Since cannabis was legalised for medical use back in November 2018, patients have faced an almost impossible chance of getting a prescription on the NHS. However, thousands of people have now accessed cannabis-based medicines through private clinics throughout the UK. The majority of these patients are looking for an effective alternative for chronic pain management.
In fact, according to Sapphire Medical Clinics, two-thirds of patients who have so far applied for treatment at Sapphire’s first clinic in Scotland have chronic pain-related conditions. These patients are also believed to have waited for a year or more to receive specialist help through the NHS.
The direct causes of chronic pain conditions are often not fully understood, making them difficult to treat effectively. However, prescription painkillers, such as opioids, are often prescribed to chronic pain patients, despite growing uncertainty regarding their efficacy and high risk of abuse and addiction.
Opioids and Chronic Pain
According to a 2012 study, over 948,000 individuals (18% of the population) were prescribed opioids – the most common being Codeine, followed by Tramadol and Morphine. The prescribing of opioid painkillers “was generally associated with reported chronic pain”.
These figures are worrying when taking into consideration the high risks of abuse and addiction carried by opioids: around 4-6% of people who misuse opioid medications switch to heroin.
These alarming figures are leading many chronic pain patients to reject opioid painkillers and embrace alternative treatment options, such as medical cannabis.
Embracing Medical Cannabis
Recent figures from Stirling medical cannabis clinic
Data from Sapphire Medical Clinics shows that 65% of referrals for medical cannabis prescriptions from their Scotland clinic have so far been for people with chronic pain, demonstrating that patients are increasingly seeking alternatives to opioid medications.
However, in Scotland at least, increased waiting times may also be having an impact on the number of chronic pain patients seeking medical cannabis treatment. The number of patients waiting a year or more for a specialist appointment through the NHS has increased by almost 300% over the past year.
According to the Sunday Post, Scottish Conservative shadow health secretary Annie Wells commented on the situation: “We should not have reached the point where this new cannabis clinic is having so many referrals for chronic pain patients. The health secretary must guarantee necessary funding to tackle growing waiting times.”
The Scottish government has also conceded that improvement of chronic pain services is a priority: “We know that there is need for improvement and this year we will publish an updated framework for chronic pain service delivery.”
Evidence for medical cannabis treatment
In addition to the trend seen in Scotland, which has likely been accelerated by poor access to specialist NHS services, there is a growing body of evidence to suggest that medical cannabis may be a viable alternative to opioid medications for the management of chronic pain.
One randomized, double-blind, placebo-controlled trial concluded that Nabilone – a synthetic cannabis medication – “appears to be a beneficial, well-tolerated treatment option for fibromyalgia [a common chronic pain condition] patients, with significant benefits in pain relief and functional improvement.”
Further, another study revealed that while no significant change was seen to pain intensities among chronic pain patients, participants did show a significant increase in quality of life scores. This was an important finding, as opioid painkillers are often associated with lower quality of life scores.
The future of medical cannabis for chronic pain
Public attitudes toward medical cannabis are rapidly becoming more liberal, often resulting in improved access to cannabis-based medicines. However, in the UK at least, there is still a long way to go.
Patient access to medical cannabis here in the UK remains unimpressive, despite over two and a half years of legalisation. The vast majority of patients – only a handful have been able to access cannabis medicines through the NHS – are accessing their medicine through private cannabis clinics like Sapphire.
As more patients look to embrace the alternative potential of cannabis for chronic pain, however, this (hopefully) will begin to change.