RCGP sets out advice for GPs on prescribing cannabis

GPs should warn patients hoping to access cannabis-based medicines that the process is 'unlikely to be fast' according to guidance published today by the RCGP.

Cannabis (Photo: iStock.com/druvo)
Cannabis (Photo: iStock.com/druvo)

Guidance on cannabis-based medicines has been drawn up by the college after the Home Office announced earlier this year that the treatments would be available on the NHS from November.

The RCGP says the guidance aims to 'support GPs to have informed conversations with patients about medicinal cannabis should the issue arise during consultations'.

Allowing access to cannabis-based products may lead to 'increased demand on GPs for information and referrals for a range of conditions, increased referral rates to pediatric neurologists and general neurologists with lengthening of waiting times', the RCGP guidance warns - although the college says that to date there is no evidence of GPs facing a surge in demand.

Medicinal cannabis

Cannabis-based medicines can only be prescribed by specialists - but the guidance sets out conditions in which patients may benefit from these products, and when GPs should consider a referral. It also covers safety concerns, side effects, evidence and legal issues for patients using the drugs.

Two products are available for use in the UK - Nabilone, which is available in capsules, and Sativex, which is an oromucosal spray. The guidance makes clear that there are 'no cannabis products delivered by smoking that have a medical license'.

RCGP chair Professor Helen Stokes-Lampard said: 'The decision to legalise medicinal cannabis for some patients, where there is an evidence-base that it could benefit them, is welcome.

Clinical need

'However, the treatments that have become legal are only able to be prescribed by specialist doctors if they have a patient with an unmet clinical need – and so it will affect a relatively small number of patients, many of whom will likely already be known by their specialist doctor.

'GPs will not be able to prescribe patients medicinal cannabis, but as the first point of contact for the vast majority of patients in the NHS it is important that we are aware of the legal situation and current clinical evidence around medicinal cannabis.

'This desktop guide aims to be a quick reference guide for GPs, providing them with the information they may need when having discussions with patients who as them about cannabis, and to make it clear to patients that GPs are not in a position to prescribe cannabis.'

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