Recent research by Lindsey Metcalf McGrath and Helen Beckett Wilson shines a light on the lived experiences of UK cannabis patients, revealing a stark disconnect between legal prescriptions and the social realities of cannabis use. While prescribing cannabis has been legal in the UK since 2018, the ongoing prohibitionist attitudes surrounding the drug continue to subject legally prescribed patients to stigma, stress, and unequal treatment.
The Research: Uncovering Patient Experiences
The study, based on qualitative interviews with 24 cannabis patients, explores how they navigate a legal system that continues to criminalise cannabis. This contradiction creates an environment where patients, despite their legal status, face stigma and misunderstanding from both healthcare professionals and the general public. These experiences are not just anecdotal but reflect deeper systemic issues within the UK’s approach to cannabis regulation.
One of the key findings of the research is the persistence of stigma power—a concept that describes how those in power use stigma to control and marginalise certain groups. In the case of cannabis patients, this stigma is perpetuated through medical, social, and legal institutions, creating a cycle of discrimination and exclusion. The study highlights the negative consequences of this stigma, from healthcare professionals misunderstanding or dismissing patient needs to police and security services treating them as potential criminals.
Stigma in Healthcare: A Major Barrier
One of the most significant barriers identified in the study is the stigma patients face within the healthcare system. Despite cannabis being legally prescribed, many healthcare providers lack the training or awareness to properly support patients. For example, some doctors still perceive cannabis as an illicit drug, even when it’s used for medical purposes. One participant reported that their GP suggested they would be better off addicted to sleeping pills than using cannabis.
This lack of understanding leaves patients feeling isolated and misunderstood. It also reflects a broader issue: the healthcare system’s failure to adapt to the legal changes surrounding cannabis. Many patients in the study reported that their healthcare providers were either unaware of or confused by the legal status of medical cannabis, resulting in negative or stigmatising attitudes. As a result, patients often find themselves having to educate their own doctors about their medication—a burden that should not fall on them.
This issue is compounded by the limited availability of cannabis prescriptions through the NHS. Most patients are forced to rely on private clinics, where the cost of obtaining legal cannabis is prohibitively expensive. The study notes that fewer than five NHS prescriptions for cannabis have been issued since 2018, highlighting the deep inequalities within the system. These inequalities are not just financial but also reflect broader social disparities, as patients from marginalised groups are more likely to face additional barriers to accessing care.
Encounters with Law Enforcement: A Constant Source of Anxiety
Another key finding of the study is the anxiety patients feel when dealing with law enforcement. Despite carrying legally prescribed medication, many patients report feeling vulnerable to police attention, particularly if they are using cannabis in public spaces. The distinctive smell of cannabis flower makes it difficult for patients to medicate discreetly, leading to concerns about being stopped, searched, or even arrested.
For marginalised groups, this fear is even more pronounced. Black patients, for example, face the added burden of racial profiling, which exacerbates their concerns about police encounters. One Black participant described how her prior experiences with the police made her hesitant to pursue a cannabis prescription, fearing that it would make her a target for further scrutiny. This fear is not unfounded, as statistics show that Black people in the UK are disproportionately more likely to be stopped and searched for drug-related offences.
The study’s findings underscore the need for better education within law enforcement. Police officers must be aware of the legal status of cannabis prescriptions and trained to treat patients with the same respect as those using other legally prescribed medications. Without this, patients will continue to feel unsafe and stigmatised, even while using their medication legally.
Social Stigma: The Challenge of Public Perception
The stigma surrounding cannabis extends beyond healthcare and law enforcement, permeating patients’ everyday lives. Many patients in the study reported feeling judged by family members, friends, and colleagues, who often view cannabis through the lens of recreational drug use rather than as a legitimate medical treatment. This social stigma forces patients to make difficult decisions about when and how to disclose their cannabis use, often choosing to conceal it to avoid judgement or exclusion.
The research highlights several strategies patients use to navigate this stigma. One common approach is concealment, where patients hide their use of cannabis to avoid confrontation or judgment. This can involve medicating in private or using less conspicuous forms of cannabis, such as oils or capsules, rather than the more pungent cannabis flower.
Another strategy is reconstruction, where patients reframe their identity as medical users to distinguish themselves from recreational users. By emphasising the medical necessity of their cannabis use, patients hope to challenge negative stereotypes and gain legitimacy in the eyes of others. However, this distinction can also be problematic, as it reinforces the divide between “good” and “bad” cannabis users, perpetuating the stigma against recreational use.
Finally, some patients adopt an advocacy role, actively educating others about the benefits of medical cannabis and challenging the misinformation that fuels stigma. These patients see public education as key to reducing stigma and normalising cannabis use as a legitimate medical treatment. Many are involved in advocacy groups or patient-led organisations that work to raise awareness and push for policy change.
Inequality in Access: A Broken System
The study’s findings also highlight the deep inequalities within the UK’s medical cannabis system. While cannabis is technically legal for medical use, access is highly restricted, with most patients having to rely on expensive private clinics. This creates a two-tiered system where only wealthier patients can afford legal cannabis, while those without the financial means are forced to break the law by purchasing cannabis from the black market.
This inequality is compounded by the lack of NHS prescriptions, which remain rare despite the legal changes. The study notes that the prohibitive cost of private cannabis prescriptions exacerbates health inequalities, leaving many patients without access to the medication they need. This situation reflects broader issues within the UK healthcare system, where access to treatment is often determined by wealth rather than medical need.
Policy Recommendations: The Need for Reform
The study concludes with several key recommendations for policy reform. First and foremost, there is an urgent need for comprehensive public and professional education about medical cannabis. Healthcare professionals, in particular, need better training on the legal status of cannabis and its potential benefits as a treatment option. Without this, patients will continue to face stigma and misunderstanding from the very people responsible for their care.
Law enforcement also requires better education to ensure that patients using legally prescribed cannabis are not subjected to unnecessary scrutiny or harassment. Police officers should be trained to recognise medical cannabis prescriptions and treat patients with the same respect as those using other medications.
Finally, the study calls for a reevaluation of the UK’s prohibitionist stance on cannabis. The current legal framework, which criminalises cannabis use outside of medical prescriptions, perpetuates stigma and inequality. To truly reduce the harms faced by cannabis patients, the government must move beyond prohibition and adopt a more evidence-based approach to drug policy—one that recognises the legitimate medical uses of cannabis and eliminates the social and legal barriers that prevent patients from accessing care.
Conclusion
The research by Metcalf McGrath and Beckett Wilson paints a stark picture of the challenges faced by UK cannabis patients. Despite being legally prescribed cannabis, patients continue to experience stigma, inequality, and social exclusion, all of which are rooted in the UK’s prohibitionist policies. The study’s findings make it clear that without comprehensive reform—both in terms of public education and policy change—cannabis patients will continue to face unnecessary harm and discrimination. It is time for the UK to move beyond outdated narratives and embrace a more compassionate and evidence-based approach to cannabis regulation.