Dr. Elaine Breslin:

I thank Deputy Kelleher for his question. He asked about the three conditions that we have selected. We carried out a scientific review of the evidence for the three conditions, namely, spasticity associated with multiple sclerosis, nausea and vomiting associated with chemotherapy and intractable severe treatment resistant epilepsy. The evidence is modest across all of the conditions. In our review of cannabis, in general we found that the evidence is poor and often conflicting for all of the indications. When we say conflicting, we mean that different reviewers consider the information to be different. For example, in the case of pain, one reviewer considered the evidence to be moderate while another stated that it is substantial, although the same data set was used. It is, therefore, difficult to reconcile those positions when trying to make a recommendation.

We have recommended that cannabis could be considered for the three conditions. We are not recommending treatment with cannabis because there are only three authorised medicines available. If patients were to have exhausted all available treatments and the feeling was that cannabis could be effective for a particular patient, cannabis treatment could be considered for those particular conditions. Authorised medicines are available for two of the three conditions and for one of the conditions, which is epilepsy, a cannabidiol oil is currently under development. Deputy Kelleher asked about the European Medicines Agency. The medicine has been accepted as an orphan medicine for the conditions of Dravet and Lennox Gastaut because it is recognised that there is an unmet need. Those are very rare-----