Our Helpline & Information Officer, Stuart Macgee looks at when medicinal cannabis can be prescribed for and what this means for people with epilepsy.
Cannabis for medicinal use has not been far away from the news recently.
However, reporting in the media has not always been accurate, often creating more confusion and misunderstanding around medical cannabis.
Below we clarify the different types of cannabis terminology and what are the clinical guidelines when medical cannabis can be prescribed for. Also, what this means for people living with epilepsy.
Cannabis terminology
When people talk about cannabis, the following terminologies often pop up:
Cannabis oil
This is the oil extracted from the whole plant. It contains the psychoactive component THC (tetrahydrocannabinol), which is what makes a person feel high.
Any cannabis oil which contains more than 0.2% of THC is illegal in the UK, unless prescribed by the NHS.
Also, cannabis oil is not the same as CBD oil, which can be bought legally in shops and online.
CBD (cannabidiol) oil
CBD oil contains less than 0.2% of THC and because of its low THC content, it is legal to buy and consume in the UK.
You can buy CBD oil (also sometimes referred to as hemp oil) in health food shops and over the internet.
Quality and strength of CBD oils vary widely. Some of them sold as CBD oil may contain more than the permissible 0.2% of THC, making you unwittingly buy illegal cannabis oil.
Also, CBD oils are sometimes contaminated with pesticides, heavy metals and other harmful chemicals.
Cannabinoids
Cannabinoids are the components that make a cannabis plant.
The two most well-known cannabinoids are CBD (cannabidiol) and THC (tetrahydrocannabinol).
Cannabis-based medicines
These are medications which have undergone clinical trials and have been licenced for use within the NHS.
Also, these could be medications based on CBD only or based on both CBD and THC.
For epilepsy, the only licensed medication in the UK is Epidyolex.
This medicine is based on CBD only and does not contain THC. It has undergone clinical trials in children with severe epilepsy syndromes.
Recreational cannabis
Cannabis bought on the street is illegal. It can vary in strength and quality and is entirely unregulated. Marijuana is the most common form of street cannabis.
What can medical cannabis be prescribed for?
Clinical guidelines only currently recommend prescribing cannabis-based medicines for three health conditions ie severe childhood epilepsy, severe nausea caused by chemotherapy treatment, and MS-related muscle spasticity.
What does this mean for people with epilepsy?
Clinical trials for one of the available cannabis-based medicines have focused on children affected by two specific epilepsy childhood syndromes, Lennox-Gastaut syndrome and Dravet syndrome.
This is why clinical guidelines only recommend the prescribing of this drug for these two epilepsy childhood syndromes, and not for adults with epilepsy.
Even though it is now legally possible for a specialist doctor to prescribe cannabis for adults with epilepsy, they are unlikely to go against clinical guidelines unless there are exceptional circumstances.
Never stop your or your child’s anti-epileptic drugs without medical advice and supervision, as this could trigger major seizures and put your or your child’s life in danger.
Never substitute your or your child’s anti-epileptic medication with non-prescribed cannabis products unless advised by a specialist.
For more information on cannabis and epilepsy, please check our factsheet, email contact@epilepsyscotland.org.uk or phone our freephone helpline on 0808 800 2200.
