In the United Kingdom, the legal status and regulations surrounding cannabis, particularly for medical use, are layered and require careful consideration. The general stance on cannabis is that it remains illegal to possess, distribute, sell, or grow. Classified as a Class B drug, possession of cannabis can lead to up to five years of imprisonment, an unlimited fine, or both. For production and supply, the penalties are even more severe, with risks of up to 14 years imprisonment.
For those found with a small amount of cannabis, typically less than one ounce, and deemed for personal use, police can issue a warning or an on-the-spot fine. However, there's a notable variability in how these laws are enforced across different regions in the UK. In some areas, such as Durham, recreational cannabis users are not a primary target for police, while in others, like Cheshire, there have been increases in cannabis prosecutions. This inconsistency indicates a 'postcode lottery' in the enforcement of cannabis laws.
Turning to the medical use of cannabis, the UK government amended the law in 2018, allowing its prescription under certain circumstances. Cannabis-Based Medicinal Products (CBMP) can be prescribed by specialist doctors registered on the General Medical Council with relevant expertise. General Practitioners (GPs) cannot prescribe CBMPs but may refer patients to a specialist if they believe the patient would benefit. Patients must meet criteria set by the National Institute of Clinical Excellence (NICE) to qualify for a prescription.
The NHS will prescribe cannabis for severe forms of epilepsy responsive to cannabinoids, nausea or vomiting caused by chemotherapy, and muscle stiffness or spasticity due to multiple sclerosis (MS). However, NICE has not authorized specialist doctors at the NHS to write prescriptions for patients unless the conditions are very extreme.
Private medical cannabis clinics and dispensaries in the UK have more flexibility in prescribing cannabis products for a broader range of conditions. They can prescribe cannabis when the specialist believes it is in the patient's best interest, the patient has a qualifying medical condition diagnosed by a licensed medical professional, and the patient has unsuccessfully tried at least two conventional pharmaceutical medications.
Conditions commonly prescribed cannabis-based medicines include anorexia, anxiety, arthritis, asthma, autism, back problems, cancer, chronic pain, Crohn's disease, depression, epilepsy, fibromyalgia, migraines, neuropathic pain, Parkinson's disease, PTSD, rheumatoid arthritis, sleep disorders, and several others.
However, it is essential to note that certain conditions, particularly some psychiatric disorders like schizophrenia, psychosis, and bipolar disorder, are excluded from cannabis prescription due to strong evidence indicating that THC can exacerbate these conditions.
In summary, while cannabis remains illegal for recreational use in the UK, its medical use is legal under specific conditions. The process to access medical cannabis involves meeting strict criteria and usually requires the involvement of specialist doctors. The range of conditions eligible for medical cannabis treatment is extensive, yet not all-inclusive, with certain limitations, especially in psychiatric disorders.
