The HPRA (Health Products Regulatory Authority - Ireland) advises that cannabis should only be made available for the treatment of patients with specified medical conditions which have failed to respond to all other previous treatments, and where there is at least modest evidence that cannabis may be effective. Such patients should be under the direct supervision of an appropriately trained and experienced medical consultant.
The specified medical conditions are:
- Spasticity associated with multiple sclerosis resistant to all standard therapies and interventions whilst under expert medical supervision
- Severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications whilst under expert medical supervision
- Intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes whilst under expert medical supervision
The selection of these medical conditions is based on:
- A possible unmet medical need for individual patients;
- The ability for the medical consultant to monitor the effectiveness of treatment using objective endpoints;
- The existence of authorised cannabis-based medicines or medicines undergoing clinical trials, consequently there is clinical evidence and some research in relation to cannabis and these conditions.