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The GP is most definitely not being difficult. Cannabis-based medicines may be depicted in the media as a cure for all ills, but the evidence is not as overwhelmingly positive as it sometimes seems. The National Institute for Health and Care Excellence (NICE) recently published guidance that made recommendations around the use of such products for various conditions. Chronic pain – the only indication under which rheumatoid arthritis might be considered to fall – was not one of them. This is because the evidence for certain cannabis-based medicines showed only a modest reduction in pain with no associated decrease in the use of opioid painkillers. When combined with the large number of people who have conditions that can cause long-term pain, the cost of using such medicines would have been significant but with a chance of only marginal gains.

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