An interview with Dr. Anne Schlag, Head of Research at DrugScience
Could you give our readers a little background on your professional life? When did you start to become interested in researching cannabis and cannabis derivatives as treatments for patients?
I’m a Psychologist and Head of Research at Drug Science. Before that I was working as a Lecturer at King’s College London, where I developed expertise across the spectrum of science and policy making, risk perception, risk management and risk communication – all very relevant to medical cannabis and its regulation!
Within my role at Drug Science, I lead the research for the Medical Cannabis Working Group, focusing on controversies surrounding medical cannabis, the improvement of patient access, and the continued development of education and stakeholder communication about medical cannabis. We are currently working on progressing the scientific evidence base of medical cannabis, to include: Patient Reported Outcomes, observational studies (such as T21) and the application of Multi-Criteria Decision Analysis to assess the benefits and safety of medical cannabis.
In addition to Project T21, Drug Science has a number of initiatives running, one of which focuses on other countries’ medical cannabis regimes and looking at what the UK can learn from these. Could you tell us more about this project and your key learnings?
This work developed from discussions in our Medical Cannabis Working Group and the realisation that the UK lags far behind most other countries in relation to patient access to medical cannabis. We looked at a range of other countries with more successful medical cannabis regimes than the UK to see what we could learn from them.
Our paper and full report outlines the key learnings in depth, so I only highlight the most important issues here. Firstly, it is essential to provide better education, training, and support for physicians and health care professionals, as well as for patients. Secondly, we clearly need to improve the currently limited evidence base. In addition to further RCTs, this can also be done by collecting Real World data (such as T21) and by looking at Patient Reported Outcomes. Patients need to be involved to a greater extent and their concerns need to be actively addressed. We also need to address the current stigma surrounding medical cannabis and highlight its differences with recreational cannabis, to move away from the latter’s negative connotations.
Out of the seven countries assessed, which do you believe provide the best framework for other countries’ medical cannabis regimes, and why?
Good question – I think it is still a bit too early to say! For most countries, the introduction of medical cannabis has had some challenges. When you look at regulations in more detail, even the Dutch or German models – which are able to provide wide patient access – have been criticised on some points. The ideal scenario would probably be a combination of frameworks, including a specialised medical cannabis office, reimbursements by insurance for most prescriptions, and a wide array of different available products.
No doubt that current levels of clinician education within this space (especially in the UK) prove a significant barrier for patient access to cannabis medicines. What can be done to remedy this? In your opinion, when should education around cannabinoids – and indeed, the endocannabinoid system – start?
We believe education on medical cannabis and the endocannabinoid system should start in medical school- so far, these topics are hardly being taught at all! Drug Science has developed a series of free educational modules for distribution to medical schools, as well as other health care providers.
As well as starting early, it is clearly important to continue education – there are so many exciting developments in medical cannabis (and I’m sure there are plenty more to come!) that it will be essential for professionals to constantly update their knowledge in line with the ever increasing scientific developments.
Countries like the Netherlands and Israel have specially dedicated medical cannabis government offices; however, many countries do not. Why do you think governments are dragging their feet in setting these up, and what do you believe to be the key benefits that can be realised from such dedicated government offices?
In terms of being slow to develop a specific medical cannabis office, I expect this might be due to the initial costs involved in setting up such a new government body, as well as the change to the current status quo.
But the potential benefits have been shown in other countries. In the Netherlands for example, the Office for Medical Cannabis (OMC) is made up of physicians, health care inspectors, lawyers, as well as patient representatives – so a wide array of perspectives are included. The OMC is responsible for the production and distribution of cannabis for medical and scientific purposes, and for the supply to pharmacies, universities and other research institutes. Because medical cannabis is produced and distributed in commission by the government, it helps to ensure product quality and patient safety. As the OMC has the exclusive right of importing and exporting medical cannabis, it helps to prevent the diversion of cannabis into the illicit market.
You can hear more from Dr. Anne Schlag at the GCI Europe Virtual Summit.
Check out other interviews on the GCI Content Hub by clicking here.