Despite mounting evidence to suggest cannabis is a viable treatment option for minors with autism spectrum disorder, Australian parents are still struggling to access it despite its nationwide legalisation for medical use in 2016. What are the roadblocks patients face there when seeking cannabis as a treatment option? Do things look set to change? And as the U.K. becomes more open to medical cannabis, are we facing similar difficulties in accessing it here?
Medical cannabis is legal in the U.K. However, only specialist physicians prescribe it on a case-by-case basis. Only patients with certain health problems are likely to be prescribed medicinal cannabis in England, according to the NHS. At this point, cannabis is not a treatment for people with A.S.D. in the U.K.
We attended the Autism Spectrum Disorders Webinar hosted by Medical Cannabis Research Australia (MRCA). Their mission statement is simple; they educate, advocate and research the use of medical cannabis in Australia. A panel of doctors and experts who prescribe cannabis to treat the symptoms of children with autism spectrum disorder and other developmental comorbidities spoke about the latest research and their patients.
Additionally, two parents of children with a range of developmental issues including ASD also spoke about their experiences of using medicinal cannabis as part of their children’s treatment plans.
Medical cannabis legality in Australia
The Australian parliament amended the Narcotic Drugs Act on February 24, 2016, effectively legalising cannabis for medicinal and scientific purposes; despite this fact, Australia's medicinal cannabis patient population remains very small.
If the product has been legal to cultivate and use for medical purposes for the past five years in Australia, why did people speaking at the webinar and those in attendance seem to have so many problems accessing cannabis as a treatment? There seem to be several factors.
Two questions that kept appearing from attendees were; how do I convince my partner about cannabis as a treatment option. Also, how do I get my doctor to investigate it or prescribe it to my child? The answer to this question comes from the same place; a lack of knowledge and stigma associated with medicinal cannabis in both the medical profession and subsequently, the wider community.
Lack of knowledge and stigma
The Australian medical community does not know enough about the potential benefits and the conditions medicinal cannabis treats. Doctors are uncertain about the format in which to administer the medication (for example, pill or liquid form). They are also uncertain of the appropriate dose to prescribe and for how long it should be given.
A lack of general guidelines for marijuana products creates an information barrier on how to use this treatment. Physicians are more likely to prescribe registered medicines that have been rigorously tested and proven to be high quality, safe, and efficient than one they’re unsure of.
“Look, change is always slow,” said Dr Barbara James. A child and adolescent psychiatrist and psychologist who uses evidence-based therapies in the Melbourne area.
“There is still a stigma with cannabis in the medical community. It’s a case of educating those who can prescribe medical cannabis.”
“And as more people worry about the outcomes of highly dosing their children on antipsychotics, opiates and benzodiazepines, we see people start to look at other options.”
“Events like this and organisations like the MRCA are certainly helping,” she continued.
“I do believe at some point, medical cannabis won’t be the last resort treatment. It will become the first port of call as a possible treatment option for developmental issues. And we will start to see more licensed practitioners in Australia (currently only licensed practitioners can prescribe cannabis as a treatment).
Prohibitive costs in Australia of medical cannabis
Another major roadblock to cannabis treatment for ASD is the price. Most health practitioners who prescribe cannabis are private practitioners. Cannabis is not covered by Australia’s Pharmaceutical Benefits Scheme (PBS).
These are two extremely large out-of-pocket costs according to Catherine, Mum to nine-year-old Carter who has ASD, cerebral palsy and Ehlers-danlos syndrome.
“It’s stupidly expensive. But for us, it’s worth it,” said Catherine.
“We spend between $800 to $1200 a month between specialist appointments and prescriptions. And we found our current doctor ourselves. The paediatric specialist we saw at our children’s hospital under the public system, removed his support of the treatment because of the red tape involved.”
“The progress Carter has made since using cannabis has been amazing. He sleeps through the night now. His progress has been phenomenal. Don’t get me wrong, he still has autism but he seems better able to cope with the symptoms now. And we were able to take him off some of the very serious medication he was on.”
There is no “standard” pathway to access medical cannabis in Australia. Clinical trials, special access schemes, and licensed prescribers are the only access routes to cannabis treatment right now. For people like Catherine, who’ve come to rely on medicinal cannabis to improve her son’s and her families quality of life, the hope is that access will become easier and costs will come down.
In the U.K., a similar lack of knowledge and political will to embrace cannabis as a treatment for serious developmental and neurological disorders most certainly exists. Since its tentative legalisation in 2018, cannabis as a treatment has been slow to take off. Has the time come to embrace the myriad ways in which medicinal cannabis could potentially be effective in the U.K?