Cannabis can­not be pre­scribed safely

The Oban Times - - Letters -

Sir, On Oc­to­ber 15, 2016, the SNP con­fer­ence backed a mo­tion to de­crim­i­nalise cannabis for med­i­cal us­age. An im­pas­sioned speech was made for pro­gres­sive so­cial jus­tice which sought help for those in chronic pain. The only ques­tion­ing del­e­gate was jeered.

Savi­tex is the medic­i­nal cannabis which has al­ready been made avail­able in Scot­land for peo­ple with mul­ti­ple scle­ro­sis. It was sanc­tioned by the Scot­tish Medicines Con­sor­tium de­spite the lack of a con­vinc­ing ev­i­dence.

The SNP pol­icy to de­crim­i­nalise cannabis for med­i­cal use in chronic pain would be dif­fi­cult to im­ple­ment. Sur­veys re­port 20 per cent of the Scot­tish pop­u­la­tion are in some form of chronic pain. Would the NHS have to grant li­cences to those judged to be in chronic pain?

En­cour­ag­ing the smok­ing of de­crim­i­nalised cannabis plants would have con­sid­er­able im­pacts on pa­tients, even if the drug it­self was pur­chased at the pa­tient’s ex­pense. Cannabis smok­ing has a pow­er­ful ad­verse ef­fect on the lungs and causes chronic ob­struc­tive pul­monary dis­ease even more ag­gres­sive than to­bacco.

Large quan­ti­ties would have to be smoked to al­le­vi­ate the phys­i­cal pain. The ‘free’ drug to the NHS would ac­tu­ally cost about £60 a month per pa­tient in in­halers for the lungs dam­aged by smok­ing cannabis.

The SNP is al­ways keen to learn from the Nordic ex­pe­ri­ence in pol­icy de­vel­op­ment for a healthy Scot­land. The ev­i­dence base for the harm­ful ef­fects of cannabis comes from a study of Swedish Army re­cruits which showed cor­re­la­tion be­tween cannabis us­age and later psy­chosis.

Cannabis-in­duced psy­chosis is very se­ri­ous for the in­di­vid­u­als af­fected for life and their fam­i­lies. De­crim­i­nal­is­ing cannabis for med­i­cal use would risk a mas­sive in­crease in cannabis psy­chosis.

To­bacco-based cig­a­rettes have re­quired taxes for so­cial con­trol. Or­gan­ised crime has now moved into the sup­ply of tax-free cig­a­rettes as a re­sponse to ad­dic­tion.

If un­taxed medic­i­nal cannabis be­came freely avail­able, would cur­rent to­bacco smok­ers switch to cheaper cannabis?

Fu­ture spend on NHS drugs in an in­de­pen­dent Scot­land would have to an­tic­i­pate a re­quire­ment for longterm anti-psy­chotics and in­halers.

I am sure those who voted for the de­crim­i­nal­i­sa­tion of cannabis for med­i­cal us­age in SNP pol­icy did so to em­pathise with Scot­tish cit­i­zens in chronic pain. How­ever, the con­se­quences to the na­tion’s health would be con­sid­er­able.

Cannabis can be ad­dic­tive and causes psy­chosis. It causes chronic lung dis­ease in most peo­ple. There is no med­i­cal ev­i­dence base that it is an ef­fec­tive drug for treat­ing chronic pain.

Cannabis im­pairs driv­ing more sig­nif­i­cantly than many painkillers. We have just man­aged to crack down on drink driv­ing. This pol­icy risks go­ing back decades in road safety with a med­i­cal ex­cuse.

NHS Scot­land poli­cies seek to en­cour­age self- care and pa­tient au­ton­omy in all chronic dis­eases, in­clud­ing pain. How­ever, the SNP pol­icy to de­crim­i­nalise cannabis for med­i­cal us­age would only en­cour­age more de­pen­dency among Scot­tish cit­i­zens and stop the de­vel­op­ment of per­sonal em­pow­er­ment in deal­ing with chronic pain.

Dr James Dou­glas, Seafield Gar­dens, Fort Wil­liam.

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