Medical Cannabis Care

Many people don't realise it, but since 2019 medical cannabis has been available to patients in the UK. I don't just mean the plethora of CBD products that one sees in every chemist and newsagent these days (from lozenges and lollipops to, believe it or not, even CBD dog shampoo!) but real cannabis containing not only (the legal) CBD, but also the highly psychoactive component, THC, which is ordinarily illegal outside of prescribed clinical care.

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Medical cannabis can only be prescribed in the UK by an experienced psychiatric medical professional for a range of psychiatric issues, including:

 

• Depression

• Anxiety

• Insomnia

• PTSD

• ADHD

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There are guidelines from the UK medicines regulatory body (the MHRA) around how medical cannabis can be prescribed, and by whom. 

 

Medical cannabis is often prescribed in the form of oils, which are taken sub-lingually (under the tongue), or flower ('weed'), which is inhaled via a vaporiser. Medical cannabis products contain varying proportions of CBD and/or CBD, according to the clinical need and the response to treatment. Careful assessment and close monitoring of the treatment is required to fulfil the government guidelines.

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Despite medical cannabis having been around for over five years in the UK, it is not available on the NHS (or only very rarely), so the majority of patients that receive this kind of treatment do so through private psychiatric services, such as mine. This means that above and beyond the costs associated with the assessment and medical monitoring of the treatment, patients will also have to pay for their own medicines, which can be costly at times, and must be born in mind when embarking on the treatment.

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All parts of the assessment and intervention processes described below may be conducted online / zoom. Face-to-face appointments are not required.

 

An approximate timeline of activities for receiving

medical cannabis in the UK is as follows:

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• The patient may self-refer to my service online. A formal referral from the GP is not required. However, your GP will be informed of the treatment if it progresses towards prescribing.

• We will talk on the phone, and I will request a copy of your Summary Care Record (SCR) from your GP.​

• In order to progress onto medical cannabis treatment, I must see evidence from your SCR that you have documented evidence of one of the diagnoses / conditions listed above (Depression, Anxiety, Insomnia, PTSD or ADHD).

• There are also a number of physical health conditions that must be excluded. For example, people with a history of serious heart disease, kidney or liver failure would be excluded.

• And there are some mental health conditions that must be excluded, including a history of psychosis or suicidal risk.

• Once confirmed as eligible, we will arrange an appointment for an online Medical Assessment.

• The initial Medical Assessment will last for 60-minutes. We will go over your SCR and your online referral form, and discuss the clinical issues that you would like to be considered for medical cannabis treatment.

• There will be a discussion about what sort of cannabis product would best suit you - based partly on your clinical issues and also on your history of (non-medical) cannabis use, if relevant.

• The general rule for starting medical cannabis is 'start low, go slow'. Often patients begin on a relatively low THC product, predominantly CBD, and then the THC component is slowly increased over time according to response.

• Once the first prescription has been decided, your medical cannabis product to be prescribed and delivered to your home from an online pharmacy. There will be clear instructions for you about how to start taking the medicine. This usually involves slowly increasing the daily dose every few days (a process called 'titration').

• Within the first four weeks of starting the initial product, we will meet again online for a follow-up appointment to review your progress on the initial product. At this point, we may decide to alter the dose further, change to a different product, or add an additional product alongside the initial medical cannabis product.

• If a new product has been added at that 4-week review session, you will need to be seen again by me for another review meeting within the next 4-weeks. And I will make arrangements with the pharmacy to dispense the new product accordingly.

• Once you are stabilised on a settled treatment plan, further review meetings will continue every three months thereafter. The pharmacy will continue sending you your medicines on a monthly basis, based on my prescribing instructions.

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And that's it!​

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I am not currently providing any direct medical services. I will be returning to full-time clinical work in April 2025, at which point details of how to book consultations will be available on this website.

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