He admitted that he has considered it and spent some time looking into securing a legal prescription, but ultimately, when all things are considered, he feels it’s not worth the hassle. He explained, “It’s not worth the faff, and I don’t see the need when I get it so easily at a good price.” The idea of change seemed to worry him, and ultimately, with a good salary and a reliable supply, he is pretty content.
On the surface, one might view his use as recreational, but it’s far from it. Medical cannabis gives his brain a break in the evening after many hours of work and allows him to switch off, ready for sleep. He is the perfect case study for legal patients and should, under the current framework, be in the legal market—but he isn’t.
While he no doubt enjoys his use of cannabis, he knows it changes his life for the better and helps him manage his ADHD symptoms throughout the week.
He seems like the ideal demographic, a case study of the forever-quoted ‘1.8 million medical cannabis users in the UK’ and the key to ‘unlocking the market.’ So, within the current legal framework, how can the medical cannabis market convert this individual from an illicit pattern to a legal one?
I’ve given this a great deal of thought, considering what I could say or offer him to encourage conversion. The challenge is best represented by imagining a legal cannabis market in the UK. I have absolutely no doubt that in a legal market, with a wide variety of easily available cultivars similar to what he consumes now, he would convert fairly quickly. This change would cause minimal disruption to his current patterns of behaviour.
The word that best sums up his ambivalence towards medical cannabis is ‘faff.’ By ‘faff,’ he’s thinking about the appointment with the doctor, the sign-up process, the paperwork, and logistics. It’s the dynamic shift from being in control of his medication to having to rely on the decision and input of someone else.
Focusing on the ‘Faff’
We need to focus on eliminating the ‘faff.’ How do we position medical cannabis prescribing so that it’s not an inconvenience but an interaction moulded to suit the patient? I’m not suggesting a ‘grey market’ style policy approach like we saw in the US—I’ve been working on politics and policy for too long to know the futility of that in the UK.
Instead, we should focus on educating patients about what makes medical cannabis prescribing unique—or what could make it unique. How does my friend get excited about an appointment with a clinician? How do we eliminate the ‘faff’ and reinvent it as a perk?
We Need More Than Awareness
For years, we (myself included!) have talked about awareness, believing that if we increase the number of people aware that medical cannabis is legal, patient numbers will surely grow.
There’s no doubt that awareness is key, but once a potential patient is made aware, the offer needs to be better than the illicit alternative.
The forever-quoted 1.8 million demographic are ‘medical cannabis patients,’ but they source from a market suited to recreational users who want good quality cannabis as easily as possible (minimal hassle). Provide a better offer than the illicit market, and the 1.8 million patients are all yours.
This repositioning doesn’t have to be a commitment to a completely different or less ‘clinical’ way of working. However, it could be a funnel to create engagement with the longer-term goal of improving patient health.
When I used to run drug treatment services in the North of England, some clients had statutory demands to engage with us as an alternative to custody. In those first sessions, we would provide a light intervention and win them over through careful education rather than strict procedures. Maybe the same light touch approach could work with medical cannabis? Let the patient know the process is light, easy and won’t result in excessive bureaucracy or questioning.
This is no easy task, but we must remember that medical cannabis prescribing sits in the private healthcare setting—a home for innovation and new ideas, free from the bureaucracy of the NHS.
Accessing Medical but Using Illicitly
I’ve recently seen patients on Reddit saying that they use the medical market to secure an in-date prescription and tub, which they then use to store their illicitly bought cannabis, keeping their legal prescription use to a minimum. While this might cause frustration within the medical market, it offers an interesting observation. This is one area where the illicit market can never outcompete—a legal prescription keeps a patient safe from exceptionally problematic and harmful prosecution.
No clinic would support a client using a legal prescription in such a way, but at least you have the chance to sell your service and demonstrate the benefits of the legal market. Perhaps that foot in the door will lead to them fully embracing a legal prescription.
For those individuals using a legal prescription this way, the ‘faff’ is worth the reward—immunity from prosecution (although technically, putting illicit cannabis in a legal tub is illegal and not advisable).
Quality of Supply
My other major concern with my friend is that the quality of his supply is exceptional. He travels to London every few months to buy in bulk, and he told me the quality rarely disappoints. While the legal market is improving, and more desired cultivars are hitting the market, consistent supply is still challenging, with many patients perpetually frustrated at product fluctuation.
I don’t think the medical market has hit a sweet spot where the offer to patients accessing the illicit market is so alluring that it’s an easy jump. There has undoubtedly been progress and some excellent marketing from groups like Mamedica and Curaleaf.
Yet my friend is a hard sell, especially while his perception remains as it is. To convince him, it might require an offer that feels clinically flexible, with a quality product that he can consistently have delivered to his door. After all, it would save him a hike to London and protect him from illicit cannabis’ most dangerous side effect—criminalisation.