Medical cannabis in the UK: who can prescribe it and for what

The conversation about Britain being permissive usually opens with "medical cannabis is legal here". It was legalised in 2018. The conditions attached to that, however, drop out in the retelling — and the person who believes the retelling risks far more than a fine.

Is cannabis no longer banned?

No. It remains a Class B drug. GOV.UK sets the penalties: up to 5 years in prison for possession, an unlimited fine, or both; up to 14 years for supply and production.

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Police may issue a warning or an on-the-spot fine of up to £90, and some people pay it without a formal warning or caution. That is police discretion, not an entitlement: repeat findings push the penalty towards the maximum.

Who can prescribe medical cannabis?

Only a specialist hospital doctor, or a doctor working under their supervision. That is how the NHS puts it, and a GP is not in that group.

The NHS goes further: it advises against asking a GP for a referral if your situation does not match the listed conditions.

Which conditions are considered?

The list is short. Rare, severe forms of epilepsy in children and adults. Vomiting or nausea caused by chemotherapy in adults. Muscle stiffness and spasms caused by multiple sclerosis.

Three products are used: Epidyolex, a highly purified CBD liquid for Lennox-Gastaut and Dravet syndromes; nabilone, a capsule for chemotherapy sickness that acts similarly to THC; and nabiximols (Sativex), a mouth spray licensed in the UK for MS spasticity.

Anxiety, insomnia and "stress" are not on the list at all.

What about long-term pain?

The NHS is cautious: the evidence is not yet strong enough to recommend it. A prescription is possible within a clinical trial, not as routine practice.

Why do so few people get a prescription?

Because that is the design. The NHS says very few people in England are likely to get one, and it would only be considered where other treatments are unsuitable or have not helped. It also warns that the benefit is likely for a very small number of patients, and that the risks of THC products, including psychosis and dependency, are not clearly understood.

Does a prescription let you smoke anywhere?

No. A prescription is a named product in a named form and dose: a liquid, a capsule, a spray. It is not permission to light up in a park.

Driving is separate. Drug driving brings a minimum one-year ban, an unlimited fine, up to six months in prison and an 11-year marker on the licence. GOV.UK lists prescription drugs you may drive on if you follow medical advice and remain fit to drive: amphetamines, benzodiazepines, methadone, opioids. Cannabis is not among them, and roadside kits screen for it.

What about products sold online and in health shops?

The NHS warns twice over. Cannabis products sold online are likely illegal to possess or supply, often contain THC, and may not be safe. CBD and hemp oils on health-shop shelves are food supplements: quality is not guaranteed, benefits are unproven, and the CBD content is usually very small, so the effect is unclear.

What does it mean for someone here on a visa?

This is the part missing from every retelling. The Suitability part of the Immigration Rules names criminality as a ground for refusal.

A custodial or suspended sentence of 12 months or more means refusal is mandatory (SUI 5.1(a)), and existing permission must be cancelled (SUI 5.2). A sentence of less than 12 months is a discretionary ground (SUI 5.3(a)). Separately, a non-custodial sentence or an out-of-court disposal recorded on a criminal record is also a discretionary ground (SUI 5.3(b)).

For visitors and stays of under six months the rule is harder: refusal is mandatory where a non-custodial sentence or recorded out-of-court disposal was given less than 12 months ago (SUI 5.4(b)).

In plain terms: the "£90 on the spot" that rumour presents as harmless is an out-of-court disposal. Once recorded, it becomes a question on application forms for years afterwards.