Recent Freedom of Information (FOI) data from the NHS Business Services Authority has prompted sensational headlines about a sharp rise in private prescriptions for medical cannabis in the UK. On the surface, the figures look dramatic. Between 2023 and 2024, prescriptions more than doubled, rising from around 283,000 to 659,000.
But these numbers need context. Without it, they risk being misunderstood.
This article explains what the data does and does not show, why prescribing has increased, and what this means for patients, clinicians and the NHS.
The most important point is this:
The FOI data counts prescriptions, not individual patients.
Medical cannabis is usually prescribed as an ongoing treatment. Patients are reviewed regularly and receive repeat prescriptions, often monthly or every six to eight weeks. One patient may therefore receive multiple prescriptions over a year.
If we use a cautious average of around eight prescriptions per patient per year, 659,000 prescriptions would equate to roughly 82,000 patients. That aligns with wider estimates suggesting there are around 80,000 to 90,000 medical cannabis patients across the UK. In population terms, this remains a very small group, especially when compared with prescribing volumes for many other specialist medicines.
Medical cannabis has been legal on prescription in the UK since November 2018. However, uptake in the early years was extremely limited.
The increase seen in recent years reflects gradual change rather than sudden expansion.
Several factors are driving this:
Greater clinical understanding
More specialist doctors now have experience of where medical cannabis may have a role, particularly for patients who have not responded to standard treatments or who cannot tolerate their side effects.
Improved guidance and governance
Over time, professional guidance, data collection and clinical frameworks have developed, making prescribing more structured and cautious.
Informed patients seeking options
Many patients turning to medical cannabis are doing so after years of unsuccessful treatment. They are often looking for better symptom control or improved quality of life, not a first-line option.
Prescribing remains tightly regulated. In the UK, unlicensed cannabis-based medicines can only be initiated by doctors on the GMC Specialist Register, with careful assessment, conservative dosing and ongoing monitoring. This pattern of growth is not unique to the UK. Similar trends have been seen in countries such as Australia, Canada and parts of Europe as clinical experience grows.
Medical cannabis is not a cure-all, and it does not work for everyone. However, patients commonly report improvements in certain symptoms, including:
Some patients are also able to reduce their use of other medicines, such as opioids, which are associated with significant side effects and risks.
UK data from sources such as Project Twenty21 and the UK Medical Cannabis Registry gives a useful picture of current prescribing patterns.
The most common groups include:
Yes, gradually.
Medical cannabis is increasingly seen by clinicians as one option among many, not a first-line treatment. Growth is likely to continue as more doctors receive appropriate training and gain experience, but prescribing remains cautious and evidence-led.
The Medical Cannabis Clinicians Society supports this approach through CPD-accredited education, prescribing guidance, peer support and ongoing professional development.
Where it is clinically appropriate, we believe it should be.
At present, almost all prescriptions are private. Many doctors who prescribe medical cannabis privately also work within the NHS and would prefer to offer this treatment based on clinical need rather than a patient’s ability to pay.
There are also potential system benefits. Better symptom control can mean fewer GP appointments, fewer emergency admissions and shorter hospital stays. In conditions such as treatment-resistant childhood epilepsy, reducing seizures can prevent repeated hospitalisation.
A 2024 health economics study found that prescribing medical cannabis for chronic pain, instead of alternative treatments, could save the NHS around £729 million per year while improving patient outcomes. A separate study by the Centre for Economics and Business Research estimated that wider NHS access could unlock up to £13.3 billion for the UK economy over ten years through better health and increased ability to work.
Medical cannabis in the UK is not the same as illicit or recreational cannabis. It is prescribed as a controlled medicine, produced to pharmaceutical standards, monitored closely and governed by strict professional and regulatory safeguards.
Understanding the data properly matters. The FOI figures reflect growing clinical activity within a regulated system.
If medical cannabis is discussed accurately and responsibly, it allows for a more informed public conversation about patient need, clinical decision-making and future access.
The Medical Cannabis Clinicians Society is the UK’s independent, clinician-led body supporting safe, evidence-led practice in this area.
By joining the Society, you get:
Whether you are already prescribing, considering prescribing, or simply want to respond to patient questions with confidence, the Society provides the structure, knowledge and professional backing to practise safely and responsibly.
Join the Medical Cannabis Clinicians Society and be part of a trusted clinical community shaping best practice in the UK.
By Zul Mamon, Expert Committee Member
This article summarises the crucial insights shared during my presentation “The Role of the Pharmacist: Best Practices for Dispensing CBPM” at the Cannabis Health Symposium on 25 November 2025, which explored how pharmacists can optimise patient outcomes and drive clinical excellence, offering a roadmap for pharmacists navigating this complex and growing area of practice.
Let’s consider Sarah’s story. Like many patients, Sarah experienced confusion and delays when trying to access her CBPM prescription.
| Sarah is a 45-year-old mother of two, living with chronic pain that has made even the simplest tasks unbearable. After years of trying traditional treatments with little success, Sarah was told by a friend to try cannabis, which is now legally available on prescription.
Sarah did some research, as we all do, using Google and found a clinic which could help her, and proceeded to complete an online form She managed to get an appointment during which an independent prescriber triaged her. The appointment lasted around 15 minutes to confirm her eligibility. Shortly afterwards, she had an appointment with a Specialist Prescriber. This lasted around 10 minutes. She was prescribed medication, and after a wait of around a day, Sarah received a payment link from a pharmacy that was connected to the clinic. Sarah was hopeful, but she had to wait to receive her prescription medicines. There was hardly any communication from the pharmacy or the clinic. When she contacted the online pharmacy by email, it took several days to receive a reply. This left Sarah feeling frustrated and uncertain about her treatment. Eventually, the medication arrived by secure post. Unsure how to use her medication, Sarah contacted the pharmacist again by email as it was the only mode of communication available. The pharmacist was unable to provide comprehensive guidance. |
This scenario is more common than we’d like to admit, and something the MCCS is working hard to ensure becomes a thing of the past.
In this article we explore how pharmacists can ensure patients like Sarah receive the guidance, support, and care they need to achieve the best outcomes.
Pharmacists are often the last point of contact in a patient’s journey for CBPMs and are responsible for providing the proper guidance and support. By implementing best practices, we can transform the experience for patients like Sarah, ensuring they receive the high-quality care they deserve.
The pharmacist’s function in the CBPM clinical pathway is multifaceted and vital. It extends far beyond simply dispensing medication. It begins with a prescription assessment to ensure legality and accuracy, followed by safe dispensing protocols.
However, the role doesn’t end there. Patient education is a cornerstone of adequate care. Pharmacists must provide clear guidance on dosage, administration methods, and potential side effects. Finally, ongoing monitoring enables tracking of therapeutic outcomes and the prompt management of issues that arise during treatment. Without access to clinical data and direct patient contact, significant gaps can emerge, leading to reduced patient education, ineffective safeguarding, and missed opportunities for clinical intervention.
The General Pharmaceutical Council (GPhC) 2025 thematic report served as a critical reference point, providing a snapshot of how CBPMs are managed across the UK. The report highlighted significant gaps in governance, safeguarding, and clinical oversight, serving as a wake-up call for the industry.
The GPhC brought two critical issues to the forefront:
1.Lack of Access to Clinical Records
Many pharmacies operate without access to a patient’s medical history. This severely limits the ability to perform meaningful safety checks for potential drug interactions, contraindications, or therapy duplications, thereby increasing the risk of adverse events.
2. Inappropriate Prescribing
The report noted instances of inappropriate prescribing, such as providing controlled drugs to individuals with a history of substance misuse. Access to clinical records would empower pharmacists to identify and flag these risks and to take appropriate action to safeguard patients.
These findings underscore the need for systemic changes to ensure pharmacists have the tools required to meet the highest standards of care.
To address the identified challenges, a robust best-practice framework is essential. This framework should be built on four key pillars:
This involves more than just a standard check. It means confirming the prescriber is on the Specialist Register and ensuring the prescription is appropriate and complies with the Misuse of Drugs Regulations 2001. Pharmacists must document all such checks.
Dispensing CBPMs requires a deep understanding of patient safety. This includes assessing medical history and monitoring for side effects.
Patients need clear, non-technical information about their medication. Pharmacists should explain dosage, administration, storage, and handling. It’s also vital to manage expectations and clarify the difference between medicinal and recreational cannabis.
Seamless communication and coordinated efforts across the healthcare team are non-negotiable. This ensures a holistic approach to patient care, reducing the risk of errors and miscommunication.
The path to optimising CBPM dispensing is not without its obstacles. Three common challenges frequently impact patient care:
Many CBPMs are imported, leading to limited availability, variable product quality, and complex procurement processes. These factors can disrupt consistent patient access to medication.
Knowledge gaps among pharmacy teams, coupled with the stigma surrounding cannabis, can create significant barriers. The GPhC report noted that many pharmacies were using unverified sources for training, highlighting a need for standardised education.
Complex dosing regimens and poor side-effect management can make it difficult for patients to adhere to their treatment plans.
Overcoming these challenges requires practical and proactive solutions.
For supply chain management, pharmacists should establish robust supplier relationships, identify backup procurement sources, and implement digital inventory-tracking systems. Developing clear communication protocols to inform patients of supply disruptions is also crucial.
To improve education and training, regular team training on CBPM knowledge is essential. Working with industry partners to develop standardised patient information resources and counselling aids can help bridge communication gaps and empower patients with clear, accessible information.
Building confidence in CBPM practice is a continuous journey. A professional development strategy grounded in the following three pillars can help pharmacists enhance their competence and provide the best possible care.
The field of CBPMs is rapidly evolving. Pharmacists must stay current with emerging research, regulatory changes, and new clinical guidelines.
Engaging with specialist groups like the Medical Cannabis Clinicians Society (MCCS), attending symposiums, and participating in peer support forums are excellent ways to share knowledge and learn from others. These networks provide a platform for collaboration and discussion.
Implementing systematic quality measures is vital. Conducting regular audits, seeking patient feedback, and refining protocols are critical steps to ensure the highest standard of care is not just met, but exceeded.
Let’s return to Sarah. Imagine if her pharmacist was well-trained in CBPMs, had access to her clinical records, and could offer clear, confident guidance. She would feel supported and reassured, knowing she is in capable hands. This is the tangible impact we can have.
By embracing our role in the clinical pathway, implementing best practices, and collaborating effectively with the wider healthcare team, we can ensure that every patient receives the care they deserve.
Let’s work together to raise the standard of CBPM practice and make a real difference in our patients’ lives.
If you’re a pharmacist working with CBPMs – or want to build your confidence in this area – now is the ideal time to join the Medical Cannabis Clinicians Society. Membership for pharmacists is just £60 a year and gives you access to peer support from pharmacy colleagues, specialist guidance, practical dispensing resources, and CPD-accredited training designed for busy clinicians.
Join today and strengthen your role in safe, effective CBPM care.
Zul Mamon is a member of the Expert Committee at the Medical Cannabis Clinicians Society, a pharmacist and a Responsible Person with extensive experience across community pharmacy and the medical cannabis sector. As the founder of Pharma Experts and co-founder of both Amber Green Clinics and Blue Angel Care, he has developed a unique perspective on the evolving landscape of modern healthcare.
Driven by a passion for advancing the profession, Zul focuses on navigating the complex challenges and identifying key opportunities within the field. He is committed to sharing his insights to help enhance patient care, improve clinical governance, and support the professional development of his peers.
The minutes from the latest meeting of the All-Party Parliamentary Group (APPG) on Medical Cannabis under Prescription, held on 3 November 2025, are now available.
You can download the full document here: APPG on Medical Cannabis Under Prescription – Minutes of Meeting, 3 November 2025
This update provides an overview of discussions, priorities, and next steps for parliamentary engagement.
The APPG on Medical Cannabis under Prescription will hold its next meeting and AGM on Tuesday 13 January 2026, 12–1pm.
Prescribing medical cannabis in the UK is still a relatively new area of practice. While the clinical opportunities are growing, doctors entering this field face a unique set of risks and regulatory requirements. One of the most important – and often misunderstood – parts of working privately with cannabis medicines is making sure you have the right insurance in place.
In this article, we spoke to Richard Cupit, Head of Healthcare at PIB Insurance Brokers, who has pioneered the firm’s medical cannabis policy, to help prescribing clinicians ensure they have all bases covered.
Unlike NHS doctors, who are automatically covered by the Clinical Negligence Scheme for Trusts (CNST), medical cannabis prescribers usually work privately. This means they must arrange their own insurance cover.
The General Medical Council (GMC) states that if you are practising medicine privately in the UK, you must have “adequate and appropriate insurance or indemnity arrangements in place covering the full scope of your medical practice.” This applies even if you’re working within NHS premises but prescribing privately.
In practice, this means that doctors stepping into cannabis prescribing – often for the first time outside the NHS – need to think differently about their professional protection.
The majority of cannabis-based medicines prescribed in the UK are also unlicensed, meaning prescribers take full clinical responsibility for their use. Not having the right insurance coverage in place could prevent you from practicing and could even jeopardise your career and have legal consequences.
Many assume that existing coverage extends to CBPM prescribing, but in many cases, insurance providers still have exclusionary policies in place when it comes to cannabis.
Many insurers now offer worldwide and digital health options, which are crucial for prescribers seeing patients online or outside the UK.
Getting the right insurance as a medical cannabis prescriber can seem like a bit of a minefield, but it doesn’t need to be.
Choose a broker that is familiar with the sector, such as PiB Insurance. Richard and the PiB team work closely with the Society, bringing extensive knowledge and experience in the unique considerations in this field of medicine.
This includes whether you prescribe remotely, internationally, or face-to-face.
It’s important to thoroughly review the policy details and be aware of any exclusions that could affect your protection. This includes which treatments and activities are included, as well as any territorial or financial limits.
Clinicians should ensure they have the right coverage and any necessary add-ons, such as worldwide cover, digital health, or run-off protection, if they plan to stop prescribing in the future.
Regulations and attitudes are evolving quickly in the medical cannabis sector, and clinicians should ensure they stay up to speed and keep careful records of their practice for future reference.
The Society works closely with PIB Insurance Brokers to arrange competitive, comprehensive policies for UK clinicians prescribing medical cannabis, because they understand the complex challenges clinicians face in this emerging field of medicine.
Richard has been working with the Society since 2021 and is passionate about supporting prescribers and helping patients access these treatments. Richard and the team not only work with individual prescribers, but clinics, importers, cultivators, manufacturers, distributors, management consultants, and tech providers in the sector.
PIB has developed tailored malpractice solutions that reflect the realities of prescribing cannabis medicines, offering doctors peace of mind with protection against both traditional liabilities and new, emerging risks.
To arrange a policy, please contact Richard Cupit, Head of Healthcare at PIB, on 07935 709160 or [email protected]. You can find out more about PIB Insurance Brokers on their website.
At the Medical Cannabis Clinicians Society, we give UK doctors the tools, guidance, and peer support to prescribe medical cannabis confidently and safely. One of the most common – and most important – questions we hear from new and existing prescribers is: How do I get the right medical cannabis insurance?
The answer is simple: you need insurance coverage that specifically covers your medical cannabis prescribing.
In the UK, medicinal cannabis products (CBMPs) can currently only be prescribed privately, apart from limited NHS use for licensed products such as Sativex and Epidyolex. This means your NHS indemnity does not cover you for most medical cannabis treatment.
The GMC requires all doctors to have adequate and appropriate insurance or indemnity arrangements covering the full scope of your practice. In reality, this means arranging a policy that includes indemnity insurance for doctors prescribing cannabis-based treatments. If your policy doesn’t explicitly list prescribing medical cannabis, you may not be protected for a claim.
Because most CBMPs are an unlicensed medicine, prescribers take full clinical responsibility for their use. Without the right insurance coverage in place, you risk being uninsured – something that could halt your treatment work immediately, affecting your patients. Being uninsured could jeopardise your career and leave you unable to practise. A lack of insurance could also impact your income if you are unable to work due to legal or regulatory issues.
Medical cannabis is an emerging and rapidly expanding field in the UK, with more healthcare professionals now prescribing cannabis-based products to help manage a range of health conditions. As this area of medicine grows, it’s increasingly important for clinicians to have robust medical indemnity insurance in place. Medical indemnity provides comprehensive cover for healthcare professionals, especially those working in private practice, by protecting them against medical malpractice claims that may arise from their clinical work.
With more patients seeking medical cannabis treatments, having the right indemnity cover not only safeguards your practice but also supports your ability to deliver high-quality care with confidence. In this evolving landscape, understanding the importance of insurance cover is essential for all medical professionals involved in prescribing medical cannabis in the UK.
Professor Mike Barnes, Chair of the Medical Cannabis Clinicians Society, says:
“Apart from two specific medications, Sativex and Epidyolex, medical cannabis is classed as an unlicensed medicine. Doctors prescribing unlicensed products take full clinical responsibility and may not be covered by standard indemnity insurance. Medical cannabis is a safe treatment with often significant benefits and few side effects. Clinicians can be reassured that if they prescribe within the legal parameters, they are very safe – although they still need insurance cover.”
To make this simple, the Medical Cannabis Clinicians Society has partnered with PIB Insurance Brokers – a leading provider of specialist healthcare cover – to arrange competitive, comprehensive policies for UK clinicians prescribing medical cannabis. It’s part of our commitment to removing barriers so clinicians can start or continue this treatment with confidence.
With this partnership, you can access:
PIB Insurance Brokers provide insurance solutions for UK doctors prescribing medical cannabis treatments.
To arrange a policy, please contact Richard Cupit, Head of Healthcare at PIB, on 07935 709160 or [email protected]. You can find out more about PIB Insurance Brokers on their website.
When choosing a medical indemnity insurance policy, it’s vital for medical cannabis clinicians to thoroughly review the policy details and be aware of any exclusions that could affect their protection.
Key aspects to consider include the scope of coverage, such as which treatments and activities are included, as well as any territorial or financial limits. Exclusions may relate to previous indemnity cover, disciplinary matters, or ongoing GMC investigations, which could leave gaps in your protection.
For medical cannabis clinicians in the UK, regulatory compliance is a fundamental part of safe and effective practice. The General Medical Council (GMC) requires all doctors to have adequate indemnity cover in place, and both NHS and private healthcare organisations may set additional standards for medical indemnity insurance. Healthcare professionals must stay informed about these requirements to ensure their insurance arrangements meet the necessary standards and protect them from potential risks.
Failing to comply with regulatory expectations can lead to significant challenges, including professional or legal consequences. By keeping up-to-date with the latest guidance and ensuring their insurance cover aligns with current regulations, medical professionals can focus on delivering the best possible care to their patients while safeguarding their own business and reputation.
Medical cannabis clinicians have access to several types of insurance designed to protect both their professional and business interests. The most critical is medical indemnity insurance, which specifically covers healthcare professionals against medical malpractice claims related to patient care.
In addition, professional liability insurance offers broader protection for errors or omissions in the delivery of professional services, while business insurance addresses risks associated with running a medical cannabis practice, such as safeguarding premises and equipment.
Each type of cover plays a vital role in ensuring that clinicians are protected from different aspects of risk. It’s essential for medical professionals to assess their practice needs and select the right combination of indemnity cover and business insurance to ensure they are fully protected in all areas of their work.
As the medical cannabis sector continues to grow in the UK, the need for tailored medical indemnity insurance will only increase. The future of medical cannabis insurance will be shaped by the evolving risks and challenges faced by healthcare professionals in this field, including the need for comprehensive cover against clinical negligence, legal defence, and business-related risks.
With the right insurance in place, medical cannabis clinicians can focus on their practice, confident that they are protected against the risks that may arise, and contribute to the continued growth and credibility of the profession in the UK.
Insurance for prescribing medical cannabis is an essential safeguard for you, your patients, and your professional reputation. Another safeguard is membership of the Society.
With MCCS membership, you get:
MCCS membership also ensures ongoing protection, including run-off cover for those entering retirement.
If you’re prescribing, or planning to prescribe, you need MCCS membership.
Join the MCCS now and get protected.
Q: Do clinicians need separate cover to prescribe CBMPs?
A: Yes. Private prescribing is not covered by NHS indemnity. Arrange indemnity insurance for doctors that explicitly includes prescribing medical cannabis.
Q: What should doctors check first with existing insurers?
A: Ask if medical cannabis is included in your insurance coverage. Get written confirmation that your prescription activity for unlicensed medicine is covered, or arrange a specialist policy.
Q: Is a medical cannabis prescription treated differently from other private prescriptions?
A: Yes. Most CBMPs are unlicensed. Adequate insurance cover is required before issuing a prescription.
Q: How can clinicians be sure their cover is valid for medical cannabis?
A: Join MCCS and use PIB Insurance Brokers. You’ll get tailored indemnity insurance for doctors prescribing medical cannabis in the UK, with explicit coverage stated.
Since the legalisation of cannabis-based medicinal products (CBPMs) in the UK in November 2018, around 40,000 patients have received these treatments, with numbers steadily increasing. There are currently 40 clinics and about 140 prescribers operating within the private sector.
However, the adoption of these medicines within the NHS has been slow, and there are no compulsory training requirements for prescribers. This has led to significant variations in clinical practice.
To address these challenges, the Medical Cannabis Clinicians Society (MCCS) has developed a Good Practice Guide. This guide aims to support prescribers and ensure patients can safely access these valuable medicines. While it is tailored primarily for clinics that focus on prescribing cannabis, the fundamental principles are relevant to a broader range of medical settings.
The MCCS hopes this guide will be adopted widely, pleading to practices that benefit patients and improve the overall quality of the medical cannabis industry. This effort highlights our dedication to raising standards and supporting prescribers with practical, applicable guidelines and support.
You can access all our public publications – including this recently published Good Practice Guide – on our website.
Not yet a member? Join the Society.
The Medical Cannabis Clinicians Society (MCCS) and Volteface have been successfully elected as the new secretariat for the Medical Cannabis under Prescription APPG – bringing new bold strategy and commitment to working collaboratively with parliament, the industry and patients to improve the UK landscape.
Since legalisation of medical cannabis in 2018 a number of significant barriers have formed – from a lack of awareness to the continued struggle of paediatric access. The tireless work of MPs in the APPG to date to raise awareness of these issues in parliament has been challenging and at times been met with strong opposition from the government. The new focus of the APPG seeks to find allies both in and out of parliament who can provide evidence-based and practical solutions to overcoming the existing barriers.
These areas of focus include:
The new secretariat offers a vast amount of industry and medical cannabis expertise. Volteface and MCCS have an expansive network across politics, mainstream media, the clinical sphere, the cannabis industry, patients and advocacy groups.
Both organisations have a deep understanding of the sector and the issues facing it. With this expertise they are well positioned to help instigate adequate change.
The secretariat feels particularly strongly about collaborating with patient groups to ensure their needs are addressed and are a centre point for engaging Westminster on the issue. Alongside this, as professionals in the sector, Volteface and MCCS wants to ensure that the industry is positioned appropriately within parliament and has a voice to raise pertinent issues around the sustained development of the sector.
Tonia Antoniazzi, Labour MP and co-chair of the APPG for medical cannabis under prescription said: “As co-chair of the APPG I’m delighted to welcome Volteface and The Medical Cannabis Clinicians Society as the new secretariat of the group. Volteface and the MCCS have a wide range of expertise which will be extremely valuable moving forward.
Progress has been slow since the law change almost 5 years ago, so it is vital that we keep this conversation alive. I’m looking forward to working alongside our new secretariat in addressing the barriers to accessing medical cannabis under prescription and I hope we can start to see change happen.”
Leon Barron, Chair of the Medical Cannabis Clinicians Society said: “I am delighted that the MCCS along with Volteface have been appointed as secretariat to the APPG on medical cannabis. We look forward to moving this conversation forwards and to bridge the gap between policy makers, clinicians, and academics. Medical cannabis is being utilised widely across the globe and has proven efficacy for a range of chronic conditions. It can play a crucial role in relieving suffering and enhancing overall quality of life. Our priority must be to find pragmatic solutions to the barriers that are restricting eligible patients in the UK accessing these medicines and we must ensure that all doctors, including GPs feel well informed and confident in prescribing medical cannabis.”
Hannah Deacon Executive Director of the Medical Cannabis Clinicians Society said: “It is an honour to be appointed secretariat to the APPG on medical cannabis. I am excited to be working with Volteface who have proven experience in this area and together I feel we will make an important contribution to ensuring the APPG continues to push forward to issues that patients, clinicians and the medical cannabis industry face. I know only too well of the suffering that patients continue to endure and the difficulties clinicians face in trying to access this prescribable medicine for their patients. I hope working together we can help move things forward to a place where patients and clinicians are better served and the industry is able to function in a more streamlined manner.”
Paul North, Director of Volteface said: “It is imperative that we work together to improve medical cannabis access and prescribing in the UK. The key to that collaboration is through parliament – an environment which can facilitate learning, find solutions to complex problems and lead to the formation of effective policy. Volteface has been engaging MPs and policy makers since its inception in 2017 and we are well aware of the challenges that lie ahead of us. Alongside our friends and colleagues at MCCS we are determined to provide MPs with the resources, knowledge and steer they need to improve medical cannabis prescribing in the UK.”
Katya Kowalski, Head of Operations of Volteface said: “I’m thrilled to be working with the APPG and the MCCS to advance the conversation around medical cannabis in parliament. Working in the sector it has been so frustrating to see the dialogue stagnate politically. There is still so much that needs to be done, particularly around effectively communicating the state of play to policy makers to raise awareness about the legality and accessibility of this medicine. There are a multitude of issues that need to be addressed for the sector to thrive and for patients to be tended to, and I look forward to advancing this through our role within the APPG.”
The Medical Cannabis Clinicians Society maintains a list of available cannabis-based medical products regularly updated and shared with its members.
As a member of the Medical Cannabis Clinicians Society, clinicians are supported with all the practical guidance they need prescribe medical cannabis safely, including training, education, peer and expert support and mentoring, FAQs and access to an accurate product list of available medications.
In the latest update for members, we have included new products available for the first time in the UK from Stenocare via Rokshaw and PCCA Ltd. Stenocare, founded in 2017, cultivates, produces, imports and sells prescription-based medical cannabis, focusing on Patient Safety, Affordability & Accessibility. In 2018, Stenocare became the first Danish company to obtain all permits to cultivate, import and trade in medicinal cannabis oils in the Danish pilot program. Stenocare is the only Danish company that has succeeded in having medical oil-based cannabis products approved for the Danish pilot program and supplies pharmaceutically-produced and uniform oil products to patients in Denmark, Sweden, Norway, UK and Australia.
All Stenocare medical cannabis sublingual oil products are produced in accordance with Good Agricultural and Collection Practices (GACP) without the use of pesticides and Good Manufacturing Practice (EU GMP) for Pharmaceutical Products. Stenocare’s products are whole-plant (full spectrum) cannabis-based medicines, that are tested for quality and compliance at external laboratories.
To access the product list, members can login here. Not yet a member? Join the Medical Cannabis Clinicians Society.
John Ellis lives with Progressive Mylopathy of uncertain cause. Here, he tells his story.
A decade of declining health
In early 2002 whilst working as a broadband technician, I began to notice loss of memory and a change in smell and taste. After a few months of this problem worsening I was put-on long-term health support with the company, as my work required quick and accurate recall a lot of technical information.
After undergoing private cognitive therapy without much success in outcomes, I spent the next few years with my wife supporting our local community, creating a community group working with the police and other official bodies. In later years we set up a community garden with the help of other locals. It was during the latter years that my illness worsened and by 2010 cognitive loss, general pain and inability to mobilise myself properly had started to set in.
By 2011/2012 my condition had become progressively worse, to the point where I needed assistance to walk. I had already visited my doctor several times with different doctors viewing my deterioration in several ways. One even put all my issues down to my use of cannabis for pain management, even though I explained why I thought it worked better than non-steroidal anti-inflammatory drugs. Eventually, I engaged with a doctor that saw me as a patient first. He immediately arranged for an appointment with Walton Hospital and a neurologist.
Reaching a diagnosis
After undergoing a raft of physical tests including an MRI, my first initial diagnosis was for Primary Progressive Multiple Sclerosis. This was ruled out and changed to Progressive Myelopathy of uncertain cause.
The MRI showed lesions in the upper right pons – part of the brainstem – and many white matter lesions, whilst somatosensory test showed I had lost the somatosensory pathways back to my central cortex. This means the electrical signals travel out from my brain but do not travel back to the central cortex. The blood test results showed very low copper/Ceruloplasmin levels and lactic acid levels well above normal.
The symptoms of the copper deficiency are wide ranging, affecting everything from cellular respiration to enzyme production involved in neurological messenger breakdown, normally only seen in people who have had bariatric surgery presenting with a loss of gait and lower body functions and muscle spasms. Normally, replacing copper fixes the problem, but for me, the copper levels stayed low and fell even further over the years.
Chronic, long-term pain
I’m in almost constant pain. It is not what I would describe as normal pain – more of a sensory overload/emptiness, with smooth objects I hold feeling like they are made from a million tiny needles to hot wires being pulled through muscle and skin and numbness to the touch in my legs.
Exhaustion and fatigue are common problems with my illness, aggravated greatly with any form of exercise or rise/fall in external temperatures. Some days my body temperature can stay at 35.6 degrees and can stay that way for days. At my worst, a flare up can take a month or two to recover from.
I have trailed several prescription drugs over the years to help with pain management.
My pain specialist said that there is no mechanical intervention that can help – such as gabapentin and amitriptyline, both of which amplified the discomfort. Lamotrigine caused horrendous locked-in dreams and night terrors. I was taken off Lamotrigine after three weeks due to possible psychosis through lack of sleep, as I became terrified to sleep.
Since then I have partly stabilised on sodium valproate, baclofen, solifenacin succinate, copper supplement and currently 0.3 grams of cannabis at bedtime which I limit due to costs.
My medical cannabis journey
I have always been aware of cannabis, using it both recreationally when I was younger and now for medical use. I’m a very long way of gaining a prescription however, as the current costs are prohibitive to me. So, I rely on black market cannabis.
My Consultant and Pain Management Specialist have both been supportive on my medical notes have listed ‘up to a gram and a half per day’ under ‘current medication’, even though this is not via a prescription as it is unaffordable at those quantities and is not yet available on the NHS.
When I was first diagnosed, I was offered a month trial of Sativex. I turned this down as I had already enquired with my CCG about prescription costs – which they had already refused on costs alone. I was however lucky enough to try Sativex several years later during a visit to Parliament regarding the prescription of cannabis products.
Sativex turned out to be very effective for most of my symptoms, reducing my tiredness and fatigue as well as the pain and spasticity in my legs. I have done the majority of my own research over the years on how it effects my illness, even surprising some of my medical providers with knowledge on how cannabinoids interact with parts of my illnesses.
The future of medical cannabis prescriptions
I believe it is vital for everyone that cannabis prescriptions and cannabis-based products are brought onto the NHS, in part because of the unreliability of black market cannabis and more importantly the general health of patients.
Like many ordinary people, I don’t have the income to be treated via private clinics with a basic prescription and costs equating to nearly a third of our income per month.
All we are asking for is a replication of the Dutch Bedrocan range of plants and oils which will suit most patient’s needs.
John Ellis is a member of the Society’s Patient Committee.
Sue Evans from York uses medical cannabis treatment to alleviate chronic pain caused by cancer. Here, she tells her story.
In December 2015 I was diagnosed with breast cancer in my right breast. I underwent a lumpectomy and a 4 week intensive course of radiotherapy. I refused chemotherapy because I considered it to be too invasive a treatment for me. In 2016 I did however, begin an endocrine treatment (Tamoxifen) to help prevent a resurgence of the cancer.
Sadly for me, one week into this endocrine treatment I suffered liver failure: I was told I had three years to live unless my liver repaired itself. I stopped the endocrine treatment, cut out alcohol and started an alkaline diet. Thankfully my liver recovered within three months and still functions well, however I was left with a threat of an associated condition called Varices, a weakening of the veins which can cause internal bleeding. To date, my follow up breast scans continue to be clear, which is positive.
Turning to CBD for chronic, long-term pain
In 2018, I developed pain in my right pelvic area which was later aggravated by a fall I had on an icy path. A bone density scan I had previously had in 2017 had revealed mild Osteopenia, so I attributed the pain in my pelvis to that condition and I did not consult a Doctor.
I did not want to rely on long term conventional painkillers for my hip because I was concerned they could aggravate the Varices threat which later down the line proved to be correct and also my liver, so I researched CBD oil as an alternative pain relief. This was no easy feat, and an expensive one, as I discovered that many brands and strengths below 1000mg did not have any effect at all on my pain. However, after two months of trailing different types I did find a CBD full spectrum (no THC) 1200mg product that instantly relieved the pain, but I had to take frequent dosages to completely control it. But it did so effectively.
In November 2019 I fell ill with an unidentified infection which caused much pain in my lower left abdomen. Despite various tests, doctors were unable to diagnose the nature of the infection, which resulted in three different courses of antibiotics being prescribed, over a period of two months. I ceased CBD oil at this time as I didn’t know if it would interfere with the medication and therefore resorted to conventional pain killers to alleviate both the abdominal pain and the chronic pain in my right hip. Sadly, the infection did not go away and after two months of this excessive pain I was rushed into hospital in January 2020, with severe internal bleeding in the stomach and upper digestive tract.
Secondary cancer diagnosis & prescription medical cannabis treatment
The internal bleeding was treated successfully and the intravenous antibiotic I was given in hospital seemed to clear up the mystery infection. However, during my week of hospitalisation a scan of my abdomen revealed bony metastases (secondary breast cancer) in my right pelvis and lower spine. Unbeknown to me this had been the cause of the chronic pain in my right hip. So despite my breast scans remaining clear it appears the cancer had resurfaced in my spine and pelvic area.
Following a consultation with an Oncologist I agreed to take a different Endocrine treatment (Letrezole), to manage the cancer going forward. I also resumed the CBD oil for the pain relief. I am unable to take conventional pain killers due to the Varices, so I realised that if the cancer got worse I would potentially need a stronger CBD medication to control any increased pain, which is what prompted me to look for a private, qualified medical cannabis consultant.
A breast cancer nurse assisted me with this task and I was introduced to Dr Liz Iveson, a member of the Society’s expert committee. Since March 2020 I have been taking prescription Bedrolite CBD oil to manage the chronic pain in my pelvis. The medical CBD is stronger than the self-medicating CBD oil I had taken previously, so I require a much lesser dose to achieve the same level of pain control.
I now take the Letrozole endocrine treatment, which luckily I have not had an adverse reaction to, and the medical cannabis for the pain relief. My three monthly checks and blood tests show that the cancer is being effectively managed.
Successfully managing pain with prescription CBD
I personally have not experienced any side effects from either non medical or medical cannabis. Though I sleep much better at night as a result of CBD, it does not cause drowsiness during the day, so it does not affect my ability to drive safely. Also my ongoing blood tests and scans show that it is not interfering with the endocrine medication I take.
To sum up my experience with CBD oil, it allows me to enjoy a pain-free, full life rather than a painful existence. I very much enjoy walking as a means to relax; with CBD oil I can walk 6 or 7 miles easily with no problem at all. Without CBD oil I struggle to walk a mile and I limp quite profusely, even getting into a standing position is difficult.
CBD treatment makes a huge difference to the quality of my life, keeping a positive attitude does too. I refuse to dwell on how many years I will live with cancer. I do not want to waste my life thinking about the day I will die. I enjoy my life and intend to continue doing so.
As a last point I would like to counter argue the placebo effect that some label CBD with. In my early days of research I had to try various brands and strengths of CBD until I found one that worked. This was extremely time consuming and very costly. If, I had been of a placebo mindset, trust me I would have settled on the first brand I tried and saved myself a whole lot of time and money!
I can only sing the praises of medical cannabis from my personal experience, and would urge anyone suffering chronic pain to at least try it. You may be surprised at what a beneficial difference it can make to one’s quality of life and mental well being.
Thank you for reading my story.
Sue Evans is a member of the Society’s Patient Committee.