Attitudes towards cannabis have been rapidly evolving. The old-school outlook of weed as a purely detrimental drug to people’s health, has been challenged repeatedly by medical studies.
There is a medical consensus that cannabis can be used as a palliative treatment for multiple sclerosis, and evidence to show it can also benefit people suffering from chronic pain; delay the onset of Alzheimer’s disease, and help those who are suffering from Crohn’s disease.
Along with these developments in the medical understanding of cannabis, many countries and states worldwide have relaxed legislation against cannabis, including the UK.
However, unlike many states in America and some European countries, cannabis use is still unnecessarily difficult for those who get health benefits from a smoke or vape.
The issue within the UK is that although many people will know that medical cannabis products are available for those who qualify, they are really only available to those who can afford private prescriptions. Whilst it is possible to get weed prescribed through the NHS, it’s a very selective and long process.
Doctors will only prescribe a small amount of the eligible for medical cannabis with a prescription. Even then, they would likely have to try multiple other treatments with drugs such as opiates that can be too strong and have nasty side effects. Many people report issues with nausea and sickness.
This is where private prescriptions come in. While private clinics claim that you can get treatment for relatively small amounts (Sapphire Medical clinics offer treatment as low as £137 per month on their website), these can vary on individual cases.
The people Artefact spoke to have claimed that costs for private prescriptions run over £1,000, creating an inequality of access and marginalisation of people on lower incomes.However, people are campaigning to make life easier for the vast majority of patients. Organisations such as Cancard are aiming to help people by distributing an ID card.
Where does this leave patients who qualify for a prescription but lack the funds to afford all the consultations and private costs? It often leaves them self-medicating from the black market and fearing repercussions from law enforcement, just for taking measures to relieve pain.
Cancard said that the card aims to “provide a medical ID that confirms that a patient lives with a condition for which they should be accessing a prescription, but they are unable to afford the legal route.
“It serves as a policing tool, so that police officers feel confident in using their given discretion and help them to treat the patient appropriately.”
Cancard expresses frustrations held by many: “The situation with medicinal cannabis in the UK is beyond all logical reasoning. We are two years since the law changed, and things have gone disastrously wrong.
“Those who can afford a private prescription can access cannabis flower and have full immunity from prosecution. Those who cannot afford this can be criminalised for consuming the same flower in the same way. The difference is an expensive piece of paper. The difference in their lives is chalk and cheese.”
In the first week of their initial rollout, Artefact spoke to Carly Barton, director at Cancard and the first person in the UK to get a private prescription for medical cannabis to see how they are managing to distribute the ID.
“We’ve had about 11 or 12,000 applications now, and I think we’ve managed to get through about 3,500. But you know, the checks take some time. The first part of the identity identification is almost like when you apply for a Monzo account, and then after that, we either take evidence in the form of an NHS summary of care to prove that you’ve got a condition on the list, or if you’d like us to, we reach out to the GP who can confirm on the patient’s behalf. So there’s a bit of waiting time in there.
“I think that people might assume that these cards are easy to get and that people might use them recreationally. That’s not the case,” Carly told us.
“Covid has just been really difficult, doing this in a pandemic, even though it’s quite a digital process. We’ve obviously got suppliers who’ve had delays and staff who’ve been poorly on and off work. But now we’re starting to see pictures come through people with big grins on their faces and their Cancard in their hand, which is great.”Many people who are eligible for medicinal cannabis may be unaware that they are, as it’s unlikely to be recommended by your GP. Carly says that although she is not in the business of encouraging people to start using cannabis (most Cancard holders will have experience with recreational use of marijuana), she thinks that research in the coming months will raise awareness.
“I do think that there is generally a greater awareness now in the UK, and that’s because of the research coming out of other countries that it is a viable treatment method for many conditions. So, I do think we will naturally see people reaching for this substance.
“I think particularly there’s a lot of research coming out of Israel, Canada, Germany, and actually in the UK about how we deal with patients who have sustained inflammation due to covid-19, what they would call long covid. Actually, what they’re showing in trials is that cannabinoids, CBD, THC, THCA, CBN are all really, really good possible treatments for people who are suffering on the back of infection of covid,” Carly said.
“I think what we’re going to see is a breakdown of some of that taboo and an engagement of conversation beyond what we have seen before.”
The British public may be on track to progress their views on medical ‘Mary Jane’, but the main people an organisation such as Cancard needs on its side, is the police. The focus of Cancard is to provide a tool so that police officers can distinguish between medicinal users and recreational users.
This way, they can use their discretion to help reduce stressful and inconvenient situations within the justice system, which can be harmful, especially for people living with an ailment. Impressively, they have gained backing from the National Police Chiefs Council (NPCC) in their goals.
“It took a good 12 months of working up the ranks. I had a really good relationship with the Police Federation drugs lead. So way before 2018, I was sort of engaging in that sort of arena to see if we [could] figure out a way to communicate better. Because I think the biggest issue I see is that there’s a real breakdown in the relationships between the most vulnerable people in our community,” Carly told us.
“They’re often living with health conditions. They’ve got disabilities, a lot of them are low income, they’re living in a quiet, vulnerable state. And the relationship with those people [and] the people that we pay to protect them has totally broken down because there is this thing in the way; there’s this gap and this misunderstanding about the way that they’re treating their health.”
Carly mentions how working with the NPCC helped the practical side of briefing a national police force. “Their guidance is taken on board nationally, and it was the only way to go to the top and disseminate this fairly. Rather than approaching individual forces, which may or may not like the idea, the best thing to do was to go for an operational guidance change from the very top.”
They received feedback from branches eager to know more about consumption methods and strains. This two-way interaction was important for Carly, and she says many police forces have agreed to advise the use of discretion and, more importantly, to leave the patient in charge of their medicine.
The back of the cards also has a police helpline that patients can ring to get information on how to handle a police stop.
Cancard has really aimed to cover all the bases, even offering a legal framework in case a patient is charged. But why is this an important part of an organisation working so closely with the police?“So it’s a fall-back, I guess if for whatever reason we get the police on a bad day, or they [the police] meet somebody who might be a poor communicator, and they’ve misread that as arrogance, and they’ve charged them anyway.”
They also provide help in other areas outside of possession: “We’ve got a free legal service in place provided by Mackrell Solicitors in London, who will help mitigate any issues that they have legally, albeit criminal or family court or any issues with their employment.”
“The cards cost £20 annually, with a one-off £10 fee at first. So that £20 annually gets you access to the card and the information, but also it’s a cushion. So if anything does go wrong, then, you know, they’ve got access to free legal services to help them.”
We spoke to Carly about her experience on prescription medication compared to illicit medication, the pros and cons of both industries.
“So my prescription cost me 1,500 quid for one month’s supply. My exact amount from my, I’m not going to say dealer, florist, would be about £150; a massive difference in what is essentially, you know, a ridiculous amount of money. Prescriptions have come down slightly, but they are still no way near competing with what patients can access elsewhere.
“So the reason that they are so expensive is because cannabis is classed as an unlicensed medicine. Therefore, it’s classed as what they call special medicine, which hasn’t been through randomised controlled trials for specific use. So it can be used for anything, but it’s classed as a special medicine,” Carly explained.
“And the other thing is that it’s imported. Importing medicine on a patient by patient basis whereby you can only have three months’ worth of that prescription in the country per named patient is very expensive.”
We’re told that the cost of importing small amounts for individual patients, with security and licensing fees, all add up to a massive amount, in addition to regular consultations that can run to more than £100 per session.
“The end customer is paying for all of those individual elements coming together, which just bump bump, bump, bump, bumps up the price. But realistically, we know that usually Dan down the road can get you beautifully organic cannabis.”
Carly says that accessing illicit Cannabis could present its own challenges too, and there was a worry for people who don’t have a “florist” but a “dealer”. It seemed fitting that Cancard is looking at addressing patient supply in future projects.
“We need to look at if can we get grow schemes licensed. Can we get Co-Op grows up and running? Can we have some kind of a service for patients who either don’t have the space or don’t have the physical capabilities to grow their own, where we can provide them with [a] product that we’ve selected and grown for them?
“That would be [what] would bring costs down, that would mean that the patient was accessing safe and regulated medicine.”
JD, a self-employed gardener from South Wales, is a Cancard applicant who agreed to speak to us about why he applied and his experience medicating with cannabis.
He has multiple conditions that he treats by vaping in microdoses, which involves taking minimal amounts of cannabis for pain relief and medical effects, not for psychoactive, stoney highs.
JD has been a recreational user for years. Still, after becoming frustrated with mainstream medications for his conditions, he discovered the medical benefits of cannabis after focusing and looking into strain-specific medication.“So I use Indica leaning hybrids during the day to kind of curb my ADHD. And then I use pretty much straight Indicas for the evening when I need to go to sleep, and I’m suffering pain. And yeah, I managed to come off all of the other kinds of medications that didn’t really seem that effective and had some horrific side effects. And I’ve replaced them with strain-specific medical cannabis.”
His adverse history with traditional medications and their side effects really highlighted the importance of patients being free to choose marijuana.
“For the anxiety and depression, I tried various medications starting with fluoxetine, which caused all sorts of problems, including stomach problems, as my IBS (irritable bowel syndrome) got considerably worse.
“I was suffering really bad, dizzy spells, hot flushes, kind of dips, and increases in my blood pressure. That would cause me to actually panic even more because I would then think shit what’s happening.”
He also suffered from serotonin syndrome and was so worried about his health he called emergency services several times.
JD believes that there have been many advances in the medical cannabis industry recently in terms of research and recognition and credits Sapphire Clinics for trying to make private prescriptions more affordable. He chose to support Cancard after coming across their videos on Facebook.
“I only heard about Cancard, I think it was in October, maybe November, and I immediately decided that that was the one I was going to support. I then went and checked out Carly’s amnesty and read about her history. And the fact that she’s doing this for very personal reasons, but she is genuinely just trying to fight for the rights of all self-medicators, and I really respected what she was trying to do.”
In his opinion, the biggest benefit Cancard had for members was the peace of mind for perhaps more vulnerable members of the public.
“I know it hasn’t changed the law, but knowing that if I was stopped on my way back from picking up some weed and I presented my card, then the police would likely go a bit more lenient, that is a huge step forward!”
All in all, this progressive idea, working alongside the police, suggests a bright future for the people in need. However, the process will be slow and require the entire country’s acceptance and support.
Featured image by Jurassic Blueberries via Flickr CC.
Edited by Darnell Christie, Tom Tyers, Emil Brierley and Daniela Ferreira Teixeira.