Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I am sorry I had to leave earlier. I apologise if I am repeating points that have been dealt with in my absence.

I wish to clarify the answer given by Dr. Nolan before I left. Dr. Nolan said that the patient who claims to require this medication must be under the supervision of a consultant but that, in theory, the prescription could be written by a registered medical practitioner. This applies only under three specified conditions, namely, resistant epilepsy, nausea to do with cancer treatment and multiple sclerosis.

One requirement to access the programme is that those involved have exhausted or used all other forms of medication. Perhaps the pharmacist, Ms Maria Egan or whoever is most suitable could outline the answer. There are examples of interactions that arise between medications and common foods, such as the interaction of certain medications with grapefruit. Often people do not identify the interaction between warfarin and spinach. Interactions with medicines are not simple. Obviously, there are the effects of medicines on other medicines but other issues can emerge through the use of certain medicines. This is not straightforward. If something has not been trialled correctly and is mixed in with other mediations or foods, then the data are not available. People can actually die from the use of some over-the-counter products with warfarin. I say as much simply as an example to show that it is not as clear-cut as ticking a box.

As I was leaving, it was stated that the European Medicines Agency has no position on this and does not endorse CBD as the evidence is not suitable. Is that correct? Have I understood that correctly?

As a pharmacist and on Deputy O'Brien's point on side effects of Prozac, having a prescription does not change the side effect profile of something. It does not really matter if one is taking Prozac or anything else with a prescription; the side effects will be the same. It just means that someone is responsible and the person is part of a care pathway.

On reimbursement costs, many unlicensed medicines are reimbursed. They get special reimbursement. My concern is that Holland, whose pharmacy system I am quite familiar with, has specific pharmaceutical grade product with specific concentrations that are used. Perhaps I am not understanding it, but will the witnesses elaborate on what exactly we are saying is okay in these three conditions? Is it an arbitrary concentration of a product or an arbitrary derivative? Are we looking at a specific breed of plant, extract or concentration? What do we have when it comes to dosage and indication? I know the evidence is poor, but have we any dosing parameters to work with?