Drug Driving: Proposed Regulations – Analysis of Consultation Responses

5. Views About the Limit for Cannabis / Sativex (Q4)

5.1 The consultation document discussed a proposed limit for cannabis. The point was made that around 1,500 people in the UK are currently prescribed Sativex (a cannabis plant-based drug licensed for medical use in the UK in the treatment of multiple sclerosis (MS)), and around 200 of these may be driving. Roadside screening tests are unable to distinguish between cannabis and Sativex.

5.2 MS is a medical condition that must be notified to the DVLA. If a patient's doctor provides an opinion to the DVLA that the patient is safe to drive, then the DVLA would notify the patient that a short-term driving licence will be issued for up to three years. Along with this notification, the DVLA proposes to include advice to drivers that if they have any involvement with the police related to their driving, they must be able to provide evidence that they have been prescribed Sativex. The DVLA also proposes to contact the Association of Chief Police Officers (ACPO) to make them aware of the situation with respect to the use of Sativex in the treatment of MS.

5.3 Given the very small number of drivers using prescribed Sativex, and the more prevalent use of illegal cannabis, the Government proposed to take a zero tolerance approach to the use of cannabis. Respondents were asked for their views:

Question 4: Is the approach we are proposing to take when specifying a limit for cannabis reasonable for those who are driving and being prescribed with the cannabis based drug Sativex (which is used to treat Multiple Sclerosis)? If not what is the evidence to support your view?

5.4 Altogether, 32 respondents (29 organisations and 3 individuals) made a comment relevant to Question 4. Of these, 23 (72%) agreed with the approach proposed by the Government regarding the limit for cannabis and four (13%) disagreed. Five other respondents (16%) made comments which did not express a clear view. See Table 5.1.

Table 5.1: Question 4: Is the approach we are proposing to take when specifying a limit for cannabis reasonable for those being prescribed Sativex?

Percentages do not all total 100 due to rounding.

Reasons for agreeing with the proposed approach

5.5 Among those 23 respondents who agreed with the proposed approach regarding cannabis and Sativex, some gave no reason. However, others described the proposal as 'reasonable', 'pragmatic' and 'proportionate', since the use of prescribed Sativex is rare, while the illegal use of cannabis is much more common.

5.6 One private sector respondent described the concern about prescribed Sativex as 'a red herring', claiming that there were only a very small number of MS sufferers taking prescribed Sativex, and many of these are unable to drive as a result of their illness. However, others emphasised that the police should be made aware that people with MS who are taking Sativex may be driving legally.

Reasons for disagreeing with the proposed approach

5.7 Four respondents disagreed with the proposed approach, and these offered lengthier and more complex comments. The reasons for disagreeing with the proposed zero tolerance approach to cannabis / Sativex were as follows:

• The proposal was considered to be inconsistent with the Government's own arguments for not pursuing Policy Option 3. In particular, the consultation document acknowledges that the use of psychoactive drugs may improve driving for some patients (resulting in freedom from pain and a greater degree of mobility). It was felt that these same arguments should apply to the use of Sativex for therapeutic purposes.
• It was thought that the proposed zero tolerance approach towards cannabis / Sativex would cause unintended harm by preventing some patients from receiving treatment that minimises their symptoms (on the one hand), and by causing nuisance to those who wish to persist with Sativex (on the other). Although respondents acknowledged that the use of Sativex is currently very low in the UK, it was thought that there is likely to be a growing acceptance and use of cannabis-based medicines over the next few years. One respondent noted that there are ongoing clinical trials related to the use of Sativex for relief of acute and severe pain in patients with ulcers, diabetes and terminal cancer.
• It was argued that this proposal represented an intention by the Government to shape evidence to fit policy, whereas those who disagreed with this proposal thought that policy should be shaped by evidence.
• The view from one road safety organisation was not entirely clear; however, this respondent appeared to be arguing for a stronger, more robust stance regarding prescribed Sativex than that proposed by the Government. This respondent made the point that Sativex is currently used as a 'last resort' to control spasticity among MS sufferers, and that MS causes a variety of symptoms which would make an individual unfit to drive. This respondent thought there should be no defence in law for patients who ignore medical advice about their prescribed medication and its effects on driving.

Other comments made by respondents

5.8 The comments of five respondents were unclear in relation to whether they agreed or disagreed with the proposed approach to cannabis / Sativex. In general, these respondents expressed concerns about the approach, but without explicitly stating whether they agreed or disagreed with it. The main concern was that people with MS and other painful conditions should be able to benefit from Sativex and to continue to use it without fear of arrest or prosecution. These respondents thought it would be distressing for people who are ill to be put in the position of having to defend their use of prescribed medication. One respondent from a charitable organisation involved in supporting people with chronic pain suggested that a central register could be set up which contains the names and addresses of all patients receiving Sativex under prescription, and that this database could be available to the police.

5.9 Respondents who were in favour of the proposal to take a zero tolerance approach to cannabis / Sativex expressed different concerns, and these were mainly about current procedures for warning patients about the dangers of driving when taking certain prescribed medications, and the procedures for notifying the DVLA about patients taking such medications. Respondents often expressed the view that any changes in legislation would need to be accompanied by clear information for prescribers, pharmacists and patients. Moreover, respondents wanted prescribers and pharmacists to take more responsibility in making patients aware of the potential risks, but also thought that people who ignore these warnings should not be able to claim a medical defence.

5.10 Some respondents supported the proposal, discussed in the consultation document (paragraph 14.20), that the DVLA notifies all drivers being prescribed Sativex to give them information about the changes to legislation.