Is Medical Cannabis Legal?
Comprehensive Guide on the Legal Status of Medical Cannabis in the UK (2024)
Overview
Medical cannabis in the UK has been a subject of significant evolution over the past decade. Following its legalisation for medical use in 2018, the landscape of regulation, prescription, and access has developed, though many hurdles remain for patients and healthcare professionals alike. As of 2024, medical cannabis is legal under certain conditions, but its availability is still tightly controlled. This guide covers the current legal status of medical cannabis in the UK, key regulatory frameworks, how patients can access medical cannabis and ongoing challenges.
Legal Framework
Cannabis Reclassification (2018)
The major shift in the legal status of medical cannabis occurred in November 2018, when the UK government reclassified cannabis-derived products for medicinal use from a Schedule 1 to a Schedule 2 controlled substance under the Misuse of Drugs Regulations 2001. This change allowed specialist doctors to prescribe cannabis-based medicines legally for the first time.
Schedule 1 drugs are considered to have no therapeutic value and are subject to strict controls.
Schedule 2 drugs are recognised as having medicinal use, allowing them to be prescribed under specific circumstances.
This reclassification did not make cannabis widely available for medical use but opened the door for controlled prescriptions by specialist physicians.
What is a Cannabis-Based Product for Medicinal Use (CBPM)?
A Cannabis-Based Product for Medicinal Use (CBPM) must meet three conditions to be legal in the UK:
It must be a preparation or product containing cannabis, cannabis resin, cannabinoids, or derivatives of cannabinoids.
It must be produced for medicinal use in humans.
It must meet the definition of a medicine under the Human Medicines Regulations 2012.
CBPMs can include THC (tetrahydrocannabinol), CBD (cannabidiol), or a combination of both. THC is the psychoactive component of cannabis, while CBD is non-intoxicating and often associated with therapeutic properties.
Prescription of Medical Cannabis
Medical cannabis can only be prescribed by a specialist doctor who is registered on the General Medical Council (GMC) Specialist Register. The prescription must also be for a condition where there is sufficient evidence that cannabis-based medicines could be effective, as judged by the doctor.
General Practitioners (GPs) cannot initiate prescriptions for medical cannabis, but they may continue them if instructed by a specialist.
Conditions Approved for Medical Cannabis
The National Institute for Health and Care Excellence (NICE) provides guidelines on the use of cannabis-based products for medicinal use. As of 2024, medical cannabis is recommended or considered for:
Severe epilepsy: Particularly in conditions like Dravet syndrome and Lennox-Gastaut syndrome, where other treatments have failed. Epidyolex, a CBD-based drug, is licensed for these conditions.
Multiple sclerosis (MS): Sativex, a cannabis-based mouth spray, is approved for spasticity associated with MS, but only in cases where other treatments haven’t worked.
Chemotherapy-induced nausea and vomiting: Medical cannabis may be prescribed for patients undergoing chemotherapy who have not responded to conventional antiemetic treatments.
Other conditions, such as chronic pain, anxiety, and fibromyalgia, the condition I have, has seen off-label prescriptions of medical cannabis, but these are rare and often come with legal and administrative complications due to the lack of extensive clinical evidence.
Access to Medical Cannabis in 2024
Private Clinics
Since the 2018 change in the law, a growing number of private clinics have emerged across the UK, offering medical cannabis prescriptions. These clinics tend to be more willing to prescribe medical cannabis for a wider range of conditions, such as chronic pain, anxiety, and sleep disorders.
Cost of Treatment: Private prescriptions can be expensive. Monthly costs for patients often range from £150 to £500, depending on the product and dosage. This can be a significant barrier for many patients.
Types of Products Available: Private clinics offer a range of products, including cannabis oils, capsules, and vaporized products that contain varying ratios of CBD and THC.
NHS Prescriptions
Access to medical cannabis through the NHS remains very limited. Despite the legal framework allowing it, many NHS doctors are reluctant to prescribe cannabis due to:
Limited clinical evidence for many conditions.
Regulatory restrictions and guidance from NICE.
Cost considerations for certain cannabis-based medicines.
As a result, NHS prescriptions for medical cannabis are rare, with most being limited to patients with severe epilepsy or MS-related spasticity. This is a major driver in my passion to produce my products.
Challenges and Barriers
Lack of Clinical Evidence
One of the main reasons for the restricted access to medical cannabis in the UK is the limited clinical evidence supporting its use for many conditions. Regulatory bodies like NICE rely on randomised controlled trials (RCTs) to evaluate the efficacy and safety of medicines, and there have been relatively few RCTs involving cannabis-based products. I am currently studying pharmacology and physiology for this reason. I am to gain my degree as a pharmaceutical scientist and assist in the much-needed research to complete these trials and develop a wider range of CBPMs. I am convinced that numerous health conditions exist, affecting millions, who could potentially benefit from this.
Professional Reluctance
Many healthcare professionals are hesitant to prescribe medical cannabis due to:
Concerns over the long-term effects of THC.
A lack of training on cannabis-based treatments.
The stigma surrounding cannabis as a historically illegal substance.
This is yet another reason why I am committed to conducting the necessary research to dismantle the stigma associated with this remarkable plant. The stigma is creating obstacles to the advancement of the medical field and the development of essential treatments.
Cost of Access
Private prescriptions are often too costly for many patients, leaving NHS access as the only viable option. However, NHS prescribing remains limited due to the above challenges, leaving many patients without affordable access to potentially life-changing treatments.
Ongoing Developments and the Future
Research and Clinical Trials
There is growing investment in research and clinical trials for cannabis-based medicines in the UK, with hopes that more conditions will soon have clear clinical guidelines. Increased evidence could lead to wider prescribing practices on the NHS, particularly for chronic pain and mental health disorders.
Policy Reviews
Patient advocacy groups and medical professionals continue to call for policy changes that will increase access to medical cannabis. The government has indicated a willingness to review the regulatory framework, but significant changes have yet to be implemented.
Public Perception
Public backing for medical cannabis is on the rise, as surveys indicate that most people favor broader access to cannabis-derived medications. This change in public opinion could potentially shape future policy reforms and diminish the stigma within the medical community. I am convinced that disseminating more information about the advantages of medical cannabis will increase the call for its availability, particularly among those who need it most, whether for personal use or family members or patients.
Conclusion
As of 2024, medical cannabis remains a strictly regulated and intricate part of the UK's healthcare system. Although it is legal for certain conditions, its accessibility is notably restricted, especially within the NHS. The future of medical cannabis in the UK is likely to hinge on additional research, revisions to clinical guidelines, and shifting public and professional perceptions of its use. The Highly Flavored Kitchen is dedicated and passionate about delivering the highest quality cannabinoids for our products. We are committed to our mission of making cannabis-based medicinal products accessible to those in need, overcoming barriers and stigmas that hinder access to the plant's benefits, and educating ourselves to the academic level necessary to conduct research that will further investigate cannabis and develop the treatments required for those living with chronic pain and other conditions.
Patients seeking medical cannabis should consult with a specialist doctor, explore options within both the NHS and private sector, and stay informed about changes in regulations and available treatments.