The Minister of State, Home Office (Baroness Williams of Trafford) (Con)
My Lords, first, I also declare an interest in MS. As the noble Lord, Lord Dubs, knows, I worked with MS patients for many years before I got involved in politics—I do not know quite how I made the transition, but that was the case. Some of the noble Lord’s anecdotes from patients chime with things that I heard. I know that there is significant feeling in the House on this issue. It is also clear from noble Lords’ remarks that they are keen that government policy on this issue should be led by evidence—as my noble friend Lord Norton of Louth said, I confirmed that yesterday—but also should not prevent patients from obtaining relief from symptoms using effective medicines.
As the noble Baroness, Lady Meacher, said, the WHO’s Expert Committee on Drug Dependence has committed to reviewing the scheduling of cannabis under the UN’s 1961 convention. The review will consider therapeutic use as well as dependence, and the abuse potential of several constituent parts of cannabis, including the cannabis plant itself and cannabis resin, cannabidiol, or CBD, THC, isomers of THC and extracts and tinctures of cannabis. The review is due to conclude by early 2019 and I, like most people here today, am very interested in its outcome and look forward to future opportunities to debate this issue—as I know we will—as and when the WHO concludes its work. I must add that the recognition of CBD as having medicinal application necessarily means that the other constituent parts will do so as well. Each compound ought to be assessed on its merits.
As noble Lords have said, cannabis in its raw herbal form continues to be listed in Schedule 1 to the Misuse of Drugs Regulations 2001 as a substance with no recognised benefits in the UK, but I must underline that this is in its raw form. The system of scheduling does not preclude medicines based on cannabis from being developed. The Misuse of Drugs Act 1971 regime, along with the associated regulations, enables the availability of controlled drugs which have recognised medicinal uses in UK healthcare—of which there are many.
We are already able to rely on a process, administered by the Medicines and Healthcare products Regulatory Agency, MHRA, in parallel with the Home Office’s licensing system, to enable medicines, including those containing controlled drugs such as cannabis, to be developed, licensed and made available for medicinal use to patients in the UK. In the case of a Schedule 1 drug such as cannabis, the Home Office is willing to consider applications for research licences to facilitate the development of new medicines, as long as the appropriate ethical approvals have been given, as we have done in the past. I am very happy to meet again with the noble Baroness, Lady Meacher, as we do regularly, to discuss this issue.
In the case of the cannabis-based drug Sativex, the Government have, as noble Lords have said, placed the product in Schedule 4 of the Misuse of Drugs Regulations to allow it to be legally supplied on prescription. Sativex was granted a marketing authorisation by the MHRA and was rigorously tested for its safety and efficacy before receiving approval for this application. This rigour should equally be applied to future medicinal products containing cannabis.
As has also been pointed out today, the MHRA has offered an opinion that products containing CBD, when used for a medical purpose, should be regulated as medicinal products. A CBD or cannabidiol product in its pure form is not controlled under the Misuse of Drugs Act 1971, so where it can be extracted and isolated from the controlled substances in cannabis it would not require a licence from the Home Office. However, a CBD product that contains any trace of psychoactive compounds that are found in cannabis, such as THC or tetrahydrocannabinol, is considered to be a controlled substance under the 1971 Act and therefore unlawful to possess and supply unless it fits the criteria for an exempt product under the Misuse of Drugs Regulations 2001. The MHRA is working with individual companies and trade bodies to make sure that products containing CBD used for a medical purpose which can be classified as medicines satisfy the requirements of the Human Medicines Regulations 2012.
We continue to facilitate forward-looking research involving cannabis and cannabinoids. There were 19 cannabinoid clinical trial authorisations granted between 2005 and 2015. These trials cover MS, dental applications, psychotic disorders, addiction to cannabis, type 2 diabetes, epilepsy, interaction with other medicines and brain diseases. Research in this area is ongoing.
The noble Baroness, Lady Greengross, asked about research into synthetic cannabinoid changes. I know that my right honourable friend the Home Secretary has commissioned the ACMD to look into whether there are barriers to research into Schedule 1 drugs as a result of changes to synthetic cannabinoid generic legislation. The Home Secretary has asked the council to provide its advice before the end of this year.
The noble Baroness, Lady Meacher, and the noble Lord, Lord Dubs, asked about Epidiolex. Our position on it is that, as for any other medicine and as we did with Sativex, it must be put through the same stringent process to ensure its safety and efficacy, for the benefit of patients.
My noble friend Lord Crickhowell suggested that the Department of Health and not the Home Office should be responsible for this. I quietly nodded there. Like the previous strategy, the 2017 drug strategy takes a cross-government approach that reflects the need for co-ordinated action to tackle the problem in all its dimensions. Given the strong link between drug use and offending, the Home Office has and will continue to provide the governance and accountability essential to the effective delivery of this cross-departmental approach. The Department of Health leads on the building recovery strand of the strategy and, together with the Home Office, leads on the reducing demand strategy, along with Public Health England. To ensure that we are doing all we can—and following my meeting with the noble Baroness, Lady Meacher—I have recently written to my noble friend Lord O’Shaughnessy, who is the Minister for Health in your Lordships’ House, to ask him to consider how the Government can facilitate the development and availability of cannabis-based medicines such as Sativex.
We are open to the development of new products based on cannabis and look forward to the review from the WHO’s expert committee. I am sure that the ACMD will follow its conclusions with great interest.
Lord Howarth of Newport
The Minister has not made any mention of Bedrocan in her response to the debate. Does she think it reasonable that TW, in the circumstances I described, has to make these visits to Holland to collect her medication, which has been prescribed for her in Britain but which she is not permitted to obtain from her local pharmacy? Is that a reasonable state of affairs and if the Minister thinks it is, why? If she thinks it is not, what will the Government do?
Baroness Williams of Trafford
I noted the noble Lord’s mention of Bedrocan. I had not heard of it and I am very willing to look into that specific drug. There are of course many drugs available in other parts of the world that are not necessarily available here and vice versa. I will write to him on that point. I will also take up the point about Alfie separately.
Baroness Meacher
May I thank everybody who has spoken so effectively in this debate? So many powerful points were made and we have managed to avoid duplication, amazingly. It just shows how many points one needs to make in relation to this—