When the United Kingdom announced the historic step of rescheduling cannabis and allowing physicians to prescribe it two months ago, there was concern from patients and advocates as to whether actual herbaceous flower would be allowed, or only extracts. Now the first patient is approved to receive cannabis under the program, and it is indeed to be dried flower. The bad news: with the National Health Service barred by bureaucratic hurdles from providing it, patients are at the mercy of the market—and the price is prohibitive.
A Brighton woman suffering from fibromyalgia is now the first patient in the United Kingdom to receive a prescription for medical marijuana following a change in the law that took effect Nov. 1. Carly Barton, 32, has been suffering from chronic pain associated with the condition since surviving a stroke some 10 years ago.
The former university lecturer was first prescribed powerful opioid drugs, including morphine and fentanyl—but said they just left her feeling "zombied," while failing to even alleviate the pain. She began self-medicating with cannabis two years ago, to much better results—but illegally. Last month, she was legally prescribed cannabis by a Manchester-based private pain specialist, Dr David McDowell.
Answering a question on the minds of many patients and advocates since the Home Office announced the rescheduling of cannabis in October, actual "flower-based products" are to be supplied Barton—imported from the Netherlands. The Dutch firm Bedrocan is named as the producer.
But if that is encouraging news, the price is decidedly not. A three-month course will cost Barton around £2,500—the equivalent of over $3,000. At her prescribed one gram per day, that comes to about four ounces—for well more than what a pound goes for on the black market.
Barton said the prescription "made history," as it is the first since Britain banned cannabis in 1928. But she has been protesting to the press that she will have to blow all of her savings on just one course—before being forced to return to the black market. Even though cannabis is now Schedule II in the UK pursuant to the October decision, the publicly funded National Health Service is still restrained from supplying it in most cases under stringent interim guidelines. Barton is calling this state of affairs "prohibition under a different name."
"The guidelines they have produced aren't working. In the month that they have been produced, no doctor has felt guided to write a prescription," Barton told the Mirror. "Those guidelines need setting on fire as far as I'm concerned, and the NHS specialists need to be made to feel comfortable about making a clinical decision."
"There is an unfair system where the rich will have access and the poor will still have their doors kicked in by police," she added to the Daily Mail.
She painted a grim picture to the Daily Star: "At the moment, patients are being turned away, there's posters up in waiting rooms saying don't even ask about it, people aren't getting an appointment if they're saying that's why they're coming over the phone." And she recalled her experiences purchasing illegally. "I've been on walking sticks [crutches] in dark parks, meeting strangers on my own in the winter in agony," she said.
Bureaucratic paradoxes
The NHS interim guidelines state that cannabis should only be provided to patients where there is clear published evidence of its efficacy, or where other medicines have been exhausted. As Britain's iNews interprets the regs: "Very few people in England are likely to be prescribed medical cannabis [through the NHS]. Currently, it is only likely to be children and adults with rare, severe forms of epilepsy or adults with vomiting or nausea caused by chemotherapy. Even with these, it would only be considered when other treatments weren't suitable or hadn't helped."
A final perversity, as Barton pointed out to Sky News, is that the high price of her cannabis is due to the cost of importing it; the same Bedrocan bud goes for only about six euros a gram in the Netherlands (just slightly over six dollars). And in addition to the outrageous price, there is also to be a burdensome delay. Because the Home Office must authorize the importation, it could be weeks before Barton actually receives her cannabis.
And this is rendered doubly perverse by the fact that the UK itself is the world's biggest producer of legal cannabis—thanks to the industrial-scale grow operations of GW Pharmaceuticals for the production of medications such as Epidiolex.
Meanwhile, unless the NHS guidelines change, and quickly, medical marijuana in the UK could be an empty promise. As iNews quotes Barton: "This prescription will absolutely clear me out—my savings, everything will be gone and in two months' time I won’t be able to afford to repeat this prescription, so I'm going to be a criminal again by buying it illegally."
Cross-post to Cannabis Now
Photo by Barbara Doduk
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