Medicinal Cannabis for All Health & Happiness

New Enforcement

In the survey-year ending March 2014, possession of cannabis offences accounted for 67% of all police recorded drug offences in the UK.

In 2015, County Durham police announced that they will no longer be targeting people who grow cannabis for personal consumption unless they are being "blatant". Derbyshire, Dorset and Surrey police announced that they will also be implementing similar schemes. The move is in response to significant budget cuts, which means police forces are having to prioritise more pressing areas.

According to figures obtained through a Freedom of Information request, there are large differences by county regarding how many cases actually result in an offender being charged. In 2016, Hampshire police had the most charges at 65%, while Cambridge had the lowest proportion of charges at only 14%.

Medical use

Medical use of cannabis was legalised in the UK on 1 November 2018, after the cases of two epileptic children who benefited from using cannabis brought increased public attention to the issue. The children (Billy Caldwell, 12, and Alfie Dingley, 6) both experienced significant improvement in their conditions after they began using cannabis, but were initially not allowed to continue their treatment under UK law. This led to increased public outcry, particularly in the case of Billy Caldwell who was hospitalised with life-threatening seizures after his medication was confiscated by authorities.

On 20 June 2018, then Health Secretary Jeremy Hunt announced his support for the medical use of cannabis and that a review would be undertaken to study changes to the law.

On 26 July 2018, Home Secretary Sajid Javid announced that cannabis products would be made legal for patients with an "exceptional clinical need", and that cannabis would be moved from a Schedule I classification to Schedule II.

On 11 October, the new provisions were officially presented and accepted in the House and the policy came into effect on 1 November 2018.

A licence is available from the home office to import prescribed medicinal cannabis.

 It is the biggest observational medical cannabis study in the UK with over 3,500 patients. 

The first UK MHRA approved medical cannabis study was approved by REC (the MHRA ethics committee) in November 2021 with the study title of "CANPAIN feasibility study: evaluating the feasibility of undertaking a pragmatic real world trial investigating CBMP in chronic pain patients" with IRAS project ID 304548 of which will be provided by LVL Health in the UK. It is now possible to obtain a private prescription for medical cannabis, providing a patient can show through medical records they have a qualifying condition.

Treatment must be initiated by a specialist consultant and may be continued under a shared care agreement by a GP or non-medical prescriber. NH S guidance states that medical cannabis should only be prescribed when there is clear published evidence of its benefit and other treatment options have been exhausted.

Sativex is an approved cannabis-derived medicine and is indicated for the treatment of spasticity caused by multiple sclerosis. Nabilone is another cannabinoid drug that has been approved by the Medicines and Healthcare products Regulatory Agency (MHRA) to treat nausea and vomiting caused by chemotherapy. Nabilone is a synthetic form of THC and not naturally derived from the plant.

Cannabidiol (CBD) oil is legal for use and sale in the UK without a prescription, as long as when it is sold to the public it is not sold as medicine. The CBD drug Epidiolex is approved for use in the EU  and can be prescribed on the NHS for children and adults with rare forms of epilepsy such as Lennox-Gastaut syndrome, Dravet syndrome and tuberous sclerosis complex (TSC).

On 31 October 2020, it was reported that the NHS has been repeatedly refusing to fund medical cannabis for children with severe epilepsy. It was reported that at least twenty families are paying for private prescriptions after not being provided by the NHS. One family reported paying £2,000 a month for their 11-year-old daughter, who had been having up to 300 seizures a day. Doctors put her into an induced coma and transported her to intensive care. After an anonymous donation was given to one of the child's parents of £2,500, the parent bought cannabis oil for their child, who after taking it was allowed home within two days. The Department of Health and Social Care said more research is needed before it can routinely prescribe cannabis-based medicines. Peter Carroll of the campaign group End Our Pain said there are dozens more families in a similar position or unable to pay for the drugs at all.

Overseas territories

See also: Cannabis in Bermuda, Cannabis in the Cayman Islands, Cannabis in Gibraltar, and Cannabis in Montserrat

Medical use of cannabis was legalised following a ruling by the Supreme Court of Bermuda in 2016.

In 2016, the governor of the British Overseas Territory of the Cayman Islands approved a change to the Misuse of Drugs Law to allow the importation and use of CBD oil for medical purposes.

Advocacy for law reform

Various organisations have been setup in the UK to seek regulatory and/or policy change around cannabis and/or cannabis-based products.

• Cannabis Industry Council
• CLEAR (Cannabis Law Reform)
• Drug Equality Alliance (DEA)
• NORML UK (Cannabis legislation reform)
• Transform Drug Policy Foundation
• UKCSC – United Kingdom Cannabis Social Club

The former Prime Minister, David Cameron, when serving in opposition, sat on the Select Committee on Home Affairs and voted to call on the Government to "initiate a discussion" within the UN about "alternative ways—including the possibility of legalisation and regulation—to tackle the global drugs dilemma".

In June 2010, it was revealed that the Home Office had been avoiding complying with the FOI request "to avoid a focus on the gaps in the evidence base" that its current drug policy had.

In 2011, the Global Commission on Drug Policy backed by Richard Branson and Judi Dench called for a review. The Home Office response on behalf of the Prime Minister was: "We have no intention of liberalising our drugs laws. Drugs are illegal because they are harmful—they destroy lives and cause untold misery to families and communities".

In 2012, a panel of MPs, as well as deputy prime-minister Nick Clegg, recommended that drug policy be reformed, as the current policy does not adequately deal with the problem. David Cameron rejected the idea, conflicting with comments he made in 2005 while competing for Conservative Party Leadership.

In 2015, James Richard Owen, an economics student at Aberystwyth University, started a petition on the UK Government's official petitions website calling for the legalisation of the cultivation, sale and use of cannabis; As of 28 September 2015 it had gathered 218,995 signatures, far in excess of the 100,000 needed for it to be considered for debate in Parliament. Parliament debated this petition on 12 October 2015.

A study published in March 2016 said that legalising cannabis in the UK would raise up to one billion pounds in tax a year and reduce the harm done to users and society. The study was carried out by a panel of experts including scientists, academics and police chiefs. It recommended legalising cannabis for over 18s, which could legally be purchased from licensed single-purpose stores. It also recommended that home-cultivation of cannabis should be legal for personal use and small-scale licensed cannabis social clubs should be legally allowed to be established. Under its recommendations, the price, potency and packaging of all sold cannabis would be controlled by the Government with a new regulator established to oversee the market, possibly modelled on Ofgem and Ofwat and drug production and sales would be taxed, raising, the panel claims, between £500m and £1bn a year. Estimates by other reports have placed the value of a legalised cannabis market in the UK at between £1 billion to £3.5 billion and have said that it could cut costs across the justice system and become a job creator.

In March 2016, the Liberal Democrats became the first major political party in the UK to support the legalisation of cannabis. The Green Party also support a legal and regulated cannabis market.

In early 2018, the Institute of Economic Affairs (IEA) published a report looking at the size of the UK cannabis market and the potential implications of legalisation. The report concluded that the current UK cannabis black market is worth over £2.5bn and cannabis tax yields could be between £204 million and £571 million. The recommendation from the IEA is that if cannabis is legalised, the duty rate should not be too high, as high tax would make retail prices less competitive and could prevent significant shrinkage of the black market. Advocates of legalisation have stated that the legalisation of cannabis would take away sales and control from criminal gangs – who also push hard drugs – in favour legitimate and regulated businesses. Legalisation has also been advocated because it would ensure the drug meets acceptable standards and is pure, while also limiting the access of young people via a minimum age for purchase, possession and use.

The Head of Lifestyle Economics at the IEA described legalisation of cannabis as a "win-win-win", noting: "criminals lose a lucrative industry, consumers get a better, safer and cheaper product and the burden on the general taxpayer is reduced".

Public opinion

A report conducted between 24 February and 14 March 2022 by Hanway and Savanta ComRes interviewed a nationally representative sample of 9,043 adults aged over 18 in several European countries, including the UK, regarding cannabis legalisation. 75% of UK respondents reported to be in favour of legal and regulated cannabis sales to over-18s, while 27% of UK respondents reported to be opposed and 16% stated neither support nor oppose. Of the 8 European countries surveyed in France, Germany, Italy, Spain, Netherlands, Portugal, Switzerland, and the UK, 55% overall reported to be in favour of legal and regulated cannabis sales to over-18s.

Medical cannabis (and cannabis oils)

"Medical cannabis" is a broad term for any sort of cannabis-based medicine used to relieve symptoms.

Many cannabis-based products are available to buy online, but their quality and content is not known. They may be illegal in the UK and potentially dangerous.

Some products that might claim to be medical cannabis, such as CBD oil or hemp oil, are available to buy legally as food supplements from health stores. But there's no guarantee these are of good quality or provide any health benefits.

Specific cannabis-based products are available on prescription as medicinal cannabis. These are only likely to benefit a very small number of patients.

Can I get a prescription for medical cannabis?

Very few people in England are likely to get an NHS prescription for medical cannabis.

Currently, it is only likely to be prescribed for the following conditions:

• children and adults with rare, severe forms of epilepsy
• adults with vomiting or nausea caused by chemotherapy
• people with muscle stiffness and spasms caused by multiple sclerosis (MS)

It would only be considered when other treatments were not suitable or had not helped.

Epidyolex for children and adults with epilepsy

Epidyolex is a highly purified liquid containing CBD (cannabidiol).

CBD is a chemical substance found in cannabis that has medical benefits.

It will not get you high, because it does not contain THC (tetrahydrocannabinol), the chemical in cannabis that makes you high.

Epidyolex can be prescribed by a specialist for patients with Lennox-Gastaut syndrome and Dravet syndrome (both rare forms of epilepsy).

Nabilone for chemotherapy patients

Many people having chemotherapy will have periods where they feel sick or vomit.

Nabilone can be prescribed to adults by a specialist to help relieve these symptoms, but only when other treatments have not helped or are not suitable.

Nabilone is a medicine, taken as a capsule, that has been developed to act in a similar way to THC (the chemical in cannabis that makes you high). You may have heard it described as a "manmade form of cannabis".

Nabiximols (Sativex) for multiple sclerosis (MS)

Nabiximols (Sativex) is a cannabis-based medicine that is sprayed into the mouth.

It is licensed in the UK for adults with MS-related muscle spasticity that has not got better with other treatments.

Read more from the MS Society on Sativex for treating muscle stiffness and spasms

Long-term pain

There is some evidence medical cannabis can help certain types of pain, though this evidence is not yet strong enough to recommend it for pain relief.

In some cases, however, it may be prescribed for pain as part of a clinical trial.

What about products available to buy?

Some cannabis-based products are available to buy over the internet without a prescription.

It's likely most of these products – even those called CBD oils – will be illegal to possess or supply. There's a good chance they will contain THC, and may not be safe to use.

Health stores sell certain types of CBD. However, there's no guarantee these products will be of good quality.

They tend to only contain very small amounts of CBD, so it's not clear what effect they would have.

Is medical cannabis safe?

The risks of using cannabis products containing THC (the chemical that gets you high) are not currently clear. That's why clinical trials are needed before they can be used. Products that only contairry these unknown risks linked with THC.

But in reality, most products will contain a certain amount of THC.

The potential risks of THC cannabis products are:

• psychosis – there is evidence that regular cannabis use in some people can increase the risk of developing a psychotic illness such as schizophrenia
• dependency on the medicine – although scientists believe this risk is probably small when its use is controlled and monitored by a specialist doctor

Generally, the more THC the product contains, the greater these risks are.

Cannabis bought illegally off the street, where the quality, ingredients and strength are not known, is the most dangerous form to use.

What are the side effects?

Depending on the type of medical cannabis you take, it's possible to develop side effects such as:

• decreased appetite
• diarrhoea
• feeling sick
• weakness
• a behavioural or mood change
• dizziness
• feeling very tired
• feeling high
• hallucinations
• suicidal thoughts

If you experience any side effects from medical cannabis, report these to your medical team. You can also report them through the

CBD and THC can affect how other medicines work. Always discuss possible interactions with a specialist.

CBD can also affect how your liver works, so doctors would need to monitor you regularly.

How do I get a prescription?

Cannabis-based medicine can only be prescribed on the NHS by a specialist hospital doctor, or under a specialist's supervision.

And it is only likely to be prescribed for a small number of patients.

A hospital specialist might consider prescribing medical cannabis:

• for epilepsy – if you (or your child) have one of the rare forms of epilepsy that might be helped by medical cannabis
• for MS – if you have spasticity from MS and other treatments for this are not helping
• for chemotherapy – if you are vomiting or feeling sick from chemotherapy and other anti-sickness treatments are not helping

The specialist will discuss with you all the other treatment options first, before considering a cannabis-based product.

A prescription for medical cannabis would only be given when it was believed to be in your best interests, and when other treatments had not worked or were not suitable.

It's expected this would only apply to a very small number of people in England.

If the above does not apply to you, do not ask a GP for a referral for medical cannabis.

How do I prove I have a prescription?

Keep your medicine in its original packaging, as the dispensing label contains important information about the medicine and the person it’s prescribed for.

The dispensing label is the label the pharmacist puts on the medicine packet when they give you your prescription medicine.

You should also keep a copy of your prescription, and a letter (if you have one) from the doctor who prescribed the medicine. The letter should include your personal details (including name and address), as well as the prescribing doctor’s name and contact details.

You may need to show ID that matches the details on the dispensing label and the prescription, or the doctor’s letter, if you have one.

Acceptable forms of ID include:

• valid passport
• photo driving licence
• proof of age card, such as a PASS card from the national Proof of Age Standards Scheme

Information: If you need any legal advice about possessing a cannabis-based medicine, speak to a legal adviser or solicitor.

Read about how to

Will the laws on cannabis be relahe government has no intention of legalising the use of cannabis for recreational (non-medical) use.

Possessing cannabis is illegal, whatever you're using it for. That includes medical use cannabis products, unless these have been prescribed for you.