From sceptic to prescriber: Dr Ali on medical cannabis for ADHD

The rate of adult ADHD diagnoses has risen sharply in recent years, accompanied (and somewhat spurred on by) a welcome surge in public understanding of the condition - largely driven through social media personal storytelling.

Platforms like TikTok and Instagram have opened up space for people living with ADHD to share their inner worlds in real time, and in doing so, explain the symptoms (things like racing thoughts, a seemingly never-ending list of to-dos, and the feeling of a million tabs open at once). That’s made it easier for others to recognise themselves and their patterns in such stories, and much harder for the condition to be swept under the rug. 

But recognition is just one small step. Getting a recognised assessment, finding the right treatment, and actually being supported are all totally separate challenges.

With NHS waiting lists stretching back years, it’s no surprise that so many feel, well… stuck. Some are put off by the idea of stimulant medication, or feel they’ve tried therapy before, and it didn’t help. Sometimes the path to support can feel more like a maze than a system.

Medical cannabis for ADHD is one of the emerging treatment options that can be used alongside conventional therapies and medications. At Releaf, our world-class clinical team includes more than 27 doctors with backgrounds spanning psychiatry, general practice, neurology, palliative care, pain management, addiction, and complex mental health.

Dr Imran Ali, a psychiatrist with 25 years of clinical experience, joined Releaf in 2024. We sat down to get his insights on what’s behind the rise in ADHD diagnosis, how medical cannabis fits into broader treatment plans, and why patient choice matters more than ever.

Dr. Ali, to start, could you give us a little on your professional background, and what brought you to Releaf?

“I have worked in mental health since 2000, 25 years now, across different regions of the UK, mainly bonnie Glasgow and rainy Manchester. During the span of a quarter of a century, I have treated a wide range of mental health presentations in the adult population aged 18 and upwards. Most of my work has focused on mental health assessments, formulation of diagnoses, development of treatment plans and prescribing of medication. My practice has been further complemented with the integration of somatic and psychotherapeutic approaches and spirituality. 

When medical cannabis was legalised in 2018, it prompted a lot of discourse amongst psychiatrists. There were concerns around the triggering of psychosis and mania with impairment in neuropsychological functioning, such as memory performance and concentration. These were significant areas of consideration in medical prescribing.  

In my view, the medical profession harboured a primarily negative view towards medical cannabis legalisation. To be honest, I was one of those cynics, whispering my concerns to fellow colleagues. 

A gradual shift occurred over a period of time, settling the storm of controversy over medical cannabis. What steered that mindset shift was the increasing numbers of patients sharing their experience in using cannabis from the black market, particularly those patients with ADHD, anxiety, and PTSD symptoms. 

Their firsthand experiences, and what their families echoed, played a big role in changing my view. This is where my interest grew from with my passion to do more for the people I look to care for, in a more comprehensive manner. Their experience of side effects from conventional medications was another factor in patients crossing the pitch from the conventional side towards a more natural treatment option. 

Some of the effects may only be short-term, but there are also longer-term ones also. That is not to say cannabis is without adverse effects.  I am a strong proponent of integrative care in a holistic approach, considering conventional treatments such as medication, alongside psychotherapy and social interventions and complementary approaches. 

The complementary approach of medical cannabis was missing in my practice. That was when I made the decision to take that step into medical cannabis, and so I joined Releaf in November 2024. 

From the start, I was seeing patients with a wide array of symptoms, ranging from ADHD, anxiety, depression, personality difficulties, and PTSD. I conducted initial assessments, followed patients up, reviewing what was working and what wasn’t; this experience informed my clinical practice and helped me understand the scope of medical cannabis. I see it as one tool in the toolbox. When it is part of a broader treatment plan, it can make a real difference in someone’s recovery.

The shift for me happened in the summer of 2024. It had been building for years through patient stories, but that was the point where I felt ready to step into this field and work with medical cannabis directly.”

In your opinion, what explains the increasing rates of ADHD diagnosis?

“The actual prevalence of ADHD is relatively stable. Most research estimates that around 3 to 4% of adults in the UK have ADHD, and that figure hasn’t changed over the last few decades. 

What has changed is the number of people being diagnosed and the number of prescriptions being issued. Both of those have increased quite a bit in recent years. There are several reasons behind this. 

The primary reason is the greater public awareness. More people now understand what ADHD is and how it can present in adults. Social media has had a big influence. Platforms like TikTok and Instagram have given people a way to share their experiences, the importance of diagnosis, and how this can be done. That has helped others recognise similar patterns in themselves.

It has also helped reduce the stigma, not just at a personal level but also in the community. ADHD used to carry the baggage of misunderstanding and negative attitudes. Now there is more acceptance of neurodiversity, and increased recognition that people think and function in different ways. 

The stigma hasn’t disappeared completely, but it is slowly being challenged and brick by brick, we are breaking through the wall of stigma. That shift has encouraged more people to come forward.

The second factor is the impact of COVID. The pandemic disrupted people’s routines and isolated many from their support networks. People found it increasingly harder to manage their symptoms, and for some people, it brought their symptoms into focus for the first time. 

As a result, more individuals reached out for help, and more assessments were carried out.

Another important issue is underdiagnoses and misdiagnosis. A lot of people with ADHD have either gone undiagnosed or been diagnosed with something else. Symptoms can overlap with conditions like bipolar disorder or behavioural issues, leading to delays in patients receiving appropriate treatment.

What we are seeing now is more thorough assessments being carried out by professionals. This is allowing people to receive a more appropriate diagnosis. That’s been a reason for the rise in diagnosis rates.”

How is attention deficit hyperactivity disorder diagnosed in the UK?

“Typically, someone will go to their GP first. The GP will carry out a pre-screening assessment and, if they feel it's appropriate, they will refer the person to a specialist ADHD service.

Once referred, the individual is assessed by a psychiatrist. That assessment usually includes a self-report questionnaire, collateral information from family members, and direct observation. The psychiatrist then collates all this information to make an informed diagnosis.

Once a diagnosis is given, a treatment plan is developed. That often includes psychoeducation, counselling, and in some cases, medication.

The process sounds straightforward, but access to assessment in the UK is a major obstacle. People are waiting a long time just to be seen, even up to 2 years. That has led many to seek private assessments. Even then, there can still be significant delays in getting that first appointment.

And even after diagnosis, not everyone chooses to go down the medication route. Some patients are concerned about the side effects of stimulant medications or the potential for dependence. Others simply prefer to take a more natural approach.

That’s where patient choice comes in. Some people want to explore different options. Medical cannabis is one of those options. It gives people more control over their treatment plan. This is the voice of the patients that cannot be ignored.”

And after someone is diagnosed, what are the typical treatments offered?

“The first step is usually psychoeducation, which helps the person understand their condition and recognise their symptoms. That is often followed by therapy, looking at the impact on their emotions and relationships, and if appropriate, stimulant medication may be offered.

But again, access can be a challenge. The delays in the system are significant. And even when medication is offered, some people aren’t comfortable with it. They might have concerns about side effects or feel that it doesn’t suit their needs. That’s when alternatives, including medical cannabis, start to come into the conversation.

Psychological therapy needs to be tailored to each person. The first step is always to ask the individual what they actually want and what kind of support they feel will help. We also need to consider their past experiences with therapy. Engagement is key and led by the patient. Essentially, if someone feels too overwhelmed and is not able to engage, then the therapy won’t be effective.

When it does work, psychological support can help someone understand their emotions better, see how ADHD is affecting them and the people around them, and start learning how to manage those challenges. But it’s not always easy.

Some people with ADHD struggle to engage with therapy because of attention and concentration issues. 

One analogy I often use is this. Imagine someone is sitting in front of a computer with two windows. That is what most people are dealing with. But for someone with ADHD, it’s like trying to work with 10 or 15 tabs opened at once. They’re constantly jumping between thoughts, emotions, and distractions. It’s hard to focus, to stay present.

That’s where medical cannabis can sometimes play a role. 

For some people with ADHD, it helps reduce inattention and anxiety, and allows the mind to quieten down. It doesn’t close all the tabs, but it can help reduce the mental clutter. That shift can make it easier for people to engage with therapy, with their work, and daily life in general.

ADHD can show up in many ways - inattention, impulsivity, sleep disturbance and anxiety. Medical cannabis can help regulate the nervous system. For a lot of people, their emotions feel like a rollercoaster. Cannabis can help regulate those emotions. 

It can reduce overthinking and help calm the internal traffic, so to speak. When that happens, people often find they’re more able to concentrate, stay focused, and feel less overwhelmed. It doesn’t mean everything goes away, but it creates more space for clarity, allowing the person to function in a more enhanced way.”

Based on your experience, have you found that certain types of medical cannabis treatments work better for people with ADHD than others, or, is it always highly individual?

“In my experience, it depends on the person’s daily routine and what they need support with at different times of day. That is where the choice of product and the timing of use becomes really important, tailoring it to the individual.

During the day, most people are trying to function in work or social settings. In those situations, I’ve found that products with more uplifting, focus-supporting properties can be helpful. This reduces overthinking and improves concentration, allowing people to perform their activities and manage their thoughts more clearly.

Then, in the evening, the focus shifts. People have been running mentally at a high pace all day, and now they need to wind down. They want to relax, enjoy their evening, eat dinner, and spend time with family. But their mind is still racing, unable to change lanes from the fast to slower one. That’s when products that offer more calming or balancing effects can be useful. They support the transition out of that high-speed mental state.

Finally, for people who struggle with sleep (which is common in ADHD), something more sedating may be appropriate at night. That can help establish a more stable sleep pattern, which in turn improves overall well-being.

So yes, the type of product matters, but it has to be tailored to the person. What works in the morning might not work in the evening. The key is matching the treatment to the functional needs of the individual at different times of day.”

Final thoughts: Medical cannabis for ADHD

ADHD affects people in very different ways. Some are overwhelmed by the cacophony of tasks, others are exhausted by the effort it can take to focus. Not everyone finds the symptom control they need through conventional treatment routes. 

For some patients, medical cannabis treatment for ADHD can and does make a huge difference. It can make it easier to concentrate, to rest, or to feel a bit more steady. It doesn’t work for everyone. But when it does, it gives people a bit more control over how they manage their day. That alone can be enough to change how someone feels about getting through it.

Releaf’s approach is grounded in something simple that’s often missed: listening to the patient. Understand what matters most to the individual, and start there. Medical cannabis isn’t a magic fix. But for some people, it helps reduce the pressure and gives them more space to cope.

If you’re exploring treatment options and want to know if medical cannabis might be right for you, you can start by using our medical cannabis eligibility checker. It only takes 20 seconds to complete, is totally free, and there’s no obligation to go further.