Findings raise doubts about possible expansion of Medical Cannabis Access Program (MCAP)
Ireland's Health Research Board (HRB) has published the results of its review of evidence regarding the safety and effectiveness of prescribed medicinal cannabis.
Mixed Results for the Medical Cannabis Access Program
The report, published on Tuesday January 23, found evidence supporting the use of medicinal cannabis prescribed for some conditions currently approved in Ireland, including cancer-related nausea and vomiting and multiple sclerosis-related spasticity.
Significant benefit was also seen for neuropathic pain, often associated with conditions such as multiple sclerosis, diabetes or spinal cord injury.
However, for most other conditions, including anxiety and pain in conditions such as cancer, rheumatic diseases and fibromyalgia, the report states “lack of conclusive evidence” regarding the effectiveness of medicinal cannabis. prescribed.
Safety of Medicinal Cannabis: Between Benefits and Side Effects
Regarding the safety of prescribed cannabis, the review found that although serious adverse events appear to be infrequent, some side effects such as dizziness, dry mouth, sedation and headache can occur.
Evidence regarding other adverse events, such as drowsiness, nausea, and psychiatric disorders, is mixed.
Impact on the Medical Cannabis Access Program (MCAP)
This study was conducted as part of the Department of Health's ongoing review of the Medical Cannabis Access Program (MCAP). Currently, only patients suffering from one of three qualifying conditions can access cannabis-based medicines through the program, which launched in 2019.
Dr Kathryn Lambe, HRB researcher and lead author of the report, said: “Our review indicates that there is evidence to support the use of prescribed medicinal cannabis for conditions such as nausea and vomiting due to chemotherapy, spasticity in multiple sclerosis and management of neuropathic pain.”
Recommendations for Future Research
The study, covering a 30-year period on the use of prescribed medicinal cannabis by adult patients, evaluated evidence from 47 reviews, covering several medical conditions.
The authors concluded that the research reviewed was “fragmented” with a “low degree of certainty in the evidence for most findings.” They made several recommendations to improve the quality of clinical data on medicinal cannabis, including analyzes for different types of pain and the use of modern treatments as active comparators rather than placebos.
Impact on Future Policies
According to the report, the findings will inform the Department of Health's position on the suitability of cannabis products for various clinical indications, as well as future responses to communications regarding the prescribing of these products.
HRB Chief Executive Dr Mairead O'Driscoll highlights the importance of informing health policy based on the latest evidence, even in areas where existing research is not sufficiently developed to draw on robust conclusions.
A “Lack of Opportunity” According to Some
The Medical Cannabis Access Program (MCAP) has been criticized for its “restrictive” nature, with fewer than 100 people believed to have enrolled in the program so far. The results of the HRB review cast doubt on possible expansion of the program.
Patient advocates express disappointment, pointing out that he did not include real-world data or consult the Irish patients who report benefits from medical cannabis, many of whom traveled abroad to access it.
Natalie O'Regan, legal researcher and drug policy advocate, said: “The HRB report highlights the need for more detailed analysis of medical cannabis. In 2024, we still hear about 'the need for more research' as a reason not to expand access. The report failed to engage with current MCAP patients and missed the opportunity to collect real-world data that is available at their doorstep. Ultimately, it is patients who will suffer the consequences of limited access to medicine that they may find invaluable.”
She adds: “A positive point was the discovery of evidence supporting medical cannabis for neuropathic pain, which I hope will be expanded in the near future.”