Change in legislation from 1st November 2018 widens access to cannabis-based products for medicinal use in humans in England, Scotland and Wales. We have summarised the existing guidance relating to cannabis-based medicinal products (CBPMs).
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The Medicines and Healthcare products Regulatory Agency (MHRA) published guidance on the supply, manufacture, importation and distribution of unlicensed cannabis-based products for medicinal (CBPMs) use as a 'special'. This guidance also contains details about:
• Record keeping
• Packaging requirements
• A flowchart process for prescribing, supplying and importing unlicensed CBPMs
• A supply chain checklist – this contains a prescription validation check and dispensing label checklist
NHS England has produced Guidance to clinicians: Cannabis-based products for medicinal use and an FAQ document. The Scottish Government and the Welsh Government have issued a letter for clinicians: Cannabis-based products for medicinal use. These all contain:
• Background to the legislation changes
• Information on prescribing cannabis-based products for medicinal use
• Information on monitoring guidance
• Details of the types of products that could be prescribed
• Current licensing information
• Clinical guidelines
NHS England has published additional guidance for clinicians: Cannabis-based products for medicinal use. This has been endorsed by the Scottish Government, Department of Health Northern Ireland and Welsh Government. The letter clarified the status of the clinical guidance issued so far and provides further details in relation to synthetic cannabinoids for medicinal use.
NHS England and NHS Improvement have reviewed NHS systems and processes to identify and recommend any action necessary to address any barriers to clinically appropriate prescribing of cannabis-based products for medicinal use (CBPMs) on the NHS. The findings and recommendations can be found here.
The British Paediatric Neurology Association has issued interim guidance on the use of cannabis‐based products for medicinal (CBPMs) use in children and young people with epilepsy. This contains:
• Summary of current knowledge
• Background considerations for prescribers
• Guidance for clinicians on prescribing CBPMs
The Association of British Neurologists has produced interim guidelines on the Use of cannabis-based products in neurological disorders.
The Royal College of Physicians has jointly produced recommendations on cannabis-based products for medicinal use (CBPMs). This has been jointly produced with the Royal College of Radiologists and in liaison with the Faculty of Pain Medicine of the Royal College of Anaesthetists. This includes information on:
• CBPM for chemotherapy induced nausea and vomiting (CINV)
• CBPM for pain
• Non-CBPM forms of ‘cannabis’
NICE (The National Institute for Health and Care Excellence) is developing guidance on the use of cannabis-based products for medicinal use, which is expected to be published in November 2019. The draft guidance went out for consultation from 8 August 2019 - 5 September 2019.
Guy's and St Thomas's NHS Foundation Trust has developed a medicinal cannabis guide. This provides a brief overview for the prescribing and supply of cannabis-based products for medicinal use. Individual Trusts can use and adapt this guidelines to meet their local needs.
HEE has produced an e-learning programme for healthcare professionals on cannabis-based products for medicinal use. NHS Education for Scotland Pharmacy are also hosting this resource, for use by all Health Care staff in Scotland.
People can be referred to the NHS website for further information on Medical cannabis (and cannabis oils).
Useful RPS resources: