The UK government has rejected a petition calling for patients with a prescription for cannabis-based medicines to be allowed to grow their own plants at home.
Around 13,000 people signed a petition calling for ‘Grow Your Own’ laws to allow patients with a prescription for cannabis-based medicinal products (CBPMs) in the UK to grow up to six plants at home for medicinal use.
In a response, published on 19 May, the Home Office said homegrown cannabis is ‘not a safe or appropriate substitute for regulated CBPMs’, and there are ‘no plans to change the law’ to permit its use.
Medical cannabis has been legal in the UK since 2018, with tens of thousands of patients now holding private prescriptions for CBPMs.
However, only a handful of patients have been able to obtain a prescription through the NHS, with the majority spending an average of £350 per month on their medication.
The petition, launched last year highlights how many patients face ‘severe financial difficulty affording their prescription’, and called for those prescribed cannabis-based medicines by a specialist to be allowed to maintain three to six flowering plants for their own medicinal use.
A growing number of countries around the world now permit home cultivation including Malta, Germany, Luxembourg, Uruguay, Mexico, Canada and 21 US states.
In Canada, regulations permit patients to grow up to four plants for medicinal cannabis, or to have a designated person do so, providing they meet the necessary requirements. Advocates in the UK have suggested that a similar ‘registration database’ could be maintained by local authorities throughout the UK to notify police of those with legally-grown plants.
“Many patients are unable to work, and are forced to turn to cheaper illicit sources due to affordability,” the petition states.
“‘Grow Your Own’ is available to cannabis patients in many other countries for this very reason, and we think must also be considered in the UK via a change to Home Office licensing/scheduling.”
However, the Government says that while it ‘sympathises with patients suffering from painful and debilitating conditions’ and ‘can understand their desire to seek the best and most affordable treatment’, expert advice ‘does not support the substitute of home grown or street cannabis for CBPMs’.
The response goes on to outline the evidence on which the decision was based, referencing the July 2018 review published by former Chief Medical Adviser, Professor Dame Sally Davies.
“Cannabis has many active chemicals and only cannabis or derivatives produced for medical use can be assumed to have the correct concentrations and ratios. Using other forms, such as grown or street cannabis, as medicine for therapeutic benefit is potentially dangerous,” it states.
“Grown cannabis has over 100 active drugs, which can have a wide variety of concentrations and ratios creating different and often severe side effects… Because different forms of grown cannabis have different concentrations and ratios of these drugs, grown or street cannabis cannot safely be substituted for medicinal cannabis.”
‘Street weed’ vs self-cultivation
Dr Callie Seaman, a cannabis scientist who has consulted on licensed CBPM manufacturing facilities around the world, says it is inaccurate to equate the risks of ‘street cannabis’ with that which has been grown by the individual themselves.
“When a patient grows their own plants they know exactly what that plant has been exposed to throughout its life cycle. They are in control of what it is fed, how pests are dealt with, how it is dried and stored,” she explains.
“Much of the “street weed” is now smuggled in from other countries, where growing practices can be less stringent, and good agricultural practices are not followed. There is also the risk of contaminants being sprayed on to the flower to increase its weight or potency with synthetic cannabinoids, such as HHC or even other research chemicals.”
Self-cultivation is not without risks, such as microbial contamination, particularly as it lacks the same level of regulatory and clinical oversight as CBPMs which are prescribed by specialist doctors.
But when this form of access is prohibited, many patients revert back to the ‘black market’ especially when private healthcare costs become unsustainable, Dr Seaman explains. Figures suggest that as many as 1.8 million people may still be self-medicating with cannabis in the UK, despite it now being legally available on prescription for over six years.
“Criminal gangs are currently breaking into the houses of those who choose to be self-sufficient and victims cannot go to the police for help… Many live in fear of the authorities coming through the door and families being split up,” she says.
“The UK needs to look at what is happening around the world, with countries like Germany, Malta and Canada having much sought-after data, to show where the downfalls are and the effects on crime.”
Learning from other markets
Approaches adopted in these jurisdictions show how home-growing can be permitted effectively under strict regulations, such as age restrictions and limitations of the number of plants. Analysis from Canada, for example, shows that the percentage of people who reported cultivating cannabis at home did not change significantly from pre to post-legalisation, nor did the demographics or use characteristics.
Meanwhile, harm-reduction strategies such as education programmes and voluntary lab testing schemes offered through licensed facilities, could also be implemented to ensure safe cultivation practices and reduce potential risks.
“By embracing a self-sufficiency model in the UK, cultivation facilities could supply cuttings and seeds of known genetics and offer analytical testing services, all of which would create jobs and stimulate the struggling economy,” Dr Seaman adds.
“They could even buy back the surplus produce, while education programs could be created so that safe practices could be followed.”
Barriers to NHS access
In its response, the government repeated calls from NICE for more research, stating that until there is ‘robust evidence on the safety, quality, and efficacy’ of CBPMs, clinicians will ‘remain reluctant to prescribe them’ and ‘the NHS will not be able to make decisions on routine funding’.
Ministers have previously said it is the responsibility of manufacturers of unlicensed products to conduct this research and seek regulatory approval in order for them to be prescribed on the NHS.
The Home Office stated: “The barrier to accessing these products on the NHS is one of evidence, not government regulation, and the Department of Health and Social Care is working closely with regulatory, research and NHS partners to establish clinical trials to test the safety and efficacy of these products.”
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Author: Sarah Sinclair
