Less than five patients in Northern Ireland have NHS prescriptions for medical cannabis

Less than five patients in Northern Ireland have a prescription for medical cannabis on the health service, six years on from when it was legalised in the UK.

The Department of Health says there remains a lack of clear evidence as to its safety, but the 2018 change in the law has made it easier for clinical trials to take place.

This will include two national NHS trials due to take place in London next year.

Among those receiving a prescription is Billy Caldwell (19) from Castlederg.

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Earlier this week, his mother Charlotte told the Irish News her son is now “thriving” from the treatment for his epilepsy after he had previously suffered up to 300 seizures a day as a child.

She raised concerns about the lack of availability on the health service and inconsistent standards in the private sector, claiming some providers were marketing medical cannabis like “a sweet-shop”.

A department spokesperson explained that doctors on the specialist register of the General Medical Council may only prescribe cannabis-based products for medicinal use (CPBMs) where it was “clinically appropriate”.

“As with any unlicensed medicine, unlicensed CBPMs can only be prescribed on a ‘named patient basis’ for indications where there is clear evidence of benefit, where there is a clinical need which cannot be met by a licensed medicine, and where established treatment options have been exhausted,” they said.

With decisions as to which treatments are best suited for individual patients a matter for clinicians, they said fewer than five patients are prescribed and supplied unlicensed CPBMs within the health service in Northern Ireland.

“There is currently limited scientific evidence that medicinal cannabis is safe and effective. There are also few licensed medicines available that have undergone the normal strict testing for medicines to ensure that the product is safe, of good quality, and is effective.”

The spokesperson added that the change in the law to reschedule medical cannabis made it easier for clinical trials to further develop an evidence base.

Research guidance from the National Institute for Health and Care Excellence (NICE) has been adopted by the department, while the National Institute for Health and Care Research (NIHR) has also encouraged manufacturers to contribute to research which can “contribute to increased knowledge in this area and to future licensing and access decisions”.

In 2025, two national NHS trials will take place led by University College London and Great Ormond Street Hospitals - investigating the safety of using cannabis for adults and children with treatment-resistant epilepsy.

Researchers hope to learn whether the medicines are safe and effective in reducing the number and severity of seizures as well as the effect on learning, sleep, behaviour, quality of life, stress and anxiety.

A particular aspect is the effects of two chemical elements found in cannabis - cannabidiol (CBD) which does not have intoxicating properties, and tetrahydrocannabinol (THC) which does.

The trials will randomly assign CBD, either with mixed with THC or a placebo, to 500 adults and children recruited into the trial from NHS sites across the UK.

If the trials are successful, they may support new applications to regulatory bodies.