‘should Never Have Been Prescribed’: Private Uk Cannabis Clinics Face Call For Tighter Regulation

Oliver Robinson felt he had exhausted accepted therapies erstwhile he near nan Priory, a backstage intelligence wellness installation wherever he was treated for slump and addiction betwixt 2019 and 2022. Initially he recovered alleviation from a caller benignant of medicine elsewhere. But by nan clip he took his ain life successful November 2023, aged 34, his medicine was making him worse.

In January, an inquest concluded that Robinson’s medicine for medicinal cannabis had “probably contributed to his death”. Catherine McKenna, nan coroner for Manchester North, besides ruled that his continued usage of nan prescription, first issued to him successful May 2022 by Curaleaf Clinic, a backstage cannabis provider, “acted arsenic an obstacle” to him receiving due psychiatric and addiction care. His family understand this to beryllium nan first ruling of its kind.

Now, Oliver’s brother, Alexander Robinson, is launching a run for tighter controls connected UK backstage cannabis clinics, including a prohibition connected prescribing to patients pinch superior intelligence illness, and greater oversight of a quickly expanding industry.

Alexander worries that others successful Oliver’s position could beryllium harmed by accessing medicinal cannabis. “If things do not alteration he is not going to beryllium nan last,” he said.

Medicinal cannabis was legalised successful 2018 aft nan mother of a young boy from Northern Ireland pinch terrible epilepsy had cannabis lipid she had brought from Canada seized astatine airdrome customs. The rule was changed truthful that cannabis-based medicinal products (CBMPs) could beryllium prescribed by doctors connected nan General Medical Council’s (GMC) master register.

Today, nan NHS typically prescribes only a mini number of licensed CBMPs – those approved by nan medicines regulator – for conditions specified arsenic terrible epilepsy, aggregate sclerosis and chemotherapy-related pain. Legally, master doctors tin prescribe cannabis-based medicines, including unlicensed products, successful NHS and backstage settings wherever they judge it clinically appropriate.

According to nan Care Quality Commission (CQC), nan healthcare regulator that oversees backstage cannabis clinics, astir products prescribed privately are unlicensed, meaning they person not been approved by nan medicines regulator. The authorities reported astir 5,000 NHS prescriptions for licensed CBMPs successful 2023.

Alexander Robinson believes others could beryllium harmed by accessing medicinal cannabis. Photograph: Graeme Robertson/The Guardian

Freedom of accusation data from NHS Business Services Authority showed location were 659,293 unlicensed cannabis products privately prescribed successful 2024, much than double nan 282,920 issued successful 2023.

About 80,000 group successful nan UK are thought to beryllium successful receipt of a backstage prescription. But location is limited evidence that cannabis is simply a suitable curen for depression.

“Under existent British National Formulary guidance, medicinal cannabis should not beryllium prescribed to personification pinch a history of terrible psychiatric disorder,” Dr Pavan Chahl, an master psychiatrist, told Oliver’s inquest. “There is simply a deficiency of grounds for efficacy successful slump and grounds it tin origin aliases worsen depression. On this evidence, Oliver Robinson should ne'er person been prescribed medicinal cannabis.”

Alexander argues nan safeguards are not beardown capable for susceptible psychiatric patients. “Oliver’s law” calls for a prohibition connected prescriptions for group pinch superior intelligence illness, mandatory consultation pinch NHS intelligence wellness teams, face-to-face assessments for analyzable cases alternatively than video consultations, tougher CQC oversight (including regular audits and publication of prescribing data), mandatory reporting of superior harms and clearer General Medical Council sanctions for unsafe prescribing.

Oliver had agelong struggled pinch his intelligence health. Once a successful spot developer successful his location municipality of Bury, he was treated for slump and debased temper by nan NHS and nan Priory, including 2 inpatient admissions, aft nan breakdown of his business and a relationship.

At nan Priory he was diagnosed pinch recurrent depressive disorder. He had been a cannabis smoker since nan property of 13, and addictive behaviours were identified arsenic a important facet affecting his mood.

After leaving nan Priory for nan 2nd time, he returned to utilizing cannabis aft uncovering an aged stash successful a drawer astatine home. “He wasn’t emotion happy, he tried immoderate and recovered that it gave him immoderate alleviation from his depressive symptoms,” Alexander recalled. Oliver told his relative that because of nan antidepressant medicine he was taking, smoking helped him entree his emotions successful therapy.

Oliver signed up to Curaleaf Clinic soon afterwards. In May 2022 he underwent a video consultation pinch Dr Urmila Bhoskar, a kid and teen psychiatrist, providing a GP summary that was 9 months aged .

After reviewing his case, Curaleaf’s multidisciplinary squad of clinicians agreed that “proceeding pinch a proceedings of aesculapian cannabis would beryllium appropriate”. Oliver received prescriptions for medicinal cannabis.

Doses of medicinal cannabis products tin beryllium particularly potent, containing up to 27% tetrahydrocannabinol (THC), nan psychoactive compound successful cannabis. Street cannabis is thought to incorporate betwixt 15% and 20% THC.

That summer, Alexander said, he began receiving calls from his mother astir Oliver, who was behaving violently. “She was panicked,” he recalled. “I’ve ne'er heard her that frightened before.”

Oliver would person blazing rows pinch his mother, raging against her disapproval of his usage of medicinal cannabis. “There were times she’d fastener herself successful nan bedroom,” Alexander said. “At 1 constituent he threatened to firebomb nan home.”

Police were regularly called to nan house. As Oliver’s behaviour became much threatening and destructive, his mother was classified arsenic a unfortunate of home abuse. Police recommended she return retired a restraining bid against her son. For nan last twelvemonth of his life, she did not spot him.

Now incapable to unrecorded pinch his mother, Oliver tried renting an Airbnb but was evicted because of his cannabis use. He began surviving successful a tent. He had mislaid his occupation and taken retired a payday indebtedness to money his prescription, which was now costing up to £1,000 a month. He was besides accessing thoroughfare cannabis erstwhile he could not spend nan clinic.

As his information worsened, Oliver (right) behaved violently towards his mother (left), who took retired a restraining bid against her son. Photograph: Family handout

Communication pinch family was fragmented. With Oliver now incapable to interaction his mother, Alexander and his begetter made judge to support channels open. But they were receiving abuse, too. Oliver had go fixated connected his medicine and aggressively dismissed anyone who challenged his belief that it was helping him.

“I person 11 months of emails and WhatsApp messages that are not my brother,” Alexander said. “They are nan angriest and astir vitriol-filled messages I person ever read.

“The adjacent 11 months were nan astir traumatic and hellish of my life. I knew he was successful nan utter doldrums, and successful changeless pain, and I knew he was struggling pinch nan depression.”

Oliver had told his family that his Priory therapist, Dr Justin Haslam, supported his cannabis use. After nan firebomb threat, Oliver’s family wrote to Haslam to corroborate what they were being told. He replied that he was “gravely concerned” and that he believed Oliver needed much acute attraction than nan Priory could offer, and referred him to NHS psychiatry.

That summer, Oliver began seeing an NHS psychiatrist successful Bury, who diagnosed bipolar disorder, slump and cannabis dependency. Oliver was referred to addiction services and warned that cannabis was contributing to his deterioration. He rejected nan test and refused to engage.

By November 2023, Oliver’s information had worsened significantly. “He starts sending maine videos of him attempting to trim his wrists pinch a blunt penknife,” Alexander said.

On 24 November, a family friend called to opportunity Oliver had been successful touch, telling them he was going to termination himself. It was not nan first warning. “We’d had respective that week,” Alexander recalled.

But this clip felt different. “He wasn’t showing online astatine all, which was different for him,” Alexander said. At 6pm, he received nan telephone to opportunity his relative was dead.

After nan inquest into Oliver’s death, nan coroner’s study group retired a bid of failings successful his care: prescribing decisions had been based connected “an out-of-date GP summary attraction record” and “incomplete information”; nan advisor psychiatrist “had nary advisor level acquisition successful treating big patients pinch Oliver’s analyzable presentation”; Curaleaf “did not pass directly” pinch Oliver’s NHS aliases backstage psychiatrists erstwhile they recovered retired he was receiving care.

A prevention of early deaths study has been issued by nan coroner to Curaleaf, which must respond by 23 April. It was besides sent to nan Care Quality Commission, which rated nan session “good” past year.

A CQC spokesperson said: “While nan coroner did not make CQC a named recipient of this report, we are reviewing nan study to see if immoderate regulatory action is needed.”

Curaleaf said successful a statement: “We statement nan circumstantial proposals group retired by nan campaign. Questions of regulatory argumentation are a matter for nan applicable bodies, including nan CQC, MHRA [Medicines and Healthcare products Regulatory Agency] and GMC. Curaleaf Clinic will prosecute constructively pinch immoderate reappraisal aliases consultation that intends to fortify diligent information crossed nan sector.”