Pubs & Prescriptions: How establishments treat patients with medical cannabis

The UK is on the verge of medical cannabis normalisation. Industry experts predict that the number of patients receiving a cannabis-based medicinal prescription will grow exponentially in the next 18 months. This questions patients' rights to take medicine as, when, and where they require it. Is the public ready? To find out, we spoke to some local pubs and bars in Brighton to find out their policies. 

Some people might wonder why patients would need to take their medical cannabis when they're out with friends at the pub. The answer to that is simple because they need to. "Why can't you wait until you get home" some people might ask. Well, it's the same reason people wouldn't wait to use an asthma inhaler; they need symptom relief at that moment, so that's when they should take their medicine. 

As a patient with Crohn's disease, I know all too well the feeling that it's not worth going out to spend time with my friends at a pub or a bar because I need to use cannabis so frequently when I'm having a flare-up. When I can take cannabis, it stops me from needing to go to the toilet to empty my bowels multiple times an hour. I decided to speak to local pubs to see their policy on patients vaping medical cannabis on the premises. In Brighton, the pungent smell of cannabis is a daily occurrence whilst roaming the quaint shopping lanes populated by independently owned boutiques. 

I'm not one for drinking due to being part of a healthy lifestyle, so I haven't had many chances to test out the public's response to a legal prescription being taken in a venue on the high street.

Medical cannabis in pubs

There is a pub opposite my front door, so this evening, I strolled across the road to find out their take on patients medicating in public spaces. It was just past 21:30. The pub had a hive of activity outside where around a dozen Morris men were winding down with a cool pint. I went inside where there was a man and a woman at the bar. It was loud so I lent in and told them I was writing an article about medical cannabis prescriptions and pubs and wanted to know what their thoughts were about a patient vaping cannabis inside. He paired a huffing sigh out with a short, sharp, vigorous shake of his head “just go outside, mate” he said and walked away from me. 

At the end of the street is another establishment, The Druid. Adorned with an artist's rendition of Stonehenge with the solstice sun behind beaming light, sounds of a folk band playing a guitar, accordion and drum kit spilt out from the doorway. 

I headed straight to the bar, where I met Harry, a bearded barman in his 20s who asked how I was. We talked past the pleasantries, and I posed the question to him. "What's the pub's policy on medicinal cannabis prescriptions being taken inside the pub? Can I or would I need to go outside?" Harry looks at me, slightly confused, "You mean like a THC oil? He asked, miming dropping a tincture to his mouth. "No," I said, "flowers in a vaporiser". 

Harry raised his eyes and told me he's never met anyone with a legal cannabis prescription before, at which point he was trying to unscrew the child safety-locked lid to the tub I had put on the bar in front of him. "It keeps it out of children's hands," I said. He laughed as he pushed down the lid, finally opening it with a twist. 

After respectfully visually inspecting the contents of the pot and smelling it, Harry told me, "We let people use nicotine vapes here…does it smell strong?" I told him, "It might, but the pub also smells strong". 

"I mean, it's not in our licence to say we can allow it, but it's also not in our licence that says we have to allow it if it's on prescription." The discussion then led to the wording of Section 8 of the Misuse of Drugs Act 1971, which prohibits premises owners and landlords from knowingly allowing the property to be used for the smoking of drugs. 

Medical cannabis is an exemption from the MDA71, but it is also required that it must be vaporised when taken as an inhaled medicine. "There's an equal argument that it would be discrimination to prevent someone from using their legally prescribed medicine when they need it", to which he replied, "Yeah, that would be true; it's an interesting one." 

Harry considered this information for a moment and seemed convinced that as a legal medicine, there would be no problem for me to pack my vaporiser and take my medical cannabis. "The manager's from Amsterdam, so he probably wouldn't even mind anyway", he joked. 

Now I wanted to see how the public would react to someone vaping their prescription at the bar. I pulled out my trusty Releaf grinder in my welcome pack, turned on my vape and started the process. 

It wasn't long before several people smelled the open jar and asked more about it. No one who interacted with me knew that cannabis was legally prescribable in the UK, but they did know it was "legal in America". The understanding supports Releaf's recent data published in the Say No To Pain report indicating that 58.3% of the sample group did not know about current medical cannabis laws. 

Back on the trail

It was time to move on and see where else was 100% patient friendly in a city with no shortage of pubs and the host to the UK's largest medical cannabis protest Green Pride.

The Hobgoblin was manned by a security guard who seemed quite intrigued about the question gesturing towards the bar. I posed the question once again and started getting a head shake. "We don't allow vaping in here anyway because it's something someone else could complain about," she explained. "When someone lit up a doobie in the garden, we asked them to leave" I explained that this was legal medicine and asked if she'd consider that it might be discrimination if they were to prevent someone from using their prescription medicine when required. She replied, "Hmmm, you'll have to speak to a manager about that". 

Shania at the Shuffle Bar had a logical thought process on the issue. "This is such an interesting topic that I've never considered." She told me. "My boyfriend was approved for his cannabis prescription two days ago." 

"Shuffle is a family-owned business, so the rules come from the top. We have a no vaping policy inside the premises because we want to make it feel comfortable for people - vaping gets complaints, and we ask people to leave who don't respect this." 

Shania continued, "I guess if someone needed to use it for anxiety whilst they were here, it would be easy for them to go outside and round the corner away from the front of the premises where the smokers go so nothing blows into the bar." 

I asked how she would feel if an MS patient was having spasms and needed to medicate where they were sitting to stop them before they could even consider moving outside, "I think that would be acceptable", she told me. 

It was Shania's last cigarette break before the cocktail bar started winding down for the evening. I saw the shop's smoking policy as she walked around the corner before lighting up. 

"I've lived in Brighton practically my whole life, but I'm from the Philippines originally. The policy there is quite good, I think. You can vape and smoke in public places, but you must blow the vapour or smoke cloud out under the table. It's all about trying to be respectful."

Medical cannabis in the smoking area

From a patient perspective, I totally understand the request to go outside to respect the space of others. Whilst a cannabis prescription used through a vaporiser is akin to using an asthma inhaler or insulin pen for many people with serious conditions, the aforementioned don't interfere with anyone else's personal space. Vaping medical cannabis requires exhalation, which other people have chosen not to breathe. 

For the same reason that people who don't use cannabis might not want to breathe in secondhand cannabis vapour, patients with a prescription equally don't want to stand with people smoking cigarettes. Breathing in secondhand smoke with toxic chemicals linked to lung cancer is not a safe medical setting for patients. You will find yourself in this situation at The Volks nightclub on Brighton's east-end beachfront if you take your prescription cannabis on a night out with you. 

Staff at The Volks told me that the police had been in touch with them about medical cannabis now that it was legal and explained that a legal prescription must be seen. It's not a case of just letting anyone smoke a joint or someone just claiming they have a medical requirement for it but haven't had a doctor's approval yet. 

Conclusion

The public is still very much unaware of the legal status of medical cannabis. Most bar staff seemed polite and reasonably exercised logic to navigate the new ground when presented with the situation. However, a minority seemed less sympathetic. 

Suppose you intend to go out and expect to be able to take your prescription inside a venue without first confirming the establishment's policy? In that case, you may be asked to leave regardless of disability discrimination. If you can use your legs without an issue, you will likely be asked to go outside for the short time it takes to vaporise medical cannabis. Britain is 16 years into the Health Act which banned smoking and required venues to maintain a clean air policy. This is an important law that most citizens like being upheld. 

Putting your cannabis prescription on the table will raise some questions from interested people around you. You may be faced with more attention from the public than you anticipate if you decide to have a vape, though. 

If you are out with your prescription, just remember to carry all your legal requirements - or if you are a Releaf patient, you just need your Releaf medical cannabis card, which handily stores all of that information for you.