FAQ: Medical cannabis in the UK

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Will I feel high using cannabis medicines?

As cannabis medicines come in a range of formats with varying proportions of THC, CBD and other cannabinoids, this will depend on the product you are using and the dose. With regular use, many patients build up a tolerance to THC which allows them to get effective relief from symptoms while avoiding the intense ‘high’ that new users may experience.Your doctor will advise a ‘start low, go slow’ approach to make sure that you are using the lowest dose necessary and to make sure that you are comfortable with the effects you experience before moving to a higher dose if required.If you are concerned about psychoactive effects, your doctor may prescribe an isolated CBD product or a medicine that contains either a balanced or higher amount of CBD. Evidence indicates that CBD counteracts some of the psychoactive effects of THC and can reduce the likelihood of the user experiencing negative side effects

Can I drive while taking cannabis medicines?

As with all medicines you should not drive if you feel that your reactions may be slowed by the medication. It is legal to drive while taking cannabis medicines and you cannot be convicted for purely having cannabinoids in your system - but if you fail a test and are shown to be inebriated (such as being unable to walk in a straight line), you may be charged.

Can I go to work while using cannabis medicines?

There is no official guidance or legislation in the UK yet around medicinal cannabis and working, therefore patients with a medicinal cannabis prescription can work.Medicinal cannabis will affect patients in different ways and as a result patients may be warned about undertaking tasks at work such operating machinery or equipment.

Can you overdose on cannabis?

While it is physically impossible to die from a cannabis overdose (you would have to consume around 40,000 times the standard amount!), you can over-consume it which may lead to an uncomfortable experience. You might experience physical or emotional discomfortor you may just feel very tired. It is important to remember that undesirable side effects will slowly subside until they disappear, usually within a few hours.You should record details about the dose and type of product you consumed and the negative side effects you experienced so you can discuss this with your specialist at your next follow-up consultation.

Can I vape medical cannabis in public?

Yes, so long as you are not smoking it you are permitted to vaporise your prescribed medical cannabis in public. It is advised that you are able to present the label on your medicine and a form of identification to demonstrate your prescribed status.

Can I travel with cannabis medicines?

You can travel within the UK with your cannabis medicine, but it is advised that you be able to present evidence if requested to prove your prescribed status. The label on your medicine should be sufficient alongside a valid form of photo identification. Before you make a journey overseas, you should confirm with customs or the embassy in your country of destination that is it permitted to bring your medicine. This will depend on the destination you are travelling to.

Will I get withdrawal if I stop taking cannabis medicines?

Yes, but the symptoms of cannabis withdrawal are not as severe as those associated with opiate use. Cannabis withdrawal symptoms include3:• cravings• difficulty sleeping• mood swings• irritability• restlessnessFor those with medical conditions there may be other unexpected outcomes of suddenly stopping any treatment. Patients may experience a return of symptoms. For those with severe neurological conditions (such as pediatric epilepsy), there may be other, more severe, outcomes. These patients’ medication should not be stopped without the advice of their prescriber.

What are the health implications of vaporising medical cannabis?

In the UK, cannabis flower must be vaporised rather than smoked. You may be concerned about the health risks of using a vaporiser, especially after hearing of instances of vaping-related lung disease in 2019. It’s important to note that none of the cases of Vaping-Associated Pulmonary Injury (VAPI) involved vaporising cannabis flower.Cannabinoids like THC and CBD are activated by heat. A dry-herb vaporiser heats the flower at a lower temperature than smoking, creating vapour instead of smoke. This reduces exposure to combustion products and may be safer than smoking. Some cannabis vaporisers have been approved as medical devices, and have proven their safety through robust supporting clinical and technical studies.If you are unsure about vaporising and/or have had issues with your lungs in the past there are other options available including capsules or oils.

What is the difference between cannabis medicines and CBD on the high street?

CBD products that can be bought on the high street, in pharmacies and online without a prescription are supplements, not cannabis medicines. CBD products are widely available, and come in a range of formulations or strengths. However, there are several important facts to know about CBD supplements. • CBD high street products are regulated as supplements rather than medicines. This means that no medicinal claims can be made about the products. • Over-the-counter CBD products are made from hemp, a low-THC variety of cannabis that is grown outdoors and has been used for centuries as fibre for textiles.CBD-containing medicines are made from pharmaceutical-grade cannabis that has a higher cannabinoid content and is grown under controlled conditions.• The strength of CBD supplements varies, but they do not typically provide as high of a CBD content as a prescribed CBD-based cannabis medicine will. • The quality of CBD supplements can be variable. Unlike cannabis medicines, CBD supplements have not been produced to pharmaceutical purity, quality and safety standards, and there is no guarantee that a product actually contains the amount of CBD that it says it does.

The Centre for Medical Cannabis (CMC) tested 30 CBD oils available in the UK in June 2019 and found that 11 of them contained less than 50% of the advertised CBD content, with one product containing no CBD at all. • CBD supplements are not allowed to contain any level of THC. However, the CMC found that 45% of the CBD supplements they tested contained trace amounts of THC, making them technically illegal in the UK. • In many cases, cannabis medicines containing some level of THC (even if very low) are considered to be more effective than CBD-only medicines. Only prescribed medicines can contain THC in the UK. After a thorough consultation, a specialist doctor can prescribe a medicine with varying proportions of CBD and THC depending on your condition and symptoms.• CBD is considered a ‘novel food’ in the UK, which means it needs to go through an approval process to show that it is safe to use in food. From April 2021, the type and range CBD products available in the UK may change, as only companies with an ongoing safety review of their CBD products will be permitted to remain on sale. It is thought that over one million people in the UK use CBD oil and many report great benefits from doing so. However, CBD supplements are not medicines, and should not be used as treatment for serious medical conditions or a replacement for visiting a healthcare practitioner when needed.

Credit: OpenCannabis