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UK: Give cannabis to elderly people with chronic pain, doctors say Tony Diver The Telegraph Saturday 05 Sep 2020 Elderly people with chronic pain including back and joint injuries should be prescribed cannabis instead of conventional painkillers, doctors have said, as polling shows that three quarters of over-55s would consider taking it. Doctors said cannabis-based medicines, including those that contain THC, the chemical that makes recreational users “high”, should be used instead of opioid medications. Draft guidance published last month by the National Institute for Health and Care Excellence suggested prescription guidelines for patients with chronic pain will soon move away from drugs like paracetamol, ibuprofen, aspirin and opioid medications such as tramadol, codeine and morphine. The draft guidance suggests more than a million chronic pain patients in the UK should instead be prescribed group exercise programmes or acupuncture. But doctors have suggested that patients with back pain could instead benefit from taking cannabis oil, which was legalised for prescription for some conditions in the UK in 2018. Although cannabis oil is not widely available on the NHS, some private clinics prescribe it if other medication has not worked. A new poll by Open Cannabis, a campaign to widen access to cannabis medicines in the UK, suggests almost three quarters of people over the age of 55 would consider cannabis medication if it was offered to them, compared to two-thirds of the population as a whole. The proportion of people over the age 75 with chronic pain in the UK could be as high as 60 per cent, research published by the BMJ suggests. Use prescriptions to keep patients away from dealers Dr Steve Hajioff, a former chair of the British Medical Association, said cannabis should be made available legally using prescriptions to prevent patients turning to black market drugs for pain relief. “Cannabis-derived medicines can help fill the gap in helping people with chronic pain, as we move away from some pain-management procedures and using opioid or non-steroidal anti-inflammatory drugs,” he told The Telegraph. “Patients who could benefit from cannabis-based medicines need to be made aware of the legal routes to access these treatments in the UK, so that they are not exposed to the dangers associated with the illegal market." There is no reliable data on how many people in the UK using cannabis illegally for pain relief, but it is thought the number could be in the millions. Cannabis was legalised for medicinal purposes in the UK in 2018 following a campaign by children with treatment-resistant epilepsy who used oil from the plant to control their seizures. Patients can now legally be prescribed medicine containing THC, the chemical compound in cannabis that makes recreational users “high” and which is otherwise banned under UK law. Products that only contain CBD, another chemical in cannabis, are already legal and are widely sold in high street shops. But despite the law change, few if any prescriptions have been issued on the NHS, after NICE guidelines said doctors should be wary of handing the oil to patients before full medical trials have taken place. There have been no randomised controlled trials in the UK for medicinal cannabis, and none are expected until at least 2021. A small study in Canada in 2010 suggested that cannabis could have an impact on long-term pain, which can include back pain and joint pain. The NHS said a “much larger trial would be needed for a longer period” to assess the effects of cannabis properly. A spokesman for the Open Cannabis campaign said: “Our long term aim is to show the government that medical cannabis is safe and effective and should be available through the NHS for a wider group of people.” https://www.telegraph.co.uk/news/2020/09/05/give-cannabis-elderly-people-chronic-pain-doctors-say/
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