High profile campaigner Vera Twomey has responded to neurologists who expressed concern over products likely to be offered through the Medical Cannabis Access Programme.

Doctors treating patients with epilepsy appear to be planning to shun the Irish Government’s Medical Cannabis Access Programme (MCAP).

Several neurologists and patient organisations have written to Minister for Health Stephen Donnelly with concerns about the products being made available under the scheme, citing fears they are “inappropriate” and “potentially harmful”.

Widespread concern

As reported by the Irish Times, the letter states:

“Not only is there a lack of evidence to support the use of THC in epilepsy, but there are significant concerns regarding its psychiatric and cognitive effects, particularly when used in children.”

All four products accepted for the programme contain THC, with those behind the letter concerned that the risks associated with THC compounds are under-appreciated.

The neurologists say that because of widespread concern, the programme now runs the risk of not being used.

The letter continued: “Because there is widespread concern about the programme among neurologists in Ireland (because inappropriate and potentially harmful products will be available through the programme), the programme runs the risk of not being utilised.”

However, despite being introduced in 2019, the MCAP still not operational. The pilot programme is set to run for five years although it is unclear if this will be extended as a result of Covid-19 disruption.

Read more: Ireland to fund patient’s medical cannabis upfront

Supply issues

There are currently no cannabis-based products available under the programme or any patients registered with the scheme.

One product has been approved for potential patients but doctors have expressed concern that the THC level is too high for a starting cannabinoid treatment for epilepsy patients. Another product has been deemed suitable by doctors, but as it is UK-manufactured there would need to be a change in legislation before it was made accessible in Ireland.

The HSE has reported that one supplier is now no longer interested in the Irish market. The products were due to be available in October or November this year but it is thought this could be pushed back due to the country of manufacture being changed.

Read more: Calls for reform to Ireland’s cannabis laws as hundreds prepare to protest

Patient response


Campaigner and mother Vera Twomey has spoken out about her concerns regarding the letter.

In a social media post, referring to how her daughter condition was improved through full extract cannabis oil, she said: “Twenty to 30 or 40 seizures a day or more eliminated by CBD and THC. The threat of further brain damage was removed almost completely. The thought that a negative campaign towards such a remarkable medication as CBD and THC is in full flow within our Republic of Ireland is a complete and utter disgusting travesty.

“The thought that families will be scared off exploring the option of THC medication by such extraordinary and unjustified measures such as refusing to acknowledge the programme set up to prescribe CBD and THC medication is one of the most destructive steps I have seen in seven years and smacks of desperation to stop access to cannabis medication.”

She added: “It is clear that the public is aware and informed of the benefits of medical cannabis because if they were not consultants would not be trying to create more barriers to access. I applaud the consultants sensible enough to prescribe this life-saving medication. I do not want to consider in much detail the real reasons why other consultants do not.”

Enrolment

There are plans to start enrolling patients on a cannabis medical use register once documentation is finalised. The department is currently working on this alongside specialists.

Twomey’s daughter Ava, is one of approximately 63 patients accessing medical cannabis in Ireland using the ministerial licence.

Until the start of the pandemic, patients had to travel to the Netherlands to import the drug back to Ireland. It is now sent directly as a result of disruption to travel. Earlier this year it was announced that cannabis medication would no longer need to be reimbursed from the HSE but would be funded upfront.

There are currently three conditions that qualify for medical cannabis in Ireland: severe epilepsy, spasticity associated with multiple sclerosis and nausea associated with chemotherapy. But patient organisations and activists say this does not go far enough and that there needs to be the inclusion of chronic pain patients.

Cannabis Health has approached HSE and the doctors involved for comment.

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