In November 2018, the law was changed to allow medical cannabis to be prescribed legally to patients in the UK. In the 4 years since, very few patients have been able to access medical cannabis through the NHS. However, in the absence of NHS prescriptions, a thriving private medical cannabis industry has emerged, helping people access cannabis legally and safely, albeit at a cost.
While it has been some time since the legal changes, this growing medical cannabis industry is still very much in its early stages, due to the time it takes to receive the authorisation and licences needed to set up a private cannabis clinic. Many members of the public are still unaware that cannabis can be prescribed legally, with a recent survey finding that 56% of people are unaware that any form of cannabis medicine is available on prescription.
Despite the slow start, prescription numbers are increasing. As of October 2022, an estimated 20,000 prescriptions have been issued by private clinics. Progress is positive, but there are still an estimated 1.4 million people in the UK using cannabis to treat medical conditions who rely on the grey market for cannabis.
Obtaining a cannabis prescription in the UK
While it might seem intuitive to go to your GP as the first port of call for a medical cannabis prescription, many people report that GPs are unsupportive, unaware of the process or simply not aware of the broad number of conditions for which cannabis can be prescribed in the UK. This can put many people off however eligible patients are free to apply directly to one of the many cannabis clinics in the UK. Most clinics provide a free ‘pre-consultation’ call or survey to check eligibility, meaning it is free to find out if you would be considered for a prescription. Usually, clinics will expect that a patient has already tried two licenced forms of medication, treatments or therapies for their condition to be eligible, and patients must not have any history of psychosis or schizophrenia.
From there, if the pre-screening indicates that cannabis could be suitable, patients book a video consultation with a clinic’s specialist doctors, who will evaluate the clinical need and discuss whether medical cannabis would be of benefit. But what happens after that call, when you’re waiting for the decision from the clinic?
Dr Neel Umapathy is a pain specialist prescribing cannabis with private clinic Mamedica, he explains that the process begins even before the first conversation. “Prior to the consultation, patients answer questions surrounding their previous medical treatments, condition and experience with cannabis. This enables our doctors to conduct an in-depth evaluation to asses if medical cannabis could be of benefit, and which delivery mechanism would be most effective.
“If the consultant and patient agree that medical cannabis would be beneficial, a prescription will be written (subject to review). When a specialist consultant prescribes a strain, they’ll be looking for something that combines a certain set of characteristics that will treat a specific ailment.
When a specialist consultant prescribes a strain, they’ll be looking for something that combines a certain set of characteristics that will treat a specific ailment.
“Within our clinic, we have a system which uses real-world patient data from North America to help us make more robust prescribing decisions, using the information collected in our initial evaluation. Quite often we will have experienced patients come to us and say ‘I consume certain strains, with X THC and Y CBD content’ which would be used to recommend something similar from our approved list of medicines.”
One size doesn’t fit all
Cannabis is a very complicated medicine. Each individual plant can contain any combination of the hundreds of known cannabinoids and terpenes, all of which have unique therapeutic values. Equally, every individual’s body will respond differently to a certain strain or cultivar of cannabis, as every endocannabinoid system is different. For some people, cannabis flower will be the most suitable method, whereas, for others, an oil, tincture, vape cartridge or capsules might be the best way to address symptoms. Dr Umapathy says the unique way every individual finds relief from cannabis means there is a huge need for choice. “Mamedica is proud to have the widest range of medical cannabis products on our list of approved medicines because we believe that one size does not fit all.
Mamedica is proud to have the widest range of medical cannabis products on our list of approved medicines because we believe that one size does not fit all.
“We personalise each treatment plan unique to a patient’s medical needs and cannabis experience. As a company, we also do not encourage patients to choose a specific brand or strain for our own business needs. Our business model enables us to be impartial and unbiased within our prescribing process, to enable patients to truly access the best of what medical cannabis has to offer.”