The truth about medical cannabis in the UK
It's been legal for health reasons since 2018, but an estimated 1.4 million people are accessing it illegally for medical self-help
words Mary Steven, additional reporting by Megan Wallace
Unlike a growing number of countries – Canada, Malta, Mexico and 19 US states and counting – the UK is still yet to fully legalise cannabis, and it doesn't look like that will be changing any time soon.
This is all despite the best efforts of certain factions of politics and very vocal campaigners. The Green Party for example, which has adopted a staunchly pro-legalisation stance when it comes to all drugs, in the grand scheme of UK politics is something of an outlier: Conservative and Labour have both it made it clear that full decriminalisation or legalisation are issues they’re not yet ready to platform.
The Conservative Party in particular has an aggressively “tough on drugs” approach, as evidenced by the 10-year strategy released last year in which they claimed that they would confiscate the passports and driving licenses of those convicted of drugs charges. It’s surprising, then, to discover that medical cannabis in the UK isn’t just some far-off dream that will never get past the House of Commons, it’s actually already a legal reality for some.
Medical cannabis for some, not for all
In November 2018, the law changed to allow the prescribing of unlicensed cannabis based medicinal products in certain circumstances, meaning that (surprise!) medical cannabis became legal in the UK. However, it wasn’t until 2020 that the first NHS prescription was actually issued and, to this day, the NHS is reticent to give them out.
NHS guidelines state that medical cannabis can only be prescribed when other treatment options have proved unsuccessful for three conditions: adults and children with severe forms of epilepsy, adults with nausea caused by chemotherapy and people with muscle stiffness and spasms caused by multiple sclerosis. It also cannot be prescribed by an NHS GP, only a specialist hospital doctor. In 2021, it was estimated that those who had successfully received an NHS prescription for medical cannabis were in the low hundreds.
However, it is now estimated that there are around 17,000 people in the UK who have legally accessed a prescription for cannabis-based products for medicinal use (CBPMs). Due to the barriers encountered via the NHS, the majority of individuals who have received a prescription have done so via private clinics.
What types of cannabis products are legal?
When approaching the topic of medical cannabis we have to remember that the forms it takes can differ significantly to the cannabis plants and buds which are synonymous with recreational use. Rather than being prescribed cannabis to smoke, individuals who access CBPMs in the UK are actually accessing a restricted number of medically-approved medicines derived from cannabis or containing THC.
In the UK, three CBPMs are available on the NHS:
- Epidyolex: a highly purified liquid containing CBD (cannabidiol) which does not contain THC (the chemical that makes cannabis users "high") and is used to treat epilepsy.
- Nabilone: a capsule medication and synthetic cannabis that mimics the effects of THC and is used to treat nausea and vomiting in adult chemotherapy patients.
- Nabiximols (Sativex): a cannabis-based mouth spray used to treat muscle stiffness in individuals with MS.
What the experts say
Understanding the different barriers to accessing medical cannabis in the UK, Woo reached out to Jonathan Nadler, CEO of The Medical Cannabis Clinics to learn more about medical cannabis, what it can help with and how it can be accessed legally.
What is the process for gaining a medical cannabis prescription privately?
Jonathan Nadler: Medical cannabis can be used to treat a variety of conditions related to chronic pain and mental health – essentially, conditions where other medications and treatments have failed, and the patient is seeking an alternative approach. The Medical Cannabis Clinics consults this group of people who have tried other medications and they have been unsuccessful. Patients are referred to us or they can self-refer.
Only specialist doctors on the GMC registry are qualified to prescribe this medicine as a last resort and our specialist consultants follow a strict code of practice throughout the whole patient journey to ensure adherence.
When a patient comes to us, they will need to have tried at least two other forms of medication to treat their condition. From here, they will undergo a consultation with one of our specialist doctors to determine their suitability to the medicine. Testament to its impact on people’s lives is the feedback we receive from patients. Many report it has helped them with various chronic conditions relating to pain, psychiatric and neurological ailments.
While it is technically legal, how available is medical cannabis on the NHS?
Jonathan Nadler: Despite being legal, unfortunately only a handful of patients have secured NHS prescriptions. It has been reported that approximately 1.4 million people are consuming cannabis illegally for medical reasons. Our stance is that there should be a lot more of those patients that have access to legal medical cannabis, but they haven’t and this is something we are opposed to and hope will change over time.
The private route is what we offer to help those needing our help, right now. And remember, medicinal cannabis is the oldest prescribed medicine known to man and considered to be extremely safe with high efficacy proven by numerous clinical, professional studies.
Is there sufficient awareness of the legality of medical cannabis in the UK?
Jonathan Nadler: There is nowhere near enough awareness that medical cannabis is legal. Despite being legal since 2018, we know there are hundreds of thousands of people out there who could benefit from using the medicine, rather than traditional medications that come with severe side effects.
Our stance is that if we reduce a person’s suffering, improve their quality of life, medicinal cannabis is worth investigating. And we are doing all that we can, as are other private clinics, to spread this message and overcome stigmatism and misinformation. We’re seeing is a real cross section of different types of patients coming to see us with conditions ranging from sleep-focussed conditions all the way through to chronic pain.
If you would like to learn more about medical cannabis in the UK and where to legally access it, the Medical Cannabis Clinicians Society has compiled a list of clinics which can legally prescribe it.