The MCAP recap: functional or failure?

With a review into the MCAP program pending, how much has really changed for Irish cannabis users?

by Carolyn DeBarra

It’s been almost a year since the first products were prescribed to a patient on Ireland’s Medical Cannabis Access Program (MCAP). There has been widespread criticism that the program is still not fully functional or inclusive enough.

There are only three conditions considered through MCAP including chemotherapy-induced nausea, multiple sclerosis and epilepsy. This leaves a huge amount of Irish patients without safe access.

Patients say that the government or doctors have not been willing to engage with them despite the desperate situations that have been created by a refusal to change the law or broaden the range of conditions.

Alicia Maher is a patient who has relocated from Cork to Spain for better access. She has found that cannabis helps her to manage her pain levels. Alicia began looking into the ministerial licence which runs in parallel to the MCAP system but found that the cost would be around €2,500 every three months.

“Nothing has changed in the past two and half years since we moved. There are now 16 patients on the MCAP program but none of those on the ministerial license can be moved over as they aren’t allowed,” she explained.

“Those with chronic pain can’t go on the MCAP program because there are only three conditions. They are going to review the evidence this year to see if they can include more conditions but I’ll be surprised if they do it.”

Alicia repeatedly emailed to see if she could bring her medication from Spain to Ireland. It was only when she applied to come home for a conference organised by Patients for Safe Access that she was told by Irish airports that she was allowed.

“I rang all the airports because I had emailed them for ages about carrying cannabis. I told the head of security that I had a prescription, and doctor’s letter – every single airport in Ireland said yes. Once I have the cannabis in a sealed container then all I needed was a letter from my doctor.”

When it comes to returning home, Alicia highlights that it’s going to be a long process before she could move back. She is wary of the review as not much is known about how it will be conducted. Another issue is that all of the products available through MCAP are CBD-dominant which won’t suit all patients so more needs to be done.

“We set out the national policy agenda where we would like to see the conditions expanded on and the products available increase because there are only four. I can’t see them expanding the conditions because they don’t want to talk about it.”

She added: “I don’t have any faith in the review because we don’t even know who is going to do it. There is a big reluctance from doctors to engage with it as we invited loads to the conference but not one showed up.”

Aimee Brown uses cannabis to help manage chronic pain from endometriosis. Aimee was repeatedly hospitalised before being diagnosed with the condition. She lost count of the number of hormonal treatments that her GP placed her on to control the bleeding and pain.

Aimee’s life changed after she started to consume cannabis but she had just assumed that everyone else felt better after they used it. She went on to have three surgeries in Ireland but the third resulted in her having to leave her job.

She says that everything revolves around the pain and that prohibition causes her anxiety.

“The psychological trauma has been much worse than any of the physical pain could have been. The constant being dismissed or told the pain is in your head. The hardest part was accepting that I am going to be in chronic pain for the rest of my life.”

She added: “I cannot accept that I risk being thrown into prison for using a medication that doesn’t cause side effects or turn me into a zombie. I’m a better person because I’m not in chronic pain. Everything revolves around the pain.”

Aimee is excluded from accessing medical cannabis through MCAP as it doesn’t recognise chronic pain patients. She feels it is unfair that patients must exhaust all other options before their consultant can consider cannabis drawing out a long process of trial and error.

“They talk about patient-centred care but I feel I’m not at the centre of my own care because they won’t listen to me when I say I have taken cannabis for 16 years and it hasn’t upset my mental health the way prohibition has.”

When it comes to progress, she believes that there needs to be mandatory training to change attitudes towards medical cannabis in a clinical setting.

“We are coming up against barriers in that there are no educators, no formal education programs and there should be mandatory training. We have some consultants who are willing to prescribe but hospital policy is preventing them.”

She concluded: “It’s the attitude of the healthcare professionals that we need to shift and the only way we can do that is to get the government to change the narrative.”

When it comes to changing the political narrative, Gino Kenny, People Before Profit TD has been one of Ireland’s most vocal politicians calling for change. He is planning to put forward a motion in September which will look at personal use and the misuse of drugs act.

“There is institutional opposition at the very top about cannabis as a medicine which is tough. Hopefully, we will see MCAP being open to more conditions because it would be a better system. It should be through GPs instead of consultants too,” he said.

He added: “The review is definitely going to be this year but it should look at commercial reasons too. If a company is going to make a medical cannabis product through that system and only a handful of people are getting it then it isn’t financially viable.”

The bill that PBP plan to put forward would be similar to other European countries regarding personal use.

He said: “We are introducing a bill very soon about legalisation. We are hoping to introduce it in September to regulate cannabis it will cover personal use and it will look at changing the current misuse of drugs act. It would be regulation and personal use which is what other countries in Europe have focused on so that’s what we want to do.”

Carolyn DeBarra is an Irish journalist based in Nottingham, England. They are also a medical cannabis patient who writes extensively on how it can help neurodiverse conditions such as ADHD, tech and also LGBT+ interest. 

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