Access to medicinal cannabis is a growing healthcare issue in Ireland. Medicinal cannabis is legally available in many countries. Canada opted for a radical approach in October when it gave the green light to both medicinal and recreational cannabis. The UK and Northern Ireland, as of 1 November this year, approved the prescription of cannabis-based products for medicinal use without obtaining a licence from the Government.
Irish regulatory framework
As the law currently stands, cannabis, cannabinol and cannabinol derivatives are listed as Schedule 1 controlled substances under the Misuse of Drugs Act 1977, as amended, (the "Acts"), meaning cannabis products are subject to the strictest level of control. Unless used for research, forensic analysis or as an essential material in an industrial manufacturing process, the manufacture, supply, distribution and/or possession of cannabis is illegal.
The legislation prohibits doctors and pharmacists from prescribing, compounding and/or supplying cannabis. The Minister for Health may issue a licence to a doctor or pharmacist enabling them to conduct these activities, similar to a named-patient procedure for unauthorised medicines. Critically, it is up to the prescriber and their patient to source the product, which sometimes means travelling to the Netherlands or Canada. Despite being available for some time, the first ever licence in Ireland was granted at the end of 2016 for a three-year-old boy suffering from a severe form of epilepsy. Since then, there are reports that the Minister for Health has issued eight more licences. But the availability of products in Ireland remains a major patient roadblock.
When discussing controlled substances, it is important to distinguish between cannabis products that are psychotogenic and those that are not, the latter not being subject to "controlled substances" restrictions. The main "active ingredients" of cannabis are cannabinoids. Of those, CBD (cannabidiol) and THC (tetrahydrocannabinol) seem to offer the most value with respect to clinical use. However, THC is the main psychotogenic component of cannabis and because of its hallucinogenic effects, it is a controlled substance under the Acts.
CBD, on the other hand is not considered a controlled substance due to its lack of psychotogenic effects. Nevertheless, availability of CBD for medicinal use is restricted due to existing legislation for drugs as was the case for Sativex, which was the first authorised...