Access, Prescribing and Costs
Medical cannabis prescriptions in the UK
Medical cannabis is not a routine treatment in the UK. For most patients, the access route is narrow, specialist-led, and only considered after standard options have not helped or are not suitable.
Medical cannabis is not a routine treatment in the UK. For most patients, the access route is narrow, specialist-led, and only considered after standard options have not helped or are not suitable.
Key takeaways
- On the NHS, cannabis-based medicine can only be prescribed by a specialist hospital doctor, or under specialist supervision.
- NHS guidance says it is only likely to be prescribed for a small number of patients.
- NICE NG144 covers intractable nausea and vomiting, chronic pain, spasticity, and severe treatment-resistant epilepsy, but that does not mean it is routinely offered for all cases in those groups.
- Private clinics may assess and prescribe in England, but that is still a clinical decision, not a guarantee.
- A GP is usually not the prescriber for this treatment.
Evidence base
The NHS position is clear: medical cannabis is considered only in a limited number of situations, and the specialist will usually want to see that other treatments have been tried first. The NHS page also says a prescription would only be given when it is in the patient's best interests.
NICE NG144 was last reviewed on 20 May 2025. Its scope is narrow and focused on a small set of conditions, which is a good reminder that the evidence base is more limited than many patients expect.
NHS England also provides guidance and support for prescribers. That guidance covers clinicians working in the NHS and in private practice in England, which is why the access pathway should be thought of as specialist-led rather than consumer-led.
What patients should know
If a clinician is considering medical cannabis, expect a proper review of:
- your diagnosis and symptoms
- what standard treatments you have already tried
- any side effects or interactions from medicines you already take
- your mental health history, pregnancy status, liver health, and driving needs
Some cannabis-based medicines are licensed for limited uses, but many are unlicensed products or specialist-only options. That means the product, dose, and monitoring plan may differ from patient to patient.
The NHS also lists possible side effects such as decreased appetite, diarrhoea, feeling sick, weakness, mood change, dizziness, tiredness, feeling high, hallucinations, and suicidal thoughts. If these appear, tell the prescriber promptly. Severe mood change, hallucinations, or suicidal thoughts need urgent medical help.
When to speak to a clinician
Speak to a clinician if:
- your symptoms have not improved with standard treatment
- you think you may fit one of the NICE-covered areas and want to know whether you are a realistic candidate
- you are considering a private clinic and want a second opinion on suitability
- you take other medicines that might interact
- you have a history of mental health problems, psychosis, or liver disease
- you are pregnant, trying to conceive, or breastfeeding
- you need to drive for work or daily life and want safety advice before starting treatment
Do not start or stop a cannabis-based medicine on your own. If access is unlikely to be suitable for your condition, it is better to know that early than to pay for a pathway that may not help.