Cannabis oil for epilepsy
The use of cannabis oil for epilepsy
There has been much talk in the media about the use of cannabis products in the treatment of epilepsy. This has generated a lot of interest but also some confusion over the different forms of cannabis that are being discussed, their legality and their safety.
We hope the information below will help to clarify the different types of cannabis products and why this is such a complex area.
First though, we must stress that street cannabis can be very dangerous and cause many mental health and respiratory problems. Epilepsy Society is not supporting the legalisation of cannabis which is an issue for a wider debate outside the field of epilepsy.
What is cannabis?
Cannabis is a controlled class B drug. It is not recognised as having any therapeutic value under the law in England and Wales.
Cannabis is made up of hundreds of different components. The most well known are two cannabinoids: CBD - cannabidiol - and THC - tetrahydrocannabinol. These are found naturally in the resin of the cannabis plant.
THC is the psychoactive compound in cannabis. It is responsible for the "high" people feel. The legal limit of THC content in a product, as stipulated by the Home Office, is 0.2%.
CBD is not psychoactive and it is thought to be responsible for many of the medical benefits associated with cannabis.
What are the different types of cannabis being talked about in the media?
There are four different levels of cannabis and it is important to distinguish between each different type:
Epidiolex is a type of medical cannabis that has been developed and trialled under licence in the US and UK. The cannabidiol (CBD) therapy has been shown to be effective in the treatment of refractory epilepsy for some with Dravet and Lennox Gastaut syndromes, tuberous sclerosis and infantile spasms. The drug is also being evaluated as an add-on therapy for adults with poorly controlled focal seizures. This cannabidiol product contains virtually no THC.
The US Food and Drugs Administration is due to grant a new drug application for Epidiolex on 27 June 2018. The European Medicines Agency is also considering licensing this medication and a decision is likely to follow later this year or early in 2019.
Epilepsy Society welcomes all new medications with the potential to offer hope to people with epilepsy. We are following closely the outcome of all trials relating to this drug.
CBD oils with THC
These oils are extracted from the cannabis plant and are complicated as they may contain differing amounts of THC, the psychoactive compound.
Some CBD oils are sold as food supplements in countries such as the US and Netherlands. They are purified to remove any trace of THC, so that they can be obtained in these countries.
CBD products from Canada usually include some THC and are not legal in many countries including the UK.
Epilepsy Society supports the Government in reviewing the regulatory framework for new drugs so that children with epilepsy have access to the excellent medical research and innovative treatments in this country, in the same way as disabled children in other leading North American and European countries. This could lead to clinicians being able to request a licence for a THC product where there is evidence that it would benefit the patient.
CBD products from health food shops and online
These contain less than 0.2 per cent THC and are therefore legal.
In 2017, the UK's medicines regulator, Medical and Healthcare products Regulatory Agency (MHRA), said that all CBD products available via the internet and high street shops, should be classed as medicines.
The MHRA has since been working with individual companies and trade bodies to make sure products containing CBD which can be classified as medicines, satisfy the legal requirements of the Human Medicines Regulations 2012.
Epilepsy Society believes that individuals or their parents or carers should decide whether or not to use CBD-based oils. However they should always discuss any decision with their healthcare professional and should not stop taking their epilepsy medication without the supervision of their doctor. Unlicensed CBD oils may not be produced to the same high standards as licensed products and could interact with epilepsy medication. This could increase the risk of side effects or seizures.
It is important to remember that cannabis bought on the street is unregulated, illegal and can cause many health problems.
Epilepsy Society does not support the use of illegal cannabis.
Is cannabis licensed in the UK?
A cannabis-based drug called Sativex has been licensed in the UK to treat multiple sclerosis (MS) - it contains THC and CBD.
Doctors could, in theory, prescribe it for other things outside of this licence, but at their own risk.
Nabilone is another licensed treatment.- This contains an artificial version of THC and can be given to cancer patients to help relieve nausea during chemotherapy.
Trials are under way to test cannabis-based drugs for other conditions including cancer pain, the eye disease glaucoma, appetite loss in people with HIV or AIDS, and epilepsy in children (see CBD-based medicines above).
Medical cannabis from outside the UK
The UK allows residents of some EU states that have signed up to Article 75 of the Schengen agreement to travel into the UK with prescribed cannabis, as long as they have a certificate authorising this from their own country. The certificate is valid for up to 30 days.
However, a UK citizen cannot travel to a country such as the Netherlands, be prescribed medical cannabis there and legally bring it back into the UK as they are not a resident of the Netherlands.
UK residents are advised not to travel abroad to bring back drugs that can’t be legally supplied in the UK. Cannabis is still a Class B drug and so anyone bringing it into the UK outside of the Schengen arrangements would risk being arrested and prosecuted.
Even if a UK doctor prescribes cannabis to be given by a Dutch pharmacist, the patient would not be able to bring that drug into the UK legally, because this would still be outside of the Schengen arrangements.
UK citizens are also allowed to travel to other Schengen states with their medication – so someone prescribed Sativex in the UK can legally take it to another country that is signed up to the agreement.