Medical cannabis and Scotland's healthcare systems
More people throughout the UK are looking for alternative options to manage long-term health conditions.
Sarah Sinclair
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9 min read
Editorial Team
The same varieties of cannabis plants exist in both the legal medical market and the illicit street market; the differences are in how the plants are grown and the quality assurances the provider can give due to how cultivation, processing and packaging are overseen and regulated.
Patients need to know that their medicine is grown in compliant conditions to ensure that it does not result in any unintended harm - the very reason there are international regulations that control the production and supply of drugs.
Cannabis produced in unlicensed facilities is often exposed to conditions that produce non-compliant products and fail the regulatory testing needed for it to be prescribable. There is no traceability in the supply chain, transparency, or quality assurance to ensure the product is what it says it is.
As an essential patient safety measure, important information is necessary to make an informed decision about whether a particular cannabis product or variety is suitable for them as an individual.
It is challenging for a doctor to keep track of a patient's progress when there is no way to know how much THC or CBD a patient is taking when they use cannabis from an unregulated supply. Controlled doses of known cannabis products allow doctors to see what works and make recommendations accordingly.
Here are ten of the most common problems that licensed medical cannabis delivers when compared to illicitly produced cannabis:
There is no guarantee that cannabis produced on the illicit market is harvested at the most suitable time.
The cannabis plant produces its medicinal compounds in the trichomes. The trichomes grow during the flower stages of the plant's life and reach maturity at a particular time based on genetics and environmental conditions.
Medical cannabis cultivation facilities control the growing environment and work to a specific schedule based on the particular varieties needs. Scientific lab equipment to carry out tests which determine the perfect window to harvest the plants with the correct amount of THC or CBD is present.
Cannabis must be dried correctly under specific conditions to allow the moisture to leave the plant at the correct speed and in a way that does not degrade the terpene profile, over-dry or dry too slowly where moulds could grow. Cannabis must be cured to give it an extended lifespan.
Dry too slowly where moulds could grow. Cannabis must be cured to give it an extended lifespan.
Unregulated suppliers cannot guarantee the variety of cannabis they sell to patients is what they say it is. This attitude towards patient care can often result in the wrong strain used to treat the wrong symptom resulting in unwanted side effects.
Cannabis varieties grown in legal facilities are licenced to pharmaceutical companies by the genetics breeder giving patients a guarantee they are being prescribed authentic genetics.
The illicit market cannabis choices are often limited to "got some" or "don't", which can be very unhelpful to someone trying to treat their medical diagnosis to derive specific symptom relief.
Cannabis clinics offer different cultivars of medical cannabis suitable for a wide range of medical conditions, ensuring patients can get access to the proper medication to improve their quality of life. Some patients need to use specific terpene profiles to treat their symptoms, but others can build up a tolerance when using the same cultivar for an extended period. Changing terpene profiles can allow patients to continue getting the same symptom relief and control over their symptoms without taking a break from their medication.
Patients cannot know the potency of untested cannabis-based medicinal products.
Producers lab-test every batch of medical cannabis grown and check the THC and CBD levels multiple times before it reaches a patient. Testing ensures the product has active medicinal compounds within it. Retesting is required to provide evidence and a certificate of analysis before it is finally packaged into 5-30g containers because temperature and time can considerably impact cannabis products' potency. Cannabis available on prescription will have a terpene analysis certificate to show which terpenes and their quantities are present. Patients can talk to their doctors to provide feedback about what is working and what isn't to advise the correct dosage.
It’s impossible to know with illicit cannabis what exactly is being inhaled. Producers who do not care about patient safety sometimes use pesticides to kill insects which could decrease the yield and value of the crop. When pesticides are heated and inhaled, they enter directly into the bloodstream causing harmful side effects with lasting damage. Pesticides are not designed for cannabis crops, and some are potentially carcinogenic.
Medical cannabis is available through prescription and tested in a lab to ensure the cultivation process has no requirement for pesticides. Labs also test for heavy metals and other harmful chemical substances that are known to be hazardous to human health and the respiratory system. Only licensed facilities can produce medical cannabis, and its transportation is controlled to ensure that contamination does not take place.
The cultivation conditions of illicitly produced cannabis are not regulated. The moisture in cultivation spaces can build up quickly without correct ventilation and air exchange leading to the perfect environment for moulds to grow. Patients with a compromised immune system could potentially die from the side effects of inhaling moulds, like Aspergillus, that grow on cannabis plants .
Mould and its spores are potentially harmful to humans' respiratory systems. Growing conditions are carefully monitored in legal cannabis cultivation facilities with sensor technology to optimise the cultivation facility's growing conditions. Producers and importers conduct lab analyses to ensure product mould contamination screening occurs before it reaches patients. Some products are gamma irradiated to ensure they are safe for patients with compromised immune systems, such as autoimmune diseases, organ transplant patients, and cancer patients on chemotherapy or radiotherapy.
Dog, cat, beard hair and who knows what else could be in your illicit cannabis. No one can carry out surprise inspections when cannabis is grown without a licence, and regulators don’t know where it is taking place. Illicit producers rarely follow standard operating procedures, so there is no way of knowing how or what kind of contamination occurred.
Regulations require staff at medical cannabis facilities to wear protective clothing; they certainly don't let their pets come to work with them and hang out in the grow rooms or run around the greenhouse! Dogs and cats shed hair and carry bacteria and other debris on their fur, which can easily brush off against a cannabis plant. Whilst this may be a cute image for a family farm, it doesn't make the grade for growing the best quality and cleanest medicine available. Some facilities are so strict they require staff to shower before going into the cultivation part of the facility and change clothes between grow rooms in case of cross-contamination or degradation of the microfibres in their PPE gowns.
Illicit cannabis could contain harmful bacteria like e-coli, salmonella and acinetobacter, which could harm or even kill patients.
Microbial load is a vital measurement to test for in medicinal cannabis products that are designed for inhalation. Some regulations govern the amount of live microbes present. If a cannabis product has over a certain amount of microbes, such as bacteria that are naturally present when the plant is growing, but also anything that should not be there; it can be gamma irradiated, killing the bacteria and rendering them inactive. Workers in legal cannabis facilities must wear protective face coverings because the bacteria in their mouths can end up in the medicine just from breathing in the room.
It’s difficult to know where the money goes and what it funds when buying illicit cannabis.
Medicinal cannabis supply chains are heavily regulated. A government must grant licences; companies with a trading and transportation licence must carry out transport. Prescriptions must be written by a doctor and dispensed by a pharmacist. Whilst every one of the services required will profit from the trade of medical cannabis, there is a guarantee that organised crime will not be profiting from patients where the funds may go towards further and potentially harmful or violent criminal activity.
Children from third-world countries as young as seven years old have been found locked up in illicit grow houses, and others have been locked away without sunlight for over three years. They are trafficked into the UK and have their passports stolen by the gangs that operate the grows. These immoral actions keep the outgoing costs low by not having to pay employees and enabling maximum profits.
Everyone who works in a legally licenced cannabis cultivation facility and owns a medical cannabis company is heavily audited for their suitability to work in the pharmaceutical industry. Background checks with links to criminal activity or history, money laundering and fraud are carried out on all staff to provide reassurance to government and international regulators that drug laws and conventions are being adhered to. International drug treaties are signed by participatingcountries and enacted to stop the exploitation of people who require medicines, and to provide transparency about who produces the drugs, and how and where. Patients can be confident that there is no link to human or modern slavery when they are prescribed medical cannabis-based products.
At Releaf, we believe that access to medical cannabis is important. That's why we offer tailored monthly packages based on your cannabis prescription, specialist consultations for medical cannabis, and a unique medical cannabis card for protection.
It is important to seek medical advice before starting any new treatments. The patient advisors at Releaf are available to provide expert advice and support. Alternatively, click here to book a consultation with one of our specialist doctors.
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Am I eligible?Editorial Team
Article written by the Releaf Editorial Team, a group of seasoned experts in cannabis healthcare, dedicated to enhancing awareness and accessibility in the field through their wealth of knowledge and experience.
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All of our articles are written by medical cannabis experts, guided by strict sourcing guidelines, and reference peer-reviewed studies and credible academic research. Our expert clinical team and compliance specialists provide valuable insights to ensure accuracy when required. Learn more in our editorial policy.
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