When most people think of cannabis, they tend to think of dubious street dealings and pungent-smelling illicit cannabis factories.
Paul Neale spent years on heavy doses of pharmaceutical prescription medications including morphine, but he said medical cannabis was the most effective medication he’d tried, and that it had changed him as a perso
While recreational cannabis is still illegal in the UK, a law change in 2018 stipulated that patients could be legally prescribed medical cannabis on condition it was via a registered specialist.
For those struggling with chronic pain, insomnia, epilepsy or anxiety disorders, a legal cannabis prescription can be life-changing, particularly when conventional medicines have failed. One person who knows this better than most is Paul Neale, a 46-year-old dad-of-two living in Morriston, Swansea.
Paul has been medicating with legal cannabis since 2019 and said he was the first person in Wales to receive the prescription. Accessing cannabis through the NHS is, however, notoriously difficult, leaving Paul with little choice than to pay private. Y
He said: “I was the first person in Wales to be prescribed legal cannabis. I suffer with post-traumatic stress disorder, borderline personality disorder and ADHD. Five years ago, I was diagnosed with a rare bone disease in my neck and spine called DISH (diffuse idiopathic skeletal hyperostosis), which is chronic pain all the way through.”
There’s a hidden community of middle-class professionals growing their own cannabis in garden sheds, cupboards and the Welsh wilderness.
Before being prescribed cannabis, Paul tried a huge range of pharmaceutical medications including MST, amitriptyline, gabapentin and morphine. He said: “Before medical cannabis, I was prescribed 100ml of morphine every week. It came to the point where I was just drinking it for fun.
“I came to cannabis through my step dad. In March, 2018, we found he had stage four cancer. We heard so much about how cannabis can benefit people who have cancer, so my mum spent quite a bit of money buying it. Sadly, he passed away before he could try it, so I used a bit of the oil and it ended up working really well.
“After trying the oil, I contacted a clinic in Lancashire for a legal prescription, but they wouldn’t accept me because I had PTSD. I then contacted Sapphire Clinic and I sent them over my GP summary of care. Not long after, I went up to Harley Street Clinic in London and met the pharmacist. I told him all about my past and what I’d been using – all completely transparent. The board assessed and approved the prescription and that was that. I just burst out crying. My wife was sitting next to me. Three years later, I’m here, making the best of it.”
Since medicating with cannabis, Paul has been able to come off a number of prescription medications he was taking before, including the morphine. He said: “In the last 18 months of receiving a medical cannabis prescription, I’ve been able to come off the morphine and diazepam, I’ve cut down on my anti-depressants and sleeping tablets. I can go out and do a day’s work, I’ve got a life. This flower has saved my life.
“When I was on morphine, I’d be zonked out, rubbing my face, gouging. I had no life, I didn’t want to be around my children. Now, I can go and play football with my 10-year-old son. And now that it’s a legal prescription, I have no anxiety about taking the medicine. My in-laws are very anti-drugs, so at the beginning they were a bit sceptical about it. Now that they’ve seen the improvement in my health and what I can do on this medicine, they support me. They’ve seen me zonked out on the sofa not wanting to do anything on my previous medication, being a bad dad, but now I’m genuinely the best dad I can be.”
Paul said his new medicine had meant he could finally enjoy a decent Swansea City game at the stadium, too, adding: “I’m a season ticket holder, but when I sit down, I get stiff. When that happens I just ask the steward if I can go out to take my medicine, and when I say it’s medical cannabis, there are no problems. It’s weird, but it’s changed my life. I do tell youngsters who smoke it now to be careful because it will have lasting effects in years to come. If you do it right though, through a doctor, it can be a life-saver.”
The NHS only prescribes cannabis in times of ‘exceptional clinical need’. This includes conditions such as severe treatment-resistant epilepsy, multiple sclerosis and chemotherapy-related vomiting.
Paul said that paying for his prescriptions had “taken his life savings”, but the cost had come down massively in recent years due to his participation in clinical research. He said: “I am now part of the Sapphire Access Scheme, so I upload my data and report how I feel and how I’m sleeping. It’s part of a university-led study. I’m massively proud to be part of it, and it cuts down the costs.”
The man leading the research at Sapphire Medical Clinics is Dr Simon Erridge. Dr Erridge is also a junior NHS doctor in North West London, and is an honorary clinic research fellow at Imperial College London.
He said: “There is a huge unmet need when it comes to treating chronic pain and anxiety disorders. Chronic pain impacts 25-50% of us at some point in our lives, and around 25% of us will suffer with an anxiety disorder. There are medications for both of those conditions, but many will have refractory symptoms, side effects, or symptoms that just aren’t well controlled.
“The six published studies we now have show improvements in health and quality of life in all patients we see, particularly in patients with chronic pain and anxiety. They also show improvements in self-reported sleep quality and self-reported anxiety symptoms as a by-product of their treatment.
“The largest proportion of patients we see have chronic pain of some description. This can be inflammatory-type pains such as arthritis, it could be fibromyalgia, or it could be pain that’s secondary to cancer or endometriosis. The second biggest cohort of patients we see have anxiety disorders such as generalised anxiety disorder, panic disorder or social anxiety. We have published our outcomes on anxiety patients, which show a reduction in symptoms of anxiety from moderate to mild after six months of treatment. We do also treat neurological conditions as well as psychiatric conditions such as post-traumatic stress disorder.”
Dr Erridge explained that the human body had its own cannabinoid system that was acted upon by cannabinoids already within the body. He said: “There are two main types of cannabinoid receptors in the body. Cannabinoid receptor one is mainly in the brain and spinal cord, and cannabinoid receptor two is mainly in our immune cells. These receptors are acted upon by cannabinoids within our body that look very much like THC (tetrahydrocannabinol), which bind to receptors and cause similar effects as those that we derive from the cannabis plant when in sufficiently high concentrations.
“Most people know about CBD (cannabidiol) and THC, but there are a number of other compounds in the plant that have a wide range of targets within the human body. The fact that they have this multitude of targets really means that there’s a broad spectrum of conditions that we can use it in. I can’t think of a real parallel in modern medicine in terms of [medical cannabis] being used across so many conditions.”
He added that, as a requirement for treatment at their clinic, they had to see their GP summary of care record so they knew the full history of the condition they were treating them for, but also any other conditions. “Every decision to prescribe is made on a case by case basis, and every patient is discussed with a multidisciplinary team – whether it’s with a psychiatrist, a neurologist or any other relevant specialist.”
Image: Unsplashed, 2H Media