Progress on prescription of medicinal cannabis (FOI)

In the debate on the proposition for medicinal cannabis, P.113/2018, the Health Minister stated:

"...I would seek [the Misuse of Drugs Advisory Council] advice upon the online courses or other training that might be available to G.P.s and their view on training G.P.s in the community to prescribe. So that we ensure, before any unlicensed medicines are made generally available in the community, they are carefully assessed and patients will not be exposed to undue risk."

What progress has been made on the training of Jersey's GPs in relation to medicinal cannabis and the human body's endocannabinoid system since the adoption of P.113/2018?

Before the words quoted in the request, the Health Minister had said in the debate that he would be willing to seek the advice of the Misuse of Drugs Advisory Council (MDAC) on whether GPs generally should be able to prescribe, and immediately after the words quoted he said: ‘At the moment , I do not believe there is any appetite from GPs to be able to prescribe these products. None have made that request to my department. It seems that States Members have not received any emails or letters in support of the proposition from local GPs…I am not aware of any movement, any great wish yet, from GPs to be able to prescribe unlicensed medicines and take the responsibility for doing so.’ 

Since the debate in November 2018, the situation remains unchanged and there have been no requests from GPs to prescribe, since the previous FOI response – please see link below, and there have been no prescriptions written for any of the unlicensed cannabis based products for medicinal use (CBPMs) by either GPs or Consultants. 

The MDAC advice was that it was not appropriate for GPs to prescribe and that prescribing should be restricted to doctors on the GMC specialist register as it is in the UK. 

It is not for MDAC to recommend any specific training that prescribers might want or need to undertake. Prescribers, if they want to prescribe any medicine, need to ensure that they are familiar with the medicine and how to use it and also how to monitor its effectiveness and side-effects and should therefore identify their own specific training needs. These CBPMs are just like any other unlicensed medical product. As unlicensed medicines, they have not been subject to controlled clinical trials to demonstrate safety and effectiveness in specific patient groups or in specific disease states. Evidence is accumulating in these areas, but not sufficient for any one product to be licensed as yet. There is clear guidance from the GMC for doctors when considering prescribing an unlicensed medicine (cannabis based or otherwise) and this generally states that unlicensed medicines should only be considered when no licensed medicine is available to meet the patient’s needs. This applies whether or not the prescriber is a GP or consultant and doctors would be expected to follow this guidance.