CANNABIS-BASED medications, including whole-plant cannabis flower and oil, are life-changing drugs for many. They have been available on prescription in the UK since 2018 but the lack of a framework allowing access to them on the NHS remains a constant barrier for around a million people believed to be eligible for legal cannabis.
In 2019, the subsidised medical cannabis programme Project Twenty21 (T21) was launched with plans to enrol to up to 20,000 disabled and chronically ill citizens who are unable to afford the cost of a private prescription. For the most serious conditions – such as that of eight-year-old Edinburgh resident Murray Gray, who has severe epilepsy – private fees can amount to thousands of pounds every month.
Monitored by the leading independent scientific body on drugs in the UK, Drug Science, the aim of the project was to not only offer a solution to low-income patients, but create the UK’s largest body of evidence to demonstrate the effectiveness and tolerability of medical cannabis.
However, devastating news of a staggering price increase set to come into place on February 1 – which for some products amounts to more than a 130% rise – has shattered the hopes and health of patients signed up to the scheme. According to a poll created for T21 patients by medicinal cannabis advocacy group PLEA, 95% of respondents said the change in price structure would have a significant impact on their lives, with most saying they would have to withdraw from the project.
READ MORE: Calls in Westminster for wider availability of medical cannabis
As a result, many legal medical cannabis patients (of which there are now more than 3000 in Scotland) are turning to the illegal drugs market, where they claim they can find cannabis that is both cheaper and easier to obtain – albeit of questionable quality. Others trying to steer clear of criminal activity are left in a position where they are choosing between paying for essential bills or medication, selling family homes, and even turning to sex work.
Gillian Flood (below), from Glasgow, has been prescribed medical cannabis oil and flower since April 2020 for fibromyalgia and post-traumatic stress disorder. Before cannabis, she tried the medications Gabapentin and Pregabalin, anti-depressants and an anti-psychotic.
The mother of six said: “I couldn’t get medical cannabis on the NHS and the private prescription fees were too high for me to sustain. When I discovered Project Twenty21 it gave me hope. The other medications
I had been on made me feel emotionally and physically numb. I was so foggy headed and I couldn’t look after my kids. Despite all the prescription pills I was on, I was still in agony. Every day was unbearable.
“Since I discovered cannabis I feel happy to be here. The longer I use cannabis, the better it gets. Within minutes of using cannabis, my muscles relax, my nausea subsides and I experience near-instant relief. I’m without a doubt a better mother to my children with cannabis in my life.”
But now, with a 40% increase in price and no access to cannabis on the NHS, Flood has to choose between medication and food, or undertake criminal activity. “I have no choice but to break the law or live in constant pain,” she says.
Kayleigh Ross (above), 28, from the Shetland Isles, was the first person in Scotland to sign up to Project Twenty21. She is a mother of five and has a cannabis prescription for Ehlers Danlos syndrome FND, fibromyalgia, emotionally unstable personality disorder, gastroparesis and autism spectrum disorder.
“Cannabis has allowed me to come off opioids and be the mum I have never been able to be,” she said. “Meeting the cost of my private prescription was already a struggle, but now it’s jumped from £799 to £1540 I can’t continue the treatment. This price increase and lack of access on the NHS is pushing vulnerable disabled families to break the law.”
Scotland’s only Healthcare Improvement Scotland-registered medical cannabis clinic, Sapphire Medical Clinics, offers a subsidised access scheme, with 1000 Scottish patients already signed up. This was expanded in December after reaching capacity, further indicating the demand for affordable medical cannabis in Scotland.
The news comes at a time when London Mayor Sadiq Khan has announced a pilot “diversion scheme” whereby people age 18-24 found in possession of small amounts of cannabis will either be sent on their way or referred to a form of counselling rather than charged with a crime.
READ MORE: Scots cops call for Scotland to adopt US style regulated cannabis market
While drugs policy is not a devolved to Holyrood, healthcare and policing are. And with such a pressing need to save patients from a criminal record, surely we could do this in Scotland? Not just for young, recreational users, but for cannabis patients who need their medication to survive.
In Scotland, drug death capital of Europe, there have been moves towards health-led drug policy-making. But, given that many Police Scotland officials are still unaware of schemes such as Cancard – a scheme which shows people are using cannabis for medical reasons – this is far from good enough for patients now living in fear of prosecution for the crime of not being able to afford their medicine.
Ronnie Cowan (below) the SNP MP for Inverclyde and vice-chair of the All-party Parliamentary Group (APPG) on Drug Policy Reform says: “For years, different police divisions have gone about this in different manner – some tolerant, some intolerant.
“But, the Lord Advocate has recently said, we should be pushing to decriminalise personal possession. That gives a clear indication to police forces that all of Police Scotland should not be arresting people for personal possession which then opens up a raft of conversations – if not arresting for possession, should we be arresting for use? Because that’s clearly what possession is intended for. Then we have to ask, why is cannabis illegal at all?”
He continues: “What they’re doing in Project Twenty21 is admirable, but it’s private medicine. It shouldn’t be down to T21 to run the scheme, it should be funded by the UK Government and made properly available on the NHS.”
Ant Lehane, head of communications for advocacy organisation Volteface, co-authored the report Sadiq Khan is using to roll out London’s diversion scheme. He explains: “It is possible to for the Lord Advocate and the SNP government to push powers to the limit and immediately expand upon diversion schemes already in place”.
Without independence, Scotland doesn’t have the authority to break free from Westminster’s 50-year-old Misuse of Drugs Act. However, our First Minister could opt for de facto cannabis decriminalisation, by removing all criminal penalties and fines for the possession of small amounts of cannabis.
READ MORE: People being ‘denied access’ to medicinal cannabis three years after law change
Through this simple change, we could edge closer to the progressive cannabis legalisation demonstrated in Malta, Germany, Luxembourg and the other EU countries which most Scottish voters did not choose to be separated from. And we could stop penalising patients, sparing them the injustice and hardship of having their legal medical cannabis supply made unaffordable.
Indeed, Holyrood could go further and look at funding its own version of project Twenty21, rescuing Scottish cannabis patients from dependence on a very unreliable black market. Or put a task force together to assess options for widening access on the NHS.
As stated in the Public Health Act 2008 and the Adult Support and Protection Act 2007, Scottish Ministers must “promote the improvement of the health of the people of Scotland” and “consider the importance of providing advocacy”.
We have a duty to protect medical cannabis patients who will now suffer more than ever without long-overdue reform. Surely it is past time for Scotland to step up and take a stand to protect the lives of our most vulnerable citizens?
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