Cannabis in the UK is currently a medicine for the rich and a crime for the poor – can the UK continue like this?
Even today judges are sentencing people for growing their own medicine. I believe the industry has to push for decriminalisation to ensure medical cannabis benefits all.
The judiciary seemed to have missed the memo highlighting that cannabis is now legal for medical use. The juxtaposition of legal medicine and illicit crime from the same plant really does come down to money and an EU GMP certificate. Policing by consent in this country is the bedrock of our system and is being eroded by the current cannabis legislation which sees massive disparities in wealth, crime and punishment based on opportunity and ethnicity.
Now, don’t get me wrong – cannabis farms with modern slaves and electricity theft are the bane of modern society and need to be stamped out. That’s why we need proper regulation with an equitable balance, and it needs to be enacted now. The future will see reparation payments for the lives blighted by the current legislation and highly likely an official apology in time. Why is the UK not looking at the global change happening now?
Well, at the same time medical cannabis became legal in the UK, the Canadians implemented the Cannabis Act. Canada legalised adult-use following two decades of successful and extensive medical access where no one died.
What can the UK learn from Canada? First, the starting point for Canada’s legislation was delivering harm reduction and quality of life outcomes. The previous two decades of medical access were not set up to focus on scientific research or ensuring cannabis was an option of last resort but an option of choice. If someone with a medical condition wanted to choose cannabis they could, if they felt better and gained benefit from using medical cannabis that was good enough for the Canadians. Patients could even get a prescription to grow their own medicine empowering them to take back control of their own health.
This is in stark contrast to the UK approach where only GMC consultants can prescribe Cannabis medication. The consultation at a private clinic can only happen after all other effective treatment options have been considered and exhausted. Each script is a specified product with no leeway for patients to choose options that may be more suitable for them as other countries allow in the dispensary system.
The private clinics since 2018 have seen around 10,000 cannabis patients, way behind other countries such as Australia with close to 100,000 patients, Germany with over 120,000 and Canada with over 350,000 patients pre-adult use. The UK has come so far but at the same time achieved so little. There are, by most estimates, around 1.75 million people using illicit cannabis for medical purposes. These people have not felt compelled to move to legal medical cannabis even though they risk legal action against them if caught, for them cannabis is a crime.
Why have more people not sought out legal cannabis?
Maybe the initial consult and the monthly script costs are too high. This seems on the surface the reason why medical cannabis has not expanded as quickly. However, the medication costs in some cases are comparable to illicit cannabis so it is not the whole story. Part of the picture seems to be that many people still don’t know medical cannabis is legally available, if they do, it is seen as too difficult to access.
I happen to think one of the key factors is clinician responses. My own personal experience shows the issues. I asked my GP about using Cannabis for my lower back pain. They told me it was only available for epileptic children, but they offered me opioid painkillers instead. I reluctantly started co-codamol but saw no benefit and knew further escalation could lead to dark addictions.
The GP had given me incorrect information and shown no understanding of Cannabis as a medication. This is why AccessKaneh was formed to help people understand cannabis and navigate the regulatory system. But even now in appointments with doctors when I mention Cannabis there is definitely a feeling of disapproval in the air. I am reasonably healthy so visits to my GP are rare.
However, if future treatment decisions are affected by my choice to use medical cannabis that makes me uneasy and for many is an untenable option. That’s why they continue in the shadows of others. Their use of cannabis means they are healthy and don’t have the medical records required to get a script. There is a multitude of reasons that a more relaxed approach will remove. Personally, I hope we move to a system where nurse practitioners or trained GPs can prescribe, like Australia and Canada. I can then find a GP that understands cannabis and looks at holistic medicine as an opportunity, not a snake oil.
On the positive side, I recently went to the Royal Society of Medicine for an event aptly named as “Pain and cannabis medicines: Everything you want to know (but were afraid to ask)” it felt like cannabis is actually starting to make an impact in the medical world amongst the more enlightened doctors so things are starting to move.
That said, listening to Paul Chrisp from NICE – National Institute for Health Care Excellence, the gatekeepers and advisors on what the NHS should fund and whose current guidelines are blocking cannabis prescribing in the health service, I was so frustrated. Mr Chrisp’s view was there is just not the evidence to the standard NICE will accept to change their opinion. He did however say they would look at real-world evidence and quality of life data but the gold standard was always going to be Randomised Controlled Trials (RCT’s).
This methodology once again disadvantages cannabis. The current research and licensing system is for single active ingredient drugs where pharma companies can recoup their RCT investment for specific conditions. Cannabis will never be able to fund such research at scale because strains and cultivars are easily reproducible and cannot be patented to get the return on Investment.
One answer is to empower citizen science and open-source research using the data from the many countries endorsing access. This approach can accumulate country-wide data into collaborative research following the model that has been shown so effective in COVID research. Maybe this model can convince NICE to make cannabis accessible to all.
Paul Chrisp’s comments made me think once again why we are not looking at the historic record of safe use. For thousands of years people have used cannabis as a medication before we sanitised medicine to symptom control and lost our holistic approach. It is only in the last hundred years since the real industrialisation of societies started that cannabis fell out of favour. The century of prohibition led patients to the shadows and vilified their medicinal cannabis use.
Strange to stand on their shoulders, listening to General Medical Council registered (GMC) consultant after consultant presenting slides and case studies on how effective the medication is. The descriptions of patients where pharma meds had not been effective but cannabis or a derivative have been, make compelling real-world evidence.
The endocannabinoid system (ECS) is the critical reason why cannabis is so effective in so many conditions. But we find out during the conference that the ECS and its operation are still not taught in medical schools because the GMC still does not deem it important enough. This is perhaps because cannabis takes us into this area of holistic caring which has always presented problems for the medical establishment and its pharma orthodoxy. The mantra “prevention is better than cure” means to me the ECS should be top of the training curriculum of all future clinicians.
Back to the question, how does the UK stop cannabis being a medicine for the rich and a crime for the poor? This has to be based on exactly the same criteria Canada used to evaluate its steps forward. Harm reduction and real-world quality of life outcomes. These guiding principles should directly affect the way the UK approaches cannabis. We can learn from around the world where health systems are subsidising the price or cost of consultations for medical cannabis, so it is a medicine for those that choose it. It’s time the NHS looked at the holistic opportunity that the ECS and medical cannabis present.
Currently, EU GMP cannabis sits in concrete and steel edifices that take away the plant’s power to regenerate our planet’s atmosphere. For me, the most important issue on the horizon is why medical cannabis is not regulated as a herbal medicine, where I believe it should really sit. If cannabis was restored as a herbal medicine the industry could actually be a leader in climate change action and environmental impacts while delivering real social change to benefit the world’s poorest and helping the majority.
The introduction of dispensaries as advocated by the Cannabis Trades Association in our 10 point plan on cannabis would reinvigorate the high street leading to a renaissance of many high streets and providing local jobs.
Cannabis will be part of the future – the question is who will it benefit?
As the great physicist Carl Sagan said:
“The illegality of Cannabis is outrageous, an impediment to full utilization of a drug which helps produce serenity and insight, sensitivity and fellowship so desperately needed in this increasingly mad and dangerous world”
Written under his pseudonym Mr. X to avoid the heavy social stigma associated with cannabis in 1969.
What has changed? Enlightened countries are re-evaluating and unleashing the healing power of cannabis, will the UK?
Medical cannabis patient advocate
Christopher Ratliff discusses getting down to the grass tax
What do cannabis businesses need to succeed?
Christopher Ratliff, president at Victus Consulting Ventures, discusses business piracy in the cannabinoid sector.
Getting down to brass tacks is an idiom thought to have originated in boat building. So let us do just that – let us build this ship and get down to brass tacks. For the less creatively inspired, let it be known, the ship I am referencing is cannabis companies in new emerging markets. Although the cannabis industry is a scientific industry and nowhere near maritime operations, I have chosen this analogy to accentuate the point of business piracy that often takes place within the cannabinoid sector.
One of the most important factors one should know about the cannabis industry is how many businesses pass around a model of; misused technical expertise to get the ship built to sail in the right direction. If specialised scientists and horticulturists are essential to properly build the “ship”, then recognising them positively will give them the courtesy to do the job. Unfortunately, many founders suffering from the Dunning–Kruger effect insist on marketing full-time roles, yet the intention is to use subject matter experts (SMEs) as contractors and eventually cut them loose.
Oftentimes the board of directors will bring in a very unqualified team to steer the ship due to their experience in banking or maybe flying kites (it does not make sense to me either). For the sake of your investment and reputation, you need to consider the ramifications of this practice. It will sink your ship, destroy lives, and turn you into the topic of someone’s lawsuit.
The times they are certainly changing like the wind that blows a sail and you do not want to blow your future sales. Any press is not good press anymore, and it probably never was.
Once the ship is built and the executive leadership team is in place, they set sail; confident in their experience to guide the ship’s direction. However, it usually sets sail about one-quarter of the way across the proverbial ocean before the experienced, technical builders are forced to walk the plank and get fed to the sharks. It is laughable to watch a group of people with a large learning curve go a portion of the way across the ocean of business development believing, “pull that rope over there, I saw them do it” will get them the rest of the way.
The confidence quickly dwindles when they find they are effectively spinning round and round in the middle of the ocean until someone else comes along to commandeer the ship. Mutiny, reverse takeover, and the same processes occur on repeat and, unfortunately, there is no one with innovative thoughts left aboard to help the situation. The sharks the poor souls encounter while treading water looking for a new ship to board are the next round of employers who may be up to the same exact activity. The sharks will undoubtedly want to speak to the captain of the previous ship to verify their qualifications. But because technical experts can be strong-willed, they will absolutely swim back ashore and try again.
However, due to the activities described, it becomes a never-ending cycle promoting distinct lies and more thought-out misrepresentation. This unfortunately leaves SMEs with genuine talent, specialised degrees, and a plethora of qualifications in a position to explain why they are no longer with the previous ship. Who in their right mind jumps off a perfectly good ship in the middle of the ocean to swim back ashore? No one unless you are Aquaman! Also, do you really believe the geniuses who pulled all the wrong ropes, read the wind incorrectly and burned the charts are willing to tell the next company your marvelous accolades of building every inch of their vessel? No of course not! A pseudo captain is not going to reveal that they are in reality… just a pirate.
Now the metaphorical point has been made, let us disembark from all the creative ship talk. The real shame about the cannabis industry in the way that it exists at the moment is how criminal and rather pathetic some of the start-up practices appear to be. Along with fraudulent misrepresentation and equity flashing, there are many stoner scientists doing a chemist’s job, banking executives leading product development decisions and grill cooks converted to “master growers” overnight because the industry titles suggest that is what they are. It literally is that ridiculous!
On the other hand, it is not every cannabis company and if you are not the target audience of this article, do not take offence. There are genuine people with great talents working at amazing companies holding the appropriate roles. It should not be a surprise that those companies and their staff members are sailing right into success within the sector.
What should start-up cannabis companies set out to do in accordance with healthy business practices?
For starters, having a broad understanding of the deployment of funds just will not cut it anymore. You need to specifically invest seed funding and even pre-seed funding into the right value-adding activities.
In my opinion, your most valuable assets are your team/staff, your equipment platform and your compliance infrastructure. Most often in the cannabis sector, you see investment going into marketing and branding, cultivar genetics and packaging.
I am not saying those activities do not also add value to building your company and consequently the brand, I am saying to clearly evaluate and prioritise investing in the interests that will generate the most effective ROI. Another point to reference is the overuse and misunderstanding of building an appropriate company culture. Most cannabis companies claim that company culture and the preservation of it is most important to the success of the business.
I concur with this notion; however, toxicity in a workplace due to a culture built upon prejudice, hierarchy and the clique mentality will not cut it either. Best business practices are to build a company culture rooted in diverse backgrounds, collaboration, and human understanding. This type of company culture will drive innovation, inclusion, and excellence in any business.
It will also drive revenue, production and promote an overall positive moral for all stakeholders. Until then there will be a lot of sinking ships and displaced sailors which is currently the “grass tax”.
Victus Consulting Ventures
Five ways science can help your cannabis business
In this article, Christopher Tasker, CEO of Global Cannabinoid Solutions, discusses how science can help your cannabis business.
Science is a practical approach to understanding the world around us that has matured throughout the history of humanity.
Throughout human existence, the role of science has been to guide the development of and better the quality of human life. Science has brought us the comfort that we so take for granted in 21st-century life.
The Cambridge dictionary defines science as “Knowledge from the study of the structure and behaviour of the physical world, especially by watching, measuring, and experimenting to develop theories that describe the results of these activities.”
Science, as we know it today, has been defined by a series of key features that underpin the scientific process.
Figure 1. The key pillars of the scientific methodology as outlined by The science council.
A brief history
The role of scientific understanding has evolved throughout human history. The roots of science date back as far as ancient Egypt where the Egyptians and Mesopotamians laid the foundation of modern sciences such as astronomy, medicine and mathematics (Hessen et al., 2009).
These early contributions shaped Greek philosophy whereby attempts were made to provide explanations of events in the physical world based on natural causes (Grant, 2007). Following the fall of the Western Roman Empire, a great deal of knowledge was lost. Some of this ancient knowledge was recovered during the Islamic Golden age which flourished with help of Islamic scholars who built on the knowledge they had absorbed (Klein-Frank, 1996). During this period, European science and society struggled for many centuries.
The Renaissance was a complex period that is described as a cultural movement of intellectual inquiry that spread across Europe early in the first millennium. Humanism was a key theme of this movement, which manifest itself in the forms of art, architecture, politics, science and literature. Towards the end of the 16th century and not long before his death, Nicolaus Copernicus published his heliocentric model of the universe which placed the sun rather than the earth at the center of the universe. This historical paradigm shift was one of the great dominoes that contributed to the scientific revolution (Rosen, 1986). Scientific contributions such as these sustained the European Renaissance which brought us great minds such as Leonardo Da Vinci, Galileo and Michelangelo as well as inventions such as the telescope and camera obscura.
The European Renaissance and the new ideas that fuelled the scientific revolution culminated in what is known historically as the Age of Enlightenment, which dominated the 17th and 18th centuries. This societal shift placed reason at the centre of authority and legitimacy paving the way for the emergence of modern science. As the 19th and 20th centuries arrived so did the professionalism of science. Modern science is now comprised of many branches that are the foundations of society as we know it today.
Francis Bacon, a pivotal figure in science history and a key contributor to the development of the modern scientific method of investigation, was quoted saying “the real and legitimate goal of sciences is the endowment of human life with new inventions and riches” (Hessen et al., 2009).
Figure 2. A depiction of the Scale of the Universe mapped to the Branches of Science and the Hierarchy of Science. The Scale of the Universe capture the average diameters of key systems.
Fun fact: It takes approximately 60 trillion atoms to make a human cell, there are roughly 32 trillion cells in a person, and 108 billion people have ever lived.
Five ways science can help your cannabis business
In many ways, we are in the midst of a 21st-century renaissance. As we move forward in this digital age of information, science is now more accessible than ever. What was once reserved for esteemed individuals at the upper echelons of society is now accessible to the masses. Leveraging science provides a tremendous opportunity to look to science as a foundation of the development of the next generation of services, solutions and innovations that will help shape the future of humanity. This takes us into the five ways that Science can help your business today.
Protection from misinformation
An understanding of the fundamental scientific laws that underpin an industry provides an anchor point from which to assess and identify risks. This knowledge base is a protective layer that helps identify threats and faults before they escalate. Solve problems efficiently and reduce the impact of bad decisions.
A fundamental scientific understanding of your field provides an empirical approach to business offering independence and confidence in decision making. A workforce that is autonomous and empowered can operate with military precision, armed with unique perspectives and ideas to create a flourishing future. This means less management and more output. No longer relying on chasing trends but instead predicting and leading new trends with your new insights.
With autonomy comes the ability to differentiate from the competition and sow the seeds of your own unique identity. No longer relying on watching the competition and build a sustainable, long-term vision for your business and its legacy. So many stones have been left unturned, science is an exploratory tool that will help you navigate this nascent cannabis industry.
A legacy is built on the social impact you bring about as a company. Science provides a means to measure the factors affecting communities and offer meaningful solutions to our ecosystem. Protecting the community from the potential harms of our business and building impact in the process. Science is a bridging language that can be used to develop and engage in a conversion with communities impacted by your work sharing culture, ethos and interpretations.
Research and data are fundamental to building new hypotheses and planning for future expansion. Science and its unique methodologies will continue to advance understanding leading to the development of new intellectual property. As you uncover new findings you then benefit from the advantages and insights gained from your discoveries.
Science continues to play a pivotal role in the development of our civilisations. Learned societies, houses of wisdom, academies and institutions have provided scientific counsel to society for generations. Our cannabis science firm is here to support the cannabis industry with this next leg of 21st-century cannabis enterprise. By combining science, education and technology we are saturating the cannabis industry with next generation of scientific services, solutions and innovations for the betterment of businesses and communities across the globe.
- Grant, E. (2007) A history of natural philosophy : from the ancient world to the nineteenth century. Cambridge University Press.
- Hessen, B. et al. (2009) The social and economic roots of the Scientific Revolution : texts by Boris Hessen and Henryk Grossmann. Springer. Available at: https://books.google.com/books/about/The_Social_and_Economic_Roots_of_the_Sci.html?id=PgmbZIybuRoC (Accessed: 4 August 2021).
- Klein-Frank, F. A.-K. (1996) History of Islamic Philosophy, History of Islamic Philosophy. Edited by S. H. Nasr and O. Leaman. Routledge. doi: 10.4324/9781003070733.
- Rosen, E. (1986) The Encyclopedia Americana. Grolier.
Global Cannabinoid Solutions
Does the UK have a wealthy future in cannabis?
President of CLEAR UK, Peter Reynolds, discusses CBD, medical and recreational cannabis in the UK.
In this article, Peter Reynolds, president of CLEAR Cannabis Law Reform, shares his views on the future of cannabis in the UK.
There is a great deal of money in cannabis. Until recently it was mostly gained illegally but in the last few years, the range of opportunities has widened to include legal production and distribution as well as investment and research in the medicines market. There are even substantial and legal opportunities in spin offs from the huge illegal market. And the possibilities are going to multiply even faster over the next decade. If you’re not in cannabis now, you almost certainly will be soon, or something closely connected to it.
It was 10 years ago that CLEAR, the UK’s longest-established cannabis group, commissioned what is still the most comprehensive study of the UK market. Back in 2011, legal access to medicinal cannabis in the form of flower was no more than an ambition. Sativex, a whole plant oil with a 1:1 THC:CBD ratio, had only just been licensed and that had taken more than 12 years of research and tens of millions in funding. The illicit market was estimated at between £2.9bn and £8.8bn per annum, with an average of £5.9bn. There were said to be around three million people consuming cannabis regularly, that is at least monthly.
We haven’t undertaken any new research since, although we’ve reviewed the possibility every year. The company we commissioned has advised that little has likely changed and, significantly, most of the government data sources that they had mined are simply no longer available. Austerity put paid to a great deal of government data collection in all areas and it’s no surprise to realise that about some issues, our political masters literally have no idea what is going on.
So we have continued to base what we do on the 2011 data and they have been confirmed many times over by smaller research projects carried out by others. Recently the number of regular consumers has been estimated lower at slightly over two million but this is now based entirely on self-reporting from the British Crime Survey, which is bound to be under-reporting. In 2011, we had also used a variety of other sources.
In 2011/12 we carried out a survey of our members which indicated that at least one-third of consumers were using cannabis, at least in part, for medical reasons. We provided our data to the highly successful End Our Pain campaign and it became generally accepted that around one million people in Britain were using illicit cannabis for medical reasons. This figure was validated when a YouGov survey in 2019, based on the largest ever polling sample, put the figure at 1.4 million, 2.8% of the adult population.
So that is an excellent place to start in evaluating the cannabis opportunity. In today’s private-only medicinal cannabis market we are getting close to 10,000 patients receiving prescriptions, so that leaves room for huge growth. It’s set to explode, especially as within a year, maybe three at the outside, it looks as though the NHS could start funding prescriptions.
I’ve given up predicting when we will have a legal adult-use market in the UK. There is no rhyme or reason to drugs policy here. As ever, it’s not our PM or home secretary who makes that decision, it’s the editor of the Daily Mail. No longer is Paul Dacre sitting behind that desk but alarmingly Boris Johnson has put him in charge of OFCOM. That bodes alarmingly for the future of broadcasting, not just on cannabis and similar issues but on anything where we want to know the truth, or at least the facts and evidence to make up our own minds.
I’ve been saying we’ll have legal adult use within five years for at least the last 10 years. The best I can offer now is that I think it will probably come quite suddenly, just like the reform on medical use and what happens in the USA will have a decisive impact. But Biden has already disappointed on his clear promise to decriminalise federally, so I’m not getting excited quite yet.
Let’s be honest though, for all the people I advise on the cannabis opportunity and licensing, it’s adult use that really excites them. Even if they don’t want to admit it (and certainly not to the great and good they are inviting onto their boards) that is how they hope to become rich. And I have no doubt that it will happen. Any facilities developed or investments made now for the medical market will readily take advantage of what will be a huge consumer market when it finally opens up.
Although it’s far from easy, there should be no restriction on ambition for developing new facilities in the UK. It takes a great deal of money and a speculative outlay of at least £300,000, excluding property costs, to set about developing a business producing medicinal cannabis. It’s not possible to obtain the necessary licenses without creating the facility first and there’s no help or guidance from the authorities which issue the licenses. But with the right knowledge, experienced advice from a variety of sources, almost anything is possible.
I wouldn’t advise anyone to get into the CBD market at present. What was a booming opportunity has been hobbled by the intervention of the Food Standards Agency (FSA) which has been breathtakingly incompetent and destructive. For products where there is no evidence of anyone ever coming to any harm from consuming them, they have tried to impose wholly unnecessary safety conditions but made a complete mess of the whole process. It’s been driven by officials who have no understanding of the products and they have been misled by a few big investors who have tried to manipulate them for their own ends. But it’s a very sad tale. No one has come out a winner and many small businesses have been destroyed for no good reason.
I’m quite certain that over-the-counter CBD ‘wellness’ products will continue and eventually the market will get the proper regulation it needs but the result of the FSA’s incompetence is that all the worthwhile products are now operating in a grey area. Anyone who isn’t already in should steer well clear for now. And if you’re offered isolate or isolate-based CBD, either as an investor or to consume, don’t bother. It’s next to useless for the purpose intended. It does have some applications in medicine but for ‘wellness’, wellbeing and the food supplement market, it’s pointless.
There are other niche opportunities for which the regulatory process already exists, such as pet products, which could be a very substantial market. There is certainly a real chance of getting ahead of any competition for anyone who acts now. As with the human medical market, it will be important to have the right expertise on board but not difficult to identify and hire the people you need.
There is room for many more cannabis clinics and for ancillary businesses such as the wholesaling and distribution of products. Customer service in this area is presently very poor and there’s a great deal of dissatisfaction amongst patients. Again, making the most of these opportunities will require hiring the right people, from doctors on the GMC specialist register who can prescribe, to pharmacists and product specialists who actually understand what they’re dealing with. By necessity, some of these people will have gained experience in the illicit market. They are the only people who know what they are doing in many instances. While this may be problematic in relation to licensing, provided the correct restrictions and procedures are put in place, it can be managed.
As I said earlier, it’s far from easy but not necessary to curtail ambition for the cannabis opportunity. One thing’s for certain, if you start now it is only going to get easier. The regulators and authorities concerned, even the FSA, are learning and there are clear signs of more flexibility and developing understanding. Cannabis is going to be very big in Britain. It’s been here for a thousand or fifteen hundred years already and although ‘they’ have tried furiously to do away with it over the past century, it’s coming back stronger than ever and Britain is going to be a healthier, happier and wealthier place as a result.
Peter Reynolds has been involved in cannabis law reform since the late 1970s. He first gave evidence to Parliament on the subject in 1983 and has contributed to every inquiry since. He was elected as leader of CLEAR Cannabis Law Reform in 2011 and is also a director of Cannabis Professionals, the trade association for CBD, hemp and medicinal cannabis businesses. He sits on three sub-committees of the UK Cannabis Industry Council and the advisory board of the Irish Medicinal Cannabis Council. He makes his living advising and consulting on cannabis licensing and product development.