Healthcare professional FAQs

Medical cannabis has been legal in the UK since November 2018, when there was a change in the laws surrounding its regulation and supply to patients.

Doctors and other healthcare professionals that are listed as specialist prescribers can legally prescribe medical cannabis for patients. A patient’s suitability for medical cannabis will depend on whether or not they have exhausted the usual treatments for their health condition.

The specialist prescriber must understand that medical cannabis is prescribed as an unlicensed special that is listed as a schedule 2 controlled drug.

Medical cannabis is safe for human consumption because it is manufactured to EU GMP standards.

Curaleaf Pharmacy works with Rokshaw, a specials manufacturer for over 10 years, to ensure the medical cannabis we import or produce is high quality.

As with any medicine, medical cannabis can have side effects which should be recorded on the patient’s records and reported to the MHRA Yellow Card scheme.

Medical cannabis can be prescribed for patients who have tried all of the available treatment options for their condition. If the available, or recommended, treatment options have not proven clinically beneficial, then a specialist prescriber can offer medical cannabis as a potential treatment or aid to manage their condition.

A specialist prescriber may consider medical cannabis for their patient if they have:

• Chronic pain, and conditions related to it, such as fibromyalgia
• A mental health condition, such as depression or anxiety
• Conditions that affect their nervous system, such as epilepsy or multiple sclerosis
• Conditions that affect their gastrointestinal system, such as IBS or Crohn’s disease
• Skin conditions that may be rare or difficult to treat
• The side effects of cancer treatment, in particular nausea or vomiting

To prescribe medical cannabis you must be a specialist prescriber. You also need a unique controlled drug private prescriber identifying number issued by the NHS, and a pink prescription pad (FP10PCD).

You need to specify the formulation and the dose. It’s good practise to prescribe only a 30 day supply on one prescription.

As medical cannabis is a schedule 2 controlled drug, the prescription is valid for 28 days. You must send the original hard copy of the prescription to the patient’s chosen pharmacy for the medication to be dispensed. It can take time to source and dispense medical cannabis depending on the formulation, so it’s recommended that you have a designated pharmacy to send prescriptions to.

If you cannot prescribe medical cannabis, you can refer your patient to a private medical clinic where there are specialist prescribers that can assess their suitability for medical cannabis. Your patient can also refer themselves to a medical clinic.

Medical cannabis might be right for your patient depending on their circumstances. You must do a thorough check of the patient’s medical history and consider all other treatment options before deciding to prescribe medical cannabis.

You will need to:

• Discuss the risks and benefits of using medical cannabis
• Talk about how you will monitor their progress
• Regularly follow up on how they’re getting on with their treatment
• Record and report treatment outcomes and side effects

You can refer your patient to a doctor that is a specialist prescriber for medical cannabis, or they can refer themselves to a private medical cannabis clinic.

CBD and THC are different types of active cannabinoids found in medical cannabis. They each have unique chemical compound structures and influence the human endocannabinoid system differently. Cannabinoids produced naturally by the body are called endocannabinoids.

Endocannabinoids attach to receptors called CB1 and CB2 in the body. THC can activate CB1 and CB2 cannabinoid receptors, while CBD does not. When THC activates CB1 and CB2 receptors, it can affect cognition, sensitivity and mobility.

CBD works in a different way to THC in the body. CBD blocks an enzyme called fatty acid amide hydrolase (FAAH). FAAH normally breaks down the body’s natural endocannabinoids. When CBD blocks FAAH, the effects of endocannabinoids in the body last longer.

THC is more “active” than CBD as it works directly on CB1 cannabinoid receptors that are found in the brain. This is why, at high doses, THC can cause a feeling of euphoria known as a “high”. CBD does not have this effect.

You can find out more about THC and CBD in medical cannabis here in the healthcare professional resources centre.

Since January 2019, non-prescription CBD products have been available to the public in the form of CBD oil drops (extracts or tinctures), gels, creams, balms, capsules, teas, edible products and other formulations. The public can buy these from health food shops, pharmacies and other outlets as there are no restrictions on where they can be sold. Currently, CBD is not a controlled substance and it is still being researched.

These non-prescription CBD products are all classed as novel foods. All non-prescription CBD products need to go through an application process as a novel food, which then needs to be approved to authorise them for sale to the public. You can find updates on authorised CBD products or extracts on the market in England and Wales here.

Non-prescription CBD products should:

• Not have controlled substances, such as THC, in them
• Not claim, or be used, to treat health conditions
• Not be given to pregnant women
• Not be given to people who take other medications

Medical cannabis products are manufactured to EU GMP standards to make them safe for human consumption as medicines for the treatment or management of health conditions. The concentration of THC and CBD in medical cannabis products are known and will always be stated on the product in a standardised format, such as 1% w/w. Medical cannabis products that contain THC are schedule 2 controlled drugs and must be prescribed by a doctor that is a specialist prescriber.