The Twenty21 project carried out a research study in the United Kingdom using a registry of patients who will be treated with medical cannabis with the aim of demonstrating the efficacy, safety and tolerability of this plant. This is one of the most important projects in the field of medicinal cannabis in Europe.
In the UK, research on cannabis for medical use has gained relevance in recent years, since several institutions like the University of Oxford or the University of Nottingham have been lately collecting and publishing the results of different research studies.
The objective is to expand the number of clinical trials with patients and set a precedent in the use of therapeutic cannabis. For this purpose, six pathologies that can be treated with active compounds derived from this plant have been selected:
- Multiple sclerosis (MS)
- Tourette syndrome
- Chronic pain
- Post-traumatic stress disorder (PTSD)
Drug Science, is an independent scientific body leading UK drug research founded in 2010 by David Nutt, Head of the Neuropsychopharmacology Unit in the Department of Brain Sciences at the Imperial College London, who has just published his biography titled Nutt Uncut. The results will be compiled through this research institution following the Twenty21 project guidelines in order to provide the necessary scientific evidence, free from political or commercial pressure, to obtain funding from the National Health Service (NHS), the social security in the United Kingdom, and thus demonstrating that the benefits of medical cannabis treatment outweigh the risks or any potential side effects.
This project has been carried out with patients who have been meticulously selected, since they have to undergo a series of interviews and tests to determine their suitability to receive cannabis-based treatments. Once they determine the patient meet the requirements, they must sign a consent form. From this moment on, the patient will have access to treatment at an established maximum price and have to be monitored every three months. These patients have a more fragile state of health than the general population and their quality of life has not been improved with other medications commonly prescribed for these conditions. Around 900 patients are already being treated and have received prescriptions for medical cannabis, and Drug Science is in charge of collecting and analyzing these medical data within the framework of Project Twenty21 for proper follow-up.
Medical cannabis treatment starts with a private consultation between a specialist doctor and the patient at a clinic approved by the Twenty21 project. During the consultation, the physician will discuss all medical cannabis treatment options to be individually tailored to each patient's needs. Clinics determine the rate for initial and follow-up consultations and the costs must be borne by patients. As more clinics will join the program, a reduction in consultation prices is expected to facilitate people’s access to this type of treatments since the cost that patients must assume can become a significant obstacle.
Once the prescription is made by the doctor, the pharmacy contacts the patient directly so that the medicine can be shipped to home, upon confirmation of the payment.
The prescription drugs are cannabis-based products for medicinal use, such as flowers and oils, sourced from their own T21 licensed producers. CBD predominates in the oils containing a balanced percentage of THC also. On the other hand, in the case of flowers THC is the predominant active compound, 61.6% of the samples target this psychoactive molecule, which is mainly found in Cannabis Sativa plants. The cost of treatment is an average £ 150 per month (about € 174) according to the MCCS guide.
Cannabis prescriptions provide a long-awaited alternative to medicinal drugs used in conventional systems of medicine which can have a high risk of dependence or cause severe side effects. According to a statement made by the National Institute for Clinical Excellence (NICE) in April 2021 recommending moving away from relying solely on opioids to treat pain towards a more holistic approach, "there is little or no evidence that treating conditions with painkillers or other commonly prescription drugs, such as benzodiazepines or opioids, improve people's quality of life, or the pain or psychological distress they may suffer, but rather that they can cause long-term harm, including possible addiction.” There are many encouraging testimonies about these treatments with cannabis that support
Medical cannabis has been legal in the United Kingdom since late 2018. During the summer of that year and after learning about Billy’s case, a twelve-year-old boy with epilepsy, the English government decided to review the existing cannabis legislation to introduce changes and avoid similar unfortunate cases in the future. Billy's case has not been the only one to come to light to demand a change in legislation. The Alfie Dingley case also caused a stir in the media. Recently, due to the new barriers to trade after Brexit began, a great deal of controversy and sense of discontent has also arisen among patients who had already been treated with cannabinoid derivatives.
The United Kingdom stands at the forefront of medical cannabis research thanks to this Twenty21 project since it will provide pioneering scientific evidence and quality data in the field of medical cannabis that would mark a milestone in commonly used universal health care in the near future. Undoubtedly, this series of studies, projects and investigations are currently experiencing a boom due to the growing interest among the general public and the work of dissemination and communication of the latest discoveries in research on the endocannabinoid system. This information is gaining ground to the detriment of the widespread misinformation and biases involving cannabis which for years has become the obstacle, a heavy retaining wall, to the generalized use of this plant as an alternative remedy to treat a wide range of major and minor medical conditions.