7 years legal: 7 legal recaps - UK medical cannabis edition

Is medical cannabis legal in the UK?

Where better to start than at the very beginning, with the legal status of medical cannabis in the UK? 

The simple answer to this question is: Yes! 

But it is important to be aware of medical cannabis legislation and rules around its use. So, when did medical cannabis become legal in the UK?

The rescheduling of medical cannabis

On the 1st of November, 2018, the UK government moved cannabis-based medicines from Schedule I to Schedule II of the Misuse of Drugs Regulations 2001. Prior to this, cannabis was legally considered to have little or no therapeutic value. 

This simple move symbolised the recognition of the therapeutic potential of cannabis and its derivatives. As a result, cannabis-based medicinal products (CBMPs) could be prescribed in the UK for the first time in almost 50 years (the full-scale prohibition of medical cannabis began with the introduction of the Misuse of Drugs Act in 1971). 

Medical cannabis in the UK

CBMPs are a class of medications derived from the cannabis plant. They can include natural cannabis flower, oils, and extracts, such as Epidyolex (CBD), as well as synthetic cannabinoids like Sativex (synthetically similar to THC).

Who can prescribe medical cannabis?

While medical cannabis has been legal in the UK for seven years, that doesn’t mean you can walk into your GP’s practice and walk out with a medical cannabis prescription. So, who can prescribe medical cannabis?

In reality, initial medical cannabis prescriptions can only be granted by GMC-registered specialist doctors. This can include health care professionals who specialise in various aspects of medicine, including neurologists, psychiatrists, and pain specialists. However, other health care professionals, including general practitioners (GPs) and nurses, are often involved in the prescribing process under shared care agreements. 

At Releaf, we have a world-class clinical team of specialist doctors, GPs, and nurses who all play a key role in our prescriptions. Together, our doctors have the relevant knowledge and expertise covering a wide range of conditions, from chronic pain and epilepsy to anxiety, endometriosis, and much more.

Can I get a medical cannabis prescription through the NHS?

As mentioned above, medical cannabis can legally be prescribed by specialist doctors registered with the General Medical Council. This includes NHS specialist doctors; however, medical cannabis prescriptions remain extremely limited in the NHS. There are several reasons for this. 

Limited recommendations and guidance

One of the key reasons NHS prescriptions for medical cannabis remain so limited is current guidance from the National Institute for Health and Care Excellence (NICE). To date, NICE has only recommended the use of medical cannabis for the treatment of three conditions: 

• Severe treatment-resistant epilepsy (limited to Dravet and Lennox Gastaut syndromes and tuberous sclerosis)
• Spasticity associated with multiple sclerosis
• Intractable chemotherapy-induced nausea and vomiting

Most NHS trusts will not fund prescriptions that fall outside NICE guidelines. To learn more about the factors affecting medical cannabis access through the NHS, take a look at our article ‘Can I get medical cannabis on the NHS?’.

Unlicensed medications

Medicines can be split into two categories: licensed and unlicensed (specials) products. To date, only three CBMPs have been licensed for use in the UK. While it is possible to prescribe a wide range of ‘specials’ medical cannabis products, these are unlikely to be offered through the NHS as they are not licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) and are not required to have been rigorously tested through clinical trials.

Why haven’t I heard more about medical cannabis?

In the UK, medical cannabis is subject to strict advertising regulations due to its status as a prescription-only medication. Unlike licensed over-the-counter medicines, which can be advertised directly to the public, CBMPs cannot be promoted directly to patients. 

While these restrictions are designed to ensure responsible dispensing and use of prescription medications, as our Chief Legal and Compliance Officer, Rupa Shah, notes, “the existing regulatory framework restricts the public’s access to information that would ordinarily be disseminated through conventional marketing."

This may contribute to the persistent lack of public awareness around the legality of medical cannabis in the UK. However, medical cannabis clinics are able to advertise their services, so you may well come across advertisements for Releaf or other clinics on social media or even billboards!

Carrying and administering medical cannabis

We understand that this can be daunting at first - after all, there remains a persistent stigma around cannabis, even when legally prescribed. The important thing to remember is that it is perfectly legal and you are well within your rights to carry and use your medicine in public.

We advise our patients to always keep a copy of their prescription to hand and keep their medication in its original packaging. This can help to make any encounters with police or other officials go that bit smoother. 

At Releaf, patients receive a UK medical cannabis card after they pay for their first prescription. This document is designed to fit in your wallet or purse and contains your name, address, and photograph, as well as your doctor’s name and patient number. It also features a QR code that can be scanned to bring up your prescription details, should you be questioned by authorities. 

Can I smoke medical cannabis?

Smoking cannabis remains illegal in the UK, even if the products have been legally prescribed for medicinal purposes. This is because smoking is associated with a large number of health risks, including cancer and emphysema. 

Patients who are prescribed medical cannabis flower can instead use a dry herb vaporiser to administer their medication. This offers a less harmful alternative to smoking while still effectively delivering the active cannabinoids within the plant. Some patients may be prescribed medical cannabis oils which can be administered sublingually (under the tongue), or medical cannabis vape cartridges. 

Learn more about the harms of smoking cannabis from one of our expert doctors, Dr Van Heerden, in our recent article ‘Not what the doctor ordered. Why smoking medical cannabis is harmful’.

Driving and medical cannabis

Medical cannabis has a wide range of therapeutic applications, but it can also be associated with side effects such as drowsiness, dizziness, and reduced coordination. So, what is the UK medical cannabis driving law?

In 2024, the Cannabis Industry Council published guidance for patients regarding the use of medical cannabis and driving. The main point is that using medical cannabis doesn’t have to mean you can’t drive. However, the patient must always use their medication according to their prescriber’s guidance and ensure they are fit to drive - i.e., do not get behind the wheel if you feel impaired or drowsy. 

Medical cannabis is a prescription medication and should be treated as such, by both the patient and the authorities. Unfortunately, not all police officers are aware of the legality of medical cannabis, so it is a good idea to have your prescription details to hand at all times. 

Medical cannabis in the UK has come a long way in the last seven years, but there is still a long way to go. Knowledge of its prescription and use is often limited, even among police and other authority figures. Therefore, it is important to be as informed as possible about your treatment. 

The information provided in this article aims to provide advice for some of the key areas of concern for medical cannabis patients; however, this is a brief recap of often complex issues. As such, this shouldn’t be taken as standalone guidance. For more information on any of the topics discussed, don’t hesitate to get in touch with a member of the Releaf team today.

Want to learn more? Head to our fast and free medical cannabis eligibility checker. In less than 20 seconds, you could have a much more solid understanding of your potential eligibility for a UK medical cannabis prescription with Releaf