Medical Cannabis in the UK: Best Practice Guidelines Urged Amid Growing Regulatory Scrutiny

The UK’s medical cannabis industry is experiencing significant growth, but with this expansion comes increased regulatory scrutiny. As prescriptions for cannabis-based medicines surge—rising 118% between 2021 and 2023—experts and regulators are calling for stricter adherence to best practice guidelines. Concerns are mounting that the sector is verging on what some describe as a ‘pseudo-recreational market,’ prompting the Care Quality Commission (CQC) and other bodies to consider more stringent oversight.

Rising Prescriptions and Regulatory Concerns

The CQC, the UK’s health and social care watchdog, recently published the Safer Management of Controlled Drugs report, which highlights a dramatic increase in prescriptions of unlicensed cannabis-based medicines. The report, which notes an annual growth rate of over 100% in such prescriptions, also flags several issues within the current system, including delays in communication between healthcare providers and challenges in ensuring cohesive patient care.

Experts, including Professor Mike Barnes, founder of the Medical Cannabis Clinicians Society (MCCS), have voiced concerns about the prescribing practices within the industry. Barnes, the first doctor to obtain a license to prescribe medical cannabis in the UK, warned that some providers might be over-prescribing, particularly high-THC products, which could contribute to the perception of a recreational market disguised as medical.

New Best Practice Guidelines from MCCS

In response to these concerns, the MCCS recently released a Good Practice Guide for prescribing cannabis-based medicines. Key recommendations include capping daily cannabis prescriptions at 2 grams and requiring peer review for any prescriptions exceeding this amount or involving products with THC levels above 22%.

“The majority of patients need no more than 2 grams a day,” explained Professor Barnes. “There are a minority of people who do need more, but it should go to a peer review panel to be approved.” He also emphasized the need to move away from an over-reliance on cannabis flower, which currently constitutes about 80% of UK prescriptions, advocating instead for a focus on products with a balanced cannabinoid profile.

Concerns Over ‘Recreational’ Influence and Marketing Tactics

The influx of North American brands, associated with recreational cannabis, into the UK market has further fueled concerns about the direction of the industry. Brands like Tyson 2.0 and Cookies have made their way into UK clinics, raising questions about the appropriateness of their product offerings in a medical context.

Adding to these worries, the MCCS has recommended that producers avoid using strain names commonly associated with recreational use, such as Girl Scout Cookies and Gorilla Glue. Such names, the organization argues, do not convey meaningful information about the medical value of the product and may contribute to the commercialization of medical cannabis in a way that mimics the recreational market.

Regulatory and Legal Challenges Ahead

As the UK’s medical cannabis sector continues to grow, it faces increasing scrutiny from regulators like the CQC. Robert Jappie, a partner at law firm Fieldfisher, believes the industry has reached a ‘tipping point,’ where the scale of the market now warrants closer regulatory attention.

“We’ve been talking about growing the sector, and there’s now sufficient patient numbers and sufficient operators that the regulators are going to have to get involved,” Jappie said. He noted that while some clinics might feel emboldened to push the boundaries of regulation, ultimately, any prescription must be approved by a specialist doctor, who serves as the gatekeeper to ensure the medicine is prescribed appropriately.

However, there is concern that an overemphasis on combating perceived recreational use could jeopardize access to legitimate medical cannabis treatments. Professor Barnes expressed fears that focusing too heavily on the recreational aspects could undermine the industry’s credibility and limit future access for patients in need.

Calls for Improved Communication and E-Prescribing

The Cannabis Industry Council (CIC) has stepped into the conversation, advocating for policy changes that would streamline communication between healthcare providers. One key proposal is the introduction of electronic prescribing (e-prescribing) for cannabis medicines, which could reduce bureaucratic inefficiencies and improve patient care by ensuring that medical records are complete and up to date.

“The current paper-based system is inefficient, results in incomplete patient records, and brings data security risks,” said Mike Morgan-Giles, CEO of the CIC. He argued that allowing e-prescribing would enhance the quality of care and help build a stronger evidence base for the effectiveness of cannabis medicines.

Morgan-Giles also called for allowing general practitioners (GPs) to prescribe cannabis medicines, which could further integrate medical cannabis into mainstream healthcare, reduce NHS waiting lists, and bring more people back into the workforce.

Navigating a Complex and Evolving Landscape

As the UK’s medical cannabis industry continues to expand, it faces a complex landscape of regulatory challenges and ethical considerations. While the potential benefits of medical cannabis are increasingly recognized, ensuring that the industry remains focused on patient care and medical integrity is crucial. With regulatory bodies paying closer attention and new best practice guidelines emerging, the future of medical cannabis in the UK will depend on balancing growth with responsible oversight.