Cannabis report: 'I would probably lose my job' says teacher who uses cannabis to ease his neurological condition
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Every evening, James (not his real name) relaxes at home with cannabis, as his children sleep. While he was a recreational user in his younger days, the 41-year-old says his use now and for the past four years is for medical reasons.
He believes the drug is central to protecting his wellbeing and puts off the day when he will have to go on regular prescribed drugs to tackle his health issues.
But, as a teacher in the west of Ireland, he is fearful of people knowing that he is a regular user of cannabis. He explains: “There are still very backward attitudes by some and little proper information on the real benefits of cannabis.”
He has never been caught in possession of cannabis but he is constantly fearful. He says:
"It would probably make me lose my job — the stigma, the rumours, and the issues around being in court for something that is prescribed as a medicine in many other countries."
The 41-year-old suffers from myasthenia gravis, a neurological condition which leads to weakness and rapid fatigue of muscles.
“I get very weak and need to rest quite a bit after any exertion," James says. "This affects my life and how I can play and look after my children.
"It also affects my sleeping patterns and in turn my mental health. I self-medicate with cannabis — from helping with sleep to relaxing muscles after exertion.
This article is part of a series in the 'Irish Examiner' — in print and online — outlining arguments for and against regulating cannabis as a medicine. Click here to read the entire series.
"The problem is that in other countries I would be prescribed exactly what is needed, whereas in an unregulated market it is very hit-and-miss. I find this infuriating that in a developed country people are in pain or discomfort due to policy.”
Sean (not his real name) was diagnosed with primary progressive Multiple Sclerosis over three years ago. The now 57-year-old Wicklow man says everybody’s symptoms are different.
He explains his condition: “I am numb from my torso to my toes on both sides, and in both hands. I am in extreme nerve, neuropathic, pain around my ribs and legs. I have spasticity — stiff, heavy legs because the muscles are not getting the right messages.”
He also suffers from ‘Lhermitte’s sign’ which is like an electric shock in his body.
“I also have 16 lesions in my brain and 14 on my spine," Sean says. "When I move my neck in a certain way, and put a bit of pressure on one of the lesions, it sends out an electric shock and it is like sticking your finger in a plug socket.
"There are also cognitive issues, fatigue, insomnia — and it is possible to have both: I can’t stay awake so I could go to bed during the day for two or three hours," Sean says.
"But then at night, it is hard to sleep because I am wide awake at the wrong time.
In the 1980s, Sean smoked cannabis recreationally but hadn’t used it for up to 30 years.
After his diagnosis, a friend of his gave him homegrown herbal cannabis to see if it would help him.
“The minute I tried it, the Lhermitte’s finally went away, the spasticity was dramatically improved," he says.
"The neuropathic pain in my ribs and in my leg eased and I was able to cut down from 2,700mg of Gabapentin to 900mg — a third.”
But he says this led to withdrawal symptoms from the Gabapentin, which then had to be upped again to deal with that. Shortly before the Covid-19 pandemic reached Europe, Sean travelled to Amsterdam on holidays, where he took some cannabis brownies.
He then tried very high-strength CBD which he said did nothing to relieve his symptoms. He says that the other well-known cannabis constituent, THC, is what helps him.
As well as improving his spasticity, he finds that cannabis also helps his gait, nerve pain and his sleeping difficulties.
“I don’t use it in a joint or anything like that," he says. "I use it in a vapouriser which is specially made for cannabis.”
Unlike Sean, James is currently not on medication for his condition.
While Myasthenia Gravis can be treated with immunosuppressant drugs and steroids, there is no cure for it. He is slow to use the medications at present because of the effects they can have on sleep and on the immune system.
But he said: “As it gets worse, I will have to think about these.
"For the moment, self-medicating is working fine. I try to follow what people in the US and Canada who are prescribed cannabis for it are doing.”
He finds it easy to source cannabis in his area in the northwest of the country.
“I don’t grow my own," he says. "I probably will in the future but with small children I just don’t have space or time. Some of my friends do grow and that is where I get some of the cannabis needed. It is always the best as it is organic — you know what is used to grow it and you know exactly what you’re getting.
"It is created for what you need from it, medicine wise.”
He gets his cannabis supply from friends, with only some being homegrown. He says that because not all of his supply is homegrown, it leads to having to use cannabis which may not dried properly or may not be good to help him sleep.
“Some cannabis is great for alertness and creativity — I need the relaxant more,” he says, adding that the non-uniformity of what he is taking is because the drug is not regulated in Ireland.
Trying to source it in Ireland is a big issue too for Sean. He says growing it is a big risk because of the smell, and the draw on electricity used for the heat lamps. He says the price on the black market is “crazy”, there is a risk attached to buying it, and there is a fear of additives being in it.
Another aspect of his using cannabis which worries him is the risk of being caught and having his driving licence revoked.
“I am using it when I can get it," Sean says. "For example, if one of my mates has grown a plant or he knows someone who is selling it. I get little bits here and there. I get it about once a week — if I stretch it out, I might get two or three days out of it.”
Sean is currently on 14 different medications, ranging between 40 and 44 tablets a day.
He believes that medicinal cannabis would help him to reduce the level of medication to six to 10 tablets per day because there would not be a need for him to have medication to control his spasticity, Lhermitte’s, and nerve pain. He is on nine tablets per day for nerve pain.
A new product due to come on the market in Ireland shortly which Sean believes would help him is produced by Tilray one of the first companies to be licensed to produce medical cannabis in Canada.
He has applied under the Medical Cannabis Access Programme (MCAP) for the product but his application has not yet been approved.
The product contains both CBD and THC, and is one of only two drugs under the MCAP which are approved for spasticity and MS.
However, the Tilray product is the only one of the two which will be reimbursed by the HSE. Sean says the MCAP scheme needs to be expanded to include conditions including chronic pain.
Currently, according to the Department of Health, there are 12 patients currently approved for products listed under Schedule 2 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019, through the MCAP.
The existing scheme covers the prescribing of cannabis-based products by medical consultants, for patients with certain medical conditions who have exhausted all other available medical treatment options.
The conditions are spasticity associated with multiple sclerosis; intractable nausea and vomiting associated with chemotherapy, and severe, refractory (treatment-resistant) epilepsy.
A department spokeswoman said: “In 2022, following completion of an updated evidence review, the Department plans to establish an expert group to further review the use of cannabis for medical use. Members have not yet been appointed to this review panel as work is ongoing on the research aspect of this work.”
Sean is currently waiting for a double hip replacement as a result of the effects of steroid medication given to him to deal with flare-ups.
He now suffers with avascular necrosis, a condition caused by the medication cutting off the blood supply to his femurs and the balls of both hips have crumbled away, leading to extreme pain.
He believes that he if he had been able to use THC instead, he would not have suffered the bone loss and would not now require double hip surgery. He says:
“A natural herb that is freely available in many countries and grows wild on the side of roads and is approved in Malta, most of America, Amsterdam, South Australia... A plant that is available in places to use recreationally would have stopped me ending up having to have a double hip replacement and all the money that will cost to the HSE.
“Plus, my life has misery for the last 18 months — I have been in severe agony.”
He hopes that surgery will mean he can reduce his medication by cutting out painkillers, and that his application for the Tilray product will be successful for the same reason.
James uses cannabis every night but as a father to young children, he waits until they are in bed.
“This is the best time anyway to use it to help with muscles and sleep," he says. "I would not use machinery or drive a car at this time.”
He has been using cannabis for self-medication for the past four years and says his use before that was purely recreational in his younger days, at college parties for example.
Although using every day, James says: “I do not believe that I am ‘addicted or hooked’.
"People get addicted far more to their prescribed drugs which have lasting consequences. There have been times where it was difficult to get and this really affected the use of one of my arms especially.
“Many studies in Canada are showing that with a regulated market the benefits from health, to youth use of cannabis, have been positive.”
Cannabis possession by adults over 18 years old has been legal in Canada since 2018. It is also legal to grow up to four cannabis plants per residence for personal use. Since 2019, the sale of cannabis edibles and concentrates is legal.
James says that self-medicating with cannabis helps him to hold down his job, which he says is stressful at times.
He continues: “I get up much easier in the mornings and feel much better because of cannabis. I have had to give up sports because of my diagnosis, but I still enjoy swimming and hill walking. It is drugs like alcohol that I have had to greatly reduce.
"Coffee also affects my muscles and can lead to weakness later on. As these are regulated at least I know what I am dealing with and can plan accordingly.”
He believes that many people who use cannabis medicinally are being forced to go to the black market because the drug is illegal in Ireland.
"This is again about education and backward government policy, where the likes of Vera Twomey had to fight tooth and nail for her daughter’s care. Many people have emigrated to Spain and more progressive countries.”
He says he is aware of people who have had to move abroad to countries such as Spain to be able to legally access cannabis for health conditions.
He believes that the current State policy on drugs is enriching drug gangs.
“Unfortunately, I believe we will be one of the last to see change in Europe, and that will be to the detriment of many citizens in this country.”