He says, ‘The government has made it quite difficult to do so. If a doctor wants to write a prescription, he or she has got to get it approved by a peer panel. It’s unheard of, a doctor having to have their prescription checked and verified and approved.’
This has led to doctors being reluctant to prescribe cannabis, Barnes says. He says that the NICE (National Institute for Health and Care Excellence) guidelines, used by hospital trusts to decide whether to prescribe medicines, are ‘rather anti-cannabis’.
He says, ‘The NICE guidelines are meant to be just guidelines, but they’re effectively mandatory. We’re lobbying to get a different view from NICE, looking at the real world evidence for cannabis rather than the pharmaceutical evidence for cannabis. Because it’s not a pharmaceutical product. If you look at it as a plant, there is massive evidence that it is efficacious, but NICE looks at it as a pharmaceutical. They’re not set up to assess a botanical.’
Barnes says that part of the problem is an ‘inbuilt conservatism among British doctors’, with organisations such as the British Paediatric Neurology Association speaking out against medical cannabis. He says, ‘There’s been a lot of very unhelpful propaganda and antagonism from some of the hierarchy.’
One of the key barriers, Barnes says, is educating doctors about the ways cannabis works in the body. Medical schools still don’t teach how cannabis works, Barnes says – which means doctors often lack a basic understanding.
He says, ‘It works in the endocannabinoid system, which is inbuilt in all of us and all vertebrates. Doctors aren’t taught about that. Medical schools, bizarrely, have known about it for 30 years, and it’s the most important master controller, neurotransmitter system in the body. But it’s not talked about. So doctors just don’t know about cannabis medicine.’