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Prescribing of medicinal cannabis

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2024.11.12

3.10   Deputy P.F.C. Ozouf of St. Saviour of the Minister for Health and Social Services regarding prescriptions of medicinal cannabis: (OQ.204/2024)

Will the Minister state the number of prescriptions of medicinal cannabis to date and indicate the primary medical conditions for which they have been prescribed; and advise what consequences have been reported, if any, relating to prescribed medicinal cannabis? Apologies for the hesitation in asking the question.

Deputy T.J.A. Binet of St. Saviour (The Minister for Health and Social Services):

I am afraid I am only able to report on prescriptions that have actually been dispensed, but I suspect those numbers will be very similar to the numbers of prescriptions that have been issued. The most recent audit was published in March of this year and indicated that just under 19,000 prescriptions were dispensed in the period January to September 2022 and that suggests an annualised rate of about 25,000 prescriptions. The audit also indicated that around 6 per cent of the Island's working age population were in receipt of unlicensed medical cannabis. This is significantly higher than the U.K. and their working-age population figure is 0.05 per cent. With regard to the primary medical conditions for which cannabis was prescribed, I regret to say that we are not able to gather this information. Only when EMIS, the patient record system, is made available to all cannabis prescribers will this be possible. As for any consequences that might result from the issue of prescriptions for medical cannabis, our own medical and health services report anecdotally that there has been an increase in the number of people presenting with acute mental illness who have been using significant amounts of prescribed and/or illicit cannabis. I am also aware that a recent inquest concluded that medical cannabis was likely to have had adverse effect on the mental health of the person concerned, albeit at an earliest point in time. I have probably exceeded my 70 words but I am very happy to answer any further questions.

The Bailiff :

You had 2½ seconds to go, but there we are.

  1. Deputy P.F.C. Ozouf :

I am very grateful for the Minister's very fulsome answer, and particularly the important reference that he made of mental health issues with very serious consequences. I think that now is not the right time to basically develop these issues because it is a massive issue. Does the Minister agree that there is a potential growing issue, which his Medical and Health Department is going to have to deal with, following this Assembly's decision to legalise prescriptions for cannabis? Would he agree that it is important that we as an Assembly have full information and he is clear about the negative effects that this decision, although well- intentioned, is having?

Deputy T.J.A. Binet :

Yes, I agree with everything that Deputy Ozouf has had to say on the subject. It would appear that we are in a situation where a previous Assembly has gone ahead and legalised medicinal cannabis without having put in place any of the required operating frameworks or necessary legislation to make sure the job is done properly. We are in a position of playing catch-up and I can assure the Assembly that we are making a great deal of effort. I sent out an email several days ago which detailed the actions that we are currently undertaking and we are moving as quickly as we can, because I agree we are in a very awkward position.

  1. Deputy H.L. Jeune of St. John , St. Lawrence and Trinity :

The Minister and Deputy Ozouf have touched on questions that I was going to ask about this link with the development of psychosis and mental health issues for those prescribed with medical marijuana. My question to the Minister would be: is he monitoring the risk of this increased amount of people in Jersey developing these mental health issues?

Deputy T.J.A. Binet :

Well, I think we are monitoring the risk to the greatest extent that we can. The mental health services are acutely aware of the situation. Once we have got EMIS, the patient records, running through all the prescribers, they will be able to see the patient records of those concerned and perhaps have a little bit more information about the prescriptions that they are able to issue. So, I think that in itself is going to help the situation.

  1. Deputy H.L. Jeune :

What support is the Minister developing to put in place for those specifically who have developed mental health issues around medical marijuana?

Deputy T.J.A. Binet :

We are not doing anything specific. As I said, we are mindful of it and we are using all of what you would expect us to do under those circumstances.

  1. Deputy T.A. Coles of St. Helier South:

Can the Minister confirm whether or not the dosage and volume of medicinal cannabis that is prescribed is currently recorded? If not, will this be something that will be done going forward?

Deputy T.J.A. Binet :

I am led to believe that is all being recorded by the people who are prescribing at the moment but, once again, that does not form part of the medical records because they do not have access to them. That should form part of that once that is all in place.

  1. Deputy T.A. Coles :

Can the Minister confirm when they hope to achieve the medical records to be shared between the department and private prescribers?

Deputy T.J.A. Binet :

I am not able to provide a precise date but once we have a clearer idea, I am very happy to pass that information on to the Deputy .

  1. Deputy P.F.C. Ozouf :

I was grateful for the Minister's absolute candour in answering the question, but can I put this into the wider context that the Minister is responsible for oversight of medicinal cannabis and its prescribing, and also the production of it in large facilities that have a huge capacity, whether that be in St. John or St. Mary or wherever it is. Can he advise the Assembly, and advise me, how he is reconciling what he says on the one hand, which is there are undoubted issues arising from prescribing medicinal cannabis, and effectively the Island promoting itself as a place to grow this stuff and seeing all the financial consequences of doing that? He has been to meetings with medicinal cannabis providers, and I just want to understand how he is reconciling these 2 genuinely difficult things.

Deputy T.J.A. Binet :

I am slightly confused by the question. It strikes me they are relatively separate. It has to be accepted that the prescribing of medical cannabis is down to the G.P.s (general practitioners) and that is a professional requirement on their part. The production of cannabis has to be done in accordance with all of the requirements of the law. It could well be the case that all of the production that is ever done in Jersey ends up being exported to elsewhere. It may well be that some of it gets used locally, but I do not really think the 2 things are necessarily connected.