By Richard Shrubb
Many people in the cannabis legalisation movement want to be free to smoke weed to aid their ailments. In theory they would want it as a herbal remedy from Holland and Barrett to aid their physical or mental pain, or even use it to attack tumours etc. In an ideal world this would be wonderful. They do it in the US and Canada so why not in the UK?
Several pressures come to bear in preventing this from happening. The obvious one is the right wing media’s jaundiced opinion of the weed. This brings about (rightly or wrongly) perceived safety issues around cannabinoids. Another issue is the general stigma around herbal remedies. Money is another issue, and the NHS being in thrall to Big Pharma – the pharmaceutical companies.
The NHS is as paranoid about the national tabloids as the rest of the government. I have written an article about a Primary Care Trust and for some reason they gave most of the care the desperate family needed after reading about themselves in the Sunday Express! You can imagine what would happen if they prescribed a herbal remedy that sent half their patients to the loony bin (as certain newspapers believe would happen)!
Early in acute phase treatment for my schizophrenia, I was very depressed. The doc refused antidepressants, saying that I should only take the antipsychotics that made me twitch, dribble and put on weight. I heard of St John’s Wort (hence, SJW), a herbal remedy known as an effective antidepressant that you can buy from the herbalist. I asked the hospital pharmacy, and ended up in an exchange of letters. They advised me they could not know the interaction between SJW and my medication so strongly advised against it. Given the dreadful side effects of my antipsychotics at the time, such a warning made me decide against taking the herb.
A year later a study into the safety and efficacy of SJW was published. It is a meta analysis of published research into SJW. We have looked at Randomised Control Trials (hence, RCT’s) as the “gold standard” of research – the meta analysis can be if you like, the “platinum standard”, a step above. They can look at a group of RCT’s and regress the findings to see if science overall, suggests any findings. Two RCT’s carried out the same way can have different results. You have say five and three of them have similar results? The meta analysis will show that in three of the five projects the findings were similar, so there are pointers toward, for example, that an extract of cannabis can reduce cancer tumour size.
The meta analysis concluded that with SJW, “overall, the analyses and the accompanying editorial suggested that SJW is a promising investigational agent for the treatment of [Major Depressive Disorder]”. The same research paper suggested it wasn’t understood which chemicals from the plant were active, or how those chemicals interacted with the brain to stop patients being depressed.
If SJW was to be used as a medicine they need to know how it works, in what cases it works, and what dose to offer. To avoid tabloid headlines (let’s be honest!) they want to know the side effects of a drug, as well as the dangers in taking it. The antidepressant Seroxat causes prolonged and painful erections in men, excessive bleeding in women’s periods, and constipation. But they know how it works, as well as the dangers of coming off (such as massive temper tantrums and even suicide – the reason the UN’s World Health Organisation advises against Seroxat’s use). Such effects need to be researched. Such research to meet strict international safety guidelines, costs money.
For a cannabis remedy to come about and be used by the NHS, it is more than likely that, as has happened with Sativex, the medicines produced will be extracts of the weed rather than the weed in its own right.
Interviewing a spokesperson at the UK’s Medicines and Healthcare Regulation Authority he explains the steps involved in getting a license for a drug. The research undertaken “involves data exclusivity for 10 years”. This will mean that once licensed, no one can use the specific results from your research into the molecule for a decade. They would have to carry it out themselves.
A spokesperson for the Association of British Pharmaceutical Industries told me by email, “The research and development costs of each new medicine are on average £1.15 billion.” She went on, “Medicine innovation is a gradual process, with the development of new medicines taking 12-15 years”.
From this you will see very high hurdles in producing a drug that the NHS will use to treat your symptoms with a cannabis extract. You must work for well over a decade on the molecule, costing well over £1 billion, and if all goes well you have a decade to make that back before others can use your research and make cheap drugs.
As a business you will want in that profit, at least another £2 billion to reinvest in research (most medicines do not make it to market so at least a billion will not make immediate returns) and enough to make your investors happy with returns to them. As a fag packet estimate, you will need to make £5 billion (over a decade, £500 million a year PROFIT) in order to survive from a £1 billion investment. Successive UK governments have whined constantly about £1 billion of fraud in the welfare budget – if a government can feel uncomfortable about that, you can see how silly that sort of cash is …
Here is the problem. To make £500 million a year profit you have to make serious money from a drug. This is arguably why GW Pharmaceuticals has had to sell Sativex at such a high price to the NHS. Primary Care Trusts fight hard not to offer it as at £175 a bottle they will have to cut spending on other drugs for other patients. GW will have to sell internationally, and compete with cannabis dispensaries in Canada and the US…. Or?
My next blog will try to find some objectivity in the risks of taking cannabis. Understanding this will inform campaigners what the real risks are (as opposed to the delusions of the Daily Mail) and help you work out how you can get cannabis prescribed as a herbal remedy. That would take the wind out of the sails of the major pharmaceutical companies. That, probably, is the only solution. To do that, we need to demystify the risks of cannabis use, and turn the tide of government opinion toward acceptance that cannabis isn’t the demon the right wing press would have it believe. A labour worthy of Hercules?
Richard Shrubb is a freelance journalist with a specific interest in medical science and sailing, for more info about Richard, see his web site www.richardshrubb.co.uk and you can follow Richard on Twitter #Shrubberz