On November 1st 2018, the United Kingdom legalized cannabis for medical use. Unfortunately, despite years of waiting, the country wasn't ready for it.
"It's a huge step forward, to say 'we're going to allow people to get the medicine they need,'" cannabis entrepreneur Cosmo Feilding told Civilized. "But, without a regulatory framework in place, there is still much that needs to be done before a patient can actually gain access."
Cosmo is the son of Amanda Feilding, who founded the Beckley Foundation—a charitable trust and think tank dedicated to researching psychoactive substances and studying evidence-based drug policy from around the world.
In 2017, Cosmo and his mother set up a joint venture with the Canopy Health Innovations (a wholly owned subsidiary of the Canopy Growth Corporation) to form the UK-based Beckley Canopy Therapeutics. The new company was created to take the cannabis produced by Canopy Growth through clinical processes in order to formulate them into pharmaceutical products.
"Basically, our goal was to take medical cannabis to the next step towards full clinical validation," said Feilding. "Which is something that doctors and regulators are crying out for around the world."
This, of course, was two years ago—and the legal status of medical cannabis in the UK has changed a great deal in that span of time.
"Last year, there was a groundswell of public outcry about the fact that patients in severe need were being denied access to cannabis," Feilding told Ciivlized. "In particular, there were these cases of two children with severe epilepsy where cannabis was able to treat them, and the UK government was denying them access to the medicine that they needed."
Partially in response to the mounting controversy, as well as the evidence of successful medical cannabis program seen in the US and Canada, the UK moved to reschedule cannabis from a Schedule I drug to a Schedule II. Under its previous classification, cannabis was officially listed as having no medicinal value. Now, thanks to this change, the substance can finally be prescribed to patients, under certain circumstances.
Although, as Feilding explained, the current system is far from perfect.
"This is something that the Beckley Foundation and other organizations have been looking for decades," he said. "Then, suddenly, within the span of a few months, the UK government went from being completely resistant to suddenly saying 'OK, we're going to change this.'"
"It happened very, very quickly—which is amazing, but the speed of change has thrown the regulators off, putting them in a difficult position."
In the US, the division between state and federal laws make it so some states have been able to slowly implement their own regulatory bodies surrounding medical cannabis, despite it being banned at the federal level. In the UK, however, it went from being totally illegal to being permitted across the entire country, despite there not being any system for implementation in place.
The speed of change left regulators scrambling to create an effective framework. Feilding explained that while there is a slow trickle of patients beginning to secure medical cannabis in the country, it not an easy process.
"Right now, it is prescribed as an 'unlicensed' medicine by specialist doctors," he said. "But because there are still major hurdles that exist, the number of prescriptions is still very low."
Based on this demand from patients, doctors, and even regulators in the country, Beckley and Canopy decided to extend their partnership to create a second venture, Spectrum Biomedical UK, a distribution company intended to "make safe medicines available as quickly as possible in the country," where Feilding serves as managing director.
"For us, the next stage is to become a mainstream medicine that doctors can be comfortable with, and that is based on evidence," he said.
While Spectrum is a commercial venture, given the previous restrictions on medical cannabis, much of the research and development being done at the company will likely go on to inform UK policy as the industry begins to take shape. They don’t pretend that their medical system exists in isolation, however.
"We don't have to reinvent the wheel here," Feilding told Civilized. "This has been done, successfully, in other countries. But, at the same time, each country has their own unique peculiarities and idiosyncrasies."
"The medical system in Canada is obviously one that we look to, and how that has worked. I hope the regulators are also looking to these countries to determine the positives of these systems—but also the mistakes—so that one doesn't have to create a medical industry as if it's never been done before."
On the topic of isolation, Feilding said that the messy political situation surrounding Brexit right now is unlikely to have any major effect on cannabis in the country.
"In some sense, it's kind of a Brexit-proof problem," he said. "Because, as a controlled substance, we don't have the benefit of free trade."
While one might assume that, based on the UK's decision to reschedule cannabis, the country would now be looking towards legalizing recreational use as well. But, as Feilding tells Civilized, that hardly seems likely any time soon.
"We only legalized medical cannabis just a few months ago," he said. "So recreational isn't even a consideration at this time. We're solely concerned with creating a functional medical system."
He added, "The market is still very much in its infancy. But, at least there is now a chance for there to actually be one."
And hopefully regulators will move fast to ensure that patients can access that new market.