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Clinicians interested in the evidence and suitability of cannabis, those already prescribing cannabis based medicinal products, those wishing to become prescribing doctors and those looking to increase their knowledge can struggle to find straightforward guidance and independent support. Guidance from regulators and the medical community has so far been contradictory.

The Society was established to support clinicians and provide the necessary support and guidance to allow clinicians to become informed, confident prescribers.

As a member, you’ll be at the forefront of the conversation around the growing medical use of cannabis, with access to an unrivalled network of prescribers thorough our Peer Support Group, where members learn from each other and access online support 7 days a week.

Joining active prescribers working across mental health, chronic pain, gastroenterology, sports medicine and more, you will have access to experts in the sector and the opportunity to access foundational training and continuous professional development, allowing you to better support your patients.

MCCS members are regular contributors to the medical cannabis conversation, guidance and debate.

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How US Open Betting Regulations Have Shaped the Market, According to Betzonic

The United States Open Championship, commonly known as the US Open, is one of golf’s four major tournaments and draws significant wagering interest from bettors across North America and beyond. Over the past decade, the regulatory landscape surrounding sports betting in the United States has undergone a dramatic transformation, and the US Open has sat at the center of many of these changes. Understanding how federal and state-level regulations have shaped the betting market around this event requires examining the legal shifts, operator behavior, and consumer access that have evolved since the landmark Supreme Court ruling of 2018.

The PASPA Repeal and Its Immediate Effect on Golf Betting

Before May 2018, sports betting in the United States was effectively prohibited outside of Nevada under the Professional and Amateur Sports Protection Act of 1992, known as PASPA. The Supreme Court’s decision in Murphy v. National Collegiate Athletic Association struck down PASPA as unconstitutional, opening the door for individual states to legalize and regulate sports wagering as they saw fit. The impact on golf betting, including wagering on the US Open, was immediate and significant.

New Jersey became one of the first states to launch legal sports betting following the ruling, with retail and mobile sportsbooks going live within weeks of the decision. By the time the 2019 US Open was held at Pebble Beach, bettors in New Jersey, Pennsylvania, West Virginia, Mississippi, and Rhode Island could place legal wagers on the event. This was a structural change, not merely a cosmetic one. Legal operators were required to report transactions, verify bettor identities, and operate within frameworks that included responsible gambling provisions — requirements that had no equivalent in the offshore market that had previously dominated US golf betting.

The shift also affected the types of bets available. Regulated sportsbooks, operating under state licensing requirements, offered outright winner markets, round-by-round betting, and head-to-head matchup wagers. However, the more exotic proposition bets that offshore books had offered for years were slower to appear in regulated markets, largely because operators were cautious about regulatory scrutiny during the early years of legalization. This conservatism gradually faded as state regulators became more comfortable with the product offerings and as competition between operators intensified.

State-by-State Fragmentation and Market Complexity

One of the most consequential features of the post-PASPA regulatory environment is that there is no unified federal framework for sports betting. Each state that has legalized wagering has done so through its own legislation, with its own licensing requirements, tax structures, and permitted bet types. As of 2024, more than 35 states have legalized sports betting in some form, but the rules governing what bettors can do — and which operators can serve them — vary considerably from state to state.

For the US Open specifically, this fragmentation creates a patchwork experience. A bettor in New York can access mobile sports betting through a limited number of licensed operators, all of whom face a 51 percent tax rate on gross gaming revenue — the highest in the country. That tax burden has a direct effect on the odds offered to consumers, since operators must maintain margins that account for the cost of doing business in high-tax environments. By contrast, a bettor in Nevada, where the regulatory framework predates PASPA and the tax rate is considerably lower, may encounter different odds and a broader range of betting options on the same US Open field.

This complexity has prompted industry analysts and dedicated sports betting resources to map out the differences in access and product quality across jurisdictions. The resource at betzonic.com/us-open-betting-sites, for example, documents how available operators and market conditions differ depending on where a bettor is located, reflecting the genuine regulatory divergence that shapes what consumers can access during major golf events like the US Open.

The fragmented landscape has also created compliance challenges for operators. A sportsbook operating in multiple states must maintain separate licensing relationships with each state’s gaming control board, implement geolocation technology to ensure bettors are physically within state borders when placing wagers, and adhere to differing rules on promotional offerings. Some states prohibit sign-up bonuses or restrict the types of promotions operators can offer, while others permit aggressive promotional campaigns. These differences affect how the US Open betting market looks and feels to consumers depending on their location.

Regulatory Influence on Odds, Liquidity, and Market Depth

Regulation does not merely determine who can bet — it shapes the quality and depth of the betting market itself. In the years following PASPA’s repeal, the US Open betting market has grown substantially in terms of handle, the total amount wagered. The American Gaming Association estimated that over $1.8 billion was wagered legally on golf in the United States in 2022 alone, a figure that would have been a fraction of that total prior to legalization simply because the legal channels did not exist for most bettors.

Greater legal handle has attracted more sophisticated operators and, with them, more competitive pricing. When fewer legal options existed, offshore books could maintain wider margins because bettors had limited alternatives. As regulated operators have entered the market and competed for customers, odds on major golf events including the US Open have tightened. This is a direct consequence of regulatory expansion, not just of general market growth.

However, regulation has also introduced constraints that affect liquidity. In-play or live betting — wagering on outcomes during the course of a round — is one area where regulated US markets have historically lagged behind European counterparts. Operators in the United Kingdom, operating under the Gambling Commission’s framework, have offered real-time betting on golf for years, including markets on individual hole outcomes and shot-by-shot wagering on select events. US regulators have been more cautious about in-play products, partly due to concerns about integrity and the speed at which suspicious activity could be identified and reported. The result is that US Open live betting in regulated American markets, while growing, remains less sophisticated than what is available in more mature betting jurisdictions.

Betzonic has noted in its coverage of the US Open betting market that the integrity monitoring requirements imposed by state regulators — including mandatory reporting of unusual betting patterns to governing bodies like the USGA — have actually contributed to a more trustworthy market environment, even if they have slowed the rollout of certain product types. The relationship between the USGA and licensed sportsbooks has formalized over time, with data sharing agreements and integrity partnerships becoming standard features of the regulated landscape.

The Role of Operator Licensing and Consumer Protections

Licensing requirements in regulated states serve a dual purpose: they generate revenue for state governments through licensing fees and taxes, and they establish standards for how operators must treat consumers. For bettors wagering on the US Open, these consumer protection standards represent a meaningful departure from the offshore market. Licensed operators are required to offer self-exclusion programs, deposit limits, and responsible gambling tools. They must also maintain segregated customer funds in most jurisdictions, meaning that a bettor’s account balance is protected even if the operator encounters financial difficulties.

These protections have practical significance. Prior to widespread legalization, US bettors who used offshore books had no legal recourse if a dispute arose or if a platform failed to pay out. The regulatory frameworks that now govern US Open betting in states like Colorado, Michigan, Illinois, and Arizona provide formal dispute resolution mechanisms and require operators to respond to complaints through established channels. This has increased consumer confidence in the legal market, which is one reason handle on major events like the US Open has grown so substantially in a relatively short period.

Advertising regulations have also shaped how the US Open betting market is presented to consumers. Following a wave of aggressive marketing in the early years of legalization, several states introduced restrictions on promotional advertising, particularly around bonus offers and free bet promotions. Massachusetts, which legalized mobile betting in 2023, included specific advertising standards in its regulatory framework from the outset, reflecting lessons learned from other states. These restrictions affect how operators compete for new customers during high-profile events like the US Open, pushing them toward product quality and odds competitiveness rather than pure promotional spending.

The trajectory of US Open betting regulation over the past several years illustrates a broader pattern: legal markets mature over time, with initial caution giving way to more nuanced frameworks that attempt to balance consumer access, operator viability, and market integrity. The United States is still in a relatively early phase of this process compared to jurisdictions like the United Kingdom or Australia, where sports betting has been legal and regulated for decades. As more states refine their approaches and as federal-level conversations about a unified framework continue, the US Open betting market will likely continue to evolve — becoming deeper, more competitive, and more sophisticated with each passing year. What is already clear is that the regulatory decisions made at both state and federal levels have fundamentally altered who bets, how they bet, and what protections they enjoy when they do.

Expert Leadership


The Society’s Expert Committee members are recognised as leading experts in their fields, dedicated to opening up access to medicinal cannabis for every patient in the UK and mentoring and supporting its members.

Information for Doctors on cannabis based medicines


Why should UK doctors become informed about medical cannabis?

Doctors in the UK should become more informed about medical cannabis because it can provide relief for a variety of medical conditions, including chronic pain and epilepsy.

Legal on prescription since November 2018, medical cannabis is available initially to qualifying patients from a doctor on the specialist register of the GMC, which makes it important for doctors to have current knowledge on its therapeutic properties so that they are able to make informed decisions when treating their patients. It is estimated that over 50,000 patients (December 2024) have a private prescription for a medical cannabis product.

A YouGov poll carried out in October 2022 found that approximately 1.8million people with diagnosed medical conditions are turning to illegally obtained cannabis to manage their illness – 400,000 more than a similar report carried out in 2019.

With any new treatment, it is crucial that clinicians and healthcare professionals are confident about dosing, interactions with other drugs, tolerability and prescribing information. When it comes to medical cannabis, it’s important that clinicians have a wider understanding of the endocannabinoid system too, and the cannabinoids THC and CBD and which has the most therapeutic effect for different conditions and symptoms.

It is important for doctors to stay up-to-date on the regulations regarding prescribing and dispensing of medical cannabis products. By becoming better educated about medical cannabis, doctors will be better equipped to offer potentially life-changing treatment options for their patients suffering from various debilitating conditions.

What conditions and symptoms can medical cannabis be prescribed for in the UK?

There are no barriers to medical cannabis treatment and any condition can be considered. In the UK, the vast majority of medical cannabis is prescribed to relieve pain and anxiety, however there are no restrictions on its use.

Medical cannabis has been used to effectively relieve the symptoms of a variety of medical conditions, including: chronic pain, cancer-related pain, multiple sclerosis (MS), HIV/AIDS, ADHD, inflammation, severe treatment resistant epilepsy, seizures, anxiety and depression. In some cases, it can be used to treat conditions like Crohn’s disease and irritable bowel syndrome. Medical cannabis has been used to treat intractable nausea and vomiting caused by chemotherapy, as well as to increase appetite in people suffering from wasting syndromes or malnutrition related to HIV/AIDS.

There is growing evidence that medical cannabis can be beneficial for treating post-traumatic stress disorder (PTSD). Some studies have suggested that medical cannabis can be used to help treat Alzheimer’s disease and Parkinson’s disease.

It is important to note that individual responses to medical cannabis will vary greatly, depending on the underlying condition being treated as well as other factors such as body weight, age, and medical history.

Who can prescribe medical cannabis in the UK?

Prescribing cannabis-based products for medicinal use in the UK is restricted initially to doctors who are listed on the Specialist Register of the General Medical Council. These clinicians should adhere to GMC guidance when prescribing CBMPs as they are classed as unlicensed medicines. Specialist Doctors should prescribe only within their area of practice and with the support of a multidisciplinary team.

Doctors who can prescribe with direction under Shared Care arrangements are also permitted to prescribe medical cannabis, though at present these are rare. Other clinicians (GPs, resident doctors, independent prescribing pharmacist and nurses) can prescribe under the direction of the initiating specialist.

According to the General Medical Council, doctors can prescribe if they satisfy the following requirements:

  • Doctors are aware of the misuse of drugs regulations
  • Doctors have a good awareness of the available guidelines
  • Doctors are aware of the evidence base for this treatment
  • Doctors are prescribing within their own area of expertise

In Canada, the US and Australia too, GPs can prescribe medical cannabis.

As a specialist doctor, how can I start prescribing medical cannabis in the UK?

The Society has developed a step by step guide to support doctors wishing to prescribe cannabis based medicines. From private clinics to independent practice, there are options for medical cannabis treatments and prescribing routes.

The information guides you through the requirements – from training, MDT support and governance to specials prescribing. A practical introduction, the guide will give you all the information you need to become a confident, compliant and well informed prescriber.

The first step to prescribing medical cannabis in the UK is to complete your training. You will need to gain a knowledge and understanding of endocannabinoid pharmacology, clinical evidence, dosing and patient management.

Read the guide in full.

What medical cannabis training is available to doctors in the UK?

Are you a healthcare professional looking to gain an expert-level understanding of medical cannabis usage?

Medical Cannabis Explained, our live course hosted by Professor Mike Barnes, is the perfect learning opportunity for members who want to become confident and competent prescribers of this effective therapy, or simply increase their understanding of the treatment.

The Society’s training provides healthcare professionals with an overview of cannabis based medicine, its historical use and applications, evidence for its use, indications, conditions and symptoms suitable for medical cannabis treatment, overviews of different products available in the UK including licensed producers, CBD/THC ratio dosages and much more – all centred around best practices for safe and responsible prescribing. It also offers insight into how these treatments may benefit patients seeking pain relief or treatment for mental health issues like anxiety or depression. The course also provides guidance on legal regulations surrounding medical cannabis so that practitioners can use their professional judgement to prescribing it responsibly and within the law.

medical cannabis training

How can I access continuing education on medical cannabis?

Through the Medical Cannabis Clinicians Society and the expert leadership, peer support and education, Consultants and Doctors can ensure they are fully informed about this treatment.

The Society offers accredited continuing education sessions and resources, as well as webinars, national conferences and networking opportunities to help doctors stay up-to-date on the latest developments in medical cannabis.

What kind of risks are there when prescribing cannabis based medicinal products?

Through generally a low-risk treatment, as medical professionals, it is paramount that doctors remain informed of any potential risks and side effects their patients may experience when using cannabis-based therapies as well as the legal ramifications associated with prescribing or administering them.

Doctors should make sure they are up to date on all relevant laws and regulations surrounding the use of medical cannabis and recreational cannabis. It is also important to be aware that there are different forms of medicinal cannabis products available for prescribing or administering to patients. These include flower, oil, capsules, tinctures, topical creams and patches. Different delivery methods can offer a variety of benefits depending on the patient’s needs and preferences.

Resources for Specialist Consultants & Doctors

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