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Exploring barriers in the UK’s medical cannabis industry

Since legalising medical cannabis in 2018 the UK medical cannabis industry’s development has been half-baked – with a number of problems hampering progression and preventing the streamlining of services.

Despite the UK being one of the biggest exporters of medical cannabis according to a report from the UN International Narcotics Control Board, the country currently has no domestic supply. This causes huge problems for patients – high prices, delays in receiving the medicines and reduced medicine quality being by the time it has arrived. 

Additionally, importing cannabis creates a huge carbon footprint for a product that could easily be produced on British soil.

Dr Callie Seaman, PhD, director and formulation chemist at AquaLabs, a plant fertiliser and plant health product development company, is also a medical cannabis advocate and Cannpass advisory council member with extensive experience in the medical cannabis industry.

Seaman spoke to Cannabis Wealth about the current barriers to medical cannabis access and industry development in the UK.

Problems with imports

All cannabis medicines are currently imported into the UK, coming from countries such as Israel and Australia. Seaman highlights that finding a supplier from overseas is relatively easy, but finding someone in the UK who is able to handle and store medical cannabis products is difficult.

Seaman commented: “What we’re finding is that a lot of distributors are almost drop shipping medical cannabis product – so, it doesn’t come into the country and to a big warehouse. What happens is that the distributor will contact the suppliers and they will then drop ship that to the customer. So the distributor themselves don’t have to have a licence to handle it. 

“There are pharmacies who have licences to handle but they never store a large amount. 

“I would say the number of steps that are involved is a big issue. If we had a domestic supply, the doctor could go to the pharmacist who would then just go to the producer in this country – there would be no need for any importers and distributors, and it would cut out quite a few number of layers, bringing the cost down. 

“I know farms that say that they can produce this at a very reasonable price and not the prices that people are seeing. So, why is all this cost being added on? It is must be the importing and transportation costs as well. You need a specialist transporter who can handle the medicine because it is a prescription and it is Schedule I. 

“It requires a specialist transporter that can handle to the product – because it is a prescription, it requires a Schedule II licence to transport it. 

“Grow it here and sell it here.”

Barriers to industry development

Parents of children with refectory epilepsy have been campaigning for years to have access to cannabis oils that are the only treatment able to stop the seizures. Families have been forced to take extreme measures to acquire the medicine such as selling their property or travelling to Holland. This lack of domestic access is causing an ever-escalating financial strain for families already taking on the emotional and medical battles that come.

In 2021, Members of Parliament filibustered the second reading of a bill designed to increase NHS access to cannabis medicines – causing despair and anger among campaigners. To add to the problem, there are currently zero doctors in the UK willing to prescribe cannabis to children.

Would creating a domestic supply and increasing education on cannabis amongst doctors help families and patients access the medicines they desperately need?

“The British Paediatric Neurology Association (BPNA) is one of the barriers because they are not recommending cannabis as a medicine for children, which means we’re not getting any prescribing doctors,” Seaman said. 

Read more: UK cannabis industry calls for government to implement new policies

“For children with refractory epilepsy there is a lack of prescribing paediatric prescribers. That’s the first bottleneck – if you’ve got no one prescribing, it doesn’t matter how much actual product you have got. 

“The second barrier to domestic supplies is licenses and the time it gets to get a licence. We need to speed up the process in this country because I’ve worked with farms in Denmark and it takes weeks to get a licence. 

“Medical cannabis companies are currently dealing with the Home Office – the same department that deals with firearms, which is ridiculous. We should have a Cannabis Office – it shouldn’t be within the Home Office. 

“This needs to be an entity to itself which deals with hemp, medicinal cannabis and anything around cannabis licenses. There are people with limited knowledge within the Home Office – which says it can’t grant licenses until the Medicines and Healthcare products Regulatory Agency (MHRA) grants a licence for a commercial product. 

“So, we are stuck in this circle of going round and round.”

Lack of understanding of cannabis

The lack of understanding of medical cannabis is a major problem, says Seaman. 

“I think there is a fear from clinicians because we have all been scammed into thinking that cannabis is going to cause psychosis. If someone has got a predisposition to psychosis, they’ve got a predisposition to psychosis. Alcohol is possibly going to trigger it – anything could trigger it,” Seaman said. 

“I also think we need to be looking more at personalised medicines as well – what works for me isn’t necessarily going to work for you. We all react differently to terpenes.”

Another nascent medical industry – the psychedelics industry – is seeing rapid growth, which Seaman attributes to the easily isolated compounds such as psilocybin found in the likes of psilocybe semilanceata mushrooms.

Cannabis contains hundreds of compounds that can be used in different combinations for different uses, and all impact each individual differently. In this regard, cannabis doesn’t fit into our traditional model or understanding of what a medicine is.

“I think there is a big trend jumping towards psychedelics because it is individual compounds. As a scientist, one compound and one treatment make statistical analysis easy – conclusions can be made very easily. Cannabis has hundreds of combinations that differ and have different effects. Sometimes it works and sometimes it doesn’t work,” commented Seaman.

“I think we need to be realistic and understand that this is a plant-based medicine. You are not going to get the same standard as synthesising an individual molecule and making tablets – there will be variations between batches. 

“There is nothing wrong with that – much like with fruit and veg. You don’t get the identical profile of minerals within that each time that you have it. I think what we need is labs available so that they can test for them and can handle these substances so that each time you are getting a batch, you are getting the actual analysis.

“I think we need to think about cannabis medicine in a completely different manner to anything else,” said Seaman. “It does not fit into pharmaceuticals.” 

The shelf life of products is another problem, says Seaman. With products being imported from the other side of the world, by the time it reaches the patient it has much less THC content, for example, than what was present when the sample was analysed. 

Doctors and patients

Patients are the driving factor behind the medical cannabis industry – and listening to their needs and experiences is paramount if the industry is to get things right, says Seaman. 

Part of this means ensuring that the right experts are available for patients who, more often than not, are much more knowledgeable about cannabis medicine than their doctors.

Seaman commented: “We need to start listening to the patients and what they want instead of telling them what they’re getting. Listen to what they found worked for them. 

“We also can’t expect doctors to learn this. We need herbalists or cannabis specialists like in the US where they call them “budtenders”. They solely specialise in cannabis, so they know the different strains of cannabis and the terpene profiles, they know how it’s been grown, how it has been extracted and that is all they specialise in. 

“A doctor would send a patient that needs a cannabis-based medicine to the budtender who would then be feeding in and working with the doctor to get the best treatment for the patient – they work in harmony together. 

“I see that working better than what we’ve got at the moment – doctors trying to learn about cannabis but also needing to know about all these other things as well. They generally could do with just a brief understanding of cannabis.”

There are a number of initiatives in the UK now that aim to educate doctors and nurses on the benefits of medical cannabis — but there are still many people in the UK who cannabis could help who may not be aware of the plant’s medical utilities. 

“One of the big things we need to do is talk to the older generation who would benefit from this. Those are the people who benefit from this and those are the people who we’ve got to educate,” concluded Seaman. 

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