Ireland's Medical Cannabis Access Program (MCAP) has a short history in Ireland. Following years of campaigning, Irelands MCAP was established in 2017 following conclusions drawn from the "Cannabis for Medical Use: A Scientific Review" report by the Health Regulatory Authority. Despite the review being conducted by medical professionals, the absence of medicinal cannabis experts has led patients to question its accuracy.
In 2019, the MCAP was finally signed into law and set up as a pilot program for a five-year period. However, securing access to medicinal cannabis products under the scheme posed significant challenges, negatively impacting numerous patients in Ireland. It was only in November 2021 that the first patient gained access to medicinal cannabis for the treatment of an aggressive form of epilepsy. Due to the overly restrictive programme, which is limited to 3 specific conditions, a little more than a handful of patients have been permitted access to medical cannabis under the MCAP scheme. Even those who celebrated the launch found themselves unable to access it due to a reluctance from health professionals to apply to the scheme.
Across Europe, physicians can now prescribe medical cannabis for an array of health conditions, including chronic pain, mental health disorders and neurological conditions. The European medical cannabis industry to projected to reach over €550 million in sales by the end of this year alone. Costs of medical cannabis across Europe are borne by the patient, with the few exceptions of Denmark, Germany, and Czechia where the cost is borne by the health system or national insurance. In Ireland only those who qualify for a medical card will have their enormous costs covered, those who don’t face the prospect of paying thousands of euros every year for their often life-saving medication.
Incorporated into the establishment of the MCAP in 2017 was a commitment to review the programme after 5 years in order to keep up with emerging evidence. Additionally in the 2020 Programme for Government " Our Shared Future" a commitment was also given to " Examine the regulations and legislation that apply to cannabis use for medical conditions and palliative care, having regard to the experience in Northern Ireland and
Great Britain." In February 2022 Gino Kenny TD launch the #WhatAboutUs campaign which aimed to highlight the restrictive nature of Ireland's medical cannabis access programme. The campaign advocated for the expansion of applicable conditions under the programme.
Review Process
In July 2022 Minister for Health Stephen Donnelly stated “The Department of Health has now commissioned an evidence review. This is examining the efficacy and the safety of the cannabis-based treatments for a wider range of conditions. When that is completed, a clinical group is going to be convened to assess the evidence and provide guidance to the Government on any potential amendments to that list.” A year on from this statement where is this review process today? In correspondence with the Department of Health last week, they confirmed the “evidence-gathering” process is still being completed. Following this review, a clinical review group will be established to assess this evidence, this review group is expected to be established towards the end of 2023.
The prolonged duration of this process raises concerns about its efficiency and its impact on patients' lives. Swift action is required to expedite this phase and ensure that the review is conducted thoroughly yet promptly. The prolonged delay in the review process has resulted in the continued suffering of patients who are unable to access medical cannabis. These individuals, who could potentially benefit from cannabis-based treatments, find themselves with limited or no therapeutic options due to existing restrictions. Consequently, these delays have led to missed opportunities to provide much-needed relief and improved quality of life for patients grappling with debilitating medical conditions.
As patients currently face barriers in accessing medical cannabis, many are forced to turn to an unregulated black market or resort to growing their own supply. Recently, a case emerged involving a patient suffering from cancer who chose to grow and cultivate cannabis to alleviate their pain. However, tragically, this patient was criminalised and convicted for their actions, further underscoring the urgency to address the issue promptly. The lack of access to regulated medical cannabis leaves patients vulnerable and highlights the pressing need for timely action in evaluating cannabis-based treatments.
Reform
To ensure patients have unfettered access to medical cannabis, critical reforms are required to address existing barriers. Firstly, the power to prescribe medical cannabis should be shifted to General Practitioners (GPs) rather than solely relying on consultants to authorize prescriptions. GPs often serve as the primary point of contact for patients and possess a deep understanding of their medical history and needs. By involving GPs in the prescription process, patients can access medical cannabis more efficiently, avoiding prolonged waiting periods associated with consultant appointments. Secondly, currently, medical cannabis is limited to addressing only three conditions, but there exists a wealth of evidence supporting its efficacy for various other ailments. Conditions such as chronic pain, migraines, menopause, sleep disorders, inflammatory diseases, and Parkinson's have shown promising responses to cannabis-based treatments. Expanding the range of conditions eligible for medical cannabis prescriptions would broaden treatment options and improve patients' quality of life. Lastly, another pressing reform entails removing the mandate that patients exhaust all other pharmaceutical options before considering medical cannabis as a treatment. This requirement imposes an undue hardship on patients, prolonging their suffering and delaying potential relief. By treating cannabis as a valid first-choice medicine for those in need, patients can access this therapeutic alternative more promptly and efficiently.
Survey
The full potential of medical cannabis and the number of potential patients in Ireland remains uncertain. The scope of individuals who could benefit from cannabis-based medicine and their willingness to access it remains unexplored.
To address this gap, I am currently conducting a survey to assess the potential size of the medical cannabis market in Ireland. If you have any medical condition, regardless of whether you believe medical cannabis would be beneficial or not, we kindly request your participation in this survey.
You can find the link to the survey here