Who can be prescribed medical cannabis?
Working out whether you might be eligible for a medical cannabis prescription — sometimes called medical weed or medical marijuana — is confusing. The rules are scattered across several places.
Looking for answers ourselves as patients, we came across a best practice guide written for prescribers by the Medical Cannabis Clinicians Society. It explained the process better than anything else we read.
This page is about adults over 21.
The short answer
In practice you would need all of these:
a diagnosed condition
a specialist consultant, working in their own specialty, willing to prescribe
evidence that other treatments were tried and did not work, were not tolerated, or were unsuitable
your medical records, obtained before the prescription is written
no licensed medicine that would meet your need
It will almost certainly be a private prescription. The NHS says "Very few people in England are likely to get an NHS prescription for medical cannabis", and nearly all UK prescribing is private, which means paying for the appointment and for the medicine.
The guide the profession wrote for itself
It is the Good Practice Guide for Prescribers of CBMPs, published by the Medical Cannabis Clinicians Society. It is written for clinicians rather than patients.
We read version 5, dated May 2026. The next review is due October 2026, and the guide is revised several times a year.
The Society is not a regulator. It does not make law, cannot license anyone, and has no statutory powers. Its guide has no legal force. It turns the framework set by law, NICE, the GMC and the MHRA, which is mostly principles, into something a prescriber can work to. Somebody has to decide what "no suitably licensed medicine that will meet the patient's need" means in a consultation, and this document guides clinicians in making that decision.
Its constitution describes the Society as "clinician-led, independent, and evidence-based". It has more than 600 members and is a community interest company. On money, the constitution asks that "all funding sources or partnerships are transparent and do not compromise its independence". Full membership is open to "Medical practitioners, Pharmacists, Nurses, Allied Health Professionals and Student clinicians" — the doctors who prescribe, the pharmacists who dispense, and the nurses around them.
It was founded in 2019 by Hannah Deacon and Professor Mike Barnes. Both names connect to the law itself. Hannah Deacon was Alfie Dingley's mother, whose campaign was one of the two cases behind the 2018 change, and Professor Barnes was the neurologist who applied for Alfie's licence.
On its own role: "Our role is not to promote prescribing, but to ensure that where it is used, it is done with appropriate clinical judgement and governance."
What conditions medical cannabis is prescribed for
There is no legal list of qualifying conditions. The guide says so plainly: "In the UK, there are no legally defined indications for prescribing CBPMs. Prescribing is based on individual clinical judgement."
The guide does describe the pattern. Prescribing "often occurs in patients who have complex, multi-system conditions, are experiencing multiple symptoms (e.g. pain, sleep disturbance, anxiety) and have been treated with multiple conventional therapies that have been ineffective, poorly tolerated, or associated with unacceptable side effects."
What cannabis is most often prescribed for:
chronic pain, including neuropathic and nociplastic pain, and pain from long-term conditions
anxiety and related disorders, including generalised anxiety disorder, PTSD and other trauma-related conditions
epilepsy, particularly treatment-resistant epilepsy
neurological conditions, including multiple sclerosis, Parkinson's disease, dystonia, Tourette's syndrome, and conditions with significant spasticity
sleep disorders, particularly alongside chronic pain or anxiety
inflammatory conditions, including inflammatory bowel disease
cancer, mainly for symptom management and quality of life, including pain, nausea and appetite
The only mental health conditions on that list are anxiety disorders — generalised anxiety disorder, PTSD and other trauma-related conditions. Depression, bipolar disorder, ADHD, autism and OCD are not among the seven. Bipolar disorder appears in the guide as a caution rather than an indication, and autism and ADHD appear only in the section on prescribing to children.
That does not mean nobody is prescribed for them. It means they are not among the ones the guide names as common.
The evidence is not equal across the seven either: "While some indications have a stronger evidence base (e.g. chronic pain, epilepsy, spasticity), others rely more heavily on emerging evidence, real-world data and clinical experience."
A prescription may be for a group of symptoms rather than a single diagnosis — "a primary indication, or a cluster of symptoms impacting overall function and quality of life."
Individual clinics publish their own lists of conditions they will consider. Those lists are not legal criteria. They describe what that clinic's clinicians are willing to act on, and they differ from clinic to clinic, which is why the same person can be turned down by one and accepted by another.
What the guide says about adults
Section 2.1 starts with the principle — prescribers "should be able to demonstrate that conventional, evidence-based treatments have been appropriately explored" — and then puts a number on it:
"In most cases, this will mean:
The patient has tried at least two recognised, evidence-based treatment options for the condition
These treatments have been given sufficient time and dose to assess effectiveness
There is clear evidence of lack of efficacy, intolerance, or unacceptable side effects"
The guide immediately softens that threshold:
"This threshold is not a strict legal requirement. It, rather, represents a patient focused clinical approach that takes into account their preferences to avoid pharmaceutical treatments and to opt for non-pharmaceutical ones. Nevertheless, the final decision of prescribing CBPM lies with the consultant and they must consider their patient's preference alongside the severity of their condition and the risk attached. The process should end with the patient's informed consent."
The same section adds: "There must be a clear unmet clinical need, and that prescribing a CBMP is in the best interests of the patient."
And the guide says plainly that the threshold can be departed from: "there will be cases where deviation from this approach is appropriate", with the reasoning recorded.
A licensed medicine used off-label counts. The guide says it is reasonable first to consider "Licensed medicines used within their marketing authorisation" and "Licensed medicines used off label, where supported by evidence and accepted clinical practice".
The guide names non-drug treatments too — "non-pharmacological approaches such as physiotherapy or acupuncture for pain" and "Psychological or behavioural interventions such as CBT or relaxation techniques for anxiety" — and says these "may form an important part of the patient's treatment history", while still asking the prescriber to consider "whether standard pharmacological options have been adequately explored."
Get your medical records before your appointment
Section 4.1: "The Summary of Care Record (or equivalent medical records) must be obtained prior to prescribing or be available at the time of the initial consultation."
You need to ask your GP for it. It has to be in place before a prescription can be written, and practices can take a while, so start early.
Nobody else can look it up for you either. The guide notes that many specialist cannabis pharmacies "do not hold NHS contracts and therefore do not have access to the NHS Summary Care Record system", and asks prescribers to pass on "a copy of the SCR, clinic letter, or a structured medication and medical history summary".
What makes prescribing harder
The guide sets these out as contraindications — a medical term for a reason not to give a treatment. An absolute contraindication means it should not be given at all. Almost nothing in this document is absolute. These are things a prescriber has to weigh and write down, not automatic refusals.
A history of psychosis or schizophrenia counts against you more than anything else. The guide calls it "the most significant contraindication to THC-containing CBPMs", especially where it is current or recent.
Even that does not rule you out. The same guide says it "should not be considered an absolute or lifelong prohibition as diagnostic labels may not fully reflect current risk", and sets out how prescribing might still work: a risk assessment, evidence of stability over time, psychiatric input, and CBD-dominant products, which it describes as "non-intoxicating and potentially antipsychotic."
The rest are "indicators of increased risk rather than absolute exclusions":
bipolar disorder or a history of mania, severe anxiety disorders, depression with suicide risk, or complex psychiatric comorbidity
severe or unstable cardiovascular disease, or a recent heart attack or stroke
cardiac dysrhythmias, particularly where a raised heart rate would pose a risk
severe liver disease or severe kidney impairment
significant respiratory disease, where an inhaled route is being considered
pregnancy, planned pregnancy, breastfeeding or fertility treatment
hypersensitivity to cannabis products, which the guide notes is rare
a history of cannabis use disorder or dependency, or escalating use without a management plan
Where a caution applies, the guide asks the prescriber to write down their reasoning, and suggests lower-THC products, slower titration and closer follow-up.
If you say you are likely to carry on using illicit cannabis, "clinicians should not initiate prescribing, as safe and responsible prescribing cannot be assured."
Being asked about past cannabis use
Many people applying for a prescription have used cannabis before, and the guide expects the prescriber to ask. It asks for "a structured, non-judgmental approach to substance use", and says these conversations "should be open and supportive, with the aim of enabling patients to disclose use honestly."
What the prescriber is asked to work out is the difference "between therapeutic use and misuse". Past use on its own does not count against you. Dependency and escalating use do, as the cautions above say.
On mental health, expect to be asked about "Family history of psychotic illness", your current diagnosis and stability, whether mental health services are involved, previous diagnoses and how you responded to treatment, "History of crisis presentations", and "Any history of inpatient psychiatric admission or intensive community support." Suicide risk is assessed.
Your other medicines
You will be asked what else you take. Most of it will be fine — "Most medicines do not have clinically significant interactions with CBPMs" — but the guide names some. More sedation with opioids, benzodiazepines, gabapentinoids and sleeping tablets. CBD can raise warfarin levels, so INR needs watching. It can raise clobazam levels too, and there is more risk of side effects with sodium valproate. Tacrolimus levels can rise. Bring a full list, including anything you bought over the counter.
What you will be asked to agree to
Before a prescription is written there is a consent conversation, and the guide sets out what it should cover. Some of it reaches outside the clinic.
On driving and work: "Legal responsibilities around driving, including impairment", and "Potential implications for safety-critical roles or workplace policies."
On the medicine: the psychoactive effects of THC, the potential for "cognitive impairment, sedation, or anxiety", how much individual response varies, and that "long-term evidence is limited for some indications."
On how it will go: effects come on gradually, particularly with oils; the dose has to be titrated before anyone can judge whether it works; and treatment begins as a time-limited trial with outcome measures agreed at the start, which may be stopped for lack of benefit, intolerable side effects, safety concerns, or an inability to stick to it.
And one thing you agree to do: "Use the medication strictly as prescribed and not share it with others."
The guide is also clear where the decision sits. "The clinician retains ultimate responsibility for the prescription", and "It is not appropriate for patients to dictate specific products or doses without clinical agreement."
Where a patient lacks capacity, clinicians "must assess and document capacity in relation to the specific decision at the time", involve family or a legal representative, and meet "a higher threshold of justification."
Cost, and being able to use it
The guide asks prescribers to consider whether you can afford the treatment and whether you can get the equipment to take it.
On cost, it asks the prescriber to weigh "Whether the patient can afford the prescribed products on an ongoing basis" and "Whether cost constraints may influence product selection or adherence", to be aware of "any clinic access schemes or discounted pricing options", and to "address affordability as part of the treatment plan". Its reason: "Cost-related decisions can have direct clinical implications and risk."
On equipment it is explicit. "Clinicians should also confirm that the patient can access and use the required equipment." That covers "The ability to obtain a medical-grade vaporiser for flower" and "Access to a compatible device where vape cartridges are prescribed". Where you cannot, that is meant to feed back into what you are prescribed: "If a patient cannot access appropriate equipment, this should be considered when selecting" the formulation.
What the law says
Regulation 16A of the Misuse of Drugs Regulations 2001 was added on 1 November 2018. It covers who may prescribe these products, who may supply them, and how they may be taken.
On prescribing, an unlicensed cannabis-based product must be "for use in accordance with a prescription or direction of a specialist medical practitioner". The regulation defines that as "a doctor included in the register of specialist medical practitioners kept under section 34D of the Medical Act 1983 (the Specialist Register)."
In plain terms, that means a consultant — a doctor who has completed specialist training in a field of medicine, rather than a GP. It does not mean a specialist in cannabis. There is no cannabis register and no cannabis qualification: the regulations simply borrowed a list that already existed for every medical specialty. What it means in practice is a consultant in the field your condition belongs to, which is why you will find pain consultants prescribing for pain and neurologists for epilepsy.
On how it may be taken: "A person shall not self-administer a cannabis-based product for medicinal use in humans by the smoking of the product (other than for research purposes in accordance with regulation 13)."
The rest is definitions and a research exemption.
The regulation says nothing about the patient. No qualifying conditions, no diagnosis requirement, nothing about how many other treatments you must have tried.
NHS England says the same:
"There is no restriction in law for which indications CBPMs may be prescribed. When prescribing CBPMs, it is a clinical decision to determine the most appropriate treatment option for a patient."
An indication is the condition a medicine is given for. NHS England is saying the law names none, and leaves the choice to the doctor.
What the medicines regulators say
None of the official sources sets a test you can measure yourself against. They ask a principle — could a licensed medicine do the job? — and hand the decision to the prescriber.
The MHRA — the Medicines and Healthcare products Regulatory Agency, the body that licenses medicines in the UK — says an unlicensed product "should not be supplied where a licensed medicinal product can meet the special needs of the patient", and that deciding whether a patient has such needs "should be a matter for the doctor listed on the GMC Specialist Register, responsible for the patient's care.
The GMC — the General Medical Council, the regulator for doctors — says the same from the other side: an unlicensed medicine may be necessary where "There is no suitably licensed medicine that will meet the patient's need."
That test is not an NHS rule. It comes from regulation 167 of the Human Medicines Regulations 2012, the law that allows an unlicensed medicine to be supplied at all, and only "in order to fulfil the special needs" of a patient. It applies to a private prescription exactly as it applies to an NHS one.
What NICE and NHS England cover
NHS England says these products "will not be considered as first line treatments", and that prescribers "should always first consider prescribing medicines that are licensed" — though it is writing for NHS prescribers. The NHS website says only that cannabis "would only be considered when other treatments were not suitable or had not helped". That NHS page is about NHS prescribing, and it carries the line "Page last reviewed: 27 May 2022 / Next review due: 27 May 2025", so its own review date has passed.
NICE, the National Institute for Health and Care Excellence, advises the NHS on which treatments it should use — weighing both the evidence and the cost. Its guideline NG144 covers four areas: intractable nausea and vomiting, chronic pain, spasticity, and severe treatment-resistant epilepsy.
Its clearest recommendation is a negative one, on chronic pain: "Do not offer" nabilone, dronabinol, THC or a THC and CBD combination to adults with chronic pain, and do not offer CBD for it "unless as part of a clinical trial".
On epilepsy, NICE made recommendations for research rather than for practice. That was widely read as a prohibition, and in March 2021 NICE issued a clarification:
"The fact that NICE made no such population-wide recommendation should not however be interpreted by healthcare professionals as meaning that they are prevented from considering the use of unlicensed cannabis-based medicinal products where that is clinically appropriate in an individual case."
"There is no recommendation against the use of cannabis-based medicinal products."
None of that is a list of who qualifies. NG144 recommends whether particular products should be offered for particular conditions, and who should prescribe them. It sets out no criteria for a patient to meet, and naming a condition in it is not the same as saying you are eligible.
Why clinics prescribe for chronic pain anyway
Every NICE guideline opens with a statement of responsibility. NG144's says:
"It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.”
NICE recommendations guide clinical judgement rather than bind a prescriber, and NICE says expressly that it makes "no recommendation against the use of cannabis-based medicinal products".
The chronic pain decision was also not a finding that the products do not work. The committee found an effect and judged it small and expensive: "the treatment effect was modest (an average improvement of about 0.4 on a scale ranging from 0 to 10)", and "the potential benefits offered were small compared with the high and ongoing costs, and the products were not an effective use of NHS resources."
NICE was assessing value to the NHS. A private patient paying for their own treatment is not in that calculation.
How old it is
NG144 was published on 11 November 2019 and its recommendations have not changed since. The March 2021 update added the epilepsy clarification; later updates in 2021, 2022 and 2025 added cross-references and links. The substance is from 2019, and the evidence behind it is older.
NICE has not scheduled a review. It says the guideline "will be reviewed if there is new evidence that is likely to change the recommendations."
The economic analysis behind the chronic pain decision used 2019 costs and 2019 evidence. A lot of UK real-world data has been gathered since, through patient registries that did not exist when the committee sat.
It remains the formal NICE position, and it dates from 2019. The prescribers' guide was last revised in May 2026.
Why the practical rules are hard to find
Search for the rules and you will find the NHS page, the NICE guideline and the law. None of them tells you what you actually need to have done.
The official sources set principles and leave the detail to prescribers. The detail ended up in a guide the profession wrote for itself, and nobody points patients to it.
Where to read it for yourself
Everything quoted on this page is linked below, along with a few places worth reading further. All of it is free except where noted.
The law
Misuse of Drugs Regulations 2001, regulation 16A — the whole of what the law says about who may prescribe and how it may be taken
Human Medicines Regulations 2012, regulation 167 — the "specials" exemption that allows an unlicensed medicine to be supplied to meet a patient's special needs. This is where the "no licensed medicine that would meet your need" test comes from, and it applies whoever is paying
NICE
NG144: Cannabis-based medicinal products — the guideline itself
The recommendations chapter — what NICE recommends, by condition
NG144, Rationale and impact — "Why the committee made the recommendations", where the chronic pain reasoning and the 0.4-point figure appear
Clarification of guidance, March 2021 — issued because the epilepsy recommendations were being read as a prohibition
Information for the public — the same guidance written for patients rather than clinicians
NHS
NHS: Medical cannabis (cannabis oil) — the page most people find first. Note it covers NHS prescribing specifically
NHS England: Cannabis-based products for medicinal use — the source of "there is no restriction in law for which indications CBPMs may be prescribed"
NHS England: support for prescribers — the hub linking their other guidance
MHRA
The supply of unlicensed medicinal products, Guidance Note 14 — what "special" means and when one may be supplied
Off-label or unlicensed use of medicines: prescribers' responsibilities — the difference between an unlicensed medicine and a licensed one used off-label
GMC
Prescribing unlicensed medicines — the professional standard
Information for doctors on cannabis-based products — short and readable, and it covers what should happen if a doctor declines to prescribe
The medical register — searchable, free, and it distinguishes the Specialist Register from the GP Register
The prescribers' own guidance
Medical Cannabis Clinicians Society: Good Practice Guide for Prescribers of CBMPs — version 5, May 2026, the edition we read (direct PDF). This is where the "at least two treatments" expectation comes from, along with the provision for one, the contraindications, and the sections on consent, cost and equipment
About the Society — who they are
MCCS constitution, November 2025 — section 2 for how the Society describes itself, 3.2 for who may join, 6 for funding and independence
Their evidence base series — three referenced volumes, £20 each. Not free, and not necessary to read this page
Checking a clinic
CQC: Cannabis-based medicinal products — registration requirements, and what the Care Quality Commission looks at when it registers and inspects a service
CQC: Find care services — the public directory. Inspection reports are free to read
If a clinic tells you that you do not meet the criteria, ask which criteria, and whose.
Written September 2026
General information, not medical or legal advice
As Prescribed sells equipment. We are not a pharmacy, a clinic or a prescriber. We cannot tell you whether you are eligible for a prescription, and nothing on this page is an assessment of anyone's circumstances.
What this page does is point you to the official sources and quote them, so you can read them yourself and ask your own questions. Whether medical cannabis is appropriate for you is a decision for a specialist doctor.
For anything about your health, your medication or your treatment, speak to a clinician.
