Written for Enterprise of Hashish by Releaf. 

Normal Practitioners (GPs) are on the frontline of healthcare within the UK, and signify the first touchpoint for sufferers hoping to get therapy.

But, in contrast to in locations like Germany, GPs are unable to make an preliminary prescription for medical hashish for sufferers within the UK.

The preliminary prescription for cannabis-based medicinal merchandise (CBPMs) should come from a GMC-registered specialist, with most prescriptions being issued by personal medical hashish clinics like Releaf.

Nevertheless, they can subject repeat prescriptions as soon as a specialist has granted an preliminary prescription, alongside conducting follow-up appointments and to make sure the therapy’s efficacy and offering repeat prescriptions.

At Releaf, sufferers are assured of a supportive expertise from each specialists and GPs. For instance this, Dr. Harrison Offiong, a GP at Releaf, shares insights on working within the medical hashish area and what sufferers can anticipate throughout follow-up appointments. Learn his insights under.

Q&A with Dr Harrison Offiong

So, Dr Offiong, when did you first resolve to develop into a GP?

“Rising up, I all the time had a fascination with the human physique, and the way issues work. My dad seen this and mentioned ‘I believe it’s best to develop into a health care provider’ after I was round 8 or so, and naturally, him being a Nigerian father – I wasn’t going to argue! I’m joking after all, my father nurtured my curiosity, and I’m glad I selected this path. 

I certified as a health care provider in 2006, then in 2009 I moved to the UK and did a grasp’s diploma in Public Well being, adopted by profitable stints working in A&E, and Normal drugs, till I began my GP coaching within the West-midlands, and I lastly felt it was the appropriate match for me. 

Though it did take me some time to choose a speciality put up qualification, in hindsight this gave me priceless insights into totally different areas of drugs, and diversified experiences general.” 

And, what led you to the medical hashish area?

“Whereas working as a GP in the course of the pandemic, I began to look into medical hashish. This began innocently and organically; I got here throughout a weblog put up about hashish’ therapeutic potential in 2020, and ever since I’ve been decided to seek out out extra. 

I stored on asking questions as to how I might work on this area as a GP. Fairly early on I grew to become a member of the Medical Hashish Clinicians Society, and later I joined Releaf, the place I now oversee present medical hashish affected person’s therapy plans, maintain appointments, sit on multidisciplinary evaluate groups, and subject repeat prescriptions beneath shared care.”

Q: Why are GPs allowed to subject repeat prescriptions for medical hashish sufferers?

“Within the UK, there are over 95,000 docs listed on the Normal Medical Council’s Specialist Register that may subject sufferers with an preliminary prescription for hashish primarily based medicinal merchandise in the event that they imagine they could be an acceptable or applicable choice for them.

Nevertheless, in actuality, solely 0.25% of those are believed to have ever issued a prescription for cannabis-based medicines, and so, appointments with these specialists may be exhausting to return by. 

There are a variety of causes as to why GPs can subject repeat prescriptions for medical hashish sufferers, and essentially the most evident is to take the burden off these specialists. By permitting GPs to watch these care plans too, we will scale back affected person ready lists occasions, in addition to scale back the likelihood of disruptions throughout therapy, and guarantee every affected person receives efficient therapy monitoring and safeguarding.

Now there are over 70,000 GPs actively practising within the UK, I’m hoping the variety of these working for medical hashish clinics like Releaf will increase, and we may also help to get extra sufferers the appropriate therapy for them.  However in the end, I hope that in time, these legislations could also be altered in order that GPs like me can observe with extra freedom, and have the identical alternatives specialists do by way of serving to as many sufferers as attainable.”

Q: What can sufferers anticipate after they see a Releaf physician?

“When sufferers come to Releaf, they’ll anticipate to work together with healthcare professionals who’re genuinely dedicated to serving to them handle their well being, and underlying medical issues. 

As a health care provider, I really feel it’s essential to construct a therapeutic relationship with sufferers and develop rapport. I additionally assume as a result of these sufferers have usually been let down by the choices they’ve beforehand tried earlier than arriving at Releaf, it’s much more essential we get it proper. 

We wish sufferers to have the ability to be trustworthy and open with us, and really feel comfy discussing any facet of their well being or treatment, to ensure they’re getting as a lot profit as they presumably can from their medical hashish therapy, and may proceed to take action.”

Q: How steadily ought to medical hashish sufferers see their physician?

“4 weeks after their preliminary prescription for medical hashish or hashish primarily based medicinal merchandise is issued by Releaf, all sufferers ought to anticipate to have a follow-up appointment. 

For extra advanced circumstances or circumstances, that is prone to be with the specialist they’d their preliminary session with, however for others they could get the prospect to fulfill with me, or one of many different fantastic docs in our crew. 

As soon as their therapy is stabilised and dealing successfully, medical hashish sufferers at Releaf ought to anticipate to see a clinician each quarter, or as soon as each three months.” 

Q: What occurs throughout these follow-up appointments?

“Throughout follow-up appointments, we in the end talk about how the affected person is doing and assess how efficient their general therapy with medical hashish has been. Fortunately, more often than not, these outcomes may be seen shortly. 

In these check-in appointments, we converse concerning the signs the affected person was beforehand experiencing essentially the most hassle with, and the way they’re doing now. We’ll additionally ask how they’re getting together with treatment titration, and see if any changes to dosing portions or routines ought to be made, or in the event that they’ve encountered any unwanted effects that want addressing. 

It’s essential to have these common appointments to not solely monitor any developments or progress, or make any sort of changes, but additionally to assist construct a real, trusting relationship between the affected person and practitioner, in order that we will handle any further well being issues which will come up.”

Q: What occurs if a affected person is experiencing unwanted effects from their medical hashish therapy?

“There are a number of unwanted effects which are talked about extra steadily than others in follow-up appointments with medical hashish sufferers, particularly these new to hashish. Nevertheless, fortunately, the vast majority of these are minor, comparable to feeling drained, and may be simply handled by making changes to their treatment focus, dosing portions, or dosing routines, which simply should be signed off and accredited by a specialist after the appointment. 

Different frequent unwanted effects embrace experiencing a dry mouth, purple eyes or an elevated urge for food. These unwanted effects can often be tackled comparatively simply by staying hydrated, utilizing over-the-counter lubricating eye gels, and by meal planning to keep away from overeating, or stocking up on wholesome snacks to curb starvation pangs. 

However, if for some motive a affected person experiences unwanted effects or antagonistic reactions which are critical, and that can’t be rectified by altering their cannabis-based therapy plan or implementing exterior measures such because the aforementioned, we’d take a special strategy. In these circumstances, we’d re-evaluate their signs and therapy targets and signpost them to an alternate therapy strategy, or to the place they might get a second opinion.”

Q: Why is it essential for medical hashish clinics to have a diversified scientific crew?

“I believe it’s actually essential that medical hashish clinics have a diversified crew of healthcare professionals. From specialists, to generalists, to nurses, and pharmacists – everyone performs a vital position in affected person care, and all of us provide totally different experience, experiences, and insights.

Our every day multidisciplinary crew opinions are actually enlightening and supply an excellent platform for open-minded dialogue and collective approaches to healthcare, and Releaf’s affected person help crew assist present sufferers with coordinated care, and enhanced communication. 

When all these cogs are turning and dealing easily, sufferers can obtain the absolute best therapy, help, and general care. And in the end, that’s why they’ve come to Releaf within the first place.”