New figures show that a potential 1.8million people are turning to the illicit market for medical cannabis, four years since it was legalised in the UK.
A recent YouGov poll suggests that approximately 1.8million people with diagnosed medical conditions are turning to illegally obtained cannabis to manage their illness.
This number has increased by around 400,000 since 2019, when a comparable report released in 2019 showed the figure to be around 1.4million.
At the same time a new study conducted by experts at Sapphire Medical Clinics has revealed that a significant proportion of the population (48.6%) are still unaware that medical cannabis is legally available on prescription and has been since November 2018.
The paper provides an in-depth analysis of responses from over 10,000 UK adults who took part in the YouGov poll which aimed to assess the public awareness of the availability, regulations, and barriers to access medical cannabis.
The study points to a lack of awareness and perceived difficulty accessing legal cannabis products, with a quarter (24%) unaware that cannabis could be legally prescribed while two-fifths (41%) were under the impression it would be too difficult to access.
The most frequently reported main barriers were its association with recreational cannabis (25.1%), being unsure if it was legal (21.3%) and being unsure what medical conditions it can be used for (17.4%).
A separate survey completed by more than 1,300 patients at Sapphire Clinics who are now receiving legally prescribed medical cannabis products showed three-quarters (74%) had previously turned to the illicit market.
Growth in prescription numbers
Despite this the number of cannabis prescriptions being issued in the UK continues to grow year on year. Figures from a recent freedom of information request show that medical cannabis prescriptions in January 2022 reached their highest level on record, six times those seen in January 2021.
During the first quarter of 2022, the number of prescriptions reached just over 19,000. For the purposes of the data, one product is classed as a single prescription, so if a patient is prescribed two different products, this would count as two prescriptions.
Over the last four years a number of initiatives have been launched to help make cannabis prescriptions more accessible, these include Project Twenty21, Grow Access Project and the Sapphire Access Scheme.
Dr Simon Erridge, head of access and research at Sapphire Medical Clinics, who was one of the lead authors on both of the studies, commented: “We’ve made significant strides in terms of improving access for patients. A large part of this has been Sapphire Clinics being focused on bringing down the costs of consultations, as well as providing a platform to robustly evaluate the evidence on outcomes for patients prescribed medical cannabis in real-world settings.
“Patients enrolling on the Sapphire Access Scheme can contribute directly to the UK Medical Cannabis Registry which now boasts a database of over 6,000 patients.”
He added: “This four-year milestone allows us to reflect on the progress that’s been made. The study suggests that whilst this regulatory change facilitated a route to access medical cannabis through appropriate specialists, it has failed to become widely available through the UK’s single-payer healthcare system, the NHS. The barriers to access are likely multifactorial and consist of stigma, a paucity of high-quality randomised controlled trials, and a lack of awareness and education amongst healthcare professionals and patients.”
Patient feedback
However, alongside a lack of awareness, feedback from patients suggests that challenges within the legal industry may also play a part in preventing patients from taking the prescription route.
Survey data published by PLEA (Patient-led engagement for access) this week suggests that over 60% of legal patients have experienced ‘unreasonable delays’ to their prescription, with 31% saying they have had issues with quality control.
On top of this, over a third of patients are paying more than £350 a month for their medication. And many are using their benefits to do so.
When asked by Cannabis Health why they preferred to access their medicine through the illicit market, patients cited concerns over quality and delivery, irradiated products, lack of choice, ‘data protection violations’ and ‘high costs’ as key reasons.
One patient said they struggled to find the money to pay for their medication up front each month. Another felt that through the legacy market they could ‘guarantee’ access, consistency, quality, and non-irradiated products.
Other patients have a legal prescription, but sometimes still have to rely on the illicit market as ‘back up’.
“There are a few reasons I buy black market sometimes, as much as I wish I didn’t have to,” said one individual, who wished to remain anonymous.
“The first is that using a variety of pharmacies, my experience increasingly is that it’s impossible to maintain a steady supply, so there’s always a back up needed. It’s not ideal because I struggle to access the strains that help most, but it’s better than nothing. This is likely to increasingly be the case if pharmacy stocks remain absurdly low, like they are at the moment.
“The other reasons relate to oil. If you get a decent supplier it can be slightly cheaper to buy through the black market.”
They added: “More importantly though, I actually started using cannabis oil in the first place, as I had a tumour. It was only through doing that that I realised it helps other things too, but because it’s not prescribed as a cancer treatment, I couldn’t get a dosage and would have to make up a reason, which totally defeats having a treatment plan.”
However, Sapphire Clinics patient Eve Hamilton, 27, says that everything changed for her when she was made aware that she was able to access medical cannabis legally for her diagnosis of autism spectrum disorder (ASD).
She said: “Having sourced cannabis illicitly as a young woman I often felt scared – but being able to access medical cannabis via prescription now gives me the reassurance that the dose is more consistent and safe. It’s made a huge difference to my life.”
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