The short answer is technically yes and practically almost never, and the gap between those two things is the single most misunderstood feature of UK medical cannabis policy.
The law changed in November 2018. What did not change was the funding, the evidence base or the clinical guidance, and those three things determine what actually happens to a patient.
What Changed in 2018 and What Did Not
Cannabis-based products for medicinal use were moved from Schedule 1 of the Misuse of Drugs Regulations 2001, the category for substances considered to have no recognised medicinal value, into Schedule 2. That made them prescribable.
Prescribing was restricted to doctors on the General Medical Council’s Specialist Register. GPs cannot initiate treatment, and neither can pharmacist or nurse prescribers.
Most products dispensed are unlicensed, meaning they have not been assessed by the medicines regulator for safety, quality or efficacy. That is a significant clinical distinction and it shapes how cautiously the NHS approaches them. Anyone asking can you get cannabis on the nhs? is really asking about that caution rather than about legality.
Where NHS Prescribing Actually Happens
There is a narrow set of circumstances in which the NHS does fund treatment, and it is worth being precise about them.
National guidance supports a small number of indications. Nabilone can be considered as an add-on for chemotherapy-induced nausea and vomiting that persists despite optimised conventional treatment. A four-week trial of a THC:CBD spray is supported for moderate to severe spasticity in multiple sclerosis where other treatments have not worked. And separate technology appraisals cover cannabidiol with clobazam for two rare, severe childhood epilepsy syndromes.
Outside those, NHS prescriptions are rare. Not prohibited, but rare, because the guidance is cautious and individual funding requests are difficult.
Why the Guidance Is Cautious
This is where public discussion tends to become heated, and the actual reason is more mundane than either side usually allows.
The evidence base for most indications remains limited. Randomised controlled trial data is thin outside the areas above, and much of what exists comes from observational registries rather than trials. National bodies assess treatments against that evidence, and where it is weak the recommendation is correspondingly narrow.
That is not a judgment that patients are imagining benefit. It is a judgment about what the published evidence can currently support, which is a different question.
The Body Reviewing All of This
The government’s statutory advisory body has been examining exactly this problem, and its position is instructive.
The Advisory Council on the Misuse of Drugs concluded in November 2020 that there was insufficient evidence at that time to fully assess the consequences of the 2018 change, noting that much of the evidence would emerge over several years. The government has since commissioned a further review, and the ACMD three-year work programme commissioning letter sets out the questions being asked.
One of those questions is unusually candid. The government asked the ACMD to consider whether the availability of these products through private prescriptions has had an inhibiting effect on the incentive to conduct clinical trials that would develop products suitable for NHS use.
That is the policy trap stated plainly by the people responsible for it. A functioning private market may be reducing the pressure to generate the evidence that would open an NHS route.
What Happens in Practice
A patient who wants to explore this route generally follows the same path.
They discover the NHS route is effectively closed for their condition. They find a private specialist service. They are assessed against the usual threshold, which typically involves having tried at least two conventional treatments without adequate result. If a prescription follows, they pay for the consultation, the follow-ups and the medicine indefinitely.
Directories comparing medical cannabis clinics exist because the sector is otherwise difficult to navigate, and because patients arriving at this point are usually doing so without a referral from anyone.
The Two-Tier Problem
The consequence is a system that is uncomfortable to describe honestly.
A treatment is lawful, regulated and prescribed by specialists, and access to it depends substantially on ability to pay. That is a familiar situation in dentistry and in some other areas, and it sits less comfortably where the alternative for the patient is often an illicit market.
Whether that resolves depends on evidence generation, which depends in part on trials that the current structure may be discouraging. It is a genuine policy problem rather than an oversight.
What This Means If You Are Considering It
Three things worth knowing before you start.
Ask your GP whether an NHS route exists for your specific condition, because occasionally one does and nobody mentioned it. The answer takes one appointment.
Understand that you will be paying for the medicine as well as the appointments, and calculate the annual figure rather than the monthly one.
And be sceptical of any provider whose marketing is more confident about the evidence than the national guidance is. The caution in that guidance is not bureaucratic obstruction, and a clinic that dismisses it is telling you something about itself.
Where It Stands
The current review may change the picture, and reviews have changed less than expected before. For now, the honest summary is that legality was granted and funding was not, and patients are navigating the space in between.
This article is general information rather than medical advice. Whether any treatment is appropriate for you is a question for a qualified clinician who has assessed you properly.
This article was provided to Verge by a third party.
