Answers to the key questions: How to get CBD on prescription? Who's eligible? What products are available? How different are these to CBD supplements? There are four different ways to get a prescription for CBD oil or medical cannabis products. Learn how to get a cbd oil prescription in Canada. Information from the NHS website on medical cannabis.
Can you get CBD on prescription?
CBD is available on prescription in the UK, but the process can be time consuming and expensive. The latest National Institute for Health and Care Excellence (NICE) guidelines have prevented the NHS from supplying anything but a small selection of licensed cannabis-based products.
However, the introduction of several private cannabis clinics means that a range of CBD and cannabis products can be prescribed if a specialist doctor believes it’s the only practical option.
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What products are available?
In the UK, cannabis-based products for medicinal use in humans’ (CBPM) fall into two main categories.
These are medicines that have been trialled and approved by the MHRA for specified uses. There are three cannabis-based medicines licensed for use in the UK:
- Epidyolex (aka epidiolex) – This is a pharmaceutical preparation of CBD designed for oral consumption. It has 100mg per ml, which is about 10%. The pure CBD is mixed with sesame oil, dehydrated alcohol, strawberry flavour and sucralose. Specialists can only prescribe Epidyolex for seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.
- Sativex – This is a mouth spray produced from cannabis with a 1:1 ratio of THC to CBD. A specialist can prescribe it for moderate to severe cases of the muscle stiffness caused by Multiple Sclerosis.
- Nabilone – Also known as Cesamet, this is a synthetic cannabinoid that can be prescribed by a specialist if other medicines are unable to reduce the severity of the nausea and vomiting caused by chemotherapy.
Because these medicines are licensed, their use is strictly controlled. Unless you’re receiving specialist treatment for one of the conditions mentioned, you won’t get a prescription for them.
An unlicensed medicine hasn’t yet been through the authorisation process, or is being used for a different reason to that outlined in the license. Medications like this will only be prescribed after careful consideration by a multidisciplinary team of specialists. They must look at the evidence available and decide if an unlicensed medicine is the best option.
Despite the slightly worrying term ‘unlicensed’, these products are produced to strict MHRA standards and sourced from pharmaceutical companies. There may not be enough evidence to apply for a license, but they won’t be prescribed unless the prescriber has weighed up all the options.
Unlicensed cannabis-based medications available in the UK include:
- Cannabis flower
- Hemp flower
- Cannabis oil
- CBD oil (doctors can prescribe higher daily amounts than is allowed by the current FSA guidance for CBD food supplements.)
- THC and CBD products for vaporising
If you receive a prescription for an unlicensed cannabis-based medication, the type and cannabinoid content of what you receive will depend on what your specialist doctor thinks is appropriate for your condition. They will write the prescription and the pharmacy will try to source it. With several specialist cannabis clinics opening in the UK, it’s more likely that you’ll be able to find a pharmacy that can fill your prescription.
Who is eligible for a prescription?
You’re eligible for a prescription for a CBPM or CBD oil if a specialist doctor believes that it’s the most appropriate medication for your condition. This is likely to be after you’ve tried several other options and your remaining choices are limited.
However, you’re only likely to receive a prescription from a private specialist doctor or a cannabis clinic. This is because NHS doctors follow the guidelines outlined by the National Institute for Health and Care Excellence (NICE). These currently recommend that:
- Doctors should not prescribe CBD or THC for chronic pain.
- Nabilone may be used for specific cases of nausea and vomiting.
- Sativex is appropriate for some adults with MS.
- Epidiolex should only be used as part of a scientific study.
If you choose to pay for a consultation with a private specialist, they may prescribe a CBPM if you have one of the following conditions:
Cancer-related appetite loss
Inflammatory bowel disease
Irritable bowel syndrome
Autistic spectrum disorder
Alzheimer’s disease symptoms
Chronic fatigue syndrome
Traumatic brain injury
Multiple Sclerosis Neuropathic pain
Functional neurological disorder
Motor neurone disease
Muscular dystrophy symptoms
Degenerative disc disease
Spinal cord injury/disease
Post-operative surgery pain
Sleep disorder Posttraumatic stress disorder
Having a diagnosis for one of these conditions does not automatically qualify you for a CBD or medical cannabis prescription. But, if you’ve unsuccessfully tried conventional medications and there are no more available to you, you may be eligible.
How can I get a prescription?
If you’ve exhausted all other options to treat your condition, you can book a consultation with a private specialist doctor or cannabis clinic. Although any doctor on the special register of the General Medical Council can legally prescribe CBPM, some may be reluctant to and might not have access to pharmacists who can fill the prescription. The best option is cannabis clinics staffed by specialist doctors who can guide you through the process and fill your prescription.
In most cases, the cost of a private consultation, repeat appointments and medication can range from a total of between £200 to £450 per month. The medicine itself is costly because multiple companies are involved from farming to production and delivery. At each stage, extra costs are added, resulting in an expensive end product. However, there are now a small number of companies who own every step of the process so are able to keep the costs down.
Although the process differs with each clinic, these are the likely steps involved:
- Find a clinic. Several options can easily be found on Google.
- Visit their website and complete the online form. They will likely want to collect personal and medical details, including permission to access your records.
- If you’re accepted to the next stage, you should receive information on how to pay for and book an appointment.
- Attend the appointment. This will be with a specialist doctor and may be over the phone or in person. It will likely involve a discussion about your condition and possible treatment.
- If they decide to prescribe you a CBPM, they will talk you through the options, including possible strengths and strains. If you want a CBD-only product such as CBD oil you can discuss this with the doctor at this point.
- Most clinics will now pass your prescription to their pharmacy who will contact you to arrange payment.
You may be eligible for a subsidy with Project 21
Project 21 is an ambitious research project that aims to create a large body of evidence on the effects of cannabis-based medicinal products. To do this, they hope to recruit more than 20,000 participants and offer them a £150 per month subsidy towards the cost of private medical cannabis.
To be accepted, you must have a history of at least two prescribed medications, that failed to manage your condition effectively and a diagnosis of at least one of these conditions:
- Anxiety Disorder
- Chronic Pain
- Multiple Sclerosis (MS)
- Post-Traumatic Stress Disorder (PTSD)
- Substance Use Disorder
- Tourette’s Syndrome
If you’re eligible for Project 21, you’ll still need to make an appointment with a clinic and follow the steps above to be assessed for a prescription. However, there is a list of approved Project 21 partners that are the best place to start.
What is the difference between prescribed CBD and CBD food supplements?
CBD oils and other products with concentrations ranging from 1% to 50% are already legal and available in the UK. There are also many brands whose products undergo third-party lab tests and meet high quality and safety standards.
The difference with prescribed CBD is that a doctor will match a specific product and strength to your diagnosis. Because it’s an unlicensed medicine, they aren’t bound by the same restrictions as retailers are for food supplements. They can prescribe daily amounts that could even be as much as 1000mg if they consider it necessary. They could even prescribe a product with a higher level of THC if they believe that it’s the best course of action for you.
Currently, prescription CBD oils are likely to be slightly more expensive than food supplements and they have the additional cost of private doctors’ appointments. However, clinics and suppliers are working together to bring the prices down and make it more accessible for those who need it.
Since the legalisation of medical cannabis in 2018, it’s taken a disappointingly long time for genuine patients to be able to access the treatment they need. However, now things are moving faster. If you go private, you can get an appointment with a specialist doctor with the ability to prescribe CBD oils and cannabis-based medications.
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Tom Russell writes extensively about CBD oil and other groundbreaking food supplements. He and his wife share their home with two daughters and a lifetime’s collection of books.
How to get a CBD oil prescription or medical cannabis prescription
There are four ways to get a prescription for CBD oil or other medical cannabis products:
- From your doctor or specialist
- From a cannabis nursing service
- From a cannabis clinic (“canna clinic”)
- From a cannabis telemedicine service
Here’s what you can expect from each of these approaches.
Your doctor or specialist
Very few doctors and specialists are readily prescribing cannabis, for a variety of reasons. Many will simply refer you to a cannabis clinic, or even suggest you go buy it from a retail store.
If your doctor is knowledgeable and willing, count yourself lucky. That said, they are unlikely to have time to educate you on all of the ins-and-outs of medical cannabis, or help you decide which licensed producer to register with. Nor are they likely to have staff at their clinic who can help.
Some doctors may have a single licensed producer that they have a relationship with. They will forward your prescription to that producer, who will then call you to help you choose a product. It’s convenient for the doctor, but it doesn’t leave the patient with any choice of producer. This is unfortunate because no single producer can meet the diversity of needs that patients have.
[By the way, Wayfare works with quite a few doctors who are prescribing cannabis but count on us to provide educational support to their patients. We can even help prepare documents you can take to your doctor.]
Cannabis nursing service
You can think of this service as a mobile clinic. The nurse will come to your home, provide education, take a medical history and connect with a doctor or Nurse Practitioner to obtain the authorization. She will also help you select an appropriate product and develop a detailed treatment plan and dosing schedule. She will then help register you with a licensed producer so you can order products by phone or on-line, and will follow up with you semi-weekly while you work toward your goal.
The cost for this service is usually fully-covered by insurance as a home nursing expense.
Wayfare falls into this category, although we do often work with patients’ own doctors, and there are some cannabis clinics who refer to us to provide extra support for patients. We are now also providing a telehealth option as well.
Over the past few years a number of specialized cannabis clinics have opened up. These are typically staffed by doctors who work there on a part-time basis. These doctors may come from specialties including psychiatry, surgery, and anesthesiology. This means that some patients may see a heart surgeon for their arthritis! But really, bless these doctors for making time to learn about cannabis and help people.
The educational portion of your visit, where you select a licensed producer and product, is quite often handled by a lay person who may have the title of “cannabis educator”, “canna counsellor”, or “patient educator”. These people rarely have medical training, although they may be knowledgable about particular strains, the pricing programs of the various producers, and how to use a vaporizer.
Cannabis telemedicine services
You can get on a video conference with a doctor or Nurse Practitioner, who will assess you and provide an authorization for medical cannabis. Some of these services are stand-alone whereas others are provided by cannabis clinics as described above.
The educational component of the service may again be handled by a lay person, sometimes via a separate video call or by telephone through a call centre.
Medical cannabis (and cannabis oils)
Many cannabis-based products are available to buy online, but their quality and content is not known. They may be illegal in the UK and potentially dangerous.
Some products that might claim to be medical cannabis, such as CBD oil or hemp oil, are available to buy legally as food supplements from health stores. But there’s no guarantee these are of good quality or provide any health benefits.
Specific cannabis-based products are available on prescription as medicinal cannabis. These are only likely to benefit a very small number of patients.
Can I get a prescription for medical cannabis?
Very few people in England are likely to get a prescription for medical cannabis.
Currently, it is only likely to be prescribed for the following conditions:
- children and adults with rare, severe forms of epilepsy
- adults with vomiting or nausea caused by chemotherapy
- people with muscle stiffness and spasms caused by multiple sclerosis (MS)
It would only be considered when other treatments were not suitable or had not helped.
Epidyolex for children and adults with epilepsy
Epidyolex is a highly purified liquid containing CBD (cannabidiol).
CBD is a chemical substance found in cannabis that has medical benefits.
It will not get you high, because it does not contain THC (tetrahydrocannabinol), the chemical in cannabis that makes you high.
Epidyolex can be prescribed by a specialist for patients with Lennox-Gastaut syndrome and Dravet syndrome (both rare forms of epilepsy).
Nabilone for chemotherapy patients
Many people having chemotherapy will have periods where they feel sick or vomit.
Nabilone can be prescribed to adults by a specialist to help relieve these symptoms, but only when other treatments have not helped or are not suitable.
Nabilone is a medicine, taken as a capsule, that has been developed to act in a similar way to THC (the chemical in cannabis that makes you high). You may have heard it described as a “manmade form of cannabis”.
Nabiximols (Sativex) for multiple sclerosis (MS)
Nabiximols (Sativex) is a cannabis-based medicine that is sprayed into the mouth.
It is licensed in the UK for adults with MS-related muscle spasticity that has not got better with other treatments.
There is some evidence medical cannabis can help certain types of pain, though this evidence is not yet strong enough to recommend it for pain relief.
In some cases, however, it may be prescribed for pain as part of a clinical trial.
What about products available to buy?
Some cannabis-based products are available to buy over the internet without a prescription.
It’s likely most of these products – even those called CBD oils – will be illegal to possess or supply. There’s a good chance they will contain THC, and may not be safe to use.
Health stores sell certain types of pure CBD. However, there’s no guarantee these products will be of good quality.
They tend to only contain very small amounts of CBD, so it’s not clear what effect they would have.
Is medical cannabis safe?
The risks of using cannabis products containing THC (the chemical that gets you high) are not currently clear. That’s why clinical trials are needed before they can be used. “Pure” products that only contain CBD, such as Epidyolex, do not carry these unknown risks linked with THC.
But in reality, most products will contain a certain amount of THC.
The main risks of THC cannabis products are:
- psychosis – there is evidence that regular cannabis use increases your risk of developing a psychotic illness such as schizophrenia
- dependency on the medicine – although scientists believe this risk is probably small when its use is controlled and monitored by a specialist doctor
Generally, the more THC the product contains, the greater these risks are.
Cannabis bought illegally off the street, where the quality, ingredients and strength are not known, is the most dangerous form to use.
What are the side effects?
Depending on the type of medical cannabis you take, it’s possible to develop side effects such as:
- decreased appetite
- feeling sick
- a behavioural or mood change
- feeling very tired
- feeling high
- suicidal thoughts
If you experience any side effects from medical cannabis, report these to your medical team. You can also report them through the Yellow Card Scheme.
CBD and THC can affect how other medicines work. Always discuss possible interactions with a specialist.
CBD can also affect how your liver works, so doctors would need to monitor you regularly.
How do I get a prescription?
You cannot get cannabis-based medicine from a GP – it can only be prescribed by a specialist hospital doctor.
And it is only likely to be prescribed for a small number of patients.
A hospital specialist might consider prescribing medical cannabis:
- for epilepsy – if you (or your child) have one of the rare forms of epilepsy that might be helped by medical cannabis
- for MS – if you have spasticity from MS and other treatments for this are not helping
- for chemotherapy – if you are vomiting or feeling sick from chemotherapy and other anti-sickness treatments are not helping
The specialist will discuss with you all the other treatment options first, before considering a cannabis-based product.
A prescription for medical cannabis would only be given when it was believed to be in your best interests, and when other treatments had not worked or were not suitable.
It’s expected this would only apply to a very small number of people in England.
If the above does not apply to you, do not ask a GP for a referral for medical cannabis.
Will the laws on cannabis be relaxed?
The government has no intention of legalising the use of cannabis for recreational (non-medical) use.
Possessing cannabis is illegal, whatever you’re using it for. That includes medical use cannabis products, unless these have been prescribed for you.