Jersey 'at risk' from legalisation of medicinal cannabis
A LACK of clinical evidence and only a few international guidelines on the prescription of medicinal cannabis could leave Jersey out on its own should anything go wrong, the head of the primary care body has said.
This week, the States voted in favour of allowing medical professionals – including GPs – to prescribe the drug, meaning that medicinal cannabis will be available to patients from February.
However, Dr Nigel Minihane, chair of the Primary Care Body, said this could cause problems for GPs as there have been few medical trials on the use of cannabis. He said the main thrust of the push towards legalising medicinal cannabis had come from a single medical review – the Barnes report – and there were very few guidelines on when and how it should be prescribed, and the recommended dosages when prescribing it.
And he said Jersey could find its indemnity rates skyrocket should any problems arise through the prescription of cannabis, as there are little to no General
Medical Council or National Institute for Health and Care Excellence guidelines on its use.
The proposition, brought by Deputy Montfort Tadier, means that Health Minister Richard Renouf will be required to bring forward legislation by the end of February next year allowing the prescription of cannabis, cannabis-derivatives, individual and cannabinoids and cannabis-derived products such as nabilone and sativex.
Dr Minihane said that when new drugs come onto the market they are usually the subject of rigorous medical trials, which has not been the case yet for cannabis products.
‘It may be that cannabis is useful in certain areas but the data is limited at the moment,’ he said. ‘The question I often get asked is “is there room for manoeuvre?” and, of course, there is a degree of manoeuvrability but if we go outside proper guidelines and something goes wrong, we are on our own.
‘The last thing we want to do is increase our indemnity.’
The UK recently allowed medicinal cannabis to be prescribed to some patients. However, this is only available in a limited number of circumstances where other treatments have been unsuccessful and can only be prescribed by a specialist doctor.
Dr Minihane added that he was not opposed to prescribing cannabis, provided that there was suitable evidence to support its medical use.
‘I think this is tasking us to feel our way,’ he said. ‘When a new drug comes on the market, people would ask why would you use them? Where are your control trials? What institutions are using it? You don’t go to one person on that. We don’t yet have the evidence and the guidelines that allow us to make the decisions we need to make.’
Last year, then-Health Minister Andrew Green announced that he would be bringing forward proposals to legalise certain cannabis products following the publication of the Barnes report.
Under his plans, products such as Sativex would have been prescribed by licensed hospital clinicians.
Deputy Tadier has long criticised the lack of progress on the issue and successfully persuaded Members to expand those plans.
Dr Minihane also raised concerns about the cost of the drugs – a cost that would ultimately have to be met by the taxpayer.
‘We spend more on drugs than we do on the whole of general practice at the moment,’ he said. ‘We have other priorities that would ultimately affect more people.’
He cited the plans to build the new hospital and the struggling state of the mental-health services as areas which required departmental funding.