Three Years On: The Uncomfortable Truths of Medical Cannabis in the UK

by Katya Kowalski


It has been exactly 3 years since the UK legalised cannabis for medical use. However, few advocates are truly satisfied, with many campaigners continuing to call on the government to make further legislative changes to the existing legal framework. Such frustrations are easy to understand, especially when they involve the plight of young children with desperate parents, seeking to alleviate their pain and suffering with administration of cannabis-based medicines.

3 years ago to the day, the country was outraged by the unnecessary suffering of children, which placed then-PM Theresa May in an untenable position. May was left with a choice – either continue to face the wrath of the media as to why life changing medication was not being administered to young children, or permit the prescribing of cannabis-based medicines. 

So, why are so many advocates far from satisfied? If cannabis-based medicines are legal, why are we not seeing rapid growth and expansion of the medical market? Why is it that only 3 cannabis prescriptions are being dispensed on the NHS?

The reality is that there are a few uncomfortable truths, which must be recognised not only to save the precious time of campaigners, but to help alleviate the suffering of those whose life would change due to cannabis-based medicines. 

The limitations of the political establishment

Political lobbying is a complex world – even more so given the current political paradigm that exists in the UK and the ever changing relationship between the media, wider society and policy makers. Creating political support has never been as simple as presenting evidence, but with cannabis, the uncomfortable truth is that to a large extent politicians don’t have a magic bullet.

The evidence base for cannabis-based medicines – particularly for young children – is exceptionally limited. We have seen first hand the incredible life changing effects cannabis-based medicines have had on children. We have seen it in the flesh, but when it comes to understanding and explaining the science, we are somewhat in the dark. 

We need more evidence, more trials, more money and ultimately more sound data to better understand why cannabis-based medicines can, in many cases, have such incredible results. However, without that data, the request to  the government is simply too great. They do not have the power to overhaul NICE guidelines and force regulators to prescribe medicines, where the evidence-base is deemed inadequate. If they did, the entire medical establishment would be in uproar and the issue would quickly escalate to a much broader discussion around policy makers vs scientists. This is definitely not a debate the current government wishes to enter on the subject of medical cannabis.

All is not lost though, we just need to focus our efforts on the practical and realistic, rather than the impossible. We need the government to increase funding and support for medical cannabis trials in which young people and families who believe they will benefit from cannabis-based medicines can sign up. Lets gather the data and position the UK as a world leader in the field.

The challenge here is that it requires coordination and support. We have numerous patient groups, industry bodies, medical professionals, companies and policy makers who are campaigning, but few combined approaches. Volteface recently joined the Cannabis Industry Council in an effort to better understand how other such groups operate and encourage others to do the same.

Hardly anyone knows cannabis can be accessed via private prescription

We have approximately 10,000 patients in the UK and the price of medical cannabis is no more expensive than illicit street cannabis. With an estimated 1.4 million medical cannabis users in the UK, we have less than 1% of the potential market legally accessing the drug. These are hardly the numbers that were expected when cannabis was legalised three years ago.

I have for a few years now argued that the key to unlocking the medical market (particularly to see wider adult-use reform) is to rapidly expand the number of medical patients. However, numbers are not increasing fast enough with a number of fundamental issues at play.

Though there are many reasons for why this is, there is one in particular we can address as campaigners and advocates.

There is a need to think far more creatively about how we can increase awareness among the general public around accessing cannabis-based medicines via private clinics. 

There are several reasons to focus our efforts in this area. By increasing the patient base you bring down the price of medicines, making it even more affordable. By increasing demand, supply chains are increased and waiting times for patients are reduced. 

This also helps reduce stigma through normalisation: the more patients, the more wider societal exposure, the more accepted cannabis becomes.

Finally, with an increased number of patients, there are ample opportunities for more data. The Drug Science Project 2021 is a great example of this, but we can do more. 

Remember why we are here

The cannabis reform space is unique: it is a fusion of diverse advocates, competing industry players, professional lobbyists, think-tanks, journalists, politicians and influencers – all with different agendas.

I have seen the tensions between these groups play out over the past four years. It’s been challenging, especially since the arrival of a legal medical market. But despite the competing interests we all have one thing in common: We want to live in a world where the power of the cannabis plant is unlocked. 

Let’s make sure we work together to make that happen and end the suffering of those whose lives would be changed by the administration of a cannabis-based medicine.

This piece was co-authored by Katya Kowalski and Paul North. Tweets @Paul__North & @KowalskiKatya

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