Patient Education Centre > Frequently Asked Questions

The Sapphire Access Scheme

The scheme gives patients reduced appointment costs in recognition of their contribution to this groundbreaking initiative
General Questions

Medical cannabis can be referred to as nature’s dimmer switch. It can turn down the intensity and frequency of symptoms associated with many conditions. 

The body has its own cannabis system known as the ‘endocannabinoid’ system. Compounds called cannabinoids that are found in the cannabis plant interact with this system to produce a number of effects. New research has shown that people who respond well to cannabis may well have a deficiency in their body’s natural cannabinoids (endocannabinoids).

The NHS only funds cannabis-based medicines for a small range of indications, namely: Dravet’s or Lennox-Gastaut syndromes (two treatment-resistant forms of epilepsy), moderate to severe stiffness associated with multiple sclerosis, and nausea and vomiting associated with chemotherapy.

Medical cannabis products for any other indication are currently only accessible via private appointments with a doctor who specialises in your type of condition. These appointments require access to information regarding your health from your GP and any letters from specialists that you have previously seen about your condition, or the person you would like us to review (if you are not enquiring for yourself).

Once we have this information, we can begin to determine whether we might be able to help. At this point, it is time to book you in for an assessment with our specialists. If our specialists agree that medical cannabis might be right for you, they will present the case to our multidisciplinary team for authorisation.

If authorised, we can move ahead and issue a prescription to our preferred partner, CBMP Access Pharmacy, or the pharmacy of your choice.

Medical cannabis has been legal in the UK since November 2018. However, prescriptions may only be initiated by a specialist doctor, like those here at Sapphire Medical Clinics. Our doctors can prescribe a range of cannabis-based products that are produced as medicines to treat medical conditions and illnesses.

GPs can only prescribe medical cannabis under a shared care agreement with a specialist doctor. GPs can refuse to prescribe medical cannabis products if they believe that they do not have the necessary knowledge to do so.

You must inform the DVLA if you start taking medical cannabis products or your insurance may not be valid. Your medicine can cause drowsiness and can initially reduce your reaction times, especially if you take alcohol or other sedatives at the same time. This increases your risk of having an accident, putting yourself and others at risk. If you are taking medicines, the rules about driving will depend on the country you are driving in. 

A statutory defence may apply if a car accident occurs where medical cannabis has been legally prescribed by a doctor and driving was not impaired. The THC level needs to exceed legal thresholds. 

A THC level of over 2micrograms/L has been judged to be sufficient to exceed the legal threshold for medical purposes (high medicinal cannabis THC doses may cause this). 

It would be best to avoid driving or undertaking tasks that require fine motor skills to prevent the likelihood of an accident until you know how the medicine affects you. The highest risk for driving would be at the times listed below: 

  • After a change in dose (especially an increase) 
  • If you are on a high dose or seem very sensitive to side effects 
  • If your current medicine causes you blurred vision, drowsiness, poor co-ordination, poor attention. 

Employers should provide reasonable workplace adjustments for disabled employees who have a medical cannabis prescription.  Patients who drive or operate machinery should not do so if affected or impaired by their medicines. Patients should also consult the occupational service for their workplace where available.

Medical Cannabis

Recreational cannabis most often has high levels of a chemical known as THC (tetrahydrocannabinol). At high levels, THC is known to have a risk of addiction, however, this risk is much lower than those associated with other medicine groups such as opiates.

Levels of THC in products that are used to treat medical illness are much lower than in recreational products. This means that medical cannabis products often have a lower potential for addiction. Clinicians at Sapphire work closely with patients in order to effectively monitor for signs of addiction and support you with the most appropriate regimen for your symptoms. 

Medical cannabis is cannabis that has been produced by companies regulated by the medicines regulator to ‘good manufacturing and distribution practices’. This means that the medicines are produced to a high standard that may be used to treat medical illnesses. 

 

Cannabinoids are chemical compounds that are found both in our bodies (endocannabinoids) and in the cannabis plant (phytocannabinoids). These compounds interact with receptors and can influence a range of physiological functions and have positive effects on the symptoms of some illnesses and conditions.

Medical cannabis that contains tetrahydrocannabinol – also known as THC – is used to treat a wide variety of conditions. The amount of THC found in medical cannabis products is typically much lower than levels found in recreational products.

THC used in combination with CBD (cannabidiol) is considered an effective treatment for a range of conditions. In addition, CBD, when taken in combination with THC, has been found to potentially counteract some of the side-effects of the psychoactive compound. THC is the known psychoactive chemical found in cannabis. Low levels of THC used to treat medical illness are not expected to cause a feeling of being ‘stoned’ or ‘high’. 

Medical cannabis products must be produced to ‘Good Manufacturing and Distribution Practises’ by manufacturers that are accredited by the medicines regulator. This means that they are classed as pharmaceutical-grade medicines and may be used to treat medical illnesses and conditions.

Medical cannabis can come in a range of forms: oils that are placed under the tongue, dried cannabis that is inhaled using a vaporiser device, topical ointments or creams for the skin, as well as oil-filled capsules. 

In comparison, cannabis products (hemp oil or CBD oil) that are produced for the wellness industry contain no or negligible THC (tetrahydrocannabinol). These oils are produced to food-grade standards and are not recommended for the treatment of medical conditions or illnesses. Research has indicated that many of these products often do not contain the levels of chemicals – namely, CBD - as indicated on the packaging. 

Medical cannabis products must be produced to ‘Good Manufacturing and Distribution Practises’ by manufacturers that are accredited by the medicines regulator. This means that they are classed as pharmaceutical-grade medicines and may be used to treat medical illnesses and conditions.

Medical cannabis can come in a range of forms: oils that are placed under the tongue, dried cannabis that is inhaled using a vaporiser device, topical ointments or creams for the skin, as well as oil-filled capsules. 

Cannabinoids are chemical compounds that are found naturally both in the cannabis plant (phytocannabinoids) and in the body (endocannabinoids). In the body, cannabinoids form part of the endocannabinoid system which also includes receptors – or switches – found on nerve cells. When activated, these receptors can influence various functions that may improve the symptoms of a number of conditions.

Medical cannabis products must be produced to ‘Good Manufacturing and Distribution Practises’ by manufacturers that are accredited by the medicines regulator. This means that they are classed as pharmaceutical-grade medicines and may be used to treat medical illnesses and conditions. The amount of THC found in medical cannabis products is typically much lower than levels found in recreational products. Recreational use of cannabis usually involves the use of products with high levels of THC in comparison to medical products. 

The recreational use of cannabis usually involved the user seeking the ‘euphoria’ or ‘high’ provided by strains with higher levels of THC. In comparison, the amount of THC in medical cannabis products can be gradually titrated to avoid the ‘high’ associated with recreational use. In the UK, the recreational use, possession, cultivation, and sale of recreational cannabis is illegal, meaning that it can only be purchased through black market ‘dealers’. Purchasing cannabis through the black market can be risky as users are often unaware of product quality and safety, and the applicability to their condition.

‘Hemp’ refers to cannabis plants that produce only a small amount of THC (in the UK, this is set at 0.2%). While hemp can be used for the extraction of CBD (cannabidiol), it is often used for industrial purposes such as for the production of textiles, paper, and bioplastics or for CBD oils.

Medical cannabis can be derived from hemp plants or high-THC cannabis plants. Cannabis-based medications are produced to ‘Good Manufacturing and Distribution Practises’ by manufacturers that are accredited by the medicines regulator. This means that they are classed as pharmaceutical-grade medicines and may be used to treat medical illnesses and conditions. Medical cannabis can come in a range of forms: oils that are placed under the tongue, dried cannabis that is inhaled using a vaporiser device, topical ointments or creams for the skin, as well as oil-filled capsules.

There is insufficient evidence to recommend the use of cannabis for the treatment of cancer, although there are known individual cases in medical literature of patients being successfully treated with for cancer with cannabis. Lab tests have also shown that some cannabis compounds may have some anticancer effects on some types of cancer cells. However, other studies have shown that high levels of THC may actually encourage the growth of other cancerous cells.

Medical cannabis has, however, been found to be useful in the management of many symptoms associated with cancer and cancer treatment. Sapphire Medical can treat and supply prescribe cannabis to patients with cancer that require symptomatic relief where standard therapy has been ineffective. We can help with appetite stimulation, pain control, insomnia, anxiety and nausea and vomiting.

Cannabis-based medications are produced to ‘Good Manufacturing and Distribution Practises’ by manufacturers that are accredited by the medicines regulator. This means that they are classed as pharmaceutical-grade medicines and may be used to treat medical illnesses and conditions. Medical cannabis can come in a range of forms: oils that are placed under the tongue, dried cannabis that is inhaled using a vaporiser device, topical ointments or creams for the skin, as well as oil-filled capsules.

Sapphire

As an independent clinic, we are proud to be able to prescribe the UK’s most affordable medical cannabis products.

A chronic pain patient who is prescribed medical cannabis pays, on average, less than £5 per day. A bottle of cannabis oil taken under the tongue starts from £30 per bottle; dried cannabis for use in vaporisers start from £5 per gram; and topical skin creams and ointments are priced from £30.

As part of the Sapphire Access Scheme, an initial assessment costs £100. Your first follow-up appointment is £50, then quarterly at £45 with a specialist prescriber.

At Sapphire, we prescribe pharmaceutical-grade medical cannabis that is produced to Good Manufacturing and Distribution Practises by accredited manufacturers. This means that all products are classed as medicines and may be used for the treatment of a variety of medical illnesses.

Medical cannabis products can come in a range of forms, including oils that may be placed under the tongue (sublingual), dried cannabis that is inhaled using a vaporiser device, ointments and creams that are applied to the skin, and oil filled capsules and sprays.

Sapphire Medical Clinics prescribe a wide range of medicinal cannabis products including oils, dried cannabis, and topical preparations for the skin. Our specialist clinicians work with each patient to identify the right product for them.

Education on cannabis is available free from a range of institutions. The Sapphire Institute for Medical Cannabis Education and Society of Cannabis Clinicians provide education and learning opportunities to a wide range of professionals and patients.

Conditions

Medical cannabis products can currently be considered for use for a number of indications and can be prescribed by a specialist clinician, supported by a multi-disciplinary team, for diagnosed conditions where first line therapies have failed. GPs can only prescribe medical cannabis under a shared care agreement with a specialist doctor. GPs can refuse to prescribe medical cannabis products if they believe that they do not have the necessary knowledge to do so.

Medical cannabis has been found to have the potential to ‘turn down’ the intensity and frequency of various symptoms associated with multiple medical conditions. For chronic pain patients, medical cannabis has been seen to reduce the intensity of pain, as well as improving sleep and well-being. There are a number of small studies that have shown it to be an effective treatment option for fibromyalgia.

As the evidence base remains small, cannabis should only be used where other treatments have failed to offer relief. Other treatments that should potentially be tried include those that are commonly prescribed for neuropathic pain, such as duloxetine or pregabalin, as well as potentially trying other analgesics. 

Medical cannabis has been called nature’s dimmer switch as it as been found to potentially reduce the severity and frequency of symptoms associated with a wide variety of conditions. In small clinical trials, cannabis has been found to potentially be helpful in reducing symptoms of post-traumatic stress disorder (PTSD).

As with other conditions, medical cannabis should only be used following the unsuccessful trial of more routine treatment options. These include antidepressants as well as talking therapies such as cognitive behavioural therapy or eye-movement desensitisation and reprocessing.

It is thought that cannabinoids (compounds produced by the cannabis plant) can affect the levels of dopamine found in the brain. A similar effect is also produced by medications known as stimulants that are used to treat attention deficit hyperactivity disorder (ADHD) in the UK. There is a modest amount of evidence that suggests that cannabis may therefore be useful in the treatment of ADHD. 

Adults that have already tried standard therapies and have not found them helpful or have experienced side effects may see cannabis as a potential treatment option. In children, cannabis is reserved for the most severe cases when used in children due to its potential to cause adverse effects. Children are at risk of mood disorders and problems with memory in early adulthood when given THC (a chemical found in the cannabis plant) due to its potential effects on the developing brain.

The most used medicines for the treatment of ADHD in the UK are methylphenidate, lisdexamphetamine, atomoxetine, and guanfacine. Clinicians expect that patients have tried standard treatment options before cannabis-based medicines are considered.

Medical cannabis is nature’s dimmer switch and has been shown to possibly help with ‘turning down’ the intensity of chronic pain, as well as improving sleep and well-being. Cannabis is not a silver bullet and may not treat the underlying cause of the chronic pain. It can take a few months to find the effective dose to treat symptoms of chronic pain. Medical cannabis is only considered for chronic pain after standard medicines and therapies have already been tried.

Medicines for ‘nerve pain’ such as duloxetine, pregabalin or amitriptyline plus another medicine of pain would be expected to be tried before cannabis. However, other types of pain may require other medications.

Medical cannabis is nature’s dimmer switch and has been shown to have the potential to ‘turn down’ the intensity of anxiety symptoms. In addition, cannabis could help to improve sleep and general well-being. Cannabis isn't effective for everyone, and standard therapy should be tried before considering it.

In the UK standard therapy to treat anxiety would be an antidepressant, most commonly sertraline, plus talking therapy (as known as behavioural therapy), CBT for example.

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