Inclusion of chronic pain conditions on cannabis access scheme will be 'kept under review'

CHRONIC PAIN CONDITIONS which are not currently listed under the new medicinal cannabis access scheme will “kept under review” for possible future inclusion, according to Health Minister Simon Harris.

Last week, the minister signed legislation to allow for the operation of the Medical Cannabis Access Programme on a pilot basis for five years.

The medicinal cannabis access scheme now makes it possible for a medical consultant to prescribe a cannabis-based treatment for a patient under his or her care, but only for patients with specific medical conditions, where the patient has failed to respond to standard treatments.

These conditions are:

• spasticity associated with multiple sclerosis
• intractable nausea and vomiting associated with chemotherapy
• severe, refractory (treatment-resistant) epilepsy

While the new programme has been welcomed, some TDs have said it does not go far enough, and have called for the list of conditions to be expanded. 

People Before Profit TD Gino Kenny, who has long campaigned for access to medicinal cannabis to be legislated for, said sufferers of chronic pain would benefit from the cannabis-based products. 

He said the “omission of chronic pain” from the list was glaring, and that many patients, some of whom are getting pain relief from opioids, would benefit from being allowed to gain access to cannabis products under the new law. 

One such example is Clare McAfee, who, writing for TheJournal.ie earlier this year, said she was prescribed fentanyl, a dangerous and highly addictive synthetic opiate with horrible side effects, for her chronic pain. She said she would like to be prescribed cannabis instead.

Harris told the deputy that as minister he has to be guided by scientific evidence and by the experts that advise his office.

“The HPRA (Health Products Regulatory Authority) report did not recommend the inclusion of chronic pain in the access programme, but I reassure the deputy, who has taken a close interest in the development of the programme, that this position will be kept under review and if better clinical evidence becomes available in the future, the inclusion of conditions such as chronic pain can be considered,” said Harris to Deputy Kenny.

For patients with conditions such as chronic pain, the ministerial licence route is an option to access medicinal cannabis outside of the programme, he added.

The ministerial licence scheme, which was the programme that allowed for the prescription of cannabis in some cases before the new legislation was signed last week, allows Irish consultants to seek a licence to prescribe medicinal cannabis to a patient if they feel it is beneficial and necessary.

Speaking in the Dáil today, the minister said he has granted 21 licences to date, adding that he has never refused to grant a licence to a consultant who has sought one.

However, the minister reassured Kenny that chronic pain conditions “will absolutely be kept under review” as the five-year pilot programme progresses.

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Kenny said the ministerial licence scheme can be “cumbersome” and there are questions about costs of travel and drug reimbursement costs for those that get a prescription but do not fall under the medicinal cannabis access programme.

Under the new access programme, the cost of the cannabis products will be the same as getting any other prescription in a pharmacy.

“You will be assessed on the same basis – if you get the drug payment scheme you will be covered in that, if you have the medical card, you’ll be covered under the prescription charges, if you are on long-term illness, you will covered under that,” said Harris last week.

Kenny said that would not be the case for those who need to get cannabis-based products under the old scheme.

“With the changes I made to the law last Wednesday, it may be possible to now start stocking some of those products in pharmacies for patients who are authorised, which might reduce the need to travel. We have made some progress on the reimbursement, but I think we can do more.

“For people who are on the cannabis access programme, the cost of the cannabis product will be met by the HSE. If one has a medical card, one will just pay the prescription charge and if one is on the drug payment scheme it will be the same as any other trip to the pharmacy as well. I am happy to continue to interact with Deputy Gino Kenny for patients who need cannabis for a medical reason to lessen their pain after everything else has been tried. We can keep these things under review,” added the minister.