Some are more equal than others

PatientsCann UK | Some Are More Equal Than Others Skip to content Equality law Prescription discrimination Opinion and analysis Some Are More Equal Than Others… Medical cannabis patients are often told that they are protected by the Equality Act 2010. For many patients, that may be true. But it is not true simply because somebody has been prescribed cannabis. PatientsCann UK® Equality Act 2010 and medical cannabis By Sal Aziz, Director On this page A prescription is not a disability certificate Who decides Presumed disabled? Volunteers Capacity matters Routes to discrimination Exceptions Finding common ground References Please note This article is general information about equality law and how PatientsCann UK® approaches it. It is not legal or medical advice. The legal test A prescription is not a disability certificate The Equality Act protects disability as a legal status. It does not create a separate protected characteristic of being a patient, taking prescribed medication or holding a medical cannabis prescription. It also does not apply universally to every relationship between an individual and an organisation. Protection depends both on whether the person meets the statutory definition of disability and on the capacity in which the organisation is dealing with them. That distinction creates an uncomfortable question: if the same practical accommodation can safely be offered to every lawful patient, why should compassion depend on whether the patient can prove that their condition crosses a legal threshold? Section 6 of the Equality Act defines disability as a physical or mental impairment having a substantial and long-term adverse effect on a person’s ability to carry out normal day-to-day activities. “Substantial” means more than minor or trivial, while “long-term” generally means that the effect has lasted, or is likely to last, at least 12 months or for the rest of the person’s life. Recurring conditions can also qualify. Some conditions receive special treatment. Cancer, HIV infection and multiple sclerosis are disabilities from diagnosis. Progressive conditions may qualify before their effects become substantial where the statutory test is satisfied. The Act also protects people who previously had a qualifying disability, subject to limited exceptions. Crucially for medical cannabis patients, the assessment normally considers what the impairment would be like without the measures being used to treat or correct it. Schedule 1 expressly includes medical treatment within those measures. A patient whose condition is well controlled by cannabis is therefore not necessarily excluded from protection simply because the treatment works. The relevant question may be what the condition would probably do without that treatment. Many medical cannabis patients are prescribed for serious, persistent or recurring conditions and are therefore likely to satisfy the definition. It would, however, be unsafe to claim that every patient is legally disabled. A prescription may provide important evidence of an underlying impairment and treatment, but it does not by itself establish the substantial, long-term effect required by section 6. The Equality Act’s exclusion of addiction to alcohol, nicotine or another substance should not be confused with lawful treatment using a controlled drug. The 2010 Disability Regulations exclude addiction itself as an impairment, subject to an exception where it originally resulted from medically prescribed drugs or other medical treatment. In most medical cannabis cases, the asserted disability will in any event be the underlying physical or mental impairment, not an assumed addiction to the prescribed medicine. Japan has arguably the most formalised and structured official framework in the world. The government issues physical booklets called Shōgaishatechō (障害者手帳) or Disability Handbook. Applications are generally made through the relevant local authority and supported by medical or specialist evidence. The precise assessment process depends on the type of certificate and the municipality involved. Pictured above is a Seishin Shōgaisha Hoken Fukushi Techō (精神障害者保健福祉手帳) or Mental Disability Health and Welfare Handbook. Similar schemes exist in other countries, such as Germany’s Schwerbehindertenausweis for severe disabilities. Whilst The Sunflower Scheme is available for anyone who self-identifies as having a hidden disability, and PIP is available for those with qualifying disability or long-term condition, no directly comparable scheme exists in the UK. 精神 手帳 京都市.jpg by Bitland is licensed under CC BY 4.0 Evidence and burden Who decides whether somebody is disabled? There is no universal Equality Act disability card and no general process through which every patient obtains a binding declaration before requesting fair treatment. Outside litigation, organisations and individuals must make practical decisions using the information reasonably available to them. Evidence might include a patient’s account of functional effects, prescription records and, where proportionate, relevant clinical or occupational-health evidence. If a dispute reaches legal proceedings, the court or tribunal ultimately determines whether the statutory definition was satisfied at the relevant time. Section 136 provides a shifting burden of proof in discrimination proceedings once there are facts from which a court could conclude, in the absence of another explanation, that a contravention occurred. That procedural rule does not make a prescription conclusive proof of disability, but neither does it entitle organisations to dismiss credible evidence until a patient has obtained a judgment. This leaves patients in a difficult position. They may have to disclose intimate medical information to establish rights that an organisation could have respected voluntarily from the outset. The more evidence demanded, the greater the intrusion. Yet if too little information is provided, an organisation may argue that it did not know, and could not reasonably have been expected to know, of the disability, particularly in a claim for discrimination arising from disability. Policy, not finding Should patients be presumed disabled in practice? As a strict statement of law, organisations should not declare every medical cannabis patient disabled. Not every patient will meet the definition, and disability is a status belonging to the person, not a label produced by the medicine. But there is an important difference between making a legal finding and adopting an inclusive policy. An organisation can usually choose to extend a proportionate adjustment, such as secure medicine storage, a private administration area, flexible breaks or an individual risk assessment, without first

Already Vaped Bud (AVB)

PatientsCann UK | Already vaped medical cannabis (AVB): a practical guide Skip to content Legal & Support AVB / ABV General information Already vaped medical cannabis (AVB): a practical guide for patients Many patients who lawfully use prescribed cannabis flower in a dry-herb vaporiser ask what to do with the material left behind after vaping. It is often called already vaped bud (AVB), or already been vaped (ABV). There is very little official guidance on the subject, but the law does provide some helpful answers. PatientsCann UK Legal & Support Plain-English guide On this page What the law says Is AVB lawful? Good practice Why keep AVB? A sensible approach General information, not legal advice This guide explains how the current law appears to apply. It is not legal advice, the law may change over time, and every patient’s circumstances are different. The short answer No duty to destroy Nothing in the law requires you to destroy cannabis the moment it has been vaporised. No time limit There is no set limit on how long lawfully prescribed cannabis may be kept. No container rule Your medication does not have to stay in its original dispensing container at all times. Quick reader poll Be honest: what happens to your AVB? A quick, anonymous poll for community interest. One tap and you are done. What do you do with your already vaped bud? Bin it right away Straight in the bin, no ceremony. Feed it to the soil Compost it and let the garden say thanks. Store it and forget it It is in a jar somewhere. Probably. Save it to re-use Waste not, want not. Dispose of it at a pharmacy Hand it in at a local community pharmacy for safe disposal. Not applicable, I do not use flower No dry-herb vaping, so no AVB to deal with. I am happy to share my anonymous answer with PatientsCann UK. Cast my vote Please note. This poll is for community interest only and is completely anonymous. It is not medical or legal advice. Whatever your answer, keep following your prescriber’s directions. Unwanted medicine can be handed in at a local community pharmacy for safe disposal, as pharmacies in the UK accept unwanted medicines from private households as part of their NHS essential services. Thanks for voting! Your answer is in, and it stays anonymous. However you handle your AVB, remember to follow your prescriber’s directions. Unwanted medicine can be handed in at a local community pharmacy for safe disposal. The legal position What does the law say? Prescribed cannabis is a controlled drug Cannabis-based products for medicinal use (CBPMs) prescribed by a specialist doctor are Schedule 2 controlled drugs under the Misuse of Drugs Regulations 2001. The Misuse of Drugs Act 1971 makes it unlawful to possess a controlled drug unless you are authorised to do so. For patients, that authority comes from the Misuse of Drugs Regulations 2001, once the medicine has been lawfully prescribed and supplied to you. What the legislation does not say Importantly, there is no provision in the legislation that: requires patients to destroy cannabis immediately after it has been vaporised; imposes a time limit on how long prescribed cannabis may be possessed; or requires medication to remain in its original dispensing container at all times. The key question Does AVB remain lawful? There is currently no reported UK court decision dealing specifically with already-vaped prescribed cannabis. However, AVB originates from medication that has been lawfully prescribed and supplied. The legislation does not say that it becomes unlawful simply because it has been heated in a vaporiser. While no definitive legal ruling exists, there appears to be no statutory requirement to dispose of it immediately after use. AVB starts life as lawfully prescribed medicine. Nothing in the legislation says it stops being lawful the moment it has been heated. PatientsCann UK, Legal & Support Sensible habits Good practice Although the law does not specifically require it, a few simple habits can make the origin of your AVB clear if anyone ever asks. Patients may wish to do the following. 1 Keep your prescription or dispensing label Hold on to your current prescription, or the label from your dispensed medication. 2 Carry proof of identity when travelling If you travel with your medication, keep proof of identity with you. 3 Reuse the original container If you are keeping AVB for later disposal, store it in the original empty dispensing container where practical. 4 Keep it separate Avoid mixing AVB with non-prescribed cannabis or any other substance. Why this helps. Together, these steps help show that the material came from medication lawfully prescribed to you, should any question ever arise. Everyday reasons Why might someone keep AVB? Some patients hold on to AVB for a short time before disposing of it, for entirely everyday reasons, including: convenience; waiting until they are home before disposing of it; or collecting it so it can be disposed of safely in one batch. Safe disposal is a genuine reason to hold on to it. The NHS advises that unwanted medicine should be returned to a pharmacy for safe disposal rather than put in household waste, so keeping AVB until you can hand it in is a responsible thing to do. The law does not distinguish between these situations. Keeping AVB briefly for any of these reasons is treated no differently from keeping it for any other. Putting it together A sensible approach Keep following your prescriber’s directions on how to use your medication. If you do keep AVB, a clearly labelled container that links it to your prescription can help show where it came from. Keep it separate from your fresh medication, though: returning AVB to a bottle that still holds unused flower can affect your dosing and contaminate medicine you have not yet used. None of this appears to be a legal requirement, but it is simple and sensible. In summary The bottom line Current UK legislation does not appear to