Minister for Health, Stephen Donnelly, TD, announced on 21 January that funding for the Medical Cannabis Access Plan (MCAP) will be added to the Health and Safety Executive (HSE) Service Plan for 2021, meaning medical cannabis will be more available later this year, in Ireland.
Irish patients have been legally allowed to take medically prescribed cannabis for some time, however, patients prescribed the substance had to travel the whole way to the Netherlands to get it legally. April 2020 saw these patients face a new challenge: COVID-19 travel restrictions. Since then, The Department of Health set up a now permanent service to import and deliver these patients’ prescribed licensed cannabis products. In some sense, the COVID-19 travel restrictions of 2020 propelled the prioritisation of funding the MCAP this year.
Assessment of Cannabis Products
Through the MCAP, potential suppliers apply to the Health Products Regulatory Authority (HPRA), who then assess if their cannabis-based products are suitable for medical use. Once deemed acceptable by the HPRA, these products can be made available on the Irish market by suppliers, for specialist doctors to prescribe.
Currently, the HPRA has deemed four of these cannabis-based therapies acceptable. These four medical cannabis treatments are available for licensed pharmacists to dispense on the receipt of proper prescription in Ireland. More products are being assessed currently, and, if accepted, these will be included in the Programme in the future.
The Medical Cannabis Access Programme ensures these licensed cannabis treatments are available only when specialist medical consultants prescribe them, for conditions not responding to other conventional therapies.
Resistant conditions that will hopefully be relieved by the MCAP include the spasticity seen in Multiple Sclerosis, the vomiting and intractable nausea (where you feel constantly as if you are about the vomit) sometimes associated with chemotherapy, and severe, refractory (treatment resistant) epilepsy.
The Health Minister spoke out about what the programme intends to achieve:
“The purpose of this Programme is to facilitate compassionate access to cannabis for medical reasons, where conventional treatment has failed. It follows the clear pathway laid out by the Health Products Regulatory Authority in their expert report ‘Cannabis for Medical Use – A Scientific Review’.”
However, Donnelly made it very clear that this Access Programme was not a stepping stone for legalising recreational weed in Ireland, stating: “There are no plans to legalise cannabis in this country.”
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Recreational vs Medical Marijuana
Unauthorised possession and supply of marijuana is still punishable by law, as these rules regarding recreational drug use remain unchanged. Many of the reasons why recreational cannabis remains illegal revolve around the potential impacts using cannabis can have on people’s mental and physical health.
Some of these concerns were highlighted in a 2017 Irish national survey, which asked General Practitioners their views on cannabis decriminalization. Around 80% of both male and female GPs agreed that cannabis use significantly affects the mental health of their patients, and 77.3% agreed that it increases the risk of developing schizophrenia.
Interestingly, although this study found that overall the majority of GPs did not support the legalization of cannabis for recreational use, significantly more males agreed or strongly agreed that it should be legalized compared to female GPs. It was also found that those with more advanced training tended to support a more liberal view regarding cannabis decriminalization.
Fascinatingly, this survey also showed that GPs working in a non-deprived, more affluent area were 56.4% more likely to agree that cannabis could help in pain relief and management, compared to GPs who worked in a deprived area.
Supporting the legislation of today, this 2017 study concluded that around 60% of both sexes agreed cannabis can aid pain management and has a role in multiple sclerosis treatment and palliative care.
Controlling the Use of Cannabis
To ensure this tight control of cannabis, a prospective supplier must hold a controlled drugs licence, processed by the HPRA, to allow import, possession, or supply of all cannabis-based products.
The HSE has also now established a strict electronic register to record all authorised prescribers, the supplied medicinal cannabis products, and patient identification data. Hopefully this data collection will pave the way for better informed practices of regulated medicinal cannabis in the future.
One financially positive aspect of the MCAP is that, if prescribed medically, cannabis-based treatments may also be accessed free of charge using the Medical Card scheme. The Health Minister stated that an additional 4 billion euros were added to the Health Budget in October 2020. Hopefully this money will fund and drive improvements in the Irish Health and Social care services, and the MCAP is just one of the programmes reaping the benefits of this funding in 2021.