Why the UK’s Medical Cannabis Access Crisis Needs More Than Prescriptions

Since 1 November 2018, the UK legalised the possibility of prescribing cannabis-based products for medicinal use (CBPMs). This milestone was widely welcomed, but nearly seven years on, many patients remain locked out of meaningful access. At Haze Labs, we believe that prescription access alone is not enough — a broader framework is urgently needed that incorporates community-based models, harm-reduction infrastructure and regulatory reform.

The Promise of Medical Cannabis — and the Reality of Access

The change in legislation in 2018 opened the door for patients with certain conditions to access CBPMs via specialist UK doctors. However, the reality looks very different:

• A report by the Care Quality Commission (CQC) revealed that between 1 July 2022 and 30 June 2023, 177,566 items of unlicensed CBPMs were dispensed in England, up from 81,476 items the year before — an increase of more than 100 % in a year.

• The same report noted that almost all of those items were dispensed through private clinics; NHS prescribing of unlicensed CBPMs was so low that it “could potentially breach patient confidentiality” when reported.

• According to a parliamentary research briefing, the number of patients accessing these medicines via the NHS remains extremely low — consistent barriers persist despite legal change.

• Less than 1% of doctors on the General Medical Council (GMC) Specialist Register are currently trained or actively prescribing medical cannabis, according to recent data.

These facts illustrate a stark reality: legalisation has not translated into accessible, equitable treatment for patients who might benefit.

Why Prescriptions Alone Are Insufficient

1.

Narrow criteria and high thresholds for NHS prescribing

Access through the NHS is restricted to a few licensed medications (e.g., Sativex, Epidyolex) and “unlicensed specials” that rely on specialist clinicians making exceptional decisions. Many patients find themselves with no pathway to access CBPMs through standard routes.

2.

Limited clinician training and awareness

With fewer than 1% of eligible specialist doctors actively prescribing, the workforce simply isn’t prepared to deliver for patients at scale. Without broader clinician education and systems change, legal prescriptions remain out of reach.

3.

Private-sector dependency and cost burden

Most prescriptions are being issued privately — meaning many patients must pay for consultations and medications themselves. This creates inequity: those with money have access, others don’t. The private surge is real, but it is not a systemic solution.

4.

Unmet demand & illicit self-medication

Estimates suggest hundreds of thousands of UK patients self-medicate using non-prescribed cannabis because they cannot access legal routes. This is both a public-health risk and an indicator that the system is failing.

5.

Lack of real-world infrastructure beyond prescription

Prescriptions alone do not address the broader issues: community education, harm-reduction, peer support, safe access to supply, quality standards, monitoring of outcomes. These structural elements remain underdeveloped.

The Additional Layers Needed — Beyond the Prescription Model

At Haze Labs, we contend that to truly resolve the access crisis, the UK needs to build complementary frameworks alongside prescriptions, including:

• Community-based support networks: Patients need access not just to medication but to education, peer support, harm-reduction advice, and safe consumption environments.

• Regulated alternative supply models: Legal prescriptions are one side — but models that support safe, controlled community access (for example via membership-based clubs or supervised distribution) could fill the gap.

• Clinician training and system integration: Scale requires teaching, guidelines, specialist networks, integration of GP referrals, and systematic pathways in the NHS.

• Data, monitoring and real-world outcomes: Use real-world data registries, outcome studies, and community feedback to widen evidence beyond limited trials. The NHS patient registry for CBPMs was launched back in 2021 but had no patients enrolled for some time.

• Equitable financing and access: Access should not depend on personal wealth. The state, insurers or other mechanisms should subsidise or enable fair access where clinically indicated.

• Harm-reduction and inclusive regulation: For many patients, especially those already relying on unofficial supply chains, safe transition needs clear regulation, safe sourcing, quality assurance and oversight.

How Haze Labs Is Contributing to the Solution

As part of the broader change agenda, Haze Labs is actively working in the following areas:

• We run patient education workshops, covering topics such as safer use, clinical pathways, legal rights and cannabis-medicine interactions.

• We have established peer-support membership protocols that verify adult access, facilitate community connection and reduce isolation among medical-cannabis users.

• We collaborate with specialist clinicians, pharmacists and advocacy groups to build clinician awareness and training around CBPMs.

• We are developing a model proposal for a UK pilot programme of a regulated community-based access framework (non-profit, membership-based) that complements prescriptions.

• We engage with policy-makers, local authorities and health systems to map what needs to change in regulation, funding and service design.

The Case for Urgent Reform

The stakes are high:

• The chronic-pain population in the UK is large, and many patients are underserved. Recent data shows that about one in four Britons live with some form of chronic pain; many self-medicate or rely on high-risk treatments.

• From an economic perspective, more inclusive medical cannabis access could reduce hospital admissions, improve wellbeing and enable more people to return to work.

• Ethically, patients who are legal users in principle should not be blocked from access in practice by structural barriers.

• From a public-health standpoint, moving from unregulated supply to safe, evidence-based access could reduce risks of contamination, inconsistent dosing and criminalisation.

Our Call to Action

We call on Government, NHS, specialist societies and professional regulators to commit to the following:

1. Develop a national pathway within the NHS for CBPM prescribing, including GP referral, education, specialist centres and reimbursement.

2. Fund clinician training and integrate medical-cannabis education into medical schools and continuing-professional development programmes.

3. Pilot community-based access models, under regulated frameworks, that sit alongside prescriptions — such as non-profit membership clubs or supervised access schemes.

4. Expand and utilise the CBPM patient registry to gather outcome data, build the evidence base and refine guidance.

5. Ensure equity of access, so that socioeconomic status does not determine who can benefit from legal medicinal cannabis.

6. Embed harm-reduction, peer-support and community engagement into any access model, acknowledging that prescription alone does not resolve social, educational or logistical barriers.

Conclusion

The legalisation of medical cannabis in 2018 was a milestone — but it was only the beginning. Today, too many UK patients still face walls: specialist bottlenecks, limited NHS engagement, high private costs, and lack of community infrastructure.

At Haze Labs, we recognise that prescriptions are necessary but not sufficient. For access to be meaningful, safe and equitable, we must build a broader framework — one that brings in community, regulation, education and innovation.

The crisis of access requires a multi-layered response. Let’s move beyond “legal on paper” and deliver access that works in practice.

References & Further Reading

• “Prescriptions for cannabis-based medicines double in a year, CQC report says,” The Pharmaceutical Journal, 18 July 2024. Link 

• “Thousands of UK patients suffering as fewer than 1% of doctors trained to prescribe legal medical cannabis,” The Cannigma, 30 Oct 2025. Link 

• UK Parliament Research Briefing – “Access to cannabis-based medicines” (CBP-8355). Link