For over 90 years, Cannabis has been an illicit substance in the UK. But before this near-century of prohibition, the plant actually enjoyed a period of widespread medical acclaim as a “wonder cure”. Since prohibition, however, medical Cannabis research experienced a crippling halt, which is still affecting the sector today.
Medical History in the UK
After successfully using Cannabis oil to treat the constant seizures of an 18-month old, clinician William O’Shaughnessy became increasingly interested in the medicinal properties of the plant and wrote extensively of its potential. O’Shaughnessy began experimenting with the plant in 1833, after noticing that locals in India were using it as a treatment for a variety of ailments.
From this time, doctors and pharmaceutical companies in the UK touted the plant as a treatment for a variety of conditions, including joint pain, cholera, and seizures.
But this medical Cannabis era was not to last. As lawmakers became more concerned about the changing society, Cannabis prohibition was introduced as a way of controlling minorities. Early prohibition, across the UK and the USA, was steeped in racism, stirring up a moral panic among the population,
This prohibition only made its way into Britain itself, after colonialists had begun to impose bans in the colonial territories, such as Mauritius, India, and Jamaica. Reports from the time blame the plant for “demoralising and deplorable” behaviour among “the natives”.
The prohibition of Cannabis, introduced at an international level in 1928 by the League of Nations, fuelled a stigma around the plant that has remained ever since. This stigma, alongside the new barriers restricting access to the plant, served to significantly halt medical Cannabis research.
Despite this setback, however, medical Cannabis continued to be available through the NHS until 1971. The final banning of Cannabis came with the Misuse of Drug Act 1971. Cannabis was placed in the most restrictive schedule (schedule 1), restricting even medical use.
Despite Cannabis being used medicinally for thousands of years, prohibition came at a time when medical research methods were developing at a pace never before seen. This has resulted in a severe gap in the knowledge around the medical effects of the plant and its compounds.
In the UK, medical Cannabis was only legalised in 2018, via it’s rescheduling within the Misuse of Drugs Act 1971. Prior to this change, Cannabis was considered among the most harmful substances available. It was placed in the same category as heroin and was considered to have no medicinal or therapeutic benefits.
Since the rescheduling, few people in the UK have been provided with a prescription for medical Cannabis products. Clinicians and policymakers throughout the UK and the rest of the world quote a lack of evidence for their hesitation in prescribing the medication.
A Lack of Evidence
In order for a new medication to be licensed in the UK, it must be shown to be at least as effective as alternative medications that are already available. Alternatively, it must have fewer or less harmful side effects.
The clinical and licensing communities also overwhelmingly expect these benefits to be demonstrated through double-blind, controlled clinical trials. And yet another hoop to jump through, policymakers also have an extremely inconvenient preference for homegrown British evidence.
Gaining approval for Cannabis research during prohibition, and even after the rescheduling, was also excessively difficult. Taking all of these factors into consideration, the well-quoted ‘lack of evidence’ is hardly surprising.
Despite the long and disappointing prohibition and its ongoing effect on Cannabis research, the future may be brighter. Drug Science recently announced that it is now recruiting for the largest medical Cannabis trial in the whole of Europe. It is hoped that this research will significantly add to the evidence needed for the recommendation of medical Cannabis treatments.
As an increasing number of jurisdictions – including large and influential countries – continue to legalise both medical and recreational Cannabis, access and regulation of the plant are expected to improve. As this happens, Cannabis research may also see an increase in both quantity and quality.