Written evidence from UK Fibromyalgia
In the UK we are in the position where medical marijuana has now been legalised but can only be prescribed through hospital consultants and for specific medical ailments, which currently excludes fibromyalgia.
CBD (Cannabidiol) and THC (Tetrahydrocannabinol) are the two most well studied medicinal substances found in the plant commonly referred to as marijuana, but more scientifically and accurately called cannabis. CBD is not classed as a controlled drug but it is the THC content which can cause euphoria in high doses and so any product which contains this is presently classed as illegal.
CBD oil is now readily available in the UK and research has found that in animals CBD oil reduces brain inflammation, by putting glial cells in the brain back into hibernation and reduces pain behaviours in rats with inflamed and painful joints and damaged nerves. Anecdotally (human) fibromyalgia sufferers have reported to UK Fibromyalgia that CBD oil is helping with their symptoms, but it seems that the greatest therapeutic response comes from the addition of a small amount of the THC element of cannabis.
Back in November 2012, Andrew Turner, Tory MP for the Isle of Wight, received a written answer to a question he had submitted to the Secretary of State for Health.
“To ask the Secretary of State for Health whether Bedrocan and Bediol forms of cannabis are available (a) under prescription and (b) on the NHS?”
The then Health Minister Norman Lamb MP, replied saying:
“Neither Bedrocan nor Bediol are licensed as medicines for use in the United Kingdom. Clinicians can prescribe any product, including any unlicensed product, subject to their primary care organisation agreeing funding, if they feel it is clinically appropriate for an individual patient after discussing the potential risks and taking into account the patient’s medical history. In these circumstances, the clinician is expected to retain clinical responsibility for the patient while prescribing the medicine.”
(Bedrocan and Bediol are two of the four varieties of medicinal cannabis available from the Dutch government’s official producer)
The law was further clarified by the new Misuse of Drugs Regulations, which came into force on 1st November 2108. The NHS has issued guidelines on cannabis for medical use, both for clinicians and for the public. Currently, it is only likely to be prescribed for severe forms of epilepsy and vomiting or nausea caused by chemotherapy
The guidance goes on to say that:
‘There is some evidence medical cannabis can help certain types of pain, though this evidence is not yet strong enough to recommend it for pain relief’.
In May 2016 Professor Michael P Barnes MD FRCP, Honorary Professor of Neurological Rehabilitation, Newcastle University, wrote one of the definitive reviews on the efficacy of medicinal cannabis and this was used by the All Party Parliamentary Group On Drug Policy Reform -called Cannabis: The Evidence for Medical Use
His summary in respect of fibromyalgia was:
‘Overall we consider there is moderate evidence of efficacy for cannabinoid usage in fibromyalgia in the context of pain management and sleep. There is insufficient evidence for recommendations to be made for other musculoskeletal disorders’.
A new study out of the Netherlands in December 2018 found that standardised pharmaceutical-grade cannabis with a tetrahydrocannabinol (THC) content was effective in treating the musculoskeletal pain caused by fibromyalgia. Conducted by Leiden University Medical Centre (LUMC) in co-operation with Bedrocan International, involved a total of 20 patients treated at four distinct moments, as well as the administration of three different cannabis products provided by Bedrocan and placebo (cannabis without the main active substances THC and CBD) by a vaporizer. Another recent study has shown that opioids are largely ineffective against chronic pain. Paired with the new Netherlands study, it seems hopeful that future studies regarding the issue will find that cannabis can be a successful replacement for opioid use.
This research led Tjalling Erkelens, the CEO of Bedrocan to say:
“The outcome is very important for patients who suffer from fibromyalgia. Now we have the serious clinical evidence that medical doctors are asking for when prescribing our products and that health insurance companies want to have, to legitimize reimbursement.”
Fibromyalgia affects 2%-5% of the UK population, which means that at least over one million people could benefit in a relaxation of the Misuse of Drugs Regulations.
UK Fibromyalgia asks the government to relax the current legislation to allow general practitioners to be able to prescribe medical marijuana to sufferers of fibromyalgia and all other patients with similar chronic pain conditions.
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UK Fibromyalgia does not advocate, condone, or encourage breaking the law. It exists to promote a change in the law by legitimate means.