need to know before buying CBD

You don’t need to be told that the CBD market has expanded hugely in recent years; the products are everywhere. Being sold online, in specialist health shops and on the high street, it’s hard to avoid CBD’s encroachment on practically every health, wellness and beauty category. With CBD face masks, massage oils, moisturisers, drinks and foodstuffs, it’s hard to blame people for seeing this touted miracle elixir as a snake oil of sorts, particularly when there are claims that CBD helps with issues from inflammation to anxiety to acne to sexual issues. 

However, some of these issues, like inflammation and anxiety as well as a number of other psychiatric, neurological and pain-related conditions have scientific evidence suggesting their efficacy. But selecting an effective and reputable CBD product that’s suitable for you can be a confusing process considering the current oversaturation of different types of products on the market. With this in mind, here’s 5 things you should know before you buy a CBD product: 

1.What CBD is:

Cannabidiol, or, as it’s commonly known, CBD, is the most common non-psychoactive cannabinoid present in the cannabis plant. As this cannabinoid is non-psychoactive, people who use CBD will not feel high after consumption, unlike people who consume products containing THC. 

CBD elicits effects in the body by binding to the endocannabinoid system, with its action occurring largely through activating other neurotransmitter systems, for example the serotonin,  adenosine and vanilloid receptors. 

2.If your CBD is in isolate form or if it’s a full-spectrum product:

CBD isolate is a (practically) pure form of CBD (often 99.9% pure) which is separated from the rest of the cannabis plant’s constituents like terpenes, flavonoids and other cannabinoids through extraction processes.

CBD isolate usually comes in a crystallised form which is then typically ground into a powdery consistency which is easier for people to consume. However, like with many other CBD products, due to the ever-expanding interest in CBD resulting in a swell of the market with people capitalising upon novel and exciting methods of administration, it is now relatively common to find CBD isolate in oil, edible or capsular forms.

People may choose to use CBD isolate for a number of reasons, particularly if they’re either trying to avoid a high from full spectrum oil that may be experienced due to its THC content, or because they may be somewhat fearful about the psychoactive risk factors associated with THC. By picking a product with very small amounts of THC or none at all, the consumer completely removes or considerably lessens any psychoactive risks involved with THC consumption.

Full-spectrum CBD, unlike isolate forms of CBD, contains CBD and a number of other cannabinoids, flavonoids and terpenes found alongside each other in the cannabis plant, including THC in some cases.

Typically though, full-spectrum CBD oils still contain very small amounts of THC and relatively high levels of CBD and other cannabinoids. This means that although there is a risk of psychoactive side effects with the THC content, as the content is so low, and because CBD is thought to counteract the psychoactive effects of THC to some extent, these risks are considered to be minimal.

Many people may choose to use full-spectrum products as the health benefits are often purported to be better than with their isolate counterparts. This is due to the theorised ‘entourage effect’ experienced when using whole plant products. 

3.The difference between CBD supplements and wellness products and medical grade CBD:

Hemp-based CBD products and general wellness products are generally classified in the category of herbal supplements and remedies rather than as medicines, with CBD products thereby being regarded as relatively similar to other well-known herbal plant remedies like maca or turmeric.

What should be noted about these products is, despite the fact that self-administrated CBD may have generally beneficial placebo or minor health effects, that no medicinal claims can be made about these products and they are not as effective as medicines, with it not being possible to prescribe them as such. Rather, the claims they make are only linked to “wellness” effects as opposed to any specific medical benefits. 

Medical grade CBD on the other can claim to have medical benefits due to the rigorous testing of the products available for prescription. Additionally, less risk is involved in receiving and using medical grade products, as medical practitioners will have been involved in discussing the best treatment options for their patients and will have established a safe and effective dosing regimen.

4.There’s a lack of regulation in the supplements market:

As many CBD-based products fall under the category of herbal supplements or wellness products, the lack of regulation and information around products in this area has led to numerous products being exposed for having basically no beneficial constituent ingredients or for containing ingredients that could be potentially harmful to consumers due to impurities and toxins.

With this in mind, consumers need to carefully consider the cannabinoid balance within retail products, as varying extraction methods for producing CBD generate different concentrations of cannabinoids in the final product.

5.How the product’s been tested:

With such concerning discrepancies between CBD products, a reputable CBD supplement should provide as much information as possible about the product so the buyer is fully aware of what they’re consuming. At least, products should have fully itemised ingredient and composition lists and should ideally show lab testing results that highlight the product’s purity and safety. 

Another good thing for consumers to check is whether their retail products have been Good Manufacturing Practice (GMP) confirmed. As a general rule, if any retail products do not meet at least some of these conditions they should not be considered for use.

Having read this article then, it should be clear that while CBD products on the high street may claim to treat a variety of issues effectively, very few of these claims can be scientifically backed up like with medical grade CBD.

At The Medical Cannabis Clinics, we would urge people to book a consultation with one of our specialists if you have any psychiatric, pain-related or neurological conditions that you would like to seek CBD or medical-cannabis treatment for. When you book a consultation with us, our specialists will give you an expert assessment to evaluate if medical cannabis treatment can help your condition, taking into account your medical history, national guidelines and your particular needs. 

Book an appointment with one of our specialists here.

Hannah Deacon Medical Cannabiz Summit Malta

Medical Cannabiz Summit Malta

I was honoured to recently be invited to speak at the Medicalcannabiz Summit in Malta. The event held some very interesting talks and panels over two days along with an exhibition where many different companies offered a range of services and support to the many stakeholders within the medical cannabis sector.

I was asked to talk about Alfie’s story and the current issues being faced by patients in the UK who wish to access medical cannabis on prescription.

I personally love these occasions, as you get to network with other people within the medical cannabis sector, all of whom have a common goal: to ensure that medicine made from cannabis is accessible to all who need it. For me, the thought of children like my son being able to access the products they need easily with a doctor who knows how to prescribe is the goal that many of us wish to see. These sorts of events help us to network, motivate discussion and enable the connection of industry partners.

When I speak about all major hurdles we came through to achieve Alfie’s license and NHS prescription it makes me realise over and over again how far we have come. When I stepped on the boat with my family to travel to the Hook of Holland to try to save his life, I never dreamed that things may end up as they have. It just shows the amazing things parents can achieve when they have the desire to help their suffering child. As a new mother, I always asked everyone else but myself what was best for my little boy, but over time as he became ill and every treatment failed him, I knew that I had to start listening to myself and every time I tell our story I am so grateful that I did.

I was also lucky enough to take my partner and daughter with me, and we were able to travel with Professor Mike Barnes who was also speaking at the conference. Our family life has never been normal for our daughter, so sometimes when we get the chance, we take her away, so she isn’t the only child in her class who hasn’t been on holiday with her parents. It was tough though not being there with Alfie, he is part of our whole family and when he isn’t there, there’s a big hole. He just doesn’t enjoy being away from home though, he needs routine and to know that he’s going to school the next day.

I will never forget those that are not fortunate enough to have access to an NHS prescription. We worked so hard to achieve what we did for Alfie, but I realise that there are many thousands of children like Alfie in the UK who need urgent access to medical cannabis on prescription. There are many thousands of patients all over the UK who will be driven to the black market if we don’t do all we can to ensure access for all who need medical cannabis on prescription.

I work with 18 families who all have very poorly children. They are fighting every day to access a prescription which every one of them has proved helps their child. Even some of their NHS doctors have tried to secure funding or tried to prescribe and every one of them has been blocked from helping them. Much of this is down to fear from the hierarchy within the hospital trusts who simply don’t understand cannabis as medicine. So today, they continue to fundraise and worry about how they can afford the next month’s supply when they should be enjoying the extra time with their child without seizures, or the time out of hospital or the first time their child has sat unaided.

To hear the patients’ and parents’ voices is so important. We are the link between businesses who wish to help patients, the patients who need help and the doctors who need to know how to access the support they must get to ensure they can prescribe.

I very much appreciate the opportunity to talk at these events as I believe it makes everyone there remember their purpose and why they are in this industry – to help the patients that will benefit from this new and exciting medicine.

*article written by Hannah Deacon