Daily Archives: March 5, 2019

Cannabis Based Medicine

It was decided that from November 1st 2018 Cannabis based medicine would be able to be prescribed by UK specialist clinicians. before the law changed it was extremely difficult to get a prescription for Cannabis based medicine. It was a big step forward when in 2018 a review into cannabis based medicine was announced by the Home Secretary, Sajid Javid this then led to a change in the law allowing it to be prescribed. Unfortunately many people are still finding it hard to access this treatment. it was announced that it would only be available to those with exceptional clinical need’s and that only specialist clinicians would be able to prescribe this medication not GP’s. Another issue was that there was no licensed Cannabis based medicine products in the UK for epilepsy yet. All of these things already made it hard to access the medication. These clauses were put in place to make sure that only those people in critical need of the treatment got the medication. Evidence of effectiveness and safety of some Cannabis based medicines in epilepsy is still quite limited.

There is some good news for the effectiveness for one part of the Cannabis plant- Cannabidiol (CBD). This is the part of the plant which does not cause the effect of a high. A CBD medicine ,under the brand name Epidiolex is now approved for use in the US and a decision is expected for European Medicines Agency later this year. However the evidence for Epidiolex focuses on Dravet and Lennox-Gastaut syndromes in children. Evidence for its use for other conditions and in other age groups is limited.

The British Paediatric Neurology Association (BPNA) guidance has focused on Cannabis-based medicines in severe epilepsy in children. It is recommended that Cannabis-based medicines be used only as a last resort. All other available licensed medicines need to have been tried without success. The Ketogenic diet must have either been tried unsuccessfully or not be suitable. Epilepsy surgery must also not be suitable. If these conditions are met the BPNA only recommends prescribing Epidiolex. It does not recommend Cannabis oil or any other Cannabis-based medicine.

Later this year the National Institute for Health and Care Excellence (NICE) is expected to publish its own guidelines for specialist clinicians. Epilepsy Action is a registered stakeholder with NICE and is engaging with them around the guidelines through the formal consultation process. Once they are published, these guidelines will replace the guidance which is currently available.

There have also been concerns about current access to Epidiolex. This is the only Cannabis-based medicine recommended by the guidance, but the guidance is still very restrictive over its use and the fact that it is not licensed yet and the high costs associated with it are also creating a problem in terms of access. Later this year this medicine is expected to be licensed for prescription in the UK. When this happens accessing the medicine should be easier but its high cost could still be a barrier when trying to access this treatment. Steps have been taken towards makint this treatment more available in the UK but there is still more that needs to be done. With the expected Epidiolex licence and the new guidelines from NICE on the horizon the situation is likely to continue to change in the next year and organisations like Epilepsy Action are working hard to make this medication more accessible to people who need it.
Source Epilepsy Action.
For more information about this new treatment go to epilepsy.org.uk/epilepsytoday

Employers and the Equality act

Employers should not refuse a person with epilepsy a job because of their condition without having a very good reason. But jobs in the Armed Forces are not covered by the Equality Act 2010. This means you can be refused a job in the Armed Forces if you are diagnosed with epilepsy. There is more information about work and your rights on the Epilepsy Action website.
The Ipswich Epilepsy Support Group have free leaflets about people working with epilepsy if you would like one please phone our helpline on 01473461407.
Source Epilepsy Action.

Pregablin and Gabapentin to be reclassified as Class C drugs

The UK government announced last week that Pregabalin and Gabapentin will be reclassified as class C under the misuse of drugs act 1971. This change will take place in April 2019. Class C is the third in the goverment’s three tier system for categorising controlled substances with the least amount of harm compared with those in class A or B. These drugs are used to treat conditions like epilepsy, nerve pain and anxiety.

The Home Office has said these medicines will still be available for legitimate use on prescription by a doctor after the change in the law. These changes mean that doctors will now have to physically sign prescriptions rather than use electronic copies. The medicines will have to be dispensed within 28 days of the prescription being written. The changes mean it will be illegal to possess these medicines without a prescription. It will also be illegal to supply or sell them. This is an effort towards stronger controls accountability and a reduction in the potential for misuse of these medicines. The concerns of these drugs relate to misuse of the medication’s. This may include taking them if you don’t have a prescription or taking them in a way not prescribed by your epilepsy specialist.

The goverment’s decision to reclassify these medicine follows experts highlighting a rising number of deaths linked to their misuse. However according to researchers from the University of Bristol more than four in five deaths(80%) involved the misuse of these medicines alongside street drugs such as Heroin.

This is not the first medicine used for epilepsy to be classified as a class C drug. Midazolam and Diazepam used as emergency medicine for prolonged seizures have been listed as class C for around 30 years.

If you have any concerns about your medicines you can speak to your GP or epilepsy specialist. You can also call the Epilepsy Action helpline free on 08088005050.

source Epilepsy Action.