How does the approval of Scotland’s first medical cannabis clinic fit into Holyrood’s drugs policy agenda?

The news that Scottish patients will have greater access to a drug whose treatment potential has been obscured by drug laws for decades comes at a time of intensified calls for evidence-based change, writes Andy Gregory

A worker checks a young cannabis plant at a medical cannabis farm near Skopje (Robert Atanasovski/AFP via Getty Images)

Regulators have given the green light to Scotland’s first medical cannabis clinic, marking another significant step in the hard-fought battle to ensure those who require such treatment can access it legally.

As of yesterday, patients with an array of conditions beyond the slim few currently catered to by the NHS will be able to book appointments at Sapphire Medical Clinic in Stirling, where physicians can now prescribe cannabis flowers and oils for ailments such as chronic pain and anxiety.

Such access was hailed as a “lifeline” by one anxiety sufferer, while the mother of a child with severe epilepsy told the BBC: “It is a step in the right direction and it means finally there will be a safe path for scared parents to take.”

Following a series of high-profile campaigns, medical cannabis was legalised in the UK in 2018.

According to NICE guidelines, a slim variety of cannabis-based medicines are currently available on the NHS, but only for those suffering severe epilepsy, multiple sclerosis and chemotherapy-induced nausea. Discretion lies ultimately in the hands of local commissioning groups, and some patients have struggled to access the cannabis-based medicines they need as a result of these barriers.

Now those living in Scotland’s central belt will have a wider, albeit financially impactful, route of access to medical cannabis for a host of conditions, which Sapphire’s managing director Dr Mikael H Sodergren says will “significantly” contribute to the evidence base for a range of cannabis therapies, as currently is the case with thousands of their patients in England.

While the Scottish Government says it has no influence over prescribing, the decision by the independent regulator, Healthcare Improvement Scotland, to approve the clinic comes in a period in which political pressure over drug-related deaths has seen the focus on drugs policy significantly intensify in Scotland.

Describing the clinic’s approval as “very welcome”, David Liddell – CEO of the Scottish Drugs Forum – told The Independent: “In a broader context there is a growing confidence in Scotland and elsewhere that has seen drugs and drug treatment based firmly in evidence and a willingness to make decisions which would at one time have been viewed as controversial.”

While medical cannabis is clearly its own distinct clinical issue, the decision accompanies a sense of shifting attitudes among Scottish politicians, media and electorate towards substances demonised for decades and how the state should treat those who use them, with Holyrood notably moving to declare drug deaths a “public health emergency” in 2019 rather than a criminal issue – a move Westminster still refuses to take.

Holyrood has long been accused of using Westminster’s hardline approach as political cover for inaction, but recent months have seen the SNP respond substantially to growing pressure to seek out and enact evidence-based solutions in the face of Europe’s highest rate of drug-related deaths.

Stirling MP Alyn Smith’s response to Monday’s news somewhat echoed this growing call for politicians to prioritise evidence over long-established orthodoxy, as he wrote on Twitter: “Good to see an evidence-based approach to the use of cannabis-based medicines and treatments. I’ve been contacted by numerous constituents on this topic, and I’m pleased Stirling will be host to Scotland’s first regulated business in this space.”

Elsewhere, the gears of change are in motion after years arguably spent in neutral – with first minister Nicola Sturgeon in January announcing a landmark £250m in funding as part of a “national mission to end what is currently a national disgrace”.

This includes pledges to take actions to overhaul a treatment system frequented by a desperately low proportion of people with problematic drug use in Scotland – some of which Holyrood had previously cited as having been blocked by Westminster and sitting outside the reach of its devolved powers.

Notably, in a sign of new willingness to engage with the issue head-on, Ms Sturgeon promised to take another look at how Holyrood can overcome the legal barriers to opening safer drug consumption facilities it has long argued are insurmountable as a result of Westminster law.

Most recently, the Scottish Parliament last week lent its unanimous support to a number of new measures aimed at reducing drug deaths, including a plan for a country-wide network of heroin-assisted treatment clinics.

And on Monday, SNP MP Tommy Sheppard published a Private Members Bill aiming to push the UK government to implement the recommendations of the Scottish Affairs Select Committee’s 2019 inquiry, including decriminalising possession of small amounts of illicit drugs – all of which Westminster previously rejected out of hand. The Scotsman reports the bill has support from MPs across the political spectrum.

These steps, prefaced by the resignation of public health minister Joe FitzPatrick in December following criticisms of inaction, also follow some fairly seismic shifts in Scotland’s media landscape in recent years, with the Daily Record coming out in favour of decriminalising drugs on its front page in 2019 – a position adopted nominally by the SNP just months later.

So while there may yet be a long way to go before campaigners see the level of change many are calling for, the news that Scottish patients will have greater access to a drug whose treatment potential has been obscured by drugs laws for decades – with Scottish patients now contributing to a growing evidence base – will likely be viewed by many as another sign of slow but tangible progress.