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It’s time Britain regulated cannabis like alcohol – the benefits are clear

Having a standard way of displaying the strength of a drug doesn’t just help consumers make purchasing decisions, it can also be used to help them understand risks

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Most of us want to know how strong an alcoholic drink is before we consume it, which is made simpler by having a standardised system. ABV, or alcohol by volume, is the accepted way of measuring and communicating alcohol potency.

Unlike alcohol, cannabis has no standard measurement of strength. It would be odd to think of only finding out how strong an alcoholic drink is once you’ve already consumed it, but that’s exactly what people who use cannabis have to do.

Although recreational use of cannabis is illegal in the UK, it is hardly a niche activity. In England and Wales, 30 per cent – that’s around 10 million – of adults aged 16 to 64 have tried the drug at least once, according to the annual crime survey. Across the Atlantic millions more have access to cannabis as most US states allow medical and/or recreational use of the drug.

The benefit of regulated markets for American consumers is they are given information about the strength of the cannabis products they can buy. In the main, this is done by suppliers indicating the amount of tetrahydrocannabinol (THC) in their products. So, THC has become the equivalent of ABV for alcohol. Instead of spirits and beers, there are low and high, forgive the pun, THC products.

Having a standard way of displaying the strength of a drug doesn’t just help consumers make purchasing decisions, it can also be used to help them understand risks. For over 30 years, successive governments have advised us on safe levels of drinking by using alcohol units as a standard. Although even with such well-established standards, not everyone is clear about what exactly a unit of alcohol is, let alone whether they heed the advice on the number they should limit themselves to.

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Nevertheless, having this standard system allows the evidence of risk to health to be communicated so that individuals have some way of knowing what the safe limit is. And this isn’t just about health, but other critical areas such as driving. Knowing how much alcohol can be consumed to stay the right side of the drink driving laws has also benefited from the standard alcohol unit. Just like alcohol, cannabis carries its own risks to health and other areas of life such as driving.

The shared intelligence from most research into drugs is the rather obvious point that the more frequently a drug is used and in greater quantity, so the risk to health increases. Without a standard cannabis unit, individuals will find it difficult to calibrate whether their use is low or high risk to their health, beyond the generalisation of “don’t use a lot and often”. What constitutes a lot? And how frequent is often? Hourly? Daily? Weekly?

The additional challenge in formulating a standard cannabis unit is that unlike alcohol, there is more than one way of ingesting the drug. Smoking and eating cannabis vary how quickly and intense the effect of cannabis will be. Edible cannabis products have a time delay in their effect which can make it difficult particularly for naive users to work out the amount they need to experience pleasure rather than pain

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Dame Carol Black has been appointed by the government to conduct an independent review of drugs in the UK. One of the recommendations she could make is to establish a standard cannabis unit. This would allow public health to advise on what constitutes a safe level of cannabis use in much the same way they do for alcohol. That would move us on from the current failure of advising everyone to abstain, which year after year millions ignore.

Most of us grow out of drug use, we don’t need to be told to refrain. We need a similarly mature approach from politicians that would provide some evidence-based information, like cannabis units, on which we could decide whether we want to use cannabis and if so, how much.

Ian Hamilton lectures in mental health at the Department of Health Sciences, University of York

1 /1 It’s time Britain regulated cannabis like alcohol

It’s time Britain regulated cannabis like alcohol

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Having a standard way of displaying the strength of a drug doesn’t just help consumers make purchasing decisions, it can also be used to help them understand risks

Medicinal cannabis: What is it and is it legal in the UK?

The law on medicinal cannabis changed in the UK in November 2018

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Charlotte Caldwell, the mother of 15-year-old Billy Caldwell, has brought her legal campaign to acquire medicinal cannabis for him through the NHS to an end.

Mrs Caldwell and her son made headlines in 2018 when officials at London’s Heathrow airport confiscated cannabis-based medicine from them, which had been obtained in Canada to treat his epilepsy.

Billy has refractory epilepsy, which can cause him to have a hundred seizures a day.

The following year, the family launched a legal challenge against the NHS and the department of health in Northern Ireland over access to his cannabis-based medicine.

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According to the Belfast News Letter, the legal proceedings were withdrawn at Belfast’s High Court on Monday 7 September 2020.

The Honourable Mrs Justice Keegan stated: “There will not be a need for further litigation, which is the last thing this family needs.”

Barrister Monye Anyadike-Danes QC, who represents Mrs Caldwell, added: “My client thinks this matter can best be pursued through the RESCAS [Refractory Epilepsy Specialist Clinical Advisory Service] panel.”

The RESCAS panel, which is led by Great Ormond Street Hospital, was created in order to bring together paediatric neurologists who specialise in epilepsy, to support patients by offering their expertise.

Mrs Caldwell will now correspond directly with the health professionals on the panel to discuss her son’s access to treatment, urging them to ensure her son’s prescription is funded, the News Letter said.

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Speaking on BBC’s The Emma Barnett Show on Monday 7 September, Mrs Caldwell said that over the past 18 months, she and Billy have been through a “very, very torturous ordeal”, with her son being “left high and dry by the powers that be”.

She explained that Billy was referred to the RESCAS panel in July this year, with the panel of eminent UK doctors coming to the conclusion “that there are no legal or clinical barriers to medical cannabis access for Billy”.

So what is medicinal cannabis, what conditions is it used to treat and is it legal to prescribe in the UK?

What is medicinal cannabis and is it legal in the UK?

The term “medicinal cannabis” is used to refer to any form of medication that contains cannabis, the NHS states.

In the UK, cannabis is classed as a Class B drug.

If a person is found in possession of cannabis, they could face up to five years in prison and/or a fine, according to the government.

If they are found to be supplying and producing the drug, they could face a life sentence, in addition to an unlimited fine.

Medicinal cannabis, on the other hand, is legal in the UK.

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On 11 October 2018, the government announced that from 1 November 2018, expert doctors would be given the authority “to legally issue prescriptions for cannabis-based medicines when they agree that their patients could benefit from this treatment”.

The government emphasised that only a “specialist doctor” – and not a GP – can prescribe “these unlicensed medicines”.

“They must make decisions on prescribing cannabis-based products for medicinal use on a case-by-case basis, and only when the patient has an unmet special clinical need that cannot be met by licensed products.”

If a product – such as CBD oil or hemp oil – is marketed as being a form of medicinal cannabis, there is “no guarantee these are of food quality or provide any health benefits”, the NHS states, explaining that these products can be bought legally as food supplements.

CBD is a non-psychoactive chemical compound found in the marijuana plant.

Products that contain CBD (cannabidiol) are not illegal in the UK, as long as they only contain trace amounts of THC (tetrahydrocannabinol), the main psychoactive compound in cannabis.

What conditions is it used to treat?

As explained by the government, while medicinal cannabis is legal, it can only be prescribed by specialist doctors on a case-by-case basis.

In England, only patients with certain health conditions are likely to be prescribed medicinal cannabis, the NHS says.

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These include: children and adults who have rare, severe forms of epilepsy; adults who have undergone chemotherapy, which has caused them to vomit or suffer from nausea; and patients with multiple sclerosis whose health condition has caused them to experience muscle stiffness and spasms.

“It would only be considered when other treatments were not suitable or had not helped,” the NHS adds.

The health service states that the “risks of using cannabis products containing THC (the chemical that gets you high) are not currently clear”, which is why further clinical trials are needed.

However, the majority of cannabis products are likely to “contain a certain amount of THC”, the NHS explains.

Side effects of medicinal cannabis can include a decreased appetite, dizziness, fatigue, diarrhoea and nausea.

1 /1 Is medicinal cannabis legal in the UK?

Is medicinal cannabis legal in the UK?

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About The Independent commenting

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The law on medicinal cannabis changed in the UK in November 2018