The United Kingdom’s Multiple Sclerosis (MS) Society has taken a stand against restricted access to medical cannabis in the country. The society launched a campaign with the hashtag #ApprovedButDenied protesting the difficulty so many patients have faced attempting to obtain medical cannabis. Medical cannabis has been legal in the nation for almost three years—so why are MS patients struggling to access the treatment? It’s this line of thought that contributed to the drive for launching a campaign.
Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system, which comprises the brain and spinal cord. Individuals with this condition have to find ways to deal with the fact that their immune system is attacking the protective sheath of nerve fiber surrounding the nerve cells, putting the body in a state of imbalance that results in muscle spasms, paralysis, disrupted bladder function, mental changes, depression, and even epilepsy.
The condition can have a devastating impact on its host, causing excessive pain and neurological dysfunction. Though a cure for MS does not yet exist, cannabinoids have been found to help relieve patients’ body pain and improve their overall quality of life. A survey conducted by researchers in 2017 revealed that more than 40% of MS patients use medical cannabis.
On Sept. 1, MS Society UK posted on Twitter, “Getting the treatment you need shouldn’t be a game of chance. But it is for the thousands of people living with MS who experience muscle spasms.” As discontent around the country’s seemingly exclusive medical cannabis supply ramped up, UK’s MS Society launched the Approved but Denied campaign in conjunction with a 30-page report.
The report states that “MS is relentless, painful and exhausting” and that “it can make it harder to do everyday things like walk, talk, eat and think.” Further, MS patients suffer from “spasticity,” a condition that involves abnormal increases in muscle tone or stiffness, both of which interfere with movement and speech and are generally associated with discomfort and pain.
The report goes on to explain, “MS is the only condition which has a licensed, cannabis-derived treatment for spasticity, called Sativex.” Sativex—a major development in both medical cannabis and MS treatment—was designed to boost homeostasis in the body but also specifically treats moderate to severe spasticity in MS patients.
But what’s the use if MS patients are struggling to get their hands on it? MS Society wrote on its website,
“Sativex, a cannabis-based spray, was approved to treat moderate to severe spasms when other treatments haven’t worked in England in 2019. Yet many people with MS are still unable to access it.”
The organization elaborates in the campaign report, stating that this lack of access is due to the fact that England’s local health bodies, called Clinical Commissioning Groups (CCGs), are not prescribing it. According to the report, only 49 out of 106 CCGs are currently funding Sativex, and only 21 of those CCGs listed Sativex as suitable for shared care. Additionally, the overall number of Sativex prescriptions in England has risen little since November 2019 despite the high demand.
The report suggests that these challenges in accessing Sativex are being exacerbated by the COVID-19 pandemic, patients’ hesitation towards cannabis products, and the perspective that Sativex is less effective than other pharmaceuticals despite published research that provides evidence of its efficacy.
The campaign also raises serious concerns about “postcode lottery,” a phenomenon referring to the fact that only patients in certain area codes can easily access Sativex depending on whether their local CCGs are funding it. Patients in areas without access are forced to either live with their pain, purchase cannabis illegally, or pay as much as €500 (about $587) a month for a private Sativex subscription.
Sativex can be consumed orally and contains the two main cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD). While the product specifically targets spasticity, it can also be useful for alleviating pain and anxiety, reducing muscle spasms, and reducing risk of epileptic fits. Sativex also contains peppermint oil and can take effect in around 30 minutes. Patients are typically advised to dose by one spray every 24 hours but should make adjustments according to their personalized treatment plans.
According to the Electronic Medicines Compendium (EMC), Sativex is used as a treatment to improve the symptoms associated with MS in adults. It is also commonly used as an “add-on” to the current treatment plan in conjunction with anti-spasticity pharmaceutical medication. The EMC advises patients that “it might take up to two weeks to find the optimal dose” and that Sativex is contraindicated, or not suggested for use, in patients who are hypersensitive to cannabinoids, have a family history of psychotic illnesses, or are breastfeeding.
Sativex is a credible, effective, and legal product (in the UK), and there is no reason the country’s MS patients shouldn’t be able to use the product if they desire. The MS Society states in its report, “Sativex is not a ‘wonder drug’—it doesn’t work for everyone with spasticity. But when it does work, the impact can be life-changing.”
If you are a resident of the UK and would like to help the UK MS Society in its mission to increase access to life-changing treatment for MS patients, you can send an email to your local CCG and ask them to fund and prescribe Sativex. If you are unsure whether Sativex is available in your area, you can use this tool on the MS Society website to see whether your local health body is prescribing Sativex.
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