Despite the 2018 rescheduling of cannabis-based medicinal products, millions continue to navigate the murky waters of illicit cannabis use for the management of chronic health conditions.
These landscapes are full of challenges, stigma, and legal inconsistency in a way that highlights a disconnect between progressive policies around medicinal cannabis and outmoded enforcement paradigms.
Illicit cannabis is used by many in the United Kingdom to control chronic health conditions.
For example, 6.38% of those with a diagnosed health condition reported use of illicit cannabis in a study of 10,965 UK adults by Erridge et al.
That is a staggering statistic, meaning there are around 1.77 million adult users of such substances in the UK. Such users suffer primarily from anxiety, chronic pain, fibromyalgia, PTSD, and multiple sclerosis.
On the other hand, demographic characteristics found to be associated with increased illicit cannabis use were younger age, male gender, in London, and not working or part-time employment.
The current legal status, which is supposed to allow for medical cannabis, is still far from acceptable, and people who feel they need this medication must resort to illegal sources.
The Prevalence and Demographics
The most commonly reported mental health condition among current illicit cannabis users is anxiety, with 775,782 affected individuals. Other highly reported conditions include chronic pain, fibromyalgia, PTSD, and multiple sclerosis.
Of the number of people who have multiple sclerosis, a very high 38.31% resort to using illicit cannabis to manage their symptoms.
The demographic profile reveals a skewed landscape. Essential users are young adults aged 18-24. Even in the case of health reasons, more men were seen to use illicit cannabis than women; 55.20% of the respondents were male.
The employment status again forms an essential criteria, with many users being in full-time or part-time employment. These figures unmask the fallacies associated with the existing legal regime and the desperation that is pushing individuals to opt for illegal cannabis consumption.
Barriers to Legal Access
And yet, even if CBMPs are to be rescheduled again, the inaccessibility of treatments using this drug is just daunting.
The study by Erridge et al. shed light on why people prefer to use illegal cannabis. The most common reason, given by 40.75% of the interviewees, was the difficulty in acquiring CBMPs legally. High costs, the demand for fast treatment, and low awareness of the legality of CBMPs augment the issue.
Alarmingly, 49% of those using illegal cannabis had never discussed CBMPs with their GP or specialist doctor. Lack of discussion denotes the deep stigma and disinformation that has characterized medical cannabis use.
On the one hand, many healthcare professionals appear to be legally constrained and not trained well to offer guidance and support to patients inquiring about CBMPs.
Human Health Risks and Societal Implications
Illicit cannabis use is fraught with risks and extends beyond an individual’s health to societal impacts.
Illicit cannabis will often contain harmful contaminants, including pathogenic bacteria and fungi, heavy metals, and pesticides, all of which are associated with significant health risks, particularly in immunocompromised persons and those with chronic lung diseases.
What’s more, this form of involvement feeds the business of organized crime and makes vulnerable individuals even more susceptible to it.
Courts across England and Wales have convicted 162,000 people for drug possession over just the last decade, with Black people over represented among those targeted by these practices of policing.
Systematic over-policing entrenches these social inequalities and keeps cycling more criminalization and marginalization. The rigid, outdated legal framework fails to address these broader societal harms; reform is urgently needed.
Is There a Path Forward?
Such multifarious problems deserve a drastic amendment of the ongoing policies.
There is a requirement for greater access to CBMPs, both in terms of awareness and knowledge about their legal position and benefits among the patients and healthcare service providers, as well as appropriate investment in research to establish their efficacy and safety through randomized controlled trials.
Affordability and accessibility issues need the focus of policy interventions. It is the role of the NHS, in this area of intervention, also to have a central role in the affordability of CBMPs, thus reducing financial burdens on the patient.
Reducing the possible harms of illegal cannabis use as a result of free access will simply mean improvements in the health outcomes of patients who suffer from long-term ailments.
A Call for Policy Overhaul
The cannabis laws in the UK are archaic relics that set themselves against the new knowledge that views cannabis as a valid medical intervention for a plethora of health concerns.
Policymakers must realize the need to urgently move to harm reduction approaches, including full decriminalization of cannabis possession, investment in vital public health campaigns, and creating an environment where patients feel free to discuss CBMPs without any stigma and fear of legal consequences.
This current situation is well beyond unacceptable, and has been for many years.
It’s estimated that 1.77 million people using illicit cannabis are not criminals but rather patients in need of relief. It’s high time the legal framework reflects this and puts patient welfare above old draconian laws.
The continuation of such illicit cannabis use in the management of chronic health conditions within the UK is a clear indication of crucial failures in both the current legality and healthcare provision.
Tackling these challenges, therefore, will need to be met with a more robust and multi-pronged solution composed of legal reforms, better education, and research.
In prioritizing these measures, we would reduce reliance on illicit cannabis and improve significantly the quality of life for people with chronic health conditions.
