Medical cannabis can be prescribed legally in the UK, but it is not an over-the-counter or retail product. The route is specialist-led, most cannabis-based products for medicinal use are unlicensed medicines, and access through the NHS remains uncommon. This overview separates the legal rules from the practical NHS and private pathways.
Key takeaways
- The 2018 change made defined cannabis-based products for medicinal use prescribable; it did not legalise general possession or create dispensaries.
- Initial prescribing of an unlicensed CBPM must be by a doctor on the GMC Specialist Register, working within their competence.
- There is no statutory list of diagnoses that alone determines whether an unlicensed CBPM may be prescribed. The specialist must make an individual clinical decision based on evidence, risks and other options.
- NICE recommendations and NHS commissioning make routine NHS access much narrower than the legal power to prescribe.
- Private care follows the same professional and controlled-drug standards; paying for an assessment does not assure a prescription.
- Prescribed cannabis is not interchangeable with a retail CBD food product or cannabis obtained outside the prescription route.
What changed in 2018
On 1 November 2018, products meeting the legal definition of a cannabis-based product for medicinal use moved from Schedule 1 to Schedule 2 in England, Wales and Scotland through amendments to the Misuse of Drugs Regulations 2001. Northern Ireland introduced a parallel Schedule 2 route under its 2002 Regulations on the same date. The changes created controlled routes for prescribing and pharmacy supply. They did not legalise growing, buying or possessing cannabis outside the authorised medical route, and smoking a CBPM remains prohibited.
The GMC explains that supply of an unlicensed CBPM must be in accordance with a prescription or direction from a doctor on its Specialist Register. The doctor must work within their competence and generally make the decision with a multidisciplinary team. A GP cannot initiate an unlicensed CBPM prescription, although ongoing care may sometimes involve another prescriber under a specialist’s direction.
NHS England is also clear that there are no legal restrictions on the medical conditions for which a CBPM may be prescribed. That does not mean a product is suitable whenever requested. The clinician considers the evidence for the individual patient, licensed and established treatments, interaction and safety risks, and the additional responsibilities attached to an unlicensed medicine.
NHS and private access
The NHS patient page says medical cannabis is only likely to benefit a small number of patients and gives examples of the licensed or guideline-supported situations in which it may be considered. NICE NG144 shapes NHS practice and funding, but its recommendations are not a universal legal diagnosis list for private specialist decisions.
A private clinic may accept a direct enquiry, then ask for medical records before a specialist assessment. Some patients instead discuss referral or records with their GP. In either route, expect a review of diagnosis, symptoms, treatment history, current medicines, mental and physical health risks, pregnancy or breastfeeding, substance-use history, driving and safety-critical work. The clinic should explain its evidence and fees before any decision.
If a prescription is issued, a pharmacy supplies the exact medicine to the named patient. The label, prescription and clinical directions matter. Keep the medicine in its original dispensing container and do not share it. How the medical cannabis prescription process works follows that route in more detail, while NHS versus private prescriptions explains the practical differences.
Private costs may include assessment, follow-up, prescription or pharmacy charges and the medicine itself. Compare the annual pathway, not one advertised entry price. See medical cannabis costs in the UK and clinic fees to ask about before signing up.
Products, evidence and safety
Some cannabis-based medicines have a marketing authorisation for specific uses; many products supplied through specialist clinics are unlicensed. Unlicensed does not mean unregulated or automatically unsafe, but it means the exact product has not gone through the standard licensing assessment for that use. The prescriber must explain the evidence, material uncertainties and monitoring plan.
Possible effects listed by the NHS include tiredness, dizziness, feeling high, mood or behavioural change, hallucinations and suicidal thoughts. CBD and THC can also affect how other medicines work. Tell the clinician about prescriptions, over-the-counter medicines and supplements, and contact the clinical team if side effects or an unexpected response occur. Seek urgent help for a severe or immediately dangerous reaction.
Do not drive if impaired. Great Britain and Northern Ireland have different drug-driving legal frameworks, so use current official guidance as well as clinical advice. The MCPH guide to medical cannabis and driving in the UK separates prescription evidence from fitness to drive.
The medical education hub covers terminology and evidence. If you are considering assessment, use the questions in choosing a medical cannabis clinic rather than treating a clinic advert as a suitability decision.
The MCPH patient guide brings the access, appointment, prescription and day-to-day guides together in one place.
Read next
- Is medical cannabis legal in the UK?
- NHS versus private medical cannabis prescriptions
- Medical cannabis side effects
Source trail
- NHS: Medical cannabis
- GOV.UK: Rescheduling of cannabis-based products for medicinal use in humans
- Northern Ireland Department of Health: CBPMs available from 1 November 2018
- NHS England: Cannabis-based products for medicinal use (CBPMs)
- GMC: Information for doctors on cannabis-based products for medicinal use
- NICE NG144: Cannabis-based medicinal products
- MHRA: Supply of unlicensed medicinal products
- MHRA: Statement on products containing cannabidiol (CBD)
