The Minister for Health has the power to grant a licence to an Irish-registered medical practitioner for access to a cannabis-based product containing THC (that would otherwise be illegal) for a named patient under their care. Given the lack of scientific evidence supporting the authorisation of such products as medicines and pending the launch of the Medical Cannabis Access Programme, this is currently (March 2021), the only means by which a prescription can be filled for a THC-containing product.
As a result, the use of this pathway has increased significantly in recent years.
How to apply
While an application can be made by any registered medical professional (e.g. a GP), it cannot be approved by the Minister without the explicit support of a specialist (i.e. a consultant neurologist in the case of epilepsy). If granted, the specialist will be responsible for the management of the patient and the monitoring of the treatment.
The Minister does not have any other powers to intervene in the doctor-patient relationship.
As products containing THC are not currently available in Ireland, the patient and doctor are responsible for sourcing the product internationally if a licence is granted. To date, Irish patients have had their prescriptions filled by a Dutch pharmacy in the Hague with products manufactured by Bedrocan and licensed by the Dutch Office of Medicinal Cannabis.
The costs of the medication must be covered by the patient. Initially, patients/caregivers also had to travel to the Netherlands to collect their prescription. However, due to Covid-19, a temporary delivery service was established in April 2020 and this was made permanent in December 2020.
Making an application
A licence application must address:
- An outline of the treatment the patient has received to date and justification from the specialist as to why it is appropriate, in their patient’s specific circumstances, to prescribe a cannabis-based product.
- Details of the cannabis-based product which it is proposed to prescribe.
- The source of the cannabis-based product.
- The arrangements for the ongoing monitoring and care of the patient once the cannabis-based treatment has commenced.
Cannabis-based products that may be supplied under the Ministerial Access Programme or the Medical Cannabis Access Programme are not authorised medicines approved by national or international medicine regulators. Although typically manufactured in accordance with good manufacturing practice (GMP) standards, they are not subject to the same evidence-based analysis or monitoring as authorised medications.