UK: independent pilot project to supply medical cannabis to 20,000 patients

Created by the scientific and charitable organization Drug Science, the TWENTY21 project aims to provide medical cannabis to 20,000 UK patients as part of a clinical trial. The pilot project aims to establish a database to motivate policy change regarding the prescription of medical cannabis.   

“Despite the medicinal status conferred on cannabis by the UK in November 2018, only a handful of prescriptions have been granted by the NHS. To find a solution to this impasse Drug Science has joined forces with United Patients Alliance,and a few medical cannabis producers to open up a treatment network for 20,000 patients,» explains Professor David Nutt, President of the organization.

One year after the legalization of medical cannabis...

The United Kingdom legalized medical cannabis last November. However, conditions of access to medicines are so restricted that in the space of a year, only around twenty patients have had access to legal cannabis via the NHS, leaving the rest of the potential patients in frustration.

«Patients are left untreated, indebted by the cost of private prescriptions, or criminalized because they are forced to obtain supplies on the black market. This situation desperately needs to change,» explains David Nutt. «The pilot project will enable patients to access vital therapy without being outlawed». The law provides for cannabis to be made available via clinical trials.

Blocking the public health system comes from specialist doctors and their hierarchies, who consider that there is currently insufficient clinical evidence for prescribing medical cannabis. The Twenty21 Project aims to address this problem by «providing a solid clinical evidence base on which prescribers can rely».

The Twenty21 Project

The project was announced last June at the’European Cannabis Week and, according to the Guardian, It will be announced publicly on Thursday. The goal is to provide medical cannabis to 20,000 patients by 2021, for two years, to investigate the potential therapeutic effects of cannabis on :

• chronic pain (estimated to affect around 28 million Britons)
• Post-traumatic stress disorder (particularly for veterans)
• Multiple sclerosis
• Tourette's syndrome

Chronic pain and multiple sclerosis are already approved as medical conditions justifying access to cannabis, but patients are refused a prescription. At the same time, the project also aims to provide cannabis as part of a harm reduction strategy in the prison environment and among populations using other substances.

Participants will be asked to report on the effects of cannabis on their symptoms, as well as any side effects, in order to build up a database on the efficacy and safety of cannabis. This will then be used to support prescription requests to the health authorities.

As these data were not obtained through double-blind clinical trials, it is not certain that they will be able to influence the position of health authorities. Nevertheless, the project has received the support of Royal College of Psychiatrists (RCP), which will oversee the experiment. It is also supported by British Pain Society and the’United Patients Alliance and benefits from industry partners (Althea, Alta-Flora and Cannuba).

By way of comparison, medical cannabis trials in France, planned for 2020, will only involve 3,000 patients.