What counts as trying two treatments?

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What counts as trying two treatments?

Treatment history paperwork, medicines and prescribed medical cannabis items on a clinical desk.

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The short answer

When people talk about needing to have tried two treatments before medical cannabis, they usually mean this: a clinic wants to see that you have already tried recognised treatments for your condition, and that they did not work well enough, caused problems, or were not suitable.

It is not a magic phrase. It is not a law that says two medicines automatically qualify you. It is also not meant to turn eligibility into a paperwork obstacle course.

The practical version is simpler:

  • your Summary Care Record is usually the key document
  • it should show the condition or symptoms being assessed
  • it should show relevant medicines or treatments you have tried
  • if those treatments are recent and clearly connected to the condition, that may be enough for a clinic to start the first assessment
  • the specialist clinician or prescriber still makes the final decision

If your SCR shows the condition and recent relevant treatments, you may not need much more than that for a clinic to start the first assessment. A recent medication history can be particularly useful, but SCR contents vary. Some clinics may ask for extra notes if the SCR is unclear, if the treatment history is older, or if the condition is not obvious from the record.

Is two treatments an official legal rule?

No. There is no simple law that says every patient must have tried exactly two treatments before a specialist can consider medical cannabis.

The official wording is broader, as explained in the UK medical cannabis patient guide. NHS and NHS inform patient guidance frame medicinal cannabis as something considered when other treatments have not worked or are unsuitable. NHS England guidance says prescribing is a clinical decision that should consider the patient, the condition, other medicines, evidence, safety, and whether licensed medicines are suitable.

So when a clinic talks about two treatments, treat it as clinic shorthand rather than a universal rule. It helps the clinic understand whether you have already explored normal treatment options for the condition. It does not replace the specialist assessment.

What can count as a treatment attempt?

A treatment attempt is usually something that was tried for the condition you are asking about.

It may count if:

  • it was prescribed or recommended for that condition
  • you tried it and it did not work well enough
  • you tried it and side effects made it unsuitable
  • it was stopped, changed, or avoided for a clinical reason
  • it appears on your Summary Care Record or medication history

For many patients, this is not complicated. If a GP or specialist prescribed medicines for the condition, and those medicines show on your SCR, that is often the evidence a clinic needs to start assessing you.

Example: migraine, triptans and amitriptyline

A realistic migraine pathway might look like this.

Someone has migraines for a while before being prescribed anything specific. They speak to their GP and are prescribed triptans. The triptans help a bit, or do not help enough, or are not very effective for the way their migraines present.

They then try amitriptyline, which is used by the NHS for pain and migraine prevention. It does not agree with them. That might mean side effects, poor tolerance, or simply that the medicine is not suitable for that person.

At that point, the SCR may show the migraine history and the treatment attempts. The patient requests the SCR from the GP surgery, sends it to a clinic, has an appointment with a specialist, and the specialist assesses whether medical cannabis is clinically appropriate.

That example does not mean migraine automatically qualifies. It shows the practical shape of the evidence: condition, previous treatments, what happened, SCR, specialist assessment.

Does it have to be two prescription medicines?

Not always in the way patients imagine, but it depends on the clinic and the condition.

Some clinics may ask for previous prescribed medicines. Others may consider wider treatment history if it is relevant and documented. The safest way to think about it is not how do I tick the box? but does my SCR show that normal treatment routes have already been tried or considered?

Do not start, stop, or request medicines just to qualify for medical cannabis. Treatment decisions should be about your health, not about constructing an eligibility trail.

What if one treatment worked but caused side effects?

That can still matter.

A treatment does not have to be completely useless to be relevant. If it helped but caused side effects that made it hard to continue, that is part of the treatment history. If it was unsuitable because of another medicine, another health condition, or the way it affected you, that is also relevant.

This is why the detail matters more than just the count. A specialist wants to understand what was tried and what happened.

What should show on your SCR?

For this kind of eligibility check, the SCR should ideally show enough to connect the dots:

  • the condition or symptoms being assessed
  • relevant prescribed medicines
  • recent medication history
  • stopped or changed medicines where visible
  • allergies or reactions where recorded
  • current medicines

Patients typically do not need lots of extra paperwork before the first eligibility check. If the SCR clearly shows the condition and recent treatments, it may be enough for the clinic to start the first assessment. Core SCR information may not show everything, so the clinic may ask for extra notes if the record is thin or unclear.

If the SCR does not show enough detail, the clinic may ask for more, which is why it helps to understand how the prescription process works. That could mean a GP note, hospital letter, specialist letter, or medication history. But do not assume you need all of that before finding out whether you may qualify.

What should you ask the clinic?

Before booking or paying, ask simple questions:

  • Is my Summary Care Record enough for the first assessment?
  • Do you need the last 12 months, or a longer history?
  • Do the treatments need to be prescription medicines?
  • What if one treatment caused side effects?
  • What if my condition is clear but the medicine history is incomplete?
  • What happens if you need more information?

The aim is to avoid wasted admin and wasted money.

What not to do

Do not try to manufacture eligibility.

Do not ask your GP for medicines purely so they appear on your record. Do not stop or change medication without clinical advice. Do not hide current medicines, mental health history, side effects, or substance-use concerns because you think they might make the assessment harder.

The cleaner route is the honest one: get your SCR, check what it shows, and let the clinic tell you whether it is enough for an assessment.

What to read next on MCPH

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