Home Secretary (finally) allows CBD oil for Billy Caldwell.

[Angilion]

But alcohol causes so many deaths and is a money drain on the NHS by clogging up the system. Not to mention the strain on the police up and down the country, especially on friday and saturday nights with drunks breaking the law.

And? That has nothing to do with the argument at hand, either in general or in the thing I was replying to. In general, this part of the the argument is about whether or not more drugs should be legalised for recreational use despite having adverse effects on users and on society in general just because one already is. Specifically, you stated this:

Are there any good points to alcohol and tobacco? None.

I replied with two good points about alcohol, thus disproving your statement. Rather amusingly, they're exactly the same for recreational use of cannabis.

So you recognise the impact on society of tobacco and want an immediate ban. But nothing on alcohol? Both cause a drain on society.

Already covered in the text you quoted:

[..]Not because it's a recreational drug. Not even because of the harm it does to users. But because of the harm it does to other people.

Because you have an inconsistant position depending on if you use a substance or not

You've said that before. By now, you should know that it's a false statement. Just in case you don't, I'll tell you again. It's a false statement. I have stated several times what my position is and why. You are ignoring that and repeatedly claiming (with no evidence and against the evidence) that my position is based on what drugs I use. Which is not true. How can I explain that to you more clearly?

My interpretation of you are saying about the most harmful drugs was because you are pushing a line against cannabis saying its harmful and should be banned

Then you should discard that interpretation because it's based on a false predicate. That line you're talking about isn't one I'm pushing.

even though study after study (which I've already posted on the thread) shows that deaths from cannabis are extremely low (even though its currently illegal) compared to the deaths that have implicated alcohol, tobacco and other medications derived from illegal drugs. If you are going to have a position that if a few people die from a drug that it should be banned, then surely the logical position would be to ban all drugs that are involved in death?

Obviously not, since that would ban most if not all drugs. Even aspirin has been involved in some deaths. You explicitly stated "medications", so that covers all drugs and not just ones used recreationally.

As for recreational use, the fact that the most commonly used recreational drugs cause the most deaths is very far from being a clear reason for legalising recreational use of other drugs that can cause death. It's a better argument for keeping them illegal for recreational use than it is for legalising them for recreational use.

Finally, there's something I've said before and are quite happy to repeat until you pay attention to it: We're not starting from a blank slate. Criminalising a drug for which recreational use is engrained in society is not at all the same as criminalising one that isn't. If alcohol was a newly invented drug, it probably would quickly be made illegal for recreational use. But it isn't a newly invented drug. Criminalising it now would be impossible without an authoritarian tyranny. Look at what happened when the USA tried it.

My position is if society is allowing these other drugs to be available then they should also allow cannabis, at the very least for medical purposes. That is a logical position. You either have to back all drugs, especially the ones with medical benefits, or ban all drugs because they cause deaths.

You position is not consistent with reality and is only consistent with itself because it's so extremely over-simplified. It's not logical to back all drugs for recreational use. Not unless you want massive social problems or you're intending to use it as a selective culling of the population and particularly strongly back drugs that often kill the users.

Now this part I can agree with, which isn't what you've been appearing to say on the thread before.

Except that it is. All the way through, at least as far back as post number 27 in this thread:

As an aside, I'll throw in a (4) for free - as I have said before, I think that cannabis should be legalised.

What I'm not doing is the usual advocacy position of claiming that cannabis is a panacea and that medical use and recreational use are connected, if not completely the same thing.

In this paragraph you have accepted that there is some medical purposes for cannabis.

No, I didn't. The paragraph you refer to made absolutely no references to medical purposes of cannabis or anything else. Drug advocates frequently confuse medical use and recreational use, presumably because it's politically useful to do so.

As for the part about studies and regulation I would say they have already been done in other countries.

And you would be wrong.

The head of the medical board in this country as given the go ahead to legalise medical cannabis products and we're just now waiting for the government to set it in motion, which I believe its said to be available in Autumn. So the case as been proven in this country.

No it hasn't. Politics has been proven in this country, but did anyone ever think otherwise?

There is good evidence for some medical purposes for some cannabinoids, but that's not what you're advocating. You're advocating recreational use of cannabis. That's a completely seperate issue, but one that recreational drug use advocates deliberately mix up.

Your position makes less sense than arguing that smoking opium for recreational purposes should be made legal because there are some medical purposes for opiates. It's the same argument, but the medical benefit of opiates is far clearer, far better understood and has far stronger evidence than the medical benefits of cannabinoids.

I suspect there is a wider issue going on with cannabis being legalised, just like it is across the western world. It kind of reminds me how at some point the tobacco industry survived years of bad publicity but was always still around. Then suddenly something changed and it immediately fell out of favour. This seems to be happening in reverse with cannabis.

I think the underlying issue is money. There's a lot of money to be made in legalised recreational drug use. Not as much as there is in illegal recreational drug use, but it's far safer and more socially acceptable unless fashions change.

 

[GGizmo]

And? That has nothing to do with the argument at hand, either in general or in the thing I was replying to. In general, this part of the the argument is about whether or not more drugs should be legalised for recreational use despite having adverse effects on users and on society in general just because one already is.

I'll have to just quote your first line or we'll be heading to quote oblivion.

I think we need some context of the debate. I'm personally not advocating for the recreational use of cannabis. The only reason why I commented about that was because you brought the recreational use of cannabis in to the debate (maybe replying to others) and how you want it to remain banned. So I said the argument you made to ban cannabis could be made for some other drugs too, especially alcohol. But I repeat this is not my position and I was merely replying to your blocking position of cannabis.

I think this is the problem when it comes to cannabis debates, people start mixing real medical use with recreational use. I'm not sure if this is a deliberate tactic by some to purposely distort the conversation. The thread was about Billy Caldwell wanting to legally have cannabis based medication. The thread wasn't talking about recreational use, at least at first.

As for you saying I was wrong about other countries having carried out studies on the uses of medical cannabis. I would say you are wrong. Do you think Canada as done no studies about the impact of cannabis before they legalised it?

Introduction of the Cannabis Act: Questions and answers
https://www.canada.ca/en/services/health/campaigns/introduction-cannabis-act-questions-answers.html

I'm sure if there was going to be some a mass health panic over the increased use of cannabis then it would have happened when these countries and states allowed more cannabis to be in society. Australia, Puerto Rico, Poland, Czech Republic, Croatia and Macedonia have all legalised it for medicinal purposes. Uruguay, Spain, Slovenia, Netherlands, Jamaica, Columbia and Chile have legalised or decriminalised it in some form. In the US - Alaska, California, Colorado, Maine, Massachusetts, Minnesota, Maryland, Mississippi, Nevada, New Hampshire, New York, North Carolina, Ohio, Oregan, Rhode Island, Vermont and Washington have all relaxed their drug laws.

Cannabis-derived medicinal products to be made available on prescription
https://www.gov.uk/government/news/...products-to-be-made-available-on-prescription

The Home Secretary decided to reschedule these products after receiving advice from experts during the two-part review he commissioned on June 19. It means that senior clinicians will be able to prescribe the medicines to patients with an exceptional clinical need.

In the first part of the review commissioned by the Home Secretary, the Chief Medical Advisor, Professor Dame Sally Davies, concluded that there is evidence that medicinal cannabis has therapeutic benefits.

The Advisory Council on the Misuse of Drugs (ACMD) carried out the second part of the review, considering the appropriate schedule for cannabis-derived medicinal products, based on the balance of harms and public health requirements.

 

[Tefal]

Pretty much anyone who wants to smoke weed is already doing it. Usage hasn't increased to anywhere near alcohol/tobacco levels even where cannabis is legal/decriminalised.

Yeah thing is you can have a nice drink but no one really sits down for a smoke for anything other than the high/because thier addicted (in the case of nicotine).

 

[Angilion]

I'll have to just quote your first line or we'll be heading to quote oblivion.

I think we need some context of the debate. I'm personally not advocating for the recreational use of cannabis. The only reason why I commented about that was because you brought the recreational use of cannabis in to the debate (maybe replying to others) and how you want it to remain banned. So I said the argument you made to ban cannabis could be made for some other drugs too, especially alcohol. But I repeat this is not my position and I was merely replying to your blocking position of cannabis.

I think this is the problem when it comes to cannabis debates, people start mixing real medical use with recreational use. I'm not sure if this is a deliberate tactic by some to purposely distort the conversation.

Which is why I am talking about recreational use. Because that's what the subject is. Medical use is a facade, a tool used by advocates of recreational use. Nobody is objecting to medically proven drugs derived from cannabis. Some people are objecting to recreational use. Some people are objecting to medical use being used as a facade for recreational use. Some people are objecting to snake oil sales to profit from people's suffering. Some people are objecting to unregulated engineered strains of cannabis with unknown effects but for which evidence of harm exists.

Cannabis is not a single drug - it's a mixture of various chemicals. Some have been studied quite well, some a bit, some not much at all. The proportions of the chemicals seems to be important, but there's not much research on that. The amount of reliable, repeatable knowledge is woefully inadequate for making sweeping statements about medical uses of cannabis (as if it was one thing, which is absolutely isn't) and using that as an excuse for legalising it for recreational use. That is the purpose of legalising cannabis (as opposed to cannabis-derived drugs) for medical use - to lead on to legalisation of recreational use.

As for you saying I was wrong about other countries having carried out studies on the uses of medical cannabis. I would say you are wrong. Do you think Canada as done no studies about the impact of cannabis before they legalised it?

Introduction of the Cannabis Act: Questions and answers
https://www.canada.ca/en/services/health/campaigns/introduction-cannabis-act-questions-answers.html

That page contains absolutely zero evidence of any medical use of cannabis. None at all.

Cannabis-derived medicinal products to be made available on prescription
https://www.gov.uk/government/news/...products-to-be-made-available-on-prescription

That page is about cannabis-derived medicinal products, not cannabis.

Where is your evidence for you claim that other countries have carried out studies on the uses of medical cannabis? Your two links are both completely irrelevant to that claim.

EDIT:

I'll ask a previous question more directly this time:

Are you in favour of legalising opium because some drugs with medicinal use are derived from it?

If not, why not? It makes at least as much sense as legalising cannabis because some drugs with medicinal use are derived from it.

 

[Sankari]

I see no harm in giving the kid some CBD oil. Whether or not it actually helps, is quite another matter.

 

[GGizmo]

Which is why I am talking about recreational use. Because that's what the subject is. Medical use is a facade, a tool used by advocates of recreational use. Nobody is objecting to medically proven drugs derived from cannabis. Some people are objecting to recreational use. Some people are objecting to medical use being used as a facade for recreational use. Some people are objecting to snake oil sales to profit from people's suffering. Some people are objecting to unregulated engineered strains of cannabis with unknown effects but for which evidence of harm exists.

The thread isn't about recreational use. It's about being able to legally prescribe the drug for medical use to Billy Caldwell. Anyone adding the recreational tag on to the conversation is attempting to distort the subject of the thread.

I think the motives for some people using medical use as a cloak to push for recreational use are a small group who have been smoking it illegally for a long time. That is a different conversation to the one we're currently having. On the snake oil sales for profit comment. The biggest victims of those people are the ones who are already ill and want to try a cannabis derived medication and they end up looking it up on the Internet and more than likely run in to one of those unsavory people. If anything that is making the argument for medical regulation even stronger. People who need it for a medical use, who are more likely those snake oil peoples customers (as the regular users will make their own) would immediately disappear once the cannabis derived medication is able to be legally prescribed by a doctor. It would result in a much safer environment.

Where is your evidence for you claim that other countries have carried out studies on the uses of medical cannabis? Your two links are both completely irrelevant to that claim.

I'll leave Evangelions link as a good page to look up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/

I think your concern that some people are going to attempt to push medical use of cannabis derived medications as a cloak to recreation use is valid. But that worry is a side issue when someone is getting relief from multiple seizures every day to the point they had to be hospitalised. I've never had a seizure. In the school I went to I've seen class mates have seizures and the first time I saw one at around 13 years old it shocked me, the violent nature of the event. I know that even one seizure would mean that child was then tired for the rest of the day. So I can't imagine that child having multiple seizures per day and not being able to help stop them. So when a cannabis derived product was available and it worked for Billy then why should the government take it away?

Do you want to be the one to take Billy Caldwell's medication away, just because you have a fear of other people using the medication debate for nefarious reasons?

I'll ask a previous question more directly this time:

Are you in favour of legalising opium because some drugs with medicinal use are derived from it?

If not, why not? It makes at least as much sense as legalising cannabis because some drugs with medicinal use are derived from it.

Those questions assume I'm pushing cannabis to be legalised fully. I'm not. So the answer is no. And as to why not is because I'm not pushing for cannabis to be fully legalised.

 

[Angilion]

[..]
I'll leave Evangelions link as a good page to look up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/
[..]

If you had read that abstract, you would have noticed that it very explicitly spoke against the drug that's being promoted here in this thread even if you ignore the fact that "medical" usage of cannabis (note - cannabis, not medicinal drugs derived from cannabis, which is a completely seperate thing). Here, I'll quote from it for you:

The interest in cannabis-based products for the treatment of refractory epilepsy has skyrocketed in recent years. Marijuana and other cannabis products with high content in Δ(9) - tetrahydrocannabinol (THC), utilized primarily for recreational purposes, are generally unsuitable for this indication, primarily because THC is associated with many undesired effects. Compared with THC, cannabidiol (CBD) shows a better defined anticonvulsant profile in animal models and is largely devoid of adverse psychoactive effects and abuse liability.

Note that CBD is already allowed. Billy Caldwell was always allowed to take CBD. This entire argument is solely about THC. Which, as your own quoted source states, is "generally unsuitable" as an anticonvulsant and is "associated with many undesired effects" and "abuse liability".

You're not advocating medicinal drugs derived from cannabis. You're advocating use of cannabis. Very different things. You might be naive enough to think that there's a difference between "medicinal" use of cannabis (again note - not drugs derived from cannabis) and recreational use of cannabis despite the fact that the former has always led to the latter and is openly used as a tool for the latter, but even in that unrealistically restricted context even the sources you cite contradict you.

The use of cannabis for medical purposes makes sense if technology is too limited to extract the medical drugs contained in it, just as the use of opium for medical purposes makes sense if technology is too limited to extract the medical drugs contained in it. But that's no longer the case. It was in the past, but it's not now.

 

[Sankari]

I'll leave Evangelions link as a good page to look up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/

I posted a link to that study because its conclusion is very conservative. It doesn't show that CBD is the wonder drug people claim it to be (though it does acknowledge some benefits) and it does not support the use of THC:

In these studies, CBD was found to be superior to placebo in reducing the frequency of convulsive (tonic-clonic, tonic, clonic, and atonic) seizures in patients with Dravet syndrome, and the frequency of drop seizures in patients with Lennox-Gastaut syndrome.

For the first time, there is now class 1 evidence that adjunctive use of CBD improves seizure control in patients with specific epilepsy syndromes.

Based on currently available information, however, it is unclear whether the improved seizure control described in these trials was related to a direct action of CBD, or was mediated by drug interactions with concomitant medications, particularly a marked increased in plasma levels of N-desmethylclobazam, the active metabolite of clobazam.

 

[GGizmo]

Note that CBD is already allowed. Billy Caldwell was always allowed to take CBD. This entire argument is solely about THC. Which, as your own quoted source states, is "generally unsuitable" as an anticonvulsant and is "associated with many undesired effects" and "abuse liability".

But that is the legal and medical argument that as been discussed. If he was taking only CBD oil with no THC then there wouldn't be any case to answer as CBD based treatments are legal as long as they don't contain over the legally allowed THC level which is 0.2%. The medication he was taking previously in the US I assume had a higher THC level. So as soon as him and his mother came in to the UK they were stopped and it confiscated.

After withdrawing the THC containing medication his seizures intensified to the point he was hospitalised. All the front line NHS agreed he should resume the treatment that was slowly down his seizures. Now from the link I posted before, the home office after consulting the top medical officer of the country as agreed and that is why the law is changing.

I'm advocating that in situations like Billy other people should be able to have access to similar types of medications.

I posted a link to that study because its conclusion is very conservative. It doesn't show that CBD is the wonder drug people claim it to be (though it does acknowledge some benefits) and it does not support the use of THC:

I think when it comes to THC its a chicken and egg situation as we can't get the indepth studies without releasing it to a larger sample area. All we can go on is real world examples.

But the debate as moved on since the start of the thread and the government have changed their course and are now going to allow cannabis based medication with THC.

 

[Energize]

You might be naive enough to think that there's a difference between "medicinal" use of cannabis (again note - not drugs derived from cannabis) and recreational use of cannabis despite the fact that the former has always led to the latter and is openly used as a tool for the latter

This is just ignoratio elenchi.

"Medical use of morphine has always lead to the recreational use of morphine, therefore there is no difference between the medical and recreational use of morphine."

Insert any other recreational drug in that sentence, the conclusion simply bears no relevance to the premise.

The use of cannabis for medical purposes makes sense if technology is too limited to extract the medical drugs contained in it, just as the use of opium for medical purposes makes sense if technology is too limited to extract the medical drugs contained in it. But that's no longer the case. It was in the past, but it's not now.

This is essentially the case though, we don't have enough data on all of the compounds contained in cannabis or a good enough understanding of the human endocannabinoid system to produce much in the way of good synthetic compounds. And the clinical trial process takes years, is everyone with a medical condition that cannabis can be useful for supposed to wait years to receive medical treatment when as crude as prescribing a plant is, it does actually benefit them?

Furthermore, even if the science were there, the pharmaceutical industry is not government run, they decide what products they want to bring to market and when, they may choose not to elect to bring many such products to market for a whole variety of reasons and often charge obscene drug prices which would be unaffordable to many when cannabis is cheap. There are so many other aspects to medical prescribing than just pure science, economics is an important one that is easily overlooked by people that have grown up in the UK where the medical system is "free".

 

[Angilion]

This is just ignoratio elenchi.

"Medical use of morphine has always lead to the recreational use of morphine, therefore there is no difference between the medical and recreational use of morphine."

Insert any other recreational drug in that sentence, the conclusion simply bears no relevance to the premise.

Can you name anywhere that legalised cannabis for medical use and didn't shortly go on to legalise it for recreational use? Particularly since the whole point of advocacy of cannabis is recreational use. That's the political goal. Medicinal use is just a useful tool for that goal. That wasn't the case with morphine. The situation is not the same. Your comparison is wrong, anyway. Cannabis is a parallel with opium, not with morphine. The distinction between a naturally occuring cocktail of chemicals and a drug derived from it, even if it's just one of the chemicals on its own, is important. The comparison also fails because all the active chemicals in opium have uses as recreational drugs but not all of the active chemicals in cannabis do.

This is essentially the case though, we don't have enough data on all of the compounds contained in cannabis or a good enough understanding of the human endocannabinoid system to produce much in the way of good synthetic compounds. And the clinical trial process takes years, is everyone with a medical condition that cannabis can be useful for supposed to wait years to receive medical treatment when as crude as prescribing a plant is, it does actually benefit them?

Yes, we don't have enough data on all of the compounds contained in cannabis. Nor do we have enough data on the extents to which various ratios of the various compounds matters. Which is why it's not obvious that legalising it for medical use is a good idea, particularly when it is overtly being used as tool for legalising recreational use (as it has been elsewhere). Particularly when there is evidence for significant harm in some cases and we don't even know why some people are harmed by the drugs and other people aren't. There's some evidence it's dosage, some evidence it's the ratio of different cannabinoids, some evidence it's other factors making some people susceptible...but we're rather too short on knowledge to declare that legalising it is just fine, it's harmless. We know it's not harmless. The limited data also indicates that it's not very useful either, but despite that fact purified cannabis extract is available on prescription in the UK (Nabiximols, which contains THC and CBD and which has undergone clinical trials).

Prescribing cocktails of drugs without clinical trials is not a good idea. It might be the least bad course of action in a few cases, but in general it's a bad idea. Clinical trials exist for very good reasons. I don't object to untested potential medical treatments in extreme cases, but I do object to untested potential medical treatments being considered mainstream, normal or a good thing. They're most useful for snake oil sellers who profit from suffering and desperation. They're a bad thing. It's just that in some cases they might be the least bad option available.

 

[Energize]

Can you name anywhere that legalised cannabis for medical use and didn't shortly go on to legalise it for recreational use? Particularly since the whole point of advocacy of cannabis is recreational use. That's the political goal. Medicinal use is just a useful tool for that goal. That wasn't the case with morphine. The situation is not the same. Your comparison is wrong, anyway. Cannabis is a parallel with opium, not with morphine. The distinction between a naturally occuring cocktail of chemicals and a drug derived from it, even if it's just one of the chemicals on its own, is important. The comparison also fails because all the active chemicals in opium have uses as recreational drugs but not all of the active chemicals in cannabis do.

It's irrelevant, that's the whole point, it's what a relevance fallacy is!

I'm not comparing the composition of morphine to cannabis, it's irrelevant, it's just another way of stating your fallacy to highlight the error in reasoning. Replace morphine with opium if suits you better.

Also please, correct me if I'm wrong here but I'm not aware of active chemicals in opium such as thebaine, noscapine and papaverine being used as recreational drugs, not to any significant extent at least, but again it's not really pertinent.

Yes, we don't have enough data on all of the compounds contained in cannabis. Nor do we have enough data on the extents to which various ratios of the various compounds matters. Which is why it's not obvious that legalising it for medical use is a good idea, particularly when it is overtly being used as tool for legalising recreational use (as it has been elsewhere). Particularly when there is evidence for significant harm in some cases and we don't even know why some people are harmed by the drugs and other people aren't. There's some evidence it's dosage, some evidence it's the ratio of different cannabinoids, some evidence it's other factors making some people susceptible...but we're rather too short on knowledge to declare that legalising it is just fine, it's harmless. We know it's not harmless. The limited data also indicates that it's not very useful either, but despite that fact purified cannabis extract is available on prescription in the UK (Nabiximols, which contains THC and CBD and which has undergone clinical trials).

Prescribing cocktails of drugs without clinical trials is not a good idea. It might be the least bad course of action in a few cases, but in general it's a bad idea. Clinical trials exist for very good reasons. I don't object to untested potential medical treatments in extreme cases, but I do object to untested potential medical treatments being considered mainstream, normal or a good thing. They're most useful for snake oil sellers who profit from suffering and desperation. They're a bad thing. It's just that in some cases they might be the least bad option available.

For arguments sake let's say you are correct and that medical use is some ploy to get recreational used legalised, I still don't think that's a bad thing, medical experts deciding what treatment is best for their patients rather than having unqualified politicians decide is most definitely a good thing.

Yes clinical trials are obviously preferable, but I would respond to that by quoting something that I edited into my last post.

even if the science were there, the pharmaceutical industry is not government run, they decide what products they want to bring to market and when, they may choose not to elect to bring many such products to market for a whole variety of reasons and often charge obscene drug prices which would be unaffordable to many when cannabis is cheap. There are so many other aspects to medical prescribing than just pure science, economics is an important one that is easily overlooked by people that have grown up in the UK where the medical system is "free".

Have you looked at the cost of Sativex for example in the bnf?

CANNABIS EXTRACT
Spray All products
Excipients
May contain

Propylene glycol

Sativex oromucosal spray (Bayer Plc)

• Schedule 4 (CD Benz)

Active ingredients

• Cannabidiol 2.5 mg per 1 dose
• Dronabinol 2.7 mg per 1 dose

NHS indicative price
270 dose (POM) £375.00

 

[Angilion]

If economics is the issue, then having a publically funded drug company that supplies the NHS at cost would be a better solution than prescribing unregulated and untested compounds of chemicals that might or might not do more good than harm overall. That's a least bad course of action in emergency cases, but it shouldn't be common practice.

That's ignoring the fact that the goal is legalising recreational use of cannabis, not medical use of medicinal drugs derived from cannabis (which is already legal and therefore doesn't need to be legalised).

 

[Energize]

If economics is the issue, then having a publically funded drug company that supplies the NHS at cost would be a better solution than prescribing unregulated and untested compounds of chemicals that might or might not do more good than harm overall. That's a least bad course of action in emergency cases, but it shouldn't be common practice.

That's ignoring the fact that the goal is legalising recreational use of cannabis, not medical use of medicinal drugs derived from cannabis (which is already legal and therefore doesn't need to be legalised).

A publicly funded pharmaceutical company that violates international drug patents such as those granted to Sativex?

How would any of this be remotely workable, you'd basically have to dump the entire GDP of the UK into a company in order to research all of the active ingredients in cannabis and the human endocannibinoid system so patients can get the same benefit they already get from cannabis, all for the sake of having to avoid legalising it.

In the end it would all be for naught because much like the benzodiazepine tranquillisers, the psychoactive effects of the drug are no doubt precisely the underlying mechanism that is providing the benefits to psychiatric patients in the first place.

 

[Angilion]

A publicly funded pharmaceutical company that violates international drug patents such as those granted to Sativex?

If Sativex is the only cannabis-derived drug compound that works, then cannabis doesn't work. So you've negated your own argument. Is it possible to patent naturally occuring cannabinoids in general?

How would any of this be remotely workable, you'd basically have to dump the entire GDP of the UK into a company in order to research all of the active ingredients in cannabis and the human endocannibinoid system so patients can get the same benefit they already get from cannabis, all for the sake of having to avoid legalising it.

Drug companies use the entire GDP of the UK to develop a drug? If that's true, how can any company afford to develop drugs? I suspect that it's not true, so I'll take a quick look...

The GDP of the UK is currently about 2.6 trillion US dollars.

The highest estimate for the development cost of the most expensive drugs, ones classed as "new molecular entities" and developed entirely by the drug company with no use of any other research, is about 2.6 billion US dollars and 1.2 billion of that is not drug development cost at all but an estimate of the money the drug company might have made in that time if it spent the money on other things. So it's 1.4 billion dollars as the highest estimate of the develpment cost of the drugs that cost the most to develop. Other drugs are cheaper to develop. Like, for example, drugs related to drugs already developed. Such as different combinations of cannabinoids, for example.

A trillion isn't the same as a billion and 1.4 isn't the same as 2.6.

In the end it would all be for naught because much like the benzodiazepine tranquillisers, the psychoactive effects of the drug are no doubt precisely the underlying mechanism that is providing the benefits to psychiatric patients in the first place.

What benefits? If there are any, do they outweigh the psychiactric problems caused by cannabis?

What about non-psychiactric medical problems, i.e. the only ones that there's good evidence for cannabis having any positive effect?

There's some unofficial evidence that LSD can be of some benefit in treating some psychiactric problems. Should we legalise LSD too? if not, why not?

But why apply radically different standards only to drugs that are used recreationally? Why bother with clinical trials for any drugs?

 

[Energize]

If Sativex is the only cannabis-derived drug compound that works, then cannabis doesn't work. So you've negated your own argument. Is it possible to patent naturally occuring cannabinoids in general?

I never suggested Sativex was the only cannabis derived drug formulation that would work. You would have to be willing to break all future patents for any cannabis derived drug formulations for your idea to work.

Why, pray tell, would any pharmaceutical company bother to research and develop drugs using natural cannibinoids as in the case of Sativex if the government is just going to ignore their patents and produce it for free? They wouldn't. It would be a sure fire way to kill medical research and drug development which would obviously be harmful to society as a whole.

Drug companies use the entire GDP of the UK to develop a drug? If that's true, how can any company afford to develop drugs? I suspect that it's not true, so I'll take a quick look...

The GDP of the UK is currently about 2.6 trillion US dollars.

The highest estimate for the development cost of the most expensive drugs, ones classed as "new molecular entities" and developed entirely by the drug company with no use of any other research, is about 2.6 billion US dollars and 1.2 billion of that is not drug development cost at all but an estimate of the money the drug company might have made in that time if it spent the money on other things. So it's 1.4 billion dollars as the highest estimate of the develpment cost of the drugs that cost the most to develop. Other drugs are cheaper to develop. Like, for example, drugs related to drugs already developed. Such as different combinations of cannabinoids, for example.

A trillion isn't the same as a billion and 1.4 isn't the same as 2.6.

You are not suggesting developing a single drug for a single indication, you are advocating prohibiting a substance to the entire patient population, that would require ruling out benefit from all active substances in cannabis for all indications else you would potentially be harming patients...

What benefits? If there are any, do they outweigh the psychiactric problems caused by cannabis?

The anxiolytic effects. Clearly for individual patients the benefits do outweigh the risks as evidenced the large swathes of physicians that are prescribing it to patients.

What about non-psychiactric medical problems, i.e. the only ones that there's good evidence for cannabis having any positive effect?

There's some unofficial evidence that LSD can be of some benefit in treating some psychiactric problems. Should we legalise LSD too? if not, why not?

But why apply radically different standards only to drugs that are used recreationally? Why bother with clinical trials for any drugs?

All drugs should be legal for doctors to prescribe. Clinical trials are essential for guiding medical practice, but that doesn't mean that they should be a pre-requisite for prescribing a drug, or should be legislatively enforced, this is why doctors spend years at medical school, clinical judgement!

You would do very well to take heed of the old adage which goes "absence of evidence is not evidence of absence".

Rarely do I come across such extreme prohibition attitudes. I have never before seen someone suggest creating a publicly funded pharmaceutical company just to justify keeping a substance illegal!

 

[Angilion]

I never suggested Sativex was the only cannabis derived drug formulation that would work. You would have to be willing to break all future patents for any cannabis derived drug formulations for your idea to work.

Why, pray tell, would any pharmaceutical company bother to research and develop drugs using natural cannibinoids as in the case of Sativex if the government is just going to ignore their patents and produce it for free? They wouldn't. It would be a sure fire way to kill medical research and drug development which would obviously be harmful to society as a whole.

That applies to any drug development company. That's what I was suggesting - a drug development company. So your counter-argument relies on outlawing any new drug development company because it might in the future develop and patent a drug before one of the current drug companies does. Is that really your position - the prohibition of any and all new drug companies?

In any case, I disagree with your claim that publically funded medical research and drug development is a sure fire way to kill medical research and drug development. Medical research and drug development being done only when drug companies are reasonably sure they can profit from it is not the only way to do medical research and drug development. It's probably not even the most efficient way (as a lot of money becomes profit for the company rather than being used for medical treatment or research).

So you're opposed to testing drugs for safety because it costs money and you're opposed to publically funded medical research and drug development because it doesn't directly provide profit to drug companies. Are you working in the marketing/PR/lobbying department for a drug company?

By the way, publically funded medical research does provide profit for drug companies - they use the results of that publically funded research to cut their own research costs.

You are not suggesting developing a single drug for a single indication, you are advocating prohibiting a substance to the entire patient population, that would require ruling out benefit from all active substances in cannabis for all indications else you would potentially be harming patients...

I'm advocating that doing appropriate safety and efficiacy testing on drugs and mixtures of drugs should be standard practice before using them in medicine. Remember Thalidomide?

You're advocating maximising profit for drug companies.

The anxiolytic effects. Clearly for individual patients the benefits do outweigh the risks as evidenced the large swathes of physicians that are prescribing it to patients.

A quick check showed positive studies for CBD and anxiety. I might well have missed the studies on THC and anxiety. Could you provide references to any?

All drugs should be legal for doctors to prescribe. Clinical trials are essential for guiding medical practice, but that doesn't mean that they should be a pre-requisite for prescribing a drug, or should be legislatively enforced, this is why doctors spend years at medical school, clinical judgement!

That would be a much more reasonable position in a society in which medical research, drug development, drug production and drug sales were publically funded rather than being geared towards profit. The profit factor skews it too much - doctors are misled, coerced and sometimes simply bribed to prescribe specific drugs in order to generate more money for a drug company. See, for example, the opiod problem in the USA.

As I have said repeatedly, I am not opposed to using untested drugs for medical purposes in extreme circumstances. I am opposed to it being routine, particularly when the motive is to increase profits for drug companies.

You would do very well to take heed of the old adage which goes "absence of evidence is not evidence of absence".

You would do very well to take heed of the new adage which goes "don't kill people for profit".

Rarely do I come across such extreme prohibition attitudes. I have never before seen someone suggest creating a publicly funded pharmaceutical company just to justify keeping a substance illegal!

I suggested created a publically funded medical research and drug development program to overcome a problem you yourself referred to - drug companies that exist to make profits not doing medical research and drug testing that doesn't have a good chance of generating large profits.

So let's see:

I'm in favour of doctors being allowed to prescribe untested drugs, untested combinations of drugs and untested substances that might be drugs - just not as a routine, normal practice to cut costs and thus increase profits for drug companies.

I'm in favour of using public money to fund medical research and drug development in order to improve medical treatment by making it geared towards medical treatment rather than profit.

I'm in favour of legalising cannabis for recreational use, as long as it's well regulated and not used in a way that infringes on other people. Not because I think that's a good thing, but because I think that's a less bad thing than the current system.

And you regard that as the most extreme prohibition position you've ever encountered. Which almost has to be a false statement, but even if you've been isolated in solitary confinement for your whole life and genuinely haven't ever encountered a more prohibitive attititude then you must hold a very extreme position yourself. Do you do so only to increase profits for drug companies? That's obviously at least a major motive for you, since you focus on it so much, but is it your only motive? Or do you think that routine untested drug use would also be a net benefit to people and not just to the bottom line of drug companies?

 

[Energize]

Your interpretation of what I have said is simply absurd.

You stated we should create a drug company to supply drugs at cost to the NHS because drugs such as Sativex are being sold at too high a price, this would require infringing on the patents of privately created drugs. That position is one would essentially prohibit new drug companies.

Thalidomide is a safe drug that is still prescribed today, commonly used medications such as isotretinoin have the same effect on the baby as thalidomide. The issue was not lack of testing on the drug but the fact it was sold over the counter with no warnings about use in pregnancy.

I don't think you can really blame people abusing drugs on doctors, look at how many people in the UK abuse benzodiazepines, is that the doctors fault as well?

I am not familiar with the studies on THC for anxiety, patients gain benefit from cannabis use in their experience and doctors in their clinical judgement view that those benefits outweigh the known risk of the drug. This may well be a placebo effect, but without research to show that, doctors should not be prohibited from prescribing a drug that is benefiting patients.

To suggest I am supporting drug companies because I am against doctors being prohibited from using their clinical judgement is just absurd.

On the subject of clinical testing, the conclusion of many placebo controlled trials is a poor reflection of reality because individuals with wildly different presentations of disease are lumped into a group such as "generalised anxiety disorder" to meet regulatory criteria.

There are actually a number of interesting studies which suggest that drug regulations have killed more people than they have saved by delaying the introduction of new drugs and making the cost of new drug development prohibitive. This is yet another reason why medical experts should be allowed to use clinical judgement where necessary.

This author states the issue better than I can.

The problem is that safety and efficacy are inherently subjective concepts, whose meaning inevitably varies from individual to individual. As noted by one observer, “No one has yet defined safety and efficacy. Nevertheless, distinguished panels attempt to make what are termed ‘scientific assessments’ in the absence of objective basing points.” In practice, safety and efficacy depend strongly on individual circumstances such as age, sex, genetic makeup, and a host of other medical and personal factors that are often difficult for regulators to know. Even more important, the meaning of safety and efficacy depends crucially on personal values and attitudes toward risk: what seems safe to one person may well seem unsafe to another in similar circumstances. By imposing collective choice in drug risk, the present system is therefore inherently controversial, requiring the arbitrary imposition of values by technocratic authority.

In this light, the debate over drug lag can be understood as a value dispute between ‘pharmacophobes”and “pharmacophiles,” that is, those who are respectively more and less risk averse to new drug hazards. An evident solution to the drug safety problem is to make all drugs available for those who want them with appropriate informational warnings. In principle, this might be done through a system of “informed choice,” where the basic object of drug policy would be to inform, not to restrict, consumer choice.

https://pdfs.semanticscholar.org/feb9/53ab293f24a14b3b3d4b748281420099b4b1.pdf

http://www.fdareview.org/05_harm.php

So let's see:

I'm in favour of doctors being allowed to prescribe untested drugs, untested combinations of drugs and untested substances that might be drugs - just not as a routine, normal practice to cut costs and thus increase profits for drug companies.

I'm in favour of using public money to fund medical research and drug development in order to improve medical treatment by making it geared towards medical treatment rather than profit.

I'm in favour of legalising cannabis for recreational use, as long as it's well regulated and not used in a way that infringes on other people. Not because I think that's a good thing, but because I think that's a less bad thing than the current system.

Then why have you basically been arguing against those positions? I also support positions 1 and 3. I'm only against position 2 because the public sector takes money from the public by force and then squanders it, private companies like cancer research UK do a much better job of doing research and drug development that's beneficial to society.

 

[Angilion]

Your interpretation of what I have said is simply absurd.

I think it's accurate. And absurd.

You stated we should create a drug company to supply drugs at cost to the NHS because drugs such as Sativex are being sold at too high a price [..]

The main point of your argument is that clinical trials should be unnecessary and part of the reason you gave for that is the cost of them. You also referred to drugs not being developed by drug companies because those companies decide there isn't enough profit in it. Publically funded drug development would address those issues. Issues you raised. So I proposed it as a solution to those issues. Publically funded medical research is already widepsread and beneficial. Why should the public pay for that research and then have to pay again to provide profits for drug companies that use the research? At the very least there should be a discount.

 

[Energize]

The main point of your argument is that clinical trials should be unnecessary and part of the reason you gave for that is the cost of them.

Clinical trials are essential for guiding medical practice,

. Why should the public pay for that research and then have to pay again to provide profits for drug companies that use the research? At the very least there should be a discount.

I don't think the public should pay for clinical research, I believe in small government.