The British government has added cannabis to the pharmacopoeia of medicines available to patients on the National Health Service.
As of November 1, "patients can be prescribed medicinal cannabis by specialist doctors," the Home Office declared in a recent statement.
Campaigners lobbied the government to reconsider its previous stance categorizing cannabis as a Class A substance, defined as having no medicinal or therapeutic value.
Public mood in the UK shifted alongside highly publicized cases in which epileptic children had their illicit cannabis medications confiscated. But Sajid Javid's appointment as home secretary in April appears to have instigated a change.
After the uproar, Javid said in June, "we completely sympathize with the families who have been facing desperate situations as they try to find treatment."
Javid listened to concerns from parents of children with conditions such as severe epilepsy and called for an urgent review of of cannabis-based medicinal products, according to the UK government.
Health authorities will now author advice for specialist clinicians responsible for prescribing cannabis products.
"The new law will not limit the types of conditions that can be considered for treatment," a Home Office statement reads. Instead, doctors "must make decisions on prescribing cannabis-based products for medicinal use on a case-by-case basis, and only when the patient has an unmet special clinical need that cannot be met by licensed products."
Psychiatrist and government drugs adviser Dr. Derek Tracy highlighted pain, multiple sclerosis and epilepsy as "obvious early candidates" for treatment with cannabis.
"The larger step from a legislative point of view has been taken," Tracy said. "What you might see is some finessing of the law in terms of specific compounds found to be particularly helpful or particularly toxic."
Tracy sits on the Advisory Council on the Misuse of Drugs, whose recommendations the Home Office has accepted almost wholesale. The council's role, he explained, "is specifically looking at harm."
"Do the drugs harm people? And we know that they can. How often is that? And so forth. The Department of Health will be taking the other side, pushing for the health part; what do we know in terms of benefits?"
Fellow G7 country Germany legalized cannabis-derived medicines in 2017, but some doctors are reluctant to prescribe it, and patients face ongoing supply shortfalls. Many users still turn to illegal means, such as growing their own cannabis, said Sascha Waterkotte, spokesman for the German Hemp Association.
"Doctors could be made more sensitive towards the law," said Waterkotte. "Germany needs more conferences for doctors, some of which have many prejudices against cannabis being used as medicine or have so far not been involved with this topic."
"I don't think there's a jurisdiction that's got this right yet," Tracy said. "I wouldn't confidently say that Canada or Germany or any other country has done it better than the UK or that we've learnt from huge mistakes; it's too early."