In 2018, the UK government rescheduled cannabis from schedule 1 – which categorises the drug as dangerous, with high potential for addiction and abuse, and no medical value – to schedule 2. Drugs categorised as schedule 2 are still recognised as having a high potential for abuse but as also having medical value, such as morphine, codeine and oxycontin.
The rescheduling of cannabis means researchers are now able to carry out clinical trials, without requiring a Home Office licence, to investigate the drug’s usefulness in treating a wide range of conditions, including epilepsy. Whilst these trials are ongoing and legal cannabis oil remains difficult to access for patients, neurologist are beginning to recommend CBD oil as an alternative treatment for some forms of epilepsy.
Epilepsy is a neurological condition which causes bursts of electrical activity in the brain known as seizures, which temporarily affect how the brain functions. This complex condition has been at the centre of an uphill battle in the UK to legalise cannabis for medicinal use.
The law in the UK was changed to allow specialist doctors to prescribe cannabis oil containing both CBD and THC, following the high profile cases of Billy Caldwell and Alfie Dingley. Both Billy and Alfie suffer from rare forms of childhood epilepsy which can cause hundreds of seizures a day.
However, this option is only available in extreme cases where conventional treatment has failed. Patients are then forced to have their prescription reviewed by a local hospital board and then approved by their local authority, despite it being prescribed by a specialist doctor. Both the hospital board and local authority can block the prescription, citing reasons such as a lack of clinical trials or a belief that it is an unsafe medicine, preventing the patient from obtaining the medicine.
If a patient does manage to get their prescription approved, they still then have to pay for the cannabis oil to be imported under licence from The Netherlands. Patients can also try going private, as prescriptions from private doctors do not go through the same scrutiny as NHS ones do. However, patients with a private prescription still have to pay for the medicine to be imported under licence from The Netherlands, which all adds up to £20,000 per year – far out of the average patient’s price range.
As more and more clinical trials are carried out to examine how cannabis can affect epilepsy, and NHS patients are blocked by local authorities from receiving medicinal cannabis, some are turning to the legal world of CBD to help treat the condition.
Current NHS guidelines claim that cannabis oils do not offer much help to those suffering from more common or milder forms of epilepsy, but that it could offer hope to youngsters suffering from severe forms of childhood epilepsy, such as Dravet Syndrome and Lennox-Gastaut Syndrome. These rare forms of epilepsy can cause hundreds of seizures every day, and are associated with learning difficulties and developmental delay, often leading to psychosis, institutionalisation, and an early death.
Cannabis oil used to treat epilepsy combines both CBD and THC which work on the Endocannabinoid System, altering brain chemistry to reduce seizures. But fears are now being raised that the psychoactive cannabinoid THC could impact brain development in young people.
Many doctors are still hesitant to prescribe cannabis oil containing THC despite it being legalised, or recommend patients try CBD – even when all other treatments have failed – choosing instead to rely on conventional medicines.
However, the British Paediatric Neurology Association (BPNA) has welcomed the rescheduling of cannabis-based medical products as it will allow for more research and clinical trials into their use in treating epilepsy and other neurological conditions. While more research is being carried out into the effects of THC on brain development, the BPNA is recommending CBD oil as a treatment for patients with rare forms of epilepsy such as Dravet and Lennox-Gastaut Syndromes which are difficult to treat with conventional pharmaceuticals.
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