I helped legalise medicinal cannabis – I regret what came next ...Middle East

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Eight years ago I joined a remarkable single mother called Charlotte Caldwell and her lively 12-year-old son on a trip to Canada that changed our drug laws.

Billy, an autistic boy suffering the torment of intractable epilepsy, became the first patient in Britain prescribed cannabis-based medication on the NHS to treat his seizures – but then the Home Office ordered their family doctor to stop doling out the drug or face disbarment.

I flew with the pair to Canada to obtain fresh supplies, only for their oil to be seized after they declared it on their return. The child’s condition deteriorated, leading to his hospitalisation – and the case provoked such furore that it forced the government into hasty legalisation of medical cannabis.

When I spoke to Charlotte last week, she told me Billy has gone three years without a seizure, which is extraordinary given the severity of his epilepsy, with hundreds of attacks a day. “You’d be blown away by his progress,” she said. “He gives you full-on eye contact, engages with people rather than withdraws, and his seizures are totally controlled. He is thriving – an amazing achievement when doctors said he wouldn’t live to see his first birthday.”

Clearly, her son offers profound witness to the case for medical cannabis. Yet when I ask about the reform that she sparked through her defiance as a mother determined to save a sick son, she was distraught over the outcome. “I am shocked and so very sad,” she replied.

I share her despair. The reform of medical cannabis that we unleashed has been a disaster, offering a textbook example of policy failure by timid politicians that needs to be urgently tackled. Britain has ended up with the worst of all worlds: a lucrative and unfettered market in recreational cannabis that lurks behind the fig leaf of the health service.

A tiny handful of people, like Billy, manage to get this drug on the NHS. Meanwhile, doctors at so-called “clinics” are doling out thousands of private prescriptions for super-strength weed – with names such as Green Joy, Laser Fuel, Space Cake and Sundaze – after a quick online “consultation”, even to patients with serious psychiatric conditions. In the words of one eminent lawyer, we have “state-sanctioned illegality” – and the consequences can be deadly.

This was exposed by the tragedy of Oliver Robinson, who killed himself in late 2023. In a landmark inquest two months ago, a Manchester coroner stated that prescription of cannabis contributed to the 34-year-old property developer’s death. His brother Alexander told me Oliver spent £1,000 a month on the drug, convinced after a single video consultation with a private clinic it was essential for treating his severe depression and complex psychiatric needs.

Heavy use sparked a downward spiral while acting as a barrier to accepting other treatments, leading to fury against any family members or psychiatrists suggesting intense weed usage might not be beneficial. “I don’t want any other family to go through the hell we suffered for three years,” said Alexander. “If these cannabis clinics did not exist, my brother might still be alive.”

This bereaved man readily accepts the drug might help people with conditions such as anxiety, epilepsy, late-stage cancer or multiple sclerosis. His concern is that clinics are acting like the infamous pill mills behind the opioid crisis that flared up in the United States – when dodgy doctors in league with a greedy pharmaceutical firm fed a market for highly addictive opioids – and that high-strength cannabis is being given to people with serious psychiatric conditions.

Alexander passed me a leaflet found among his brother’s possessions from a clinic advocating cannabis to treat depression and post-traumatic stress. Yet a comprehensive Anglo-Australian study published this month by The Lancet says there are no grounds to suggest the drug helps such conditions. “The routine use of cannabinoids for the treatment of mental disorders …is currently rarely justified,” concluded the researchers.

Another study just published as a preprint by British and Canadian psychologists underlines this failure of Britain’s medical cannabis model. It found that people with prescriptions are more likely to use high-potency products, meeting the threshold for high-risk use, and that nine in 10 of them obtain supplies from street dealers.

Yet the most recent report by the Care Quality Commission regulator revealed that prescriptions surged 130 per cent over the previous year to 346,000 for “a very wide range of medical conditions”, often despite “poor evidence” for these cannabis products that are meant to be used only for unmet medical needs. Other credible data suggests almost twice this number of annual prescriptions.

Unfortunately the government ignored the approach of other nations that designed bespoke medical cannabis programmes. Instead it used the “specials framework” – intended for rare cases of cutting-edge clinical cases – as architecture for a mass market. Then former health secretary Matt Hancock, sweeping aside restraints to conditions where there is some evidence for efficacy or keeping it under the NHS umbrella, unleashed the private sector. And our medical cannabis market turned into a farce.

It is worth £300m annually, ignores standard clinical procedures, is dominated by firms that do not collect data for potent products, and features a few doctors churning out prescriptions for a wide range of conditions regardless of any expertise. Meanwhile, many chronically ill people cannot afford to access the medications.

As Ms Caldwell now says, we should divorce the medical market from the recreational market, with effective regulation to protect people with serious mental health conditions. Any return to prohibition would be ridiculous, given its obvious failure while fuelling violent gangsterism. There is also genuine demand for medical cannabis for conditions such as drug-resistant epilepsy and chemotherapy-induced nausea.

The best model to mimic is Canada with its licensing of products, patient registration, strict age restrictions, and clear divergence between medical and recreational markets.

Above all, Westminster needs to stop pathetically shying away from serious drug reform, which remains one of the most egregious examples of political failure with so many deadly and destructive consequences.

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