As of 1 November 2018, some cannabis products have become legal for medicinal use. NASS is aware that a large proportion of people with axial spondyloarthritis (axial SpA) including ankylosing spondylitis (AS) may use cannabis-based products to help with pain relief. As such NASS welcomes this development, as well as the National Institute for Health and Care Excellence (NICE) Guidance which is currently in development and due to be published on 21 October 2019. NASS is a registered stakeholder and will be contributing throughout the development process with the input of people with axial SpA (AS). A recent survey conducted by NASS shows that 52% of respondents with axial SpA have used cannabis-based products for pain relief, often in conjunction with other medications, particularly non-steroidal anti-inflammatory drugs, simple pain killers and biologic drugs. Anecdotal evidence currently exists that many patients find cannabis based products can provide pain relief; there is however a lack of clinical studies. NASS would welcome clinical research which specifically looked at the benefits of cannabis-based products for people with axial SpA (AS).
NASS remains cautious; patients must be informed of any potential side effects that such products may cause. Only cannabis-based products where the tetrahydrocannabinol (THC), the psychoactive element of cannabis, has been removed are to be considered.
Clear guidance for health care professionals and patient pathway for prescription are very important to ensure that these products are used in the most appropriate way.