‘Known unknowns’ of medical cannabis
By Katya Kowalski, Head of Operations, Volteface
Despite the legalisation of medical cannabis in 2018, prescribing practices have remained low and relatively contentious within the UK clinical population. In fact less than 1% of clinicians that can prescribe, currently do.
There are a variety of reasons for why medical cannabis has remained on the fringes of healthcare; it is a complicated drug and it doesn’t fit neatly into our medical framework. Although we have been using cannabis for thousands of years medically, we are only just starting to understand it and rigorously study it scientifically.
One of the key reasons why uptake in medical cannabis prescribing has been so low is due to the way in which the rescheduling happened in the first place. Medical cannabis had been framed as a political issue through a mass media campaign, which led to many clinicians feeling sceptical toward the drug due to the emotive aspect. For something as evidence-based and scientific, it is extremely uncommon to see a medicine rescheduled in the way that cannabis had been.
Given these teething points within the clinical community, at Volteface we sought out to research the barriers and hesitations faced by clinicians in the UK toward feeling comfortable and confident in prescribing medical cannabis.
Our latest Volteface report, Known Unknowns is a deep dive into these perceptions amongst clinicians, and what we can do about it as an industry. After speaking to dozens of specialist clinicians, three key concerns emerged from the research as to why they feel hesitant around prescribing cannabis – evidence, governance and the ‘uniqueness’ of cannabis as a medicine.
The overarching take home message across these themes was that cannabis does not fit neatly into the mainstream medical framework. It was evident that clinicians lacked support, guidance and education on the practicalities of medical cannabis prescribing.
Now in order for clinicians to feel confident in prescribing, solutions should be based around and address the concerns concluded in the report. The report presents several solutions and case studies of work taking place within the industry to sensibly medicalise cannabis further.
These solutions and recommendations have focused on:
- How and why prescribing outside of the clinic model is an appropriate way to bring cannabis into everyday practice without the need for exceptionalism
- Focusing on the development products with indication specificity that are backed with data, in order to build trust and credibility
- Why further clinical trials need to be conducted and how organisations are currently going about this
- The creation of innovative mechanisms of dosing and administration, to make cannabis look and feel more like a medicine that is used in routine practice. This addresses a lot of the barriers around it being too closely associated with a recreational drug
- The focus on promoting peer to peer support and education amongst clinicians, addressing the lack of knowledge and awareness
For the industry to move forward, we need to be solutions focused and listen to the concerns of clinicians. This has been one of the limitations of the industry to date, not sufficiently listening to clinicians or being sufficiently focused on the barriers that are preventing a higher uptake of prescribing.
Known Unknowns calls on the need to bring cannabis into the mainstream, broadening out prescribing and bursting the cannabis industry echo chamber. In order to be patient focused as an industry, we must be clinician focused.
Volteface are a member of the Cannabis Industry Council. You can read the Known Unknowns report here.