Cannabis is a plant which grows really well in the UK, similar to growth of tomatoes. Cannabis has well documented therapeutic benefits, it can also have a pleasant “high” similar to the effects of alcohol. Like alcohol, overuse it can have adverse effects, particularly on young teenagers, so it’s in everyone’s interest to learn about and understand this extraordinary plant; “The Emperor” of all plants.
Cannabis seeds are not illegal in UK, as THC is not present and only appears in the bud towards the end of the outdoor growth phase. Choosing which cannabis seed to plant is like going into an off license and buying alcohol, there are hundreds of variations. Beer is about 4% proof, while whiskey and other spirits can be as high as 80%. In some countries, they sensibly get teenagers used to the effects of alcohol before they reach 18, by giving them diluted wine.
You would not want a teenager’s initial experience of alcohol to be with a strong whiskey and we should think the same about cannabis. Most drug dealers are selling very strong cannabis (Skunk) because the hit is obvious and fast and that’s what most newcomers want when they decide to rebel and start drinking or smoking weed. Who is going to be able to offer advice? All teenagers have heard is “say no” to all drugs, which is confusing when you consider the health problems created by prescribed opiates.
Parents can give some advice about alcohol, but know next to nothing about cannabis. Prohibition has never worked in fact, trade in unregulated alcohol in the US grew exponentially and had serious consequences for public health. As the trade in illegal alcohol became more lucrative, the quality of alcohol on the black market declined. I would make the same argument about black market cannabis where its easier for young teenagers to buy concentrated cannabis, than a glass of wine. But the very children who could benefit from a THC concentration as dilute as Calpol are being denied by people who know little about this extraordinary plant. Prohibition only benefits drug dealers and businessmen, keeps the price extremely high and restricts access to the people who would have a therapeutic benefit from consuming it. Different countries and states in US have different rules about cannabis consumption. Canada has embraced it 100% and I expect eventually most countries will take the view enforcment is too costly. In fact a woman named Carly Barton has started a campaign to allow people who would benefit from cannabis therapeutically to grow their own. She sufffers from Fibromyalgia and cannabis has transformed her life.
My relationship with cannabis
I am a child of the 60s & 70s, who had a privileged upbringing, 10 years at an Irish boarding school from the age of 7. I smoked cigarettes at 11, got drunk for the first time at 14 and smoked my first cannabis “joint” at 15; smoking and drinking at that age was not unusual for my generation. Trained as a PE teacher in late70’s and moved to Copenhagen in 1979 and was one of the pioneers of the fitness boom in the early 80s. There are few better places in the world to live than Copenhagen and if you were partial to an occasional cannabis joint, it could be bought without problems in Christiania. Fair to say I was a regular cannabis smoker until I stopped smoking cigarettes when I started to study chiropractic in 1991.
I would still have a few puffs if friends had a joint. If only for the amusement of listening to young friends like Malin and Cecelia, warning me that cannabis was a “gateway drug to heroin, (not that heroin or strong drugs ever had the slightest appeal to me). Cannabis did not appear to affect my cognitive ability, I was President of the Student Union for two years and gained a BSc in Chiropractic in 1996 and a Masters in Health Promotion in 2004. My private practice is based in Kingston upon Thames at Spinal Joint (no pun intended). I am writing a memoir at the moment called “Cancer Drove me up the Wall”
In April 2011, I was diagnosed with rectal cancer, had radiotherapy, surgery, and 12 cycles of chemotherapy and was given the all clear in August 2012. In August 2013 I was told the cancer had metastasised and was incurable, average life expectancy with chemotherapy was 22 months. I started chemo and was getting the same side effects as I experienced in 2011 and decided to stop as the prognosis was “death”. My consultant warned me that the cancer might progress rapidly without chemo and suggested more radiotherapy which shrunk the tumors. By coincidence the same week I received a text from a Danish friend suggesting cannabis oil instead of chemotherapy.
If I had £1 for every “miracle” cure that has been suggested to me, I would be a rich man. Nevertheless, I had nothing to lose. A friend sourced 60 ml from Canada and I consumed it over three months starting the week of the Brazil World Cup in 2014. It did not start well as the cannabis was very concentrated (Skunk) compared with anything I had tried before, but I have been clear of cancer since then. I could put forward may theories as to what happened starting with the Netflix documentary “Heal”;
The big difference from what I did in 2011 and what I did in 2014, was that I consumed 60 ml of cannabis oil and stopped chemotherapy. My consultants knew I was taking it, I wrote about it on FaceBook, but did not “promote” my story because I did not want to create false hope.
I am not or have been part of any campaign to legalise cannabis, I am not a member of any organisation connected with cannabis or chiropractic for that matter, in the words of the great Groucho Marks; “I would refuse to join an organisation that would have me as a member”. There are two main organisations campaigning for greater access to cannabis; “End Our Pain” and “United Patients Alliance”. There may be other groups out there and I wish them all well but I would rather stick pins in my eyes, rather than spend time trying to convince politicians, medical academics and journalists that the earth is flat. I am just sharing what I know about cannabis and people can take it or leave it.
Reported Therapeutic benefits of the cannabis plant
I remember the story of David Hibbit in April 2016 which filled me with hope; “Cannabis oil cured his cancer” then devastation to hear he died 13 months later. Nevertheless he lived 12 months longer than his doctors predicted. There was some hope and that has to be much better than no hope at all.
Its April 2019, I have bought the Daily Mail for the first time. They are not happy that the police are not bothering to take action against people consuming cannabis. I have gone way way beyond my cancer prognosis and am still clear. In scientific parlance my anecdode is an “outlier” in medical research, I believe I am alive because I was willing to break the law. The police were informed by the Paramedic in 2014 after I experienced psychosis having consumed too much, they knew I was not a criminal. I would probably need to live to 150 before the medical establishment would acknowledge that my surviving this long is amazing. Like everybody, I will die one day and it will probably be from cancer (as well as destroy cancer cells radio & chemotherapy cause cancer). My death will be the proof skeptics need to say there is only one way to treat cancer and its the medical way??
In March 2016, I was contacted by a mother named Hannah Deacon, She had been told I was taking cannabis oil and wanted to learn about it, as she had read it might help her son Alfie who had a rare form of epilepsy. This was news to me, but I did not think the oil I was taking was suitable for a child. At the time, I knew nothing about making the oil or how the concentrate “skunk” oil I was taking could be diluted. I promised to keep her in mind if I heard anything, as I was researching sources in Europe. One of my closest friends John Costeloe, had been diagnosed with a terminal brain tumor and we were looking for sources in Europe.
Amsterdam was the obvious place to start and at the Hash Museum in Amsterdam, I was told about an independent Pharmacy in the Hague, which was making Cannabis oil on prescription. I contacted the Transvall Apotheek and arranged a meeting with the pharmacist Arwin, a really nice guy, I told him my story, he was not surprised in the least. He explained the cannabis he was producing was very dilute, especially for children with epilepsy. A neurologist had observed benefits in a child whose mother had given her some and asked Arwin if it was possible to extract pharmaceutical grade oil to give to children in his care.
Arwin explained the process of extraction, which produced a very concentrated oil similar to the stuff I was taking and then he diluted this substance using a hypoallergenic oil and put into little drop bottles which were administered to children in drops under the tongue. What amazed me was the cannabis plants being used was imported from a farm in the UK? It was legal for businessmen to make money by exporting cannabis in UK, but British people are not allowed to consume it. A feminized seed costs about £5 From Royal Queen Seeds , the plant which takes 6 months to grow and grows like tomatoes, is worth about £1,000, to drug dealers and these growers because the plant is illegal. I bet a few politicians had a few nice treats for helping sort out those UK growing licenses.
I told Arwin about Hanah Deacon and Alfie and he printed off copies of all the research being done on cannabis on a range of conditions, especially children with epilepsy. Arwins oil was no use for my friend John, which we eventually got in Spain, but was just what Hannah was looking for and I contacted her as soon as I returned to UK and gave her Arvins contact details. She still had to convince family and friends this was an option for Alfie. In 2017 the family moved to the Hague and Alfie got a prescription and started taking the oil which transformed his life.
Legalisation for medical use
The family returned to UK in early 2018 and started a petition which was signed by 400,000 people, and subsequently was presented to Prime Minister Theresa May at 10 Downing Street in March 2018. May promised urgent action but the Home Office let it drift as soon as Hannah was out of the media spotlight. Then in June 2018 another boy Billy Caldwell had his oil confiscated at Heathrow airport and cannabis was back in the News. It was obvious listening to interviews, with Health Secretary Jeremy Hunt and Home Secretary Sajid David about Billy Caldwell, that they were unaware of the assurances Hannah had been given in March. On 19th of June Hannah spoke on BBC Radio 4 and the Victoia Darbyshire show and let the world know she felt let down by Prime Minister Theresa May. Her appearance spooked the Home Office into action and by the end of the day, Alfie was granted the first UK license for the medical use of cannabis. On November 1st cannabis was made legal for Medical use in UK. The letter to doctors states “Under the proposed new regime, all cannabis-based products for medicinal use apart from Sativex® (listed in Schedule 4 of the MDR and which has a market authorisation) would be unlicensed medicines”.
This is important because there is a “patent” on Sativex. It was developed by the UK company GW Pharmaceuticals as a “pharmaceutical product standardised in composition, formulation, and dose”. Its principal active cannabinoid components are: tetrahydrocannabinol (THC) and cannabidiol (CBD). Each spray delivers a dose of 2.7 mg THC and 2.5 mg CBD. That is an approximate ratio of 1/. In truth, you can’t “patent” something that grows naturally in the garden, you can get those exact same ratios in a plant for example “Medical Mass” from Royal Queen Seeds. Three seeds cost 24 Euros and would be ready to consume in October, if you planted now.
You could easily make the concentrated oil in your kitchen and dilute to taste. Then put the liquid in a spray like “Sativex” does, or take in drop form as the children with epilepsy are doing. To make the dilution with precisely 2.7mg of THC and 2.5 CBD you would need a spectrometer which is expensive and necessary for specific doses with young children. In countries where cannabis is legal, you can take your oil to a lab and they will tell you the exact ratios for 30 euros.
Bedrocan oil which many of the children with epilepsy are seeking is just less concentrated 2% THC, they acknowledge people can make it themselves. If it was my child that had epilepsy, I would get it from them. Ideally, you could buy it in the local chemist or on the NHS. If I could not afford their prices, I would make my own. and I would prefer them producing it than the pharmaceutical industry, which no doubt will buy the company before long. Bedrocan oil is not very concentrated, I would guess drinking an entire bottle would just make me a bit drowsy. Caile Blackwell gave cannabis to her son without a prescription and I am certain many parents are doing the same, but can’t say for fear of social services stepping in and putting their child into “care”.
Tilray is a Canadian company producing cannabis oil. It has three bottles with different THC/CBD ratios. 10/10 oil is similar to what I have described above “Each bottle of Tilray oil contains a target content of 400 mg total THC & 400 mg total CBD. THC & CBD levels vary by lot. For the purposes of calculating monthly allotment only, each oil bottle is equivalent to 5 grams of whole flower (Equivalency: 8 mL = 1 g dried cannabis)”.
I purchased my oil on the black market, probably not the most reliable way to get good quality cannabis oil. I judged it by sampling it from dealers I got to know in Spain who had a certificate from a lab. As the demand has grown people looking for bigger profits move in and there are many pitfalls from buying online or on the black market. If you cant afford it and to be sure of best quality, I would say grow your own cannabis and make your own oil. There are issues to consider with dose for children, I often got it wrong when I was self medicating but it was not a big deal.
Unlike Bedrocan and Tilray the pharmaceutical industry was not prepared for this sudden growth in medical cannabis and would wish to control the market, I suspect that’s why things are still moving slowly as one can see from the debate in Parliament on April 8 2019 , after another child Teegan Appleby had her medicinal cannabis confiscated after trying to bring it back to UK from the Hague. The government’s responses to single cases on this issue reminds one of the quote attributed to Joseph Stalin; “One death is a tragedy 25,000 deaths is a statistic”.
Listening to the debate in parliament I could only conclude; were ever so many words spoken by so many people who knew so little about the subjects they were talking about. Most of the MPs were doing their best to reflect the understandable emotions of their constituents, who are suffering, trying to access cannabis oil. Then you had “career politician” the Secretary of State for Health, Matt Hancock, who in 2018 was charged with promoting the government’s pro-technology credentials and is now lecturing MPs on “Evidence Based Medicine”??
“Evidence” in clinical sciences
To be fair to Hancock the use of the word “evidence” by politicians and PR people working in health care, only demonstrated the lack of understanding of David Sackets model of “Evidence-Based Medicine” (EBM) Early in development of the EBM model there were concerns that it might be a “dangerous innovation, perpetrated by the arrogant to serve cost cutters and suppress clinical freedom”, and you could say that was part of the reason for setting up. The “National Institute for Clinical Excellence” (NICE) in 2005. Politicians are able to pass decisions, rather than allow doctors to use their clinical judgment regarding whether cannabis would be beneficial for patients. NICE is often associated with controversy because the need to make decisions at a national level can conflict with what is in the best interests of an individual patient.
“Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research”.
Understanding this concept of “evidence” is crucial to advancing clinical science, which is way more complex and less predictable that physical science. For example, I can predict accurately that if I apply heat to water it will boil at 100C, but if we were to add other questions like how long will it take to boil, this would be dependent on “variables” like the source of the heat and how much water was being boiled. Human physiology has so many variables it is impossible to predict outcomes with any certainty. So statistical tests are applied to data collected externally, to help decision making for clinicians. Conclusions are based on the fact that an average person will respond in an average way. Thats how my 22 months were calculated, it was wrong, so obviously, this “scientific” research did not apply to me. We have all heard the expression “Lies, damned lies and statistics”.
Sackets model is based on three pilars: 1) The “best available external evidence”; in the UK, for use of cannabis to treat epilepsy, would be the case study of Alfie Dingle and any other children who have gone to Holland to get cannabis oil. 2) The experience of the doctor to apply the best evidence to a patient. The doctors caring for the children with epilepsy and observing the changes are now the clinicians with the “experience”. Unfortunately, prescribing cannabis-based products for medicinal use in UK is restricted to only those clinicians listed on a Specialist Register of the “General Medical Council”. So in Sacketts EBM model, these Doctors have little “evidence” and no “experience” to base their prescribing decisions on and presumably thats why only 2 children have received a prescription since it was legalised. 3) Patients beliefs and previous experience.
Fans of Joseph Heller will be reminded of Yossarian’s dilemma in the satirical novel; “Catch 22”. Yossarian knew he was mentally unfit to fly bombing missions to Germany in WW2. But the rule was if you were sane enough to ask a doctor to be relieved from duty, you were sane enough to fly, therefore there was no point in Yossarian going to the doctor. Or for that matter parents asking one of the 95,000 UK doctors Health Secretary Matt Hancock was referring to, when he said they want to prescribe cannabis for their patients, but are unable to because of “lack of evidence”. And you cant build an evidence base unless people are having cannabis prescribed. Only 2 NHS prescriptions have been issued in the UK, one to Alfie Dingley and another to Sophia Gibson. Two other children have got prescriptions privately which they have to pay for Billy Caldwell and Jorga Emerson which costs the family around £1,000 a month,which probably saves the NHS much more in ambulance and A&E costs.
Research has been performed by Dutch Neurologists, however from my time sitting on the General Chiropractic Council (GCC), I can remember when clinicians tried to defended clinical decisions in “Fitness to Practice Hearings”, using research from the US it was dismissed as not being in the context of UK health Care (jargon for not being politically correct) .
Yet with this paucity of even basic clinical evidence for the use of “medical cannabis” in the hierarchy of clinical evidence, Hancock is telling MPs and the public, that a Randomised Contol Trial (RCT) is being developed?? When the starting point would be an “observational trial” (case controlled studies), as suggested by the MP Nick Smith in the debate, the foundations of the hierarchy of evidence in “Evidence Based Medicine”.
To do a RCT you would need to give a placebo to some children chosen randomly in the trial. Would these proactive parents want to participate in a trial knowing their child might not get the cannabis oil that could help, when the child might experience uncontrolled seisures as a result?
Sackett understood the limitations of his EBM model and the pitfalls to be avoided and this comment is very relevant to the parents seeking cannabis oil for their children today
“Good doctors use both individual clinical expertise and the best available external evidence (published), and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient”.
That’s where people wishing to try cannabis oil are today and even though I have said I would rather stick pins in my eyes rather than get involved in the politics of health again, here I am expressing my opinions again. I am one of the few people to be kicked off a regulatory body “The General Chiropractic Council” for making public what went on at “Closed Meetings” and concluding the body was “not fit for purpose”; I doubt if the General Medical Council is much different.
Politics of the criminalisation of the Cannabis plant
The people involved in the campaign to have cannabis legalised for medical use have always believed their battle should be kept separate from recreational use. They were correct, insofar as their campaign has drawn attention to the therapeutic benefits of consuming cannabis. The campaign got feet in the door and has achieved much more than I expected, but cannabis should not be left to industries with only a profit motive. In my opinion, now is the time for a change in strategy. The campaign should be broadened to recreational use to involve more stakeholders in the discussion and bring more pressure to bear on the “Home Office”, drug dealers and business men hoping to make fortunes from cannabis estimated by some at £106 bn. In December 2018, Altria, the parent company of Marlboro and other American tobacco brands, invested $1.8 billion in Cronos Group, a Canadian cannabis company. We must not leave decision making in the hands of people who know little about cannabis and are unlikely to seek advice from people they have been criminalising during the last 50 years.
Right now in charge of the process of broadening access to the oil of the cannabis plant, is Chief medical officer Dame Sally Davis. It’s as if Mary Berry was put in charge of building a house on the basis of cake mix, being a bit like cement. Reading her bio, I would guess she avoided cannabis users like the plague at university. Then there are politicians like Bill Clinton who wanted to appear that they were openminded enough to try cannabis, but “did not inhale”, or David Cameron who,like me,was a regular cannabis user in his youth, as were a number of British politicians Then they get into positions where they could influence the debate, but political expediency trumps knowledge and rigorous science every time and allows fear and ignorance to permeate. Former Drug Czar David Nott stated the reclasification of cannabis by Gordon Brown in 2009 was to please the editor of the Dail Mail rather than on the basis of science.
Of course, I feel sorry for people who go to extremes to self medicate with drugs or alcohol to make their lives bearable after started using these substances socially to loosen up. To blame access to these substances for the social problems they create is a denial of the deeper rooted social issues in these peoples lives and let’s face it. people are encouraged to medicate children with sythetic toxins from the day they are born.
Last August I was a guest on Good Morning Britain debating my approach to children’s health with Dr Hillary Jones. The presenter Kate Garroway in exasperation asked me “Why do you think you know more than the doctors”? I gave my cancer story as the answer and they were not interested, why did you not medicate your children like we all do, was the agenda they were pushing. I could have said no one has a monopoly on knowledge and certainly not medical doctors who were advising people to take up smoking in the fifties to relax.