The UK's legal cannabinoid sector 'needs to work to develop trust' and give 'more freedom' to the likes of pharmacists, a review of how the UK can become a leader in cannabinoid innovation has determined.

Medical use of cannabis, when prescribed by a registered specialist doctor, was legalised in November 2018, but 'this market has evolved by accident, without coordinated government action or a coherent strategy to steward it to maturity,' The Hodges Review has found.

The review of the UK legal cannabinoid industry, led by Oxford University's Professor Christopher Hodges, was commissioned by the Centre of Medicinal Cannabis and the Association for the Cannabinoid Industry, and has particular regard to how public policy and regulation can support the sector’s growth and development.

The report, launched today, argues that 'the UK’s legal cannabinoid sector needs to work to develop trust, and more freedom should be given to the trusted actors already in the market - prescribers, pharmacists, regulated suppliers, government-funded trial sites and licensed researchers.'

It says 'building a responsible medicinal cannabis sector requires regulation, but it should also be based upon a level of trust with the parties involved in dispensing and supplying the product to patients.

'Through existing licensing rules, and the inspection regime of the CQC, the companies importing and distributing CBPMs [cannabis-based products for medicinal use], as well as the doctors and pharmacists prescribing and dispensing such medicines, already occupy a position of trust. It therefore adds unnecessary cost to their operations to treat them like they are not already trusted members of a professional, certified, licensed and inspected supply chain.'

The report also acknowledges that 'it is unlikely that the public or politicians will agree with the assertion that cannabis presents no harms,' but that 'it is a question of balance and of adopting proportionate regulations that are designed with the risks in mind.' It is also about 'taking into account the strict medicinal access channel that has been created and the trusted actors  - specialist doctors, registered pharmacists, licenced suppliers and transport companies - that are permitted to handle and supply it,' the report says.

The review suggests licensed suppliers of CBPM should be permitted 'to utilise mainstream, trackable, signed-for delivery options to reduce the cost to patients of private CBPM prescriptions,' arguing that, 'with auditable records of licensed pharmacists and new rules requiring child-safe packaging, it is no longer necessary to require expensive controlled drug couriers for delivering CBPMs to patients.'

Among 20 recommendations made by the report was the need to establish an agency to provide oversight and guide the sector.

The review also concluded that GPs should be allowed to prescribe medicinal cannabis, advocating the rollout of a national trial for GP-prescribing of CBPMs, with systematic data collection to inform future guidelines.

It may be that such prescriptions, when issued in the private or public system, would need to involve patient enrolment in a national registry to help gather real world evidence, it added.

The review noted a new survey of public attitudes has found that one in five (19%) respondents personally know someone whose health has benefited from medicinal cannabis.

And 63% of respondents would be supportive if a family member was taking medicinal cannabis to address a health condition, with only 8% saying they would be somewhat or very opposed to it.

Two-thirds of respondents said GPs should be allowed to prescribe medicinal cannabis with 37% saying they would trust their GP to prescribe such treatment.

The report concluded that both regulators and industry have an obligation to cooperate to steward this new industry and support it to develop in an innovative but also safe and responsible way.

Professor Hodges, emeritus professor of justice systems at the Centre for Socio-Legal Studies at the University of Oxford, said:‘It is no longer wise or sustainable for the government to continue to take a distanced, disinterested or laissez faire attitude to the sector as a whole, as it has done since the cannabis sector’s inception.

‘The seeds are there for rapid growth but it cannot happen without a clear strategy built upon coordinated Government stewardship and the ambition to not just tolerate, but actively nurture the sector to expand and mature, so it attracts more investment, jobs and innovations, and secures political support and public recognition.’