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2018.02.20
5 Deputy M. Tadier of St. Helier of the Minister for Health and Social Services
regarding the prescription of medicinal cannabis products: [OQ.34/2018]
Will G.P.s (general practitioners) be able to prescribe medicinal cannabis products to their patients; if so, when; and if not, why not?
Senator A.K.F. Green (The Minister for Health and Social Services):
The Deputy of course knows the answer to this question. G.P.s can currently prescribe Sativex on a private basis. The advice I received, as the Deputy knows, from the Misuse of Drugs Advisory Council, which includes a G.P. among its membership, was that prescription of off-label medical cannabis-based products should be restricted to specialist hospital consultants only and that the supply should be from the hospital pharmacy. This is what I am implementing.
- Deputy M. Tadier :
I am getting exasperated with this Minster but it is nothing compared to the suffering of people I get contacted with, and other people in this Assembly get contacted with, who are suffering with the likes of cancer, with severe chronic pain, spasticity and other symptoms. The Minister talks about off-label products, but the whole point is that these should not be off-label anymore. The evidence in the reports have been produced. Why are these now not licenced products. We know of Tilray and Bedrocan that exist. Should it not be the case that this Minister should empower G.P.s to prescribe these medicines, like they do with any other opiate-based medicines or whatever type of medicines that are not available simply on off-label, but that they can be prescribed to those who need these drugs urgently now?
Senator A.K.F. Green:
Clearly, the Deputy either does not understand or does not listen to the answers given. Off-label merely means that the product is used for treatment in a way that it was not tested for clinically. So a doctor may choose to use a medicine that was clinically tested for M.S. (Multiple Sclerosis), for example a doctor may choose to use it for something else even though it has not been clinically tested. That is what off-label means. I am sorry if the Deputy is frustrated. I am frustrated trying to get hold of products that are produced to good manufacturing practice that we can get in into Jersey through countries where it is still illegal. I know the Deputy thinks it is very easy but I can assure him it is not. It is a daily quest of mine to get this right. I want to help the people who are suffering, but I want to help them with safe products that the clinicians approve.
- Deputy M. Tadier :
The Minister knows that Sativex is an ineffective form of cannabis for most people who would benefit from a more effective and user-friendly form of cannabinoid for their particular symptoms. So saying that there is something that can be prescribed off-label, essentially saying doctors can prescribe something which is inappropriate for the symptoms, is simply not acceptable. He is the Minister so it is fine for me to be frustrated but his frustration must be taken out on himself and his staff in that case. Will the Minister acknowledge that these medicines already exist, they have already been tested and there are people out there who are willing to bring them in and to prescribe them, both as G.P.s and dispense them as pharmacies? Why can he not take swift action in this regard?
Senator A.K.F. Green:
Clearly, the Deputy knows far better than M.D.A.C. (Misuse of Drugs Advisory Council), which consists of the Head of Probation, Crown Advocates Solicitor General, the States Pharmacist, the States Vet, clearly the Deputy knows much better than all these people. If it was easy to get this product in, produced to good manufacturing standards, believe me they would be here today. But we cannot approve products that we know that are not produced to good manufacturing standards when they are being prescribed by the public for the benefit of people. I want a solution for people but I want a safe solution, a clinically approved solution, and the right solution, not just any solution.