There is a further barrier to this patient accessing cannabis-based medicines, and that is the stringent framework within which they can be prescribed. Initially this can only be done by doctors included on the General Medical Council’s Specialist Register who have a special interest in the condition being treated. This is the same on both an NHS and private basis. 

Other doctors can continue prescribing once the patient is stabilised, but only if shared care arrangements are in place. In practice, the types of patients who are likely to benefit from cannabis-based medicines are likely to be under specialist care anyway.

According to NICE, there are only a few conditions for which cannabis-based medicines may be used: nabilone as an add-on for chemotherapy-induced nausea and vomiting, THC:CBD spray for moderate to severe spasticity in adults with multiple sclerosis, and cannabidiol with clobazam for seizures associated with certain severe forms of epilepsy. In all cases, cannabis-based medicines may only be used if other medicines have been tried and shown not to work and, even if prescribed, regular reviews should take place to ensure they are effective otherwise the treatment should be stopped.

Cannabis-based medicines made the headlines when they were rescheduled towards the end of 2018. One of the major benefits of this legislative change was the fact that it became easier for clinical trials to be conducted to develop the evidence base for such products.