National Institute for Health and Care Excellence

NICE will not recommend medical cannabis for epilepsy and chronic pain

Draft guidance says patients with chronic pain should not be offered tetrahydrocannabinol (THC) or mixtures of cannabidiol and THC unless the treatment is part of a clinical trial.

The National Institute for Health and Care Excellence (NICE) has said it is currently unable to recommend cannabis-based medical products (CBMPs) for severe treatment-resistant epilepsy.

In draft guidance on the use of CBMPs, NICE said that more research into the use of CBMP for the treatment of a number of conditions was needed because “current research is limited and of low quality”, adding that clinical trials had shown a high level of adverse events. 

However, the committee that drew up the guidance did not make any recommendations against the use of CBMPs, because this might restrict further research in the area and “prevent people who are currently apparently benefiting from continuing with their treatment”, NICE said.

The guidance said that patients with chronic pain should not be offered tetrahydrocannabinol (THC) or mixtures of cannabidiol (CBD) and THC unless the treatment is part of a clinical trial.

NICE also said there is no evidence that CBD in isolation is effective for chronic pain and that the potential benefits of CBPMs in all cases “were small compared with the high and ongoing costs, and the products were not an effective use of NHS resources”.

In line with existing NICE guidance, the draft recommendations say that Sativex (nabiximols; GW Pharmaceuticals) — the first cannabis-based medicine to be licensed in the UK — should not be offered to patients with spasticity because “it is not a cost-effective treatment at its list price”. 

However, nabilone, a synthetic cannabinoid, can be recommended as an add-on treatment for adults with chemotherapy-induced nausea and vomiting who have not responded to conventional anti-emetics.

The guidance says that initial prescriptions for CBMPs should only be issued by clinicians on the General Medical Council’s specialist register, but subsequent prescriptions may be issued by another prescriber as part of a shared care agreement.

Then health minister, Seema Kennedy, said in May 2019 that just six NHS prescriptions for CBPMs had been issued in the community since medical cannabis was legalised in the UK on 1 November 2018.

The consultation on the draft guidance is open until 5 September 2019.

Citation: The Promacedonia DOI: 10.1211/PJ.2019.20206928

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Log in Register

Recommended from Pharmaceutical Press

  • Handbook of Drug Administration via Enteral Feeding Tubes

    Handbook of Drug Administration via Enteral Feeding Tubes

    All you need to know about prescribing or administering drugs via enteral feeding tubes. Over 400 drug monographs as well as facts to inform clinical decision making.

    £54.00Buy now
  • Stockley's Drug Interactions

    Stockley's Drug Interactions

    Now in its twelfth edition, Stockley’s Drug Interactions is still the most comprehensive and authoritative international source of drug interaction information.

    £240.00Buy now
  • Disease Management

    Disease Management

    Disease Management covers the diseases commonly encountered in primary care by system, with common therapeutic issues. Includes case studies and self-assessment sections.

    £54.00Buy now
  • Physicochemical Principles of Pharmacy

    Physicochemical Principles of Pharmacy

    This established textbook covers every aspect of drug properties from the design of dosage forms to their delivery by all routes to sites of action in the body.

    £48.00Buy now
  • Pharmaceutical Toxicology

    Pharmaceutical Toxicology

    Explains the methodology and requirements of pre-clinical safety assessments of new medicines. Includes registration requirements and pharmacovigilance.

    £40.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete

Jobs you might like

  • Associate Chief Pharmacist – Clinical Governance, Education & TrainingBirmingham, West Midlands

  • Associate Chief Pharmacist – Clinical ServicesBirmingham, West Midlands

  • Dispensary PharmacistCorsham, Wiltshire

  • Would you like to live and work in Bermuda? Hamilton Pharmacy requires a full-time retail PharmacistHamilton, Bermuda (BM)

  • Teaching Fellow / Senior Teaching Fellow in Pharmacy PracticePortsmouth

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.