A series of new studies have assessed current data from the UK Medical Cannabis Registry (UKMCR) – the largest patient registry of its kind in the UK. The recent findings present outcomes of current patients who have been prescribed medical cannabis products for treatment-resistant epilepsy, depression, or inflammatory bowel disease (IBD). Patient-reported outcomes have been presented in a series of articles over the last few weeks with the aim of establishing further real-world evidence of the potential medicinal benefits of cannabis.
The rescheduling of cannabis in 2018 allowed for the medicinal use of the drug in the UK for the first time in almost 50 years. While the move represented a significant milestone in the ongoing global liberalisation of cannabis legislation, current policy and guidelines have drawn a lot of criticism from patients, clinicians, and drug policy groups alike. Under the current legislation, cannabis-based medicines can only be prescribed by specialist clinicians and only three prescriptions have so far been granted through the NHS. Furthermore, medical cannabis treatment is currently only recommended for a handful of conditions.
The extremely low rate of access to medical cannabis through the NHS has meant that the vast majority of patients have no choice but to continue using illicit products or gain a prescription through a private clinic. Recent figures suggest that around 1.4 million people in the UK may be self-medicating with cannabis from the black market. In comparison, reports from 2022 reveal that around 17,000 patients have now gained access to a legal medical cannabis prescription. The reason for this disparity? According to lawmakers and some clinicians, evidence for the safety and efficacy of cannabis-based medicines remains limited.
Sapphire Medical Clinics is one of a number of private clinics that offer medical cannabis treatment to patients with a wide variety of conditions, including epilepsy, depression, anxiety, and IBD. Physicians from Sapphire Medical Clinics established the UK Medical Cannabis Registry in 2021 to gather real-world outcomes from patients in the UK.
Outcomes from Medical Cannabis Patients
The UKMCR records patient-reported outcome measures to determine the potential of medical cannabis for the treatment of various conditions. The most recent data, published in a series of articles, have focused on the treatment of inflammatory bowel disease (IBD), treatment-resistant epilepsy, and depression. Adverse events associated with medical cannabis treatment are also recorded in order to determine the safety, as well as the efficacy, of treatment.
Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease (IBD) refers to a category of conditions that affect the gastrointestinal tract, including Ulcerative Colitis (CD) and Crohn’s disease. It is estimated that around 1 in 200 people in Western countries are affected by IBD. Common symptoms of IBD include abdominal pain, diarrhoea, weight loss, malnutrition, and fatigue. Conventional treatments typically focus on inducing and maintaining disease remission and symptom management. However, current treatments remain limited in effectiveness with a significant number of patients interested in alternative options.
Researchers aimed to understand the safety and efficacy of medical cannabis as a treatment for IBD. According to patient-reported outcomes from 76 patients on the UK Medical Cannabis Registry, medical cannabis treatment was associated with improvements in IBD-specific health-related quality of life over the short term (3 months). Participating patients also reported improvements in anxiety, depression and sleep quality and a reduction in the number of opioids consumed to manage symptoms associated with the condition.
You can read more about patient outcomes for medical cannabis treatment of IBD, as well as the researchers’ conclusions here.
Depression
Depression is one of the most common mental health conditions and a leading cause of disability worldwide. It is estimated that around 5% of all adults are affected by depression, making effective management and treatment an extremely important consideration. Furthermore, depression often occurs in combination with other conditions and diseases, including cancer, chronic pain, and anxiety. Current treatments include the use of anti-depressant medications and therapy; however, some anti-depressants have been found to cause significant side effects and recent findings suggest they may only be effective in around 50% of cases.
A total of 129 patients from the UKMCR were included in an analysis to determine the potential of medical cannabis for the treatment of depression. Interestingly, participating patients reported reduced anxiety and other closely linked symptoms including anxiety at a similar rate as observed in patients receiving antidepressant medications – a clinically significant outcome. However, it is noted that “the broad range in changes to PHQ-9 [a scale that assesses the presence and severity of depression] scores indicates that response to CBMPs varies on an individual basis and may reflect a degree of confounding bias.” Adverse events associated with medical cannabis treatment were largely reported to be mild to moderate in severity.
While more research is undoubtedly needed to fully understand the role of medical cannabis as a treatment for depression, the authors of the current study highlight that medical cannabis treatment was associated with improvements in depression symptoms, in addition to anxiety, sleep quality, and overall health-related quality of life.
If you would like to learn more about these results and their potential implications, you can read the full study here: ‘Assessment of clinical outcomes of medicinal cannabis therapy for depression: analysis from the UK Medical Cannabis Registry’
Treatment-Resistant Epilepsy
The potential of medical cannabis treatment for otherwise treatment-resistant epilepsy has been covered significantly in the mainstream media over the last few years. It can even be said that the high-profile cases of children including Alfie Dingley and Billy Caldwell went a long way towards triggering the legalisation of medical cannabis back in November 2018. Treatment-resistant epilepsy is also one of the few conditions for which medical cannabis treatment is officially recommended by the National Institute of Health and Care Excellence (NICE). Nonetheless, the vast majority of medical cannabis prescriptions for the treatment of epilepsy are still fulfilled by private clinics.
Of the 37 epilepsy patients who were included in the most recent analysis of the UKMCR, almost two-thirds achieved at least a 50% reduction in seizure frequency, including 94.1% (n=16) of patients treated with CBD and Δ9-THC. These findings support previous studies that have found an association between cannabis treatment and a reduction in seizure frequency and severity in treatment-resistant epilepsy.
You can access the full report on UKMCR outcomes for patients with treatment-resistant epilepsy here: ‘Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment-Resistant Epilepsy – Analysis from the UK Medical Cannabis Registry’
Medical Cannabis Treatment Moving Forward
Access to medical cannabis is slowly but surely improving on a global level; however, there is certainly still a long way to go. Research studies like the ones mentioned in this article and the UK Medical Cannabis Registry are essential if we are to continue to see improvements in patients’ ability to access potentially life-changing cannabis-based medications.
Dr Simon Erridge, Head of Research and Access at Sapphire Medical Clinics, explains the importance of these findings:
“The high-quality research we have undertaken has helped us to further understand the long-term effects of medical cannabis. However, there is still a lack of clinical trial evidence and funding to conduct randomised controlled trials, which is necessary to be able to better evaluate the true treatment effect of medicinal cannabis before this medication will become available on the NHS.
“By collecting, analysing, and publishing this data we are playing our part in ensuring the UK is a leader in medical cannabis research and we are committed to providing education to healthcare professionals and patients on safe and legal access to medical cannabis.”
The global cannabis industry has evolved significantly over the last few years, but there is still a long way to go. In a climate where laws and regulations remain inconsistent from country to country, important aspects of medical cannabis development remain limited. From research to supply, it is essential that we remain dedicated to creating safe and effective channels to promote the ongoing improvements needed at all levels of the cannabis industry. To this end, the Shweed team is passionate about playing our own role as an intermediary within medical cannabis and consumer cannabinoid international supply chains.
Chris Liddy, President & Technical Director at Shweed, commented:
“Research and data driven initiatives that the UKMCR and others around the world are actively building are vital to the treatment of a multitude of conditions across many demographics. Shweed actively supports patients and stakeholders by helping to develop effective medical cannabis supply chains that are highly efficient and fit for purpose in the short and long term.”