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Determining Eligibility for Treatment
Determining whether a patient is eligible for treatment with a Cannabis-Based Product for Medicinal use (CBMP) is a decision made solely by a specialist doctor following a thorough consultation. The criteria are based on a combination of the patient’s medical condition, their treatment history, and a careful assessment of the potential risks and benefits. This section provides a general overview of the factors that clinicians typically consider. It is for informational purposes only and is not a substitute for a professional medical evaluation.
Overview of Qualifying Conditions
There is no definitive, government-mandated list of conditions that qualify for a CBMP prescription in the UK. While The National Institute for Health and Care Excellence (NICE) has provided specific recommendations for a very limited number of conditions for NHS treatment, private specialists can use their clinical judgement to prescribe for a wider range of ailments where there is a clear clinical need and evidence of potential benefit.
Generally, prescriptions are considered for patients with chronic conditions that have not been successfully managed with conventional, licensed treatments. Conditions commonly seen in UK private clinics include, but are not limited to:
- Pain Conditions: Such as chronic pain, fibromyalgia, neuropathic pain, and pain associated with arthritis or Ehlers-Danlos syndromes.
- Psychiatric Conditions: Including anxiety disorders, Post-Traumatic Stress Disorder (PTSD), and sleep disorders.
- Neurological Conditions: Such as epilepsy, Multiple Sclerosis (MS), Parkinson’s disease, and Tourette’s syndrome.
- Gastrointestinal Conditions: Including Crohn’s disease and Ulcerative Colitis.
- Oncology-related symptoms: Such as chemotherapy-induced nausea and vomiting.
It is crucial to understand that having one of these conditions does not guarantee eligibility. The final decision rests with the prescribing specialist.
The “Two Previous Treatments” Rule Explained
A fundamental principle for assessing eligibility is that a patient must have first tried conventional, licensed treatments for their condition. As a general guideline, clinicians will look for evidence that a patient has tried at least two different licensed medications or therapies without achieving adequate symptom relief or experiencing intolerable side effects.
This “tried two” rule demonstrates to the specialist that other established medical options have been exhausted, making the consideration of an unlicensed medicine like a CBMP a reasonable next step. Patients are typically required to provide their Summary Care Record (SCR) or other medical notes as evidence of their treatment history.
Contraindications (Who Should Not Use Medical Cannabis)
Just as with any medicine, CBMPs are not suitable for everyone. A doctor will not prescribe a cannabis-based product if they believe it could be unsafe for the patient. These situations are known as contraindications.
While a full assessment is required, common contraindications include:
- Pregnancy or Breastfeeding: CBMPs are not prescribed to patients who are pregnant, planning to become pregnant, or are breastfeeding.
- Severe Cardiovascular Disease: Patients with serious heart conditions, such as unstable angina, severe arrhythmia, or a recent heart attack, may not be eligible.
- History of Psychosis or Schizophrenia: A personal or immediate family history of psychotic disorders is typically a strong contraindication.
- Allergy: A known allergy to cannabis or any of the cannabinoids.
- Severe Liver or Kidney Disease: These conditions may affect how the body processes the medication.
This is not an exhaustive list. A specialist doctor will conduct a full review of a patient’s medical history and current health status to determine if a CBMP is a safe and appropriate option for them.