June 18, 2018

expert reaction to home office decision on Billy Caldwell

This roundup was sent out on Saturday 16th June 2018 and was in response to the Home Office over its refusal to release medicinal cannabis oil that it had confiscated from the family of a severely epileptic boy. Several hours later, the government reversed this decision and issued the boy in question a license to be treated with the oil.

Dr Tom Freeman, Senior Academic Fellow at King’s College London, said:

“Billy’s tragic case highlights the urgent need to remove cannabis from its current schedule 1 status – implying that it has no medical use. The compassionate decision of the Home Office to return Billy’s confiscated medicine following the intensification of his seizures illustrates how this legislation is unfit for purpose. Removing cannabis from schedule 1 would facilitate the treatment of many more young people experiencing debilitating symptoms like Billy. It would also help scientists to develop new and more effective cannabinoid-based medicines for a range of other conditions.”

Prof David Nutt, The Edmond J Safra Chair and Head of the Centre for Neuropsychopharmacology, Imperial College London, and founder of DrugScience, Independent Scientific Committee on Drugs, said: 

“Good news – the Home Sec has agreed to let Billy Caldwell have his cannabis medicine in hospital for 20 days. This may not seem a great concession but it could be a landmark decision as it concedes the medicinal value of cannabis oil.  But it has further implications  because Billy will not be cured in that time and won’t want to spend his life in hospital in order to be treated. The government will therefore need a new strategy, which I would suggest should be to move the control of drugs from the Home Office whose only policy response is prohibition, to the department of health who at least have the competence to evaluate medical claims. There will be many other people in the UK  with severe epilepsy who are likely to benefit from medical cannabis and provision must be made to stop them suffering brain damage and death from cannabis-treatable seizures.”

Clare Pelham, Chief Executive of the Epilepsy Society,  said: 

‘We congratulate the Home Secretary on his compassionate response. This is a complex area that requires further thoughtful consideration and Epilepsy Society looks forward to supporting the Government in this important work.’

Dr Amir Englund, Post-doctoral researcher in Psychopharmacology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London said:

“There is now strong evidence from several randomised controlled trials that cannabidiol (CBD, a non-intoxicating cannabis compound) has anti-convulsant effects in rare forms of treatment-resistant epilepsies with minimal side effects, where 3-5% become completely free of seizures. A high dose of CBD is required for this, where studies have shown 20mg CBD per kilogram body weight per day to be needed (significantly more than in currently available products).

Also THC (the main active compound of cannabis and the one causing intoxication) has shown to have anti-convulsant effect in some animal studies and a few reports in patients with epilepsy. Clearly, there is evidence from his treating physicians that Billy’s medication works for him where others have failed.

The duty of government is to protect its citizens from harm with regulations on medicines so that the ones doctors prescribe are safe and effective. However, there are instances which these measures become counterproductive and harmful. This is such an instance, and the Home Office should allow an exemption so that he does not come to further harm.”

Dr Michael Bloomfield, Clinical Lecturer in General Psychiatry at UCL, said:

“I think this should be a matter for the child, his family and his treating doctors and current legal framework is impeding that. I think that on the one hand the current laws are too strict – preventing careful supervised prescription of similar products in special cases in this case (if indeed his doctors agree with that and I haven’t seen any statements from the hospital to confirm this – only from the family). On the other hand – the issue of “medical marijuana” is far from straightforward and any “medical marijuana” needs a scientific evidence base in the form of medical trials etc – which is currently lacking for many disorders and has become for many jurisdictions a potential way of decriminalising cannabis through the back door in way that may be associated with reductions in the perceived harm of the drug and increased heavy use and dependence on adolescents and young adults who are most at risk of the harms associated with heavy cannabis use.”

Prof David Nutt, The Edmond J Safra Chair and Head of the Centre for Neuropsychopharmacology, Imperial College London, and founder of DrugScience, Independent Scientific Committee on Drugs, said: 

“Billy’s case is a classic example of multiple failings because we don’t have a joined up drugs policy. Cannabis to oil is a medicine in many countries but not in UK. A Dutch boy with Billy’s diagnosis could bring his oil into UK but Billy can’t because the home office say it is not a medicine and I keep it in schedule 1. So even though it clearly has revolutionised his health, so is for Billy a proven medicine,  no UK doc can prescribe. Absurd inhumane and the product of a failed 50 year prohibitionist approach to recreational cannabis that has actually increased use harms and denied medical progress”

Declared interests

None received.