FOCUS: The reasons behind the boom in medicinal cannabis prescriptions

Friday 13 August 2021

Hundreds of people in Guernsey are being prescribed medicinal cannabis from UK clinics, who are witnessing ever-increasing demand because of the legal system's "severe" approach to personal use.

While the debate around the illegality of personal use cannabis continues to rage on, the medicinal cannabis market is booming, with nine clinics offering medicinal cannabis to increasing patient numbers.

It has been argued that this could in part be down to the severity of Guernsey’s legal system when dealing with personal use.

“I feel like that for such a small area there is a high demand for medicinal cannabis products,” said Head of Cannabis UK, Clare Holliday, on its use in the Bailiwick.

“If you’re caught with cannabis in the island there are much stricter laws, and it has forced genuine patients down the medical route. 

“In the UK you wouldn’t be looking at a sentence for having 20/30 grams, you’d be cautioned and sent on your way,” she said.

Ms Holliday works for IPS Pharma, a cannabis manufacturer and importer. They receive prescriptions from cannabis clinics in the UK and then ship the product directly to the patient.

Pictured: The UK clinics can only prescribe one month at a time.

“[These laws] definitely have an impact on the number of patients we see coming from Guernsey,” said Ms Holliday.

Medicinal cannabis was legalised in 2019, but immediately hit a stumbling block with no licenced clinicians in Guernsey to prescribe it.

Subsequently, a legal change in September 2020 allowed UK clinicians to import medicinal cannabis to patients in the island. This has remained the case ever since, with several clinics prescribing and importing variations of cannabis to people in the island.

Unlike Jersey, there is no local cannabis clinic, however one supplier in Jersey is now recruiting Guernsey-registered medical consultants to develop an on-island offering.

Pictured: The Medical Cannabis Clinic operates in Jersey and can dispense cannabis in-island.

There’s an important distinction to make between CBD products and the cannabis supplied by these UK clinics.

CBD is a compound found in cannabis that has been widely available in Guernsey for some time now, from skin creams to energy drinks.

Cannabis with the active THC ingredient is an illegal drug that can attract very hefty prison sentences for both cultivation and importation. Possession, even for personal use, lands defendants in hot water. 

Many people in the island have been using cannabis for decades and have now jumped at the opportunity to use the drug legally.

“There have been patients who have been using cannabis illicitly for many, many years,” said Specialist Nurse, Sophie Hayes.

Pictured: The Richards Guidelines for drug importation and supply instruct that personal use should "not generally result in a lighter sentence" as all drugs, no matter how small the quantity, "add to the stock in the island". 

Ms Hayes works for one of the clinics that provide medicinal cannabis to the island, Integro Medical Clinics Limited. She works alongside Dr Anthony Ordman, a Senior Medical Consultant and Lead Clinician.

Express spoke to both Ms Hayes and Dr Ordman about why more and more people are using medicinal cannabis.

“I spent most of my career using conventional medicines in the NHS pain clinics; these medicines are hopeless,” said Dr Ordman.

“Morphine is addictive, it only works for the first six weeks and then you’re hooked on it. Things like gabapentin only help one person in five, and people get hooked on it too; Ibuprofen rots their stomachs and kidneys, you can do a lot of harm to people.

“Because the chemicals derived from cannabis plants are so similar to chemicals found in the nervous system and in the immune system of human bodies, they seem to restore balance in a much more natural way,” he said.

“Sophie and I are finding that three in four are helped by cannabis medicines and we aim to never have side effects. You can’t say that with conventional medicines.”

Case Study

A cannabis user in Guernsey, who chose to remain anonymous, said he suffered with back pain for the majority of his adult life, culminating in acute insomnia over the past three years.

“I attempted numerous methods of traditional care from anti-inflammatories, PT sessions, chiropractors, osteopaths, physiotherapy, anti-depressants, opioids and numerous other medications. 

“I found none of this worked and through the process I developed an allergy to opioids due to consistent use over the years and have now refused out right to ever use them again for pain,” he said.

“I found that medical cannabis has now helped me to sleep for the first time in three years, so from this alone it has become more of a solution for me than years of treatment.”

He uses the cannabis flower, but the product can also come in both an oil and tablet form, with the potential for skin patches in the future.

“We talk to them about it as a medicine and advise on its proper use"

As Ms Holliday notes, there are conditions attached to the herbal cannabis sent over to Guernsey. 

“Prescriptions for medical cannabis are not to be smoked, they are only to be used with a medical vaporiser device – essentially, if you roll it up and smoke it, it’s no longer legal,” she said. 

Vape pens have become a prominent feature in cannabis related arrests in the island, and it’s unclear how the use of the flower product, once obtained by a patient, is policed.

The prescription process itself is highly regulated, and a patient needs to hit certain criteria before being prescribed anything.

“There has to be a genuine diagnosed condition and they need to have tried a number of licenced medicines before they come through the clinic,” said Ms Holliday, who cites guidelines put in place by the National Institute for Health and Care Excellence. 

If cannabis is fully legalised the medicinal cannabis industry may fall away, but currently it’s simply getting bigger. 

Sapphire Medical Clinic is another UK supplier, and they treat a “substantial” number of Guernsey patients since their inception in October 2020.

“We are seeing growing demand for access in Guernsey to medical cannabis through Sapphire Clinics and indeed other crown dependencies. This is reflective of the growing education provided on efficacy, safety, and access,” said Dr Simon Erridge, Head of Research and Access.

Additionally, Ms Hayes from Integro thinks there’ll always be a need for medicinal cannabis and argues that these UK clinics are much more than just ‘cannabis suppliers’.

“We talk to them about it as a medicine, and approach it as a medicine, and we can advise on its proper use.

“Patients who think that complete legalisation is the way forward, when they identify that they’re using it therapeutically and they change the way they think about it, it becomes less important in their lives,” she said.