Is There a Doctor in the House? Patient Access to Medical Cannabis

• How does a doctor register to prescribe cannabis?
• What ailments is cannabis most routinely prescribed for?
• What practical steps can be taken by businesses and professionals alike to overcome the current hurdles?
• When can we expect medical cannabis to be part of the curriculum in medical school?
• Why has the NHS failed to adopt medical cannabis in earnest?

At Prohibition Partners LIVE last month, we were joined by leading clinicians, business leaders and prescribing doctors – from the UK and Canada – to discuss hurdles faced by the industry.

This expert panel – consisting of Professor Mike Barnes (Medical Cannabis Clinicians Society), Dr Rebecca Moore (The Medical Cannabis Clinics), Richard Hurley (The British Medical Journal), and Bradley Moore (Global Cannabis Applications Corp.) – delved deeper into patient access to medical cannabis.

Below is a full transcription of the insightful panel discussion.

Richard Hurley: Hi, my name’s Richard Hurley. Welcome to this panel discussion, “Is there a doctor in the house”? The British Medical Journal has been covering medical cannabis developments over the past few years. In the UK in 2018, there were high profile cases of young children with otherwise untreatable epilepsy finding that their symptoms were hugely reduced by taking natural cannabis products that their parents were buying abroad. After huge media attention, the government rescheduled cannabis products to recognise that they had medical benefits. And so, it could be legally prescribed by doctors.

The NHS then created rules for prescribing and professional associations, like the Royal College of Physicians and the British Paediatric Neurology Association, issued evidence-based guidance for prescribing. Yet today, as far as I understand, the number of NHS patients receiving full-spectrum cannabis plant products, you can count on your fingers. But meanwhile, commercial cannabis clinics seem to be blooming, but also charging patients huge sums of money for access to cannabis, while it’s done unlicensed and perhaps under-researched treatments. There’s huge commercial interest in medical cannabis. Predictions of markets tend to be worth billions and a simultaneously burgeoning market.

And of course, there are also some industry players who are interested in the recreational cannabis market. Cannabis clearly has medical benefits, but the question is how can we make sure the right patients get access to the right treatment? I’m joined today by some experts in this very topic.

Professor Mike Barnes is honouree Professor of Neurological Rehabilitation at Newcastle University. Dr. Becca Moore is a Psychiatrist and prescribing Doctor at a private cannabis clinic, and Bradley Moore is CEO of Global Cannabis Application Corporation. So, perhaps, Rebecca would you mind explaining what’s happened for patients since the law changed in the UK?

Dr. Rebecca Moore: So, I mean, I can speak about my experience of that, which is I work in one of the private medical cannabis clinics. And as you said, seeing an increasing number of people presenting, wanting to be assessed for whether they would be prescribed medicinal cannabis for a wide range of diagnoses. And certainly, you know, an explosion of people interested in coming for a consultation. And as a clinician I’m seeing a huge amount of people find this life-changing in terms of treatment and results. But clearly, in terms of an NHS pathway, it’s not yet something that I, as a consultant, although I have tried, can readily get colleagues to prescribe via an NHS route. It is something that is expensive which, thus, prohibits patients from accessing it.

Richard Hurley: And what kind of conditions are you prescribing for? Is it mainly psychiatric conditions?

Dr. Rebecca Moore: It is for me because obviously that’s my expertise. So, you know, PTSD, depression, ADHD, anxiety, insomnia, fibromyalgia, are all conditions which can really be helped in this way with a prescription. But then I also have colleagues who are gastroenterologists, pain specialists in oncology, so a different array of reasons why people might come for consultations.

Richard Hurley: And Mike, would you like to talk about this as well? What’s your view on what’s happened since the law changed [in the UK] in 2018?

Professor Mike Barnes : Well, you know, I thought the 1st November 2018 was potentially an excellent day. The media campaign was successful and the law was changed, but certainly that hasn’t shown to be the case in reality. As you said earlier, to the best of my knowledge there’s only three National Health Service prescriptions [in the UK]. And there’s no legal reason why doctors can’t prescribe. 6,000 I think is roughly the number at the moment have been prescribed privately. Now the costs privately are coming down. They are about half of what they were when this started about a year ago, but nevertheless, that still makes them very expensive for many people. In fact, out of the question for many people, even though the costs are now roughly £5 or £6 for a gram of cannabis, which is a reasonable price.

But nevertheless, if the NHS was prescribing in bulk volume, as should be the case, then the cost would presumably come down and be much more affordable. But that’s not the case at the moment. I think it’s largely because of the really negative guidelines produced by bodies, including the British Paediatric Neurology Association, which I don’t agree with at all. There are more realistic, sensible, balanced guidelines I would say. But some doctors in the NHS are wanting to prescribe medical cannabis and have been stopped from doing so because of guidelines, and some are prevented from doing so by their hospital hierarchy who don’t want to go against certain guidelines for example.

And we’ve had recently one case has got through the internal NHS. The consultant wants to prescribe the Trust has said, yes, you can prescribe. It’s gone to NHS England for funding approval. And then it’s been stopped. So if you want a prescription on the NHS, you’ve got to get through three barriers: the consultant, the hospital hierarchy, and then finally, it has NHS England to approve the funding. Despite Matt Hancock, publicly saying he would make sure that there was no barrier to cannabis prescriptions on the grounds of cost, NHS England is refusing on the grounds of cost.

There are 1.4 million people using cannabis for medical purposes [in the UK], not recreationally, for medical purposes illegally, of course, plus more than that who don’t want to criminalise themselves. We’re looking conservatively at about 2 million people at least who would benefit from this medicine. And so far in their analysis the number of NHS prescriptions is just three. There’s 1,999,997 more people to prescribe on the NHS. So to say we have not yet succeeded in getting this medicine to be readily available is an understatement.

Richard Hurley: And where does that number come from, Mike, – 2 million, I didn’t quite follow that.

Professor Mike Barnes: So that was a survey done two or three years ago now. I think it was originally done by United Patients Alliance. It’s a figure that’s been sort of verified. Obviously it’s an illegal market, so you can never guarantee that figure. But I think it’s generally accepted as about 1.4 million people using cannabis medically, and then to which you need to add those who would benefit from it, with pain or anxiety or epilepsy who don’t wish to use it illegally at the moment. The figures roughly could say 2%, if you look at the countries where it’s legal, very crudely, 2% of the population benefit from cannabis prescription. So if we have a population of 66 million in this country you can comfortably multiply that by two. So the figures give or take, 1.5 to 2 million would benefit from this medicine.

Richard Hurley: Thank you. Great. Bradley, would you like to say something at this point about the change for patients, the law change?

Bradley Moore: What I can tell you is, for example, I think statistically Mike’s numbers are pretty much spot on, even when we look at Canada. So for example, in Q1 this year, we had 329,000 Canadians registered as medical cannabis patients. But when you actually look at the surveying around that, you can get a prescription, you can have a cultivation at home for a certain amount of plants, but the vast majority of people are still using off-the-books, illegal cannabis. And the real question about that is, why? Right? And so there’s a cost factor structure in there, but there’s also this irrelevancy of, you know, for example, and I’ll give this example last year, Q4, I got diagnosed with cancer and had to go through 27 chemo treatments and 27 radiation treatments.

And again, if you think that I wanted to add something for my post-treatment recovery, that wasn’t opioid based, I would’ve been delighted. The problem was finding somebody who could help me with that in Canada, in Vancouver, which is very, I’d probably say more open to it. And then the other thing is their knowledge base. There’s just a lack of information. And, from my perspective, there’s a lack of data. Lack of data drives lack of meaningful regulations. And I think what I’m hearing from both sides, on the other side of the ocean, the same thing is happening in the UK, right? So people will try to figure it out themselves. Especially if you’re looking at somebody who is a Mom, who’s in the suburbs, and has a child with epilepsy, I couldn’t imagine them trying to take something and put it into their system.

You know what, honestly, for what I was dealing with primarily the relief of pain, for radiation burns, I couldn’t sit down long enough to do the homework or the research. And there was whether I went and bought it at an illegal dispensary. Because we have legal over here, which are non-medical, or I went and I signed up for the Canadian Health Program. The information, what people knew was no different.

And that’s the problem, the person behind the counter, or the person prescribing, is giving me the exact same things. One might be covered by my health insurance, a private health insurance, and one is out of pocket. And I think for the way we perceive it, that’s the biggest problem. It’s information.

Richard Hurley: And do you think there’s a difference in the medical professions openness to prescribe cannabis then or acceptance of cannabis as a medicine in Canada compared to the situation in the UK? I mean, we all have the same data, don’t we?

Bradley Moore: Well, we all have the same lack of data – and I think that is probably something we can all agree upon. I mean, look, there’s a fundamental problem. We’re dealing with a plant, right? There are a lot of variances in there and we only know what we know, and once again I’m going to stand to the experts on these things, I’m just the data guy. We deal with the construct of what we’re given, but if we know what a certain percentage of the product does to our body, we know the other parts impacted. That’s still not enough unless you have a full data stream almost on a per-gram basis, like on a consumer to per-gram basis.

I’ve always been a big patient advocate and when you become the patient, it changes your perspective. It reinforces anything to one direction or the other direction. And one of the things that I found is, I went to a British Columbia cancer clinic and I asked them, I said, what do you think, I’m going to defer to the experts? You know, what their answer was. We just can’t tell you, we don’t know what to tell you, but we can tell you that morphine will do this for you. We can tell you that these three other things will do this for you. And in lieu of, trying to figure out I put it this way. I couldn’t imagine a parent. Even as a patient going through it and thinking, well, what if I have a seizure?

That’s what, Mike and Dr. Moore are saying, it’s the exact same thing. If it’s happening in Canada, guarantee a version of it’s happening in the UK as it’s happening in any state in the United States, as it’s happening in Israel, or it’s happening anywhere in the EU. And I think when the EU came out in Q4 2019, or Q4 2018, and said, we need to take it [cannabis] off schedule one, there was a big ‘but’ – ‘but’ we need more information.

Richard Hurley: Okay. Becca, have you noticed a change in the profession since 2018? What’s happened in the medical profession, are attitudes changing?

Dr. Rebecca Moore: I think they are changing, but I think I would say that it’s still very new. And I think that, you know, lots of people are really interested and really curious about this and want to learn more, whether that means they’ll end up prescribing, possibly not. But I think people are starting to really recognise that this is something that can be potentially helpful and that we’re gathering more data. I taught 500 GPs recently and over half of them said that they wanted to prescribe, but weren’t able to, for some of the process that we’ve already described. So I think there’s a lot of interest now for people to want to learn more and to prescribe. And I think also, certainly in the UK and I’m sure Canada, this is an area where the patient voices are so powerful and I think they are driving change as well. I think that’s brilliant because we need to hear their stories and their expertise.

Richard Hurley: Thank you. Thanks. So Mike, coming at the same question from a slightly different angle, why do you think the guidelines from the RCP and the paediatric neurologists, I can’t remember the word you used to describe them, but you know, you think they’re overly cautious or too strict. Why? I mean, why is that the case?

Professor Mike Barnes: It was a little bit of two or three reasons. I think the stigma around cannabis hasn’t permeated to the higher echelons of the medical profession. I think that’s one. But I think the main reason is actually that those bodies that have produced guidelines have looked at cannabis as a pharmaceutical product, and they’ve wanting it to jump through the pharmaceutical hoops. They want it to go through double blind placebo controlled studies. And they are just totally inappropriate for a plant. It doesn’t work that way, unless you take isolates, then you compare an isolate, say CPD with a placebo, but then you miss out what I think is, I don’t think can be argued now scientifically about the entourage effect, which means the whole plant is better than the sum of the individual components of the plant. So the whole plant works better. I don’t think there’s any doubt at all about that.

And of course, if you look at the whole plant with 140-plus cannabinoids and a hundred-plus terpenes, let alone flavonoids, you can’t in all honesty conduct a double-blind placebo-controlled study like you can with a single molecule pharmaceutical product. It just doesn’t work. So what you’ve got to do is look at what is now fashionably called ‘real world evidence’. That’s actually what it really does to the patient. And there’s a huge amount of data on observational studies and case studies. All of a sudden, of course, with COVID real-world data is finding some sort of traction and is meaningful. And looking at the vaccines, people are looking at real-world data, I think all this is fine, but when it comes to something like cannabis, all of a sudden it’s not fine.

And we still have to put it back into a pharmaceutical box. Cannabis does not fit into a pharmaceutical box. If you look at the real world basis, there is overwhelming evidence. I’m not one of these people who says cannabis is a cure for every known disease in any remote sense, but for certain conditions, there’s a lot of hard evidence behind it and that’s what these bodies don’t recognise, or don’t want to recognise.

Richard Hurley: You have to be very careful of observational evidence, don’t we? I mean, it’s, it’s prone to all kinds of bias and flaws.

Professor Mike Barnes: Yes, but you’re in danger of going down a pharmaceutical route, Richard, because you shouldn’t forget that there’s something like 165 million people, 165 million people who use cannabis every day in this world. And that’s a huge amount of safety data. Somebody at the Health Select Committee about 18 months ago said, this might be the next thalidomide –  complete and utter rubbish. Millions of people have used it for thousands of years. And we would know if it was the next thalidomide. So, a doctor’s concern has got to be patient safety. And I don’t think there’s any doubt on any parameter that cannabis is a safe medicine. It doesn’t kill people like opioids. The other parameter then doctors need to look at is whether it works. And we know it works on a real world basis for a lot of conditions, for a lot of people, maybe not everybody. Something like 80% of people who prescribed it for pain would have a painkilling effect. Something like 80% plus of those use it for epilepsy has a very useful anticonvulsant effect.

So, we know it’s working, we know it’s safe, and we’ve got to remember also that we’re not suggesting it’s a first line for anything, we’re looking at people who have reached the end of the road for let’s take pain medication. Nothing else is used epilepsy. They’ve used every anticonvulsant, there is nothing else is working. And in that situation, I think it’s verging on the immoral not to try something that we know is safe and we know works, or because it hasn’t jumped through a pharmaceutical, double blind placebo controlled study. We need more evidence.  We need more evidence, but for heaven’s sake, let’s use it for those who are suffering at the moment, now, with their pain or their anxiety or their epilepsy. That’s my view.

Richard Hurley: Thank you. Bradley, do you want to say anything more about data and evidence? Does that relate to what your company does?

Bradley Moore: I think, Mike nailed it, right? I think the facts are undeniable and I think you come up with a good question about the perception or the construct that somebody’s answering a question and how they answer it, or the environment, which the answer means is truthful or not. Right? If you’re sitting in a clinical study, I have just much propensity to lie to you about how I’m feeling versus having a conversation with Mike. And obviously there are different controls. So it’s the contract, when we sat down ‘x’ amount of years ago now we said, okay, how is this breaking? Cause I’m the kind of guy that had a lot of investments in cannabis and I was all excited.

And I just said, hanging a neon green or red cross and having some guy who’s used it for 30 years and who has to have a lot of THC in his system, if I’m walking in for the first time, and I’m not feeling well, and I want some advice. So it boils down to that aggregate data set. But you can’t discount that guy’s experience. But the point is to understand him in context of that. We run by a very simple kind of theme in the company. I had the good fortune of spending seven months in Israel in 2018 really digging into the Israeli model and how it works. And it’s so over controlled. I mean, you can’t even look sideways without getting caught doing something.

But there’s a lot of research and science going into it. And Israel’s is actually older than the Canadian program. But at that point in time, they only had 29,000 patients. Right? And so, it was very strictly controlled. And so the short end of it was, was to understand what happens with a person when they use a product, a specific product for a specific ailment at a given point in time, under a set of circumstances, if we can get to that and capture that, and then layer that information, then we can get to something we believe is average efficacy. And I use that term loosely and broadly, but if we get to an average efficacy, then we can start to at least have spectrums that further doctors can say, well, there’s a variance on either side.

But as Mike said, and I’m sure we all agree, when you have a product, a plant with variations, this is why you have to start looking at good manufacturing process or GCAC. So, for example the president of Canopy’s investment arms said that there are stricter controls for growing tobacco than there is for cannabis in North America. I mean, that’s crazy. So, you know, on the package of tobacco, we say you’re going to die, but in cannabis we don’t say what it will do for you. And there’s a gap. There’s a gap there on the manufacturer side, especially in North America or Canada. And there’s a lack of accountability on these things. All you have to do is look at Canopy, the largest grow in the world is under investigation by Health Canada for using “average labelling”.

So, they’re saying that there is supposed to be a test for THC and CBD ratios, and now they’re coming out. They’re saying, well, everything is 20%. Well, it’s not, it might be more, it might be less. And that’s a big problem. How as a consumer can you trust anything if it’s not even accurately labeled? And I think that’s it. That’s a huge problem. And it’s something that we need to look at. That’s just the nature of the evolution of the industry and it became more about money and less about patients. It’s about Becca’s patients and about the people that Mike works with. It’s about understanding what’s happening and you can’t discount that there are ways to self-monitor people.

I mean, we happen to use the blockchain because, you know, once you recorded on there, you recorded on there. It’s not going anywhere. My objective is to measure 128 million grams over two years. That’s, you know, on average 300 grams a year, that’s 400,000 patients. I mean, if we could pull that off, that would be the largest ongoing cannabis-type clinical study ever, you know?

And so, the idea is there are tools, but Mike nailed that, you can’t come at this the same way, because your start point is at the end point. There’s just basic common sense logic. It doesn’t mean you can’t come to the same conclusion. And I think that’s where regulators fall down. Right? And regulators fall down, you know. Even if it was two years ago, three years ago, even the head of the FDA in the United States said, we need to start listening to what people tell us more. And that’s it.

Richard Hurley: Okay, thank you, Bradley.

Professor Mike Barnes: And we do need to regulate the industry. I agree, just briefly, you know, this is an unlicensed medicine, and I think that producers have an obligation to make the product as good and as safe and as well labeled as possible, with proper certificates. We need much better quality of product and information about that product. Absolutely, absolutely right.

Bradley Moore: We give regulators meaningful data, then they can regulate effectively, and hold. And at the same time, if we have enough data, then we can create a feedback. We do something called seed-to-seed, not seed-to-sale. The idea and the construct behind that is important pushing information back to the grower. They want to sell more stuff. So they need the feedback and there’s ways to do it that don’t break HIPAA compliance or GDPR standards. The point around it is the answer is always in the data, we just have to get our heads wrapped around it.

It’s okay to come at this problem from a different way. And you know what, maybe thankfully, because it is cannabis it’s not medicine per se, as Mike said, because there’s no formulation, this is the opportunity to actually do it and start to move ourselves towards more personalised medical paths.

Richard Hurley: Becca, are you involved in research in your, is your clinic involved in any research?

Dr. Rebecca Moore: Starting to be. I think they’re starting to gather data.

Richard Hurley: You mentioned Project 21 before, and it’s Drug Science, isn’t it, David Nutt’s project? But could you just say a little bit more about that?

Dr. Rebecca Moore: Yeah, of course. People can register in it that have certain diagnoses, anxiety, PTSD, ADHD, and then they go through a program where they have regular follow-ups, regular screening. It tracks their response at one month, three months, six months, nine months with standardised scores and scales, which are called out from their original assessments. So identifies, which might be the best source to be tracking them on. And he’s like quality of a whole host of sort of global outcomes. And then also sort of patient perspective. It means that they can access some of the products, in terms of costs. So it’s really great as well, that would otherwise be excluded from accessing this as a treatment.

Professor Mike Barnes: Yeah. There’s 900 people on the T21 program now. So that in itself is a good quantity of data. And obviously by the means of the title 2021, the aim was to get to 20,000 patients. They weren’t at the end of this year, but it’s a major undertaking and we’ll produce some really interesting, meaningful long-term data. So I think it’s a great project.

Richard Hurley: Are you involved in research or data collection, Mike?

Professor Mike Barnes: I’m the Clinical Director of T21 now, so I’m involved in that research. I used to be involved a long time ago with Sativex. In the very, very early days Sativex was the first licensed cannabis medicine, which is a combination of CBD and THC licensed from spasticity in MS, made by GW Pharma. So I was involved with that right at again, that was perhaps 20 years ago. But not more recently until the 21 project, I moved into other areas of research.

Richard Hurley: Great. And Mike, what needs to happen next then? What should happen to help the patients who would benefit from access to medical cannabis? Is it more legal change? Is it a shift in the profession? Is it just about collecting more data? What needs to happen and how can that happen?

Professor Mike Barnes: That several things needs to happen. Yeah. The law is actually quite liberal in the UK and I don’t have any great problem with that. A doctor can prescribe for any condition for which he or she thinks there is the best interest of that patient. So that’s, that’s good. I think the only regulation change I would like to see is allowed general practitioners to prescribe. I think GPS, if I might perhaps oversimplify it to an extent, it will be very good cannabis providers. They tend to be a little more holistic than many of my consultants specialists. They clearly know the patient and the family. They know the nuances of that family dynamics. I think that’s all important when you’re dealing with symptoms and because many of the things that cannabis is good for like anxiety and pain are things that generally until you get to the severe, very severe end of the spectrum for within the GP parameters.

So, I think opening prescription to GPs would be really useful. I think other than that, it comes down to education and there’s a lot of ignorance and a lot of misinformation amongst my medical colleagues. And I think teaching doctors, even if didn’t want to prescribe, just so they can make a sensible decision, whether this is right for you, I don’t want to prescribe, but I know someone who can, you know? I’m not suggesting every doctor should be prescribed, but of course not, that would be silly. But I think we need good quality educational programs so that the doctors can learn about it, know that it is safe, know how to deal with it because it’s a plant. And a lot of doctors don’t understand what to do with a plant, let alone vaping for example, I mean, how many doctors have been taught about vaping and 60% of the prescriptions are for a vape.

So, I think I would put the priorities as number one education. I think Tony Blair said that, didn’t he? Education, education, education. So when you got down to number four, let’s get GPs to prescribe. And I think if you put those things together, we’ll be in a better place.

Richard Hurley: And you’re involved in some activities to improve clinicians’ education, I think, is that right? What else needs to happen?

Professor Mike Barnes: The trouble is in this country, the education of doctors falls to the doctor community itself. There’s not a sort of formal governmental body that can do it very readily. So at the moment we’ve set up the medical cannabis coalition society when the law change in November 18, we’re now got over 200 members and by definition, their clinicians and all doctors, pharmacists, and some nurses, but mainly they’re potentially prescribing doctors. So, having that peer support system is really useful because, okay, you can teach someone the basics in a day, is course, sure.

But then it’s more important for mentoring of those doctors and someone to ask questions off and someone to carry on supporting. Many of the clinics do that themselves, but the society also does that. So I’d like to see better training and the society does training. The academy of medical cannabis, now drug science does a monthly training session as well. And I’ve trained about a 100 doctors now.

Richard Hurley: They still aren’t prescribing?

Professor Mike Barnes: Some are. Some have come on that course. Well, there’s about 60, 60 as of yesterday, there was 61 prescribing doctors in the UK, and I’ve taught about a 100. So some come into the course quite rightly and totally a great, they want to learn more about it, but they don’t want to prescribe, and some are waiting to prescribe. I think we’ll up to about a 100 doctors prescribing by the summer. And when you think about it, you don’t need that many more than that. If you’ve got in every locality, one expert prescribing cannabis physician and other doctors educated to note when it might benefit people who can then refer to that local cannabis physician, I think we’ve resolved the problem. So I think probably 200 prescribing doctors in the UK, one or two for every hospital trust or CCG would be enough to cover the needs of many of the people in this country.

Richard Hurley: Thanks Mike. Becca, do you want to say anything about education? I think we have about five minutes left. So if you have anything to say on education and then I’ll get some final words from you all that would be great. Thank you.

Dr. Rebecca Moore: Yeah. I mean, I agree with what Mike said. I mean, I’d like to see more thoughts about this, even in medical school, more discussion about this in the nursing field of medicine and for people to be really talking about this. And I think I’d also say, for prescribers it’s important to have a care network of people around us. Because it actually quite frightening to be one of the first prescribers, because, you know, there are lots of colleagues who are not sympathetic, indeed quite critical. So, it did feel like quite a thing to be one of the first prescribers. What has happened is that prescribers are seeing the effects, which have been life changing in many, many patient cases. But I absolutely agree that education is key and I think, you know, that makes a huge difference.

Richard Hurley: And just some final words from you all, do you have anything else to add, Becca, that you’d like to talk about now or to sum up?

Dr. Rebecca Moore: I would just like anybody watching to get curious about this, to learn a bit more about it. Whether you want to be prescriber or not is not actually the issue, but actually there is a lot to learn. I think, it really is a great medicine for many people that have complex and chronic conditions where there’s interplay of pain and mental health. Just stay curious and open to it.

Richard Hurley: Bradley, do you have any closing words?

Bradley Moore: Yeah. I mean, first of all, it was a great discussion. It’s interesting to hear from the other side, you know, sitting over here in Western Canada, what’s happening in the UK. Look, I think it’s a multi-dimensional problem. It doesn’t start at one point and goes forward. There are attack points, you know, one of the big things we’re doing is we’ve applied for a non-possession selling license to put ourselves between the manufacturer and the consumer, and we’re going to educate the consumer. And we’re going to say, if you don’t know what this is, you shouldn’t take it. Therefore put pressure on the manufacturer. That’s uniquely-Canadian because of the way the system’s set up over here. But at the end of the day, somebody still needs to get educated, right?

And then if you put the demand, then you can start to create education over here. And we have to provide the tools and we have to provide tools all the way across from the consumer to a pharmacist, to a medical professional, all the way through to the regulator. And so, I believe the industry in itself. If you’re in Ottawa for example, you don’t know way less than a guy like Mike or some like Becca, who know what’s going on [in the UK]. So, at the end of the day, we’ve all got to come together to provide this information, right?

And then hopefully there’s adaption, and it’s just like all things it’s going to take time. But the points needs to be hammered home consistently. And if consumers at one point say, hey, I’m going to use this, but you need to do a better job at telling me what’s in it. Then that will do a lot to pull things through all the way, through patient advocacy. Patient advocacy is huge.

Richard Hurley: Thank you, Bradley. Mike, do you have any final words, just one minute now?

Professor Mike Barnes : Yeah. I just would like to emphasise that I’m not in any way, and none of us on the panel are saying in any way, that cannabis is some sort of magic cure. If you read, go on the internet, some people do say that but they are wrong. It’s just a very useful medicine for treating a lot of symptoms that otherwise medicine has let people down in the sense that there’s nothing else left. There’s no more painkillers to try, there’s no more anticonvulsants drivers, no more anti-anxiety drugs, or treatments to try, everything has failed.

We’ve got a good, safe medicine that doesn’t work for everyone, it’s not right for everyone, but for heaven’s sake, it’s there. It’s good. It’s useful for many people let’s just get out and use it and learn as we go along. And that’s what the doctors I think need to realise. Let’s sit safe, learn as we go along study what is a remarkable plant and let’s take it forward on them, use it as part of the normal medicine armoury.

Richard Hurley: Great. Thank you so much. What a fascinating conversation. Thank you to Dr. Rebecca Moore, Professor Mike Barnes, Bradley Moore. Thank you all. Thank you to Cannabis Europa.

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