Greenhaus Quarterly News Roundup (Autumn Edition)

UK Cannabis News

With only 5 NHS prescriptions written for medical cannabis in the five years since its legalisation, what has gone wrong?

The 1st November 2018 was a day of celebration for parents hoping to access lifesaving cannabis treatments for their children in the UK. Following high profile media campaigns supported by celebrities and parents of children with treatment resistant epilepsy, Savid Javid announced the rescheduling of medical cannabis. This allowed for specialist consultants to prescribe the still unlicensed medication, if it was deemed to be in the best interest of the patient. To this day, a full five years later, only five patients have been given NHS access to cannabis, with the thousands of other patients trying to access this life saving treatment, being forced to either fund the treatment privately (costing thousands of pounds/month) or just go without (if they are unable to fund it). Over the same period of time, the private prescription market has flourished, with over 140,000 patients receiving private cannabis treatment. 

There is certainly not a lack of evidence as to the drugs effectiveness. Alfie Dingley was the first to be prescribed cannabis through the NHS, hoping that the drug could successfully treat the severe epilepsy that was killing him. Alfie has now been seizure free for over three years. He plays football, annoys his sister and takes the bus to school on his own. Clearly the treatment has been life changing for Alfie, however other children with very similar conditions have been denied treatment and so are still suffering with daily seizures that could eventually be fatal.

So what has actually gone wrong with NHS prescribed cannabis? The real issue comes from the lack of regulation and real guidelines for prescriptions within this new industry. In 2019, 2020 and 2021 recommendations to review the guidelines surrounding cannabis prescriptions were announced, however to date no recommendations or review have taken place. Alongside this, The NHS launched a cannabis patient registry in April 2021, and to date not a single patient has been registered. 

In September 2023, in its latest report on drugs, the Home Affairs Committee recommended that the government widen access to cannabis on the NHS before the end of the next parliament. However, it failed to provide any indication of a path forward. Unfortunately it seems like many of those in parliament want to appear to support the medical cannabis revolution, without actually bearing the responsibility of opening up a new green wave in the country. All in all, it seems the patients who need these treatments are the ones who suffer the most from the regulatory red tape holding the industry back.

UK medical cannabis imports have have tripled in size this year

In a stark contrast to the failing NHS medical cannabis scheme, the market for private cannabis prescriptions is booming, with reports stating that imports to the UK medical market have tripled in the last year, with 23,890 k.g already coming into the country this year but only 7,762 k.g being imported in 2022. Estimates now show over 30,000 private cannabis prescriptions, with an average cost of between £6 - 11/gram, suggesting the market could hit a valuation of £143m this year, considerably beating the current predictions for the medicinal market, and indicating an increase in awareness of cannabis medicines.

Even with this massive increase in imported medical cannabis, patients are still seeing inconsistencies in supply and quality, meaning there is still definitely a big reliance on black market sales for many consumers. Medical cannabis cultivation companies are now beginning to come online in the UK, potentially reducing the need for imports. One such company, Glass Pharms, is hoping to provide a secure supply chain for UK patients built here in the UK by the end of year, so that patients will no longer have to be concerned that when their prescriptions run out, they will not be able to get resupplied. Clearly money talks when it comes to the pharmaceutical industry, with many more developments being seen in the private sector over public funded cannabis treatments. With cannabis prescriptions becoming more and more common as time goes on, will we get to a point where cannabis becomes decriminalised by proxy, as the police are faced with prescriptions over prosecutions en masse?

IPS Pharma and Grow Group announce launch of the first legal, British-born brand of UK-formulated medical cannabis extracts

Advanced Vapour Devices (AVD), one of the leading, vertically integrated cannabis vapouriser companies have announced a new partnership, launching their Vida Vape series into the UK legal market. Clare Holliday, head of medical cannabis UK at IPS Pharma clarified the decision to select AVD hardware, stating, "We recognized a significant demand for extract vaporiser products in the UK market. The Vida product line was developed based on feedback from patients, pharmacies and clinicians. We opted for AVD's hardware for its track record across North America of industry-leading performance, adherence to international manufacturing standards, supply chain efficiency and positive patient experience." With prescriptions recommending vaping over smoking cannabis it is clear that the market for vaporisers specifically designed for vaporising cannabis flower and extracts is not only growing significantly but is definitely here to stay. It will be extremely interesting to see what the future holds for medical cannabis devices in this country.

Pioneering trial looks to treat glioblastoma brain tumours with cannabis medications

It has recently come to light that patients with some of the most aggressive brain tumours (glioblastomas) are routinely asking their doctors for advice on cannabis medications. With most doctors being unable to offer the medication, many are forced to purchase cannabis privately or even through the black market, where they will then use it without real professional advice or testing. For these patients the prognosis is bleak, with the average life expectancy of sufferers being between just 12 and 18 months, and treatments being both limited and invasive. 

There is now however a new hope emerging, in the shape of a major, pioneering UK clinical trial using a cannabis-derived drug called nabiximols to treat these aggressive brain tumours. The trial has opened in Leeds and Manchester and is being largely crowd-funded (with many patients getting involved in the funding). It is led by a charity called The Brain Tumour Charity. 

The three year, phase II trial will recruit 230 glioblastoma patients across 14 hospitals in England, Scotland and Wales. “The treatment of glioblastomas is extremely challenging. Even with surgery, radiotherapy and chemotherapy, nearly all of these brain tumours re-grow within a year, and unfortunately there are very few options for patients once this occurs. 

“Cannabinoid-based drugs have well-described effects in the brain and there has been a lot of interest in their use across different cancers for a long time now. Glioblastomas have receptors to cannabinoids on their cell surface, and laboratory studies on glioblastoma cells have shown these drugs may slow tumour growth and work particularly well when used with temozolomide.  Even if these drugs won’t cure glioblastomas completely, anything that can slow its spread, whilst increasing both the quality of life and life expectancy of those suffering with a disease that offers patients very little hope must be celebrated. 

International Cannabis News

Ukraine race to legalise cannabis in a bid to help those wounded at war

A bill to legalise medical cannabis in Ukraine has passed a major legal hurdle, awaiting just one more stage of approval through the country's parliament. It is expected to receive this final approval without many issues, creating a national medical marijuana program to provide access to patients with conditions such as cancer or post-traumatic stress disorder (PTSD) resulting from the ongoing war.

The process of cannabis legalisation has been ongoing in Ukraine since a first bill was proposed in 2021, however It is estimated that nearly 2 million citizens will now benefit from the legalisation. President Zelensky has openly aired his support of the policy change, stating that “In particular, we must finally fairly legalise cannabis-based medicines for all those who need them, with appropriate scientific research and controlled Ukrainian production."  

House Lawmakers Introduce Amended Marijuana Legalisation Bill

The USA has a rather strange relationship with cannabis. The country has largely led the way to cannabis reforms with worldwide legalisation often following their models. With only 3 states refusing any changes to their current legislation, and 23 states allowing full recreational use, it would be easy to think that cannabis was fully legal in the country, however the truth is far from different. 

The USA is governed by both State and Federal laws. Where the state laws have modernised, allowing patients and consumers access to medical and recreational cannabis, federal law still classes cannabis as a Schedule I substance, meaning that it has no recognised medical uses. This has led to a whole host of issues within the industry, including insurance and banking problems as federally governed companies will simply not allow the cannabis industry in. Even Facebook (Meta) and Google ban advertising from not just cannabis brands but even totally legal CBD products, which are tarred with the same brush. 

Lawmakers have now on several occasions tried to push legalisation bills through the senate but are yet to be successful, however lawmakers in the U.S. House of Representatives last week refiled a bipartisan bill to legalise and regulate marijuana at the national level.

Mace’s reintroduction of the States Reform Act comes in the midst of calls from the Biden administration to reschedule marijuana under the CSA. Democrats also recently introduced a revised version of the Secure and Fair Enforcement (SAFE) Banking Act, a bill that would give state-legal cannabis businesses easier access to banking services. Could this be the final push to rescheduling cannabis at a federal level, finally releasing prisoners who are solely held on non violent cannabis offences?

Mushroom News

MPs call for mushrooms and psychedelic drugs to be downgraded from Schedule I

With all of the recent research, therapies and buzz emerging around psilocybin and psychedelic therapies in general, it is no surprise that scientists and MP’s within the UK are calling for the substance to be reclassified, allowing easier access for research and trials to take place. Currently psilocybin containing mushrooms are in the most stringent UK classification, both class A and schedule I (which is meant to mean that there are no known or recognised therapeutic or medical benefits of the drug). The restrictions around mushroom research is actually even tighter than that around heroin, hindering a breakthrough industry that could in fact be the answer to the country's growing mental health problems.  Makes a lot of sense right?

MP’s have for a long time been shouting out for a reconsideration of this classification, citing the ongoing medical research that has been playing out throughout the world as evidence for this change. Sufferers of largely untreatable conditions such as PTSD and depression are now being treated successfully with psilocybin therapies. Sometimes the success is long lasting from just one or two sessions of treatment. The NHS currently spends £650,000/day on prozac (antidepressant) prescriptions (with a lot of evidence now emerging showing their ineffectiveness). Mushrooms instead are not just cheap to produce but also only require quarterly sessions (at the most) to see their benefits, which means patients wouldn’t have to take daily doses of antidepressant medications.

MP’s from across the various parties have been calling for their reclassification since around 2021, with Labour MP Charlotte Nichols and Conservative MP Crispin Blunt being just two of the Members of Parliament who have been calling for this reclassification. The debate is usually met with the same answer, that since being added to the controlled list in 1971 these drugs have not been subject to any recent analysis of their harm and that a review of these regulations was of no priority to the current government.

Change may however be on the horizon with pressure from both media and MP’s rising. On 12th May 2023, an open letter by the Royal College of Psychiatrists and others was sent to the Combating Drugs Minister urging him to consider rescheduling psilocybin in light of the increasing mental health burden in the UK. The letter was also signed by the Conservative Drug Policy Reform Group, CALM, SANE, Heroic Hearts Project UK, Clusterbusters and Drug Science. The letter stated that a growing body of evidence suggests psychedelic drugs may have wide-ranging therapeutic benefits, including treating depression and post-traumatic stress disorder. In particular, psilocybin—a naturally derived compound found in certain fungi—has received increasing scientific attention. As Professor Neill has suggested, the therapeutic potential of psychedelic drugs could be significant because “we have not enabled patients to access better medicines than the standard drugs, so I would say that psychiatry research has hit a brick wall”.Indeed, we have received evidence of the transformational effect of psilocybin in helping a veteran and cancer survivor overcome their mental health conditions. 

The ACMD (Advisory Council for the Misuse of Drugs) have finally changed their tone. The Combating Drugs Minister said that he was “very, very sympathetic” to making it less bureaucratic and burdensome for researchers, “and then for doctors to prescribe where there is a medical need”. The ACMD are reviewing the barriers to researching Schedule 1 drugs, and ways to reduce such barriers. On 18 May 2023, the House of Commons was told during a debate on psilocybin treatments that the ACMD’s considerations were at a “well advanced” stage and that the Home Office should “expect its advice in the near future” for it to consider. Watch this space to see just what changes are in store for UK psilocybin therapies in the future.

Epping Forest: Foragers warned not to pick ancient woodland's mushrooms

Did you know that mushrooms and the mycelial roots which grow under the ground are often essential to the life of the trees and plants that they live beside. The two form a symbiotic relationship, with the tree's roots becoming intertwined with the mushroom's mycelium. Without one, the other would die. The fungi play an important role in protecting the roots of trees, providing water and vital minerals.

The mushrooms that we see and eat are purely the fruiting body of the organism, akin to the flower on a plant, which only appears for a short period of time. Removing mushrooms from a forest and damaging the mycelial matts that live underneath the ground can be extremely damaging for the forest as a whole. 

Foragers living close to the Epping Forest area have been warned against picking mushrooms from the forest, as the fungi are vital to the health of the forest's one million trees. The forest is home to 440 rare and endangered fungi species. Conservationists say picking them damages the valuable forest biodiversity that has developed over the past 10,000 years. One forager was found with 49kg of freshly picked mushrooms, with 9 prosecutions for illegal foraging in the forest since 2009.