There have been discussions about the place and purpose of medicinal cannabis for decades, and since doctors have been given the ability to prescribe it starting in 2018, these discussions have intensified.
In the first two years of its approval, despite the demand for medical cannabis, just 12 NHS prescriptions were approved, along with less than 50 private prescriptions, according to a 2020 study.
Part of the reason for this is that cannabis, along with cannabinol, resins and oils, are all Class B drugs and this legal status has significantly affected the ability to prescribe it as a medication and undertake meaningful research into its effects and potential benefits.
As a result of this, the answer to when it can be medically described is split between the very limited number of conditions for which it is approved for NHS use, and the conditions which the National Institute for Health and Care Excellence (NICE) has suggested medicinal cannabis can help.
NHS Approved Treatments
The approval of medicinal cannabis started with the stories of Billy Caldwell and Alfie Dingley, two children who suffered from rare and extreme forms of epilepsy but had found a rare reprieve through cannabis-based treatments.
These severe epileptic conditions, such as Dravet syndrome and Lennox-Gastaut syndrome, are two of the primary reasons why an NHS prescription for medical cannabis will be provided, but they are not the only ones.
A cannabis spray named Sativex will also sometimes be prescribed for people suffering from multiple sclerosis to help with the spasms and stiffness caused by the condition that cannot be treated in other ways.
Finally, it can be used to help people suffering from nausea caused by intense chemotherapy treatments, but only when other treatments have been found to not be enough to help completely treat the condition.
Other Recommendations
These three cases are the times that patients in the UK are most likely to get a prescription on the NHS but that still does not make it especially likely.
However, there are other circumstances where medicinal cannabis might be a recommended treatment option and would be prescribed by a doctor, either via a private prescription or through a clinical trial.
Whilst there has been a lot of discussion about the potential for cannabis to treat chronic pain with some evidence to support these claims, neither NICE nor the NHS are in a position to prescribe it for pain relief.
However, someone who has been entered into a clinical trial to determine the effects of various cannabis-derived medicines on pain relief would have access to a prescription, with the scope of potential benefits being so high.
There are a lot of different types of cannabis medication, dosages and potential for its use in a lot of different treatments, but one of the reasons why the recommendations are currently so restrictive is because of a chicken-and-egg issue surrounding medical research.
Because cannabis is also a Class B drug, it makes clinical trials more complex to set up and because of that, there is limited high-quality research outside of the three main treatments the NHS and NICE recommend, although this is very slowly changing.