At the time of writing, the NHS is not prescribing medical cannabis, so patients must be prepared to pay for a private prescription. However, an NHS specialist is legally permitted to prescribe the medicine, so it always worth asking! See question 2 for more on this. Find a clinic on the internet (a Google search for medical cannabis clinics will give you a range of choices, or have a look at our clinic directory) and fill in the details required – this usually includes information about your medical history. When the clinic responds, they will provide next steps which will vary by provider. You may need to speak to your GP for a referral letter, or ask them to release your medical notes to the clinic. They may contact your GP on your behalf. Your records will be sent to the clinic’s consultant who will decide whether you are eligible for medical cannabis treatments. Clinics will not see you without the relevant medical records or a GP referral. If you are eligible for medical cannabis treatment, you will be sent an appointment request via tele-health consultation (during restrictions due to Covid-19).
Currently, medical cannabis prescriptions are only available in the private sector. Limited guidance for doctors mean that no new NHS prescriptions for medical cannabis have been issued in last 18 months. Legally there is no barrier, but in practical terms this is almost impossible. There are three exceptions. Sativex is a cannabis medicine licensed for use with spasticity in multiple sclerosis and can be prescribed on the NHS. Also, Epidyolex can now be prescribed on the NHS for certain childhood epilepsies (Dravet and Lennox-Gastaut syndromes) alongside another drug called Clobazam. Finally, a synthetic cannabis called Nabilone is also prescribable on the NHS for severe nausea and vomiting, usually during chemotherapy.
Any doctor on GMC Specialist Register can prescribe medical cannabis. This is usually a hospital consultant. A GP can prescribe under shared care arrangements under the direction of a specialist. You are more likely to be prescribed medical cannabis from a doctor working for a medical cannabis clinic as those doctors are more likely to have been trained in cannabis medicine.
Contact one of the cannabis specialist clinics now operating in the UK, or contact the Society, who can point you in the right direction.
In most cannabis clinics you can self-refer but they will need to contact your doctor to confirm your medical history.
A medical cannabis clinic can still see you. GPs are obliged to provide a medical summary to your medical cannabis clinic so this should not be a barrier to treatment. A GP can prescribe for follow-up under the direction of a specialist. This might be possible (although currently unlikely). The clinic can ask your GP if he/she would be willing to prescribe for follow up appointments.
There are no barriers to medical cannabis treatment and any condition can be considered. However, most prescriptions are for chronic pain, anxiety, PTSD, epilepsy and muscle spasm (spasticity).
This is the body’s own “cannabis” system. We all have cannabinoid nerve receptors in our brain and elsewhere in the body. We produce chemicals, called endocannabinoids, which lock on to those receptors and perform vital functions. This system is responsible for such things as pain control, mood control, anti-inflammation response, control of bodily movement, epilepsy, etc. The plant cannabinoids, called phytocannbinoids, help that system by also locking on to those receptors. This is why cannabis has so many potential uses.
Both THC and CBD have medical properties. THC is the cannabinoid that is the major part of recreational cannabis and in high doses can cause impairment. In lower doses it is a muscle relaxant, can help with sleep and many different causes of pain. It can also help with nausea and other chemotherapy related side effects. CBD does not cause impairment. CBD is often used in anxiety, epilepsy and pain management also. There is much overlap between the two when controlling symptoms. When you are assessed by a doctor they will determine the combination that is most likely to help your symptoms. Most doctors start with a higher CBD product with small amounts of THC and increase the dose slowly, but it will depend on your previous exposure to cannabis and your symptoms. If prescribed carefully, the side effects one commonly recognised with recreational cannabis and unopposed THC use are usually very minimal and well tolerated.
Over-the-counter CBD is usually derived from hemp. Hemp is a cannabis strain that has been grown for centuries for its strong stem that is used for paper and building materials, for example. It is also used for hemp seed oil production, which is a very healthy oil which can be used in cooking. However, hemp contains high levels of CBD and very little other cannabinoids and few of the other components, like terpenes and flavonoids. It is thought by many that these other components are essential for the full medical benefit of the plant (the entourage effect). So, over-the-counter CBD might be useful for some conditions but less likely to help than the prescribed medicine. Also note the over-the-counter CBD products cannot make any medical claims for their products and they are not subject to such stringent controls as a medical product. It is sometimes difficult to know what to take and in what dose.
Medical cannabis not only contains cannabinoids, but also other chemicals called terpenes (which give smell) and flavonoids (which give colour). There are over 130 cannabinoids, in addition to CBD and THC, as well as over 100 terpenes and flavonoids. It is thought that the full plant with all those components in various proportions give a better medical effect than the individual parts. That is the entourage effect and explains why the full plant prescriptions may be better than the over-the-counter hemp CBD products.
Generally, recreational cannabis is high in THC and low in CBD – opposite to most of the initial medical cannabis prescriptions. Also, recreational cannabis comes with no guarantees of safety and quality and may well be contaminated with other chemicals like heavy metals and pesticides. Usually, you will not know what’s in recreational cannabis and one batch is likely to be different from the next.
Medical cannabis and UK law
You are not legally allowed to do this. We don’t encourage anyone to break the law. The MCCS believe that regulated, GMP quality cannabis provided under expert care and with monitored dosage is the right way to access medical cannabis. GMP (Good Manufacturing Practice) means that the products are high quality, consistent and free from any contaminants. Only GMP products can be prescribed in the UK.
It is, of course, possible to be stopped in possession of cannabis. You will need to show that you have been legally prescribed the product. It’s a good idea to carry your prescription with you. If you have over-the-counter CBD then it should be sufficient to say that it is a legal product, but keep the container with you.



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