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Cannabis based drugs: how will they be used in practice?

BMJ 2018; 363 doi: (Published 05 November 2018) Cite this as: BMJ 2018;363:k4665
  1. Nigel Hawkes
  1. London

It became legal for doctors to prescribe cannabis based drugs on 1 November. But who will be able to issue these products, for what conditions, and what’s the evidence? Nigel Hawkes reports

Who can prescribe?

Only specialists, and they will be expected to get approval from the chair of their hospital’s drug and therapeutics committee, or the medical director, on a named patient basis. GPs cannot prescribe.

What indications are included?

NHS England lists just two: children with rare forms of epilepsy and adults with nausea or vomiting caused by chemotherapy.1 “Very few people in England are likely to get a prescription for medical cannabis,” its guidance to patients says.2

What’s the evidence of benefit in these conditions?

Deb Pal, professor of paediatric epilepsy at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, says that there is now good evidence from clinical trials that drugs based on cannabidiol are effective against two types of severe childhood epilepsy: Dravet syndrome and Lennox-Gastaut …

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