Medical Cannabis UK FAQs

Medical cannabis works by acting on your endocannabinoid system (ECS). This exists in each of us and helps functions including pain control, sleep and mood.

While it's still an area of ongoing research, there's some evidence that medical cannabis may be beneficial for conditions including chronic pain.

Chronic or persistent pain is defined as pain lasting longer than 3 months. Medical Cannabis can be used as when an individual has exceptional clinical needs and at least two other treatments have not worked

While the list of conditions this might cover is too long to list, common ones we treat include:

• Back Pain

• Cancer Pain

• CRPS

• Endometriosis

• Facial Pain

• Fibromyalgia

• Joint Pain

• Knee Pain

• Multiple Sclerosis pain

• Sciatica

This isn't a complete list and everyone's experience with pain is unique. Medical Cannabis can be used to treat other conditions too.

Medical Cannabis can only be prescribed by clinicians who are on the 'Specialist Register' of the General Medical Council.

With us, you'll be under the care of a consultant who is on the Specialist Register. They'll have experience prescribing Medical Cannabis. They'll assess whether Medical Cannabis is a suitable treatment for you and tell you why.

There is ongoing global research and real-world data that shows the efficacy of Medical Cannabis. It may benefit chronic pain sufferers where other first-line medications have failed.

Medical cannabis works by acting on your endocannabinoid system (ECS). This exists in each of us and helps functions including pain control, sleep and mood.

For example, our own data has shown:

• 94% of patients reported an improvement in the severity of their pain

• 77% of patients reported improvement in mental health

• 88% of patients improved in at least component of quality of life

• 59% of patients using opioids reported they stopped all use

• 97% experienced no adverse effects

References quoted: Leva Clinic has a number of proprietary data sources, including working with researchers from Imperial College London and participates in research with Project Twenty21, Drug Science.

Research is ongoing to find evidence of medical cannabis in the UK. Leva Clinic is a research partner of Drug Science who are at the forefront of much of this research.

Through Project T21, together we're helping to build a picture of medical cannabis efficacy by following thousands of patients. For example, recent studies have shown:

• 35.3% reporting their treatment had made a real and worthwhile difference

• 20% reported a considerable improvement

• Only 3.4% reported no improvement

• A drop in pain severity sores from an average 5.9 to 4.9 after three months

• A drop in pain interference from an average 7 to 5.7 after three months

• Mean scores for sleep quality improved from 12.7 to 10 after three months (high scores indicate more issues of sleep on daily life)

See Project T21 for information on these studies and more.

Medical cannabis works by acting on your endocannabinoid system (ECS). This exists in each of us and helps functions including pain control, sleep and mood. Medical cannabis helps different people in different ways so the length of time it takes to show benefit will vary between individuals.

The onset of medical cannabis effects varies depending on factors such how it's taken and the dosage. Some general guidelines:

• Inhaling e.g. vaping - the effects are usually felt within minutes

• Oral e.g. oils - these usually take slightly longer to take effect, perhaps between 1-2 hours

Some patients will find their pain feels better quite quickly, some will gain benefit over a period of a few weeks.

If you are not feeling benefit by the first follow up appointment, your clinician may recommend an adjustment in your dose or change the type of medication prescribed.

Your consultant will discuss this with you during your consultations, taking into effect other factors such as your lifestyle and pain experience when prescribing.

How long the effects of time medical cannabis last depends on details like how it's consumed and the dosage taken. Here are some rough guidelines:

• Inhaling e.g. vaping - effects typically last for 2-4 hours

• Oral e.g. oils - the psychoactive effects may last from 4-8 hours or more

Your consultant will go into this in more detail when you meet.

Medical cannabis and pain medication prescription drugs work in different ways to alleviate pain, and there are some key differences between the two.

1. How they work: prescription drugs such as opioids and NSAIDs work by blocking pain signals or reducing inflammation. Medical cannabis works by interacting with the body's endocannabinoid system, which is involved in regulating pain, inflammation, and other processes.

2. Side effects: typical prescription pain medications can have a range of side effects, depending on the drug, including drowsiness, constipation, nausea, and addiction. Medical cannabis can also cause side effects, such as dizziness, dry mouth, and impaired coordination, but these tend to be less severe than the side effects of some pain medication prescription drugs.

3. Tolerance and dependence: opioid pain medication prescription drugs can be highly addictive and can lead to tolerance and dependence, which means that higher doses are needed over time to achieve the same pain relief. Medical cannabis can also lead to tolerance and dependence, but the risk appears to be lower than with opioids.

4. Availability: pain medication prescription drugs are widely available and can be prescribed by most healthcare professionals, whereas medical cannabis is only available with a prescription from a doctor on the Specialist Register of the GMC.

5. Cost: the cost of medical cannabis can be higher than some pain medication prescription drugs. It’s not available on the NHS and may not be covered by insurance (check with your insurer first).

CBD (cannabidiol) is a chemical compound found in the cannabis plant.

The main difference between over-the-counter health food shop CBD and medical cannabis is that CBD does not contain significant amounts of THC (tetrahydrocannabinol). This is because it’s derived from hemp and not cannabis. Medical cannabis can contain varying amounts of THC.

Hemp-derived CBD is legal to buy in high street shops in the UK as long as it contains trace amounts of THC. This CBD is sold as a supplement. 

Medical cannabis is medical grade, highly regulated and is only available on prescription for specific medical conditions, such as chronic pain.

In the UK, medical cannabis can only be prescribed by doctors who are registered with the General Medical Council (GMC) and listed on their Specialist Register.

A prescribing consultant needs to be satisfied that you've tried all suitable treatments available to you. These need to have proven ineffective. 

You'll be assessed for your suitability for medical cannabis on a case-by-case basis. Any decisions are based on your case history and consultant assessment.

Leva Clinic consultants are all on the Specialist Register and have extensive experience and training in both pain management and the use of cannabis-based medical products.

Yes, Medical Cannabis is legal in the UK. Since the law was passed in 2018, Medical Cannabis is allowed for the treatment of chronic pain conditions when an individual has exceptional clinical needs and at least two other treatments have not worked. 

Our consultants are pain specialists with experience working with Medical Cannabis.

Medical cannabis may produce undesirable effects such as dizziness and drowsiness. These effects might impair your judgement or performance of skilled tasks. Note that this is the same as with any medication, including painkillers like opioids.

Please refer to gov.uk's section on drugs and driving: the law which states "It’s illegal in England, Scotland and Wales to drive with legal drugs in your body if it impairs your driving."

There are many differences between medical and recreational cannabis. These include their intended use, form, how it's taken, dosage and more.

Medical cannabis is prescribed by a doctor and is generally taken in specific doses, with a specific method of administration, such as vaping or taking an oil.

Recreational cannabis is usually smoked or ingested in edible form with no specific dosages or medical guidance.

Medical cannabis can have higher levels of CBD, a non-psychoactive compound, and lower levels of THC, the psychoactive compound that causes the "high" associated with recreational cannabis use. Medical cannabis is produced to EU GMP (Good Manufacturing Practices) and is grown organically under strict conditions. The EU GMP ensures quality control and that patients know what they are getting.

UK private health insurance policies do not generally cover medical cannabis, though they may cover initial medical assessments.

Many insurance policies cover acute conditions and medical cannabis is typically used for chronic conditions where other medication or treatment has not worked.

Given the change of the industry, it may be that some private health insurers cover medical cannabis costs. You're advised to speak to insurers to find out.

Globally, a large number of countries have now legalised medical cannabis use and a substantial number of patients are able to access their medications. Yet in the UK, where it was legalised in November 2018, only a handful of NHS prescriptions have been written.

Reasons for this are manyfold and include the perceived lack of clinical evidence due to the challenges of studying this product through randomised controlled trials.

In order to develop the current evidence base, the importance of incorporating real-world data (RWD) to assess the effectiveness and efficacy of medical cannabis has gradually become recognised.

Project Twenty21 (T21) is the UK's first medical cannabis registry, launched in August 2020.

Any adult based in the UK who has been living with chronic pain and tried at least 2 treatments for their pain may be eligible. Leva Clinic clinicians reserve the right to not prescribe Medical Cannabis treatment if they deem it not suitable for the patient.

There is a possibility of a clinically significant interaction between other prescriptions or over the counter medicines you may be taking and cannabis based products.

During your first meeting with your consultation, they'll want to know all about your medication. This will help determine how appropriate medical cannabis is in light of other pain medication that you're taking.

Your consultant will make sure that you start on a concentration and dose/titration of Medical Cannabis that does not make you feel high.

They'll start you on a low dosing schedule, like you might have seen on other medications. For example "0.1ml twice daily, increase by 0.1ml every 3 days up to 0.5ml maximum".

From there you are in full control of how quickly you increase up to the maximum daily dose.

It's important you follow this schedule intuitively. If you were to feel any side-effects you can contact us immediately.

Any side effects of medical cannabis are more likely to occur when your treatment first starts.

In most cases the side effects are quite mild and wear off within a few days. It's important to document these and share any concerns with your consultant.

Here's a list of typical side effects:

Very common (affecting more than 1 in 10 people)

• Feeling dizzy or tired.

Common (affecting less than 1 in 10 people)

• Feeling depressed or confused.

• Feeling over excited or losing touch with reality.

• Problems with your memory or having trouble concentrating.

• Feeling sleepy or giddy.

• Blurred vision.

• Eating more or less than usual.

• Changed sense of taste or a dry mouth.

• Constipation or diarrhoea.

• Feeling or being sick.

• Lack of energy or feeling weak or generally unwell.

• Feeling abnormal or drunk.

• Loss of balance or falling over.

Uncommon (affecting less than 1 in 100 people)

• Seeing or hearing things that are not there (hallucinations).

• Believing ideas that are not true.

• Feeling that other people are against you.

• Thoughts of suicide.

• Fainting.

• Changes in pulse rate, heart rate or blood pressure.

• Tummy pain

There are two main types of medical cannabis: oils and flowers. Medical cannabis flower will have the same distinctive smell as illicit cannabis.

Vaped cannabis does not smell as strongly as recreational smoked cannabis. This is because it heats the leaf and doesn’t burn it.

No. If Leva Clinic are made aware that a patient is taking other forms of cannabis alongside prescribed medical cannabis their prescription for medical cannabis will be stopped with immediate effect.

This is very dependent on where you're travelling to. Firstly, it's important that you prevent an interruption in any medication. Contact your doctor before you travel to discuss the consequences of interruption.

You should contact the destination country's embassy or consulate to find out the legal status of cannabis and specifically the legal status of medical cannabis.

Depending on the legal status of medical cannabis, there are several options and tasks to do:

If cannabis is legal for adult recreational use, ask the following:

• Can you bring your medication with you?

• Do you need to carry a copy or the original prescription?

• What are the rules regarding carrying / taking your medication while in the country? Do you need a local licence? How to acquire it? Can you get it in advance remotely?

• If you run out of medication during your stay at the destination, how can you procure equivalent product? (pharmacy, state owned shop, dispensary, etc) Would you need a prescription or can you purchase cannabis product without? Can you get a prescription locally?

Once you have those answers, contact your doctor to organise a mitigating plan. It may involve switching to a form and dose that is legal in your country of destination. It may involve a new titration plan and adding a new medication to your prescription if that new form of cannabis does not cover all your symptoms. It may also mean weaning off completely of medical cannabis and starting one or more medication (legal in the country of destination) for the period of the travel.

If cannabis is legal for medical use only, ask the following:

• Is there a set list of conditions for which cannabis can be prescribed?

• What is that list? If your condition is not on that list, does that mean you cannot benefit of medical cannabis if it has been prescribed and dispensed abroad?

• Can you bring your medication with you?

• Do you need to carry a copy or the original prescription?

• What are the rules regarding carrying / taking your medication while in the country? Do you need a local licence? How to acquire it? Can you get it in advance remotely?

• If you run out of medication during your stay at the destination, how can you procure equivalent product? (pharmacy, state own shop, dispensary, etc) Do you need a local prescription? Can you use your UK prescription?

Once you have those answers, contact your doctor to organise a mitigating plan. It may involve switching to a form and dose that is legal in your country of destination. It may involve a new titration plan and adding a new medication to your prescription if that new form of cannabis does not cover all your symptoms. It may also mean weaning off completely of medical cannabis and starting one or more medication (legal in the country of destination) for the period of the travel.

If cannabis is illegal in all forms and for all use, do the following:

• Contact your doctor to organise a mitigating plan. It may involve weaning off of medical cannabis and starting one or more medication (legal in the country of destination) for the period of the travel.

IMPORTANT
In case of transit via one or more countries on your way to the destination, the whole process needs to be repeated for each country.

If you're already a patient of Leva Clinic, upon request and with a week’s notice, we can provide a clinical letter and certified copy of your prescription.

Medical cannabis may affect memory and cognitive function in various ways, depending on the individual and ratio of THC to CBD, and dosage of cannabis used.

It could impact in ways such as making it more difficult to remember things that have happened recently, make it trickier to concentrate on tasks or affect your decision making.

It's important that you discuss the potential risks and benefits with your consultant before using.

The risk of addiction to medical cannabis is very low, however may be higher in individuals who:

• Use cannabis frequently or at high doses

• Have a history of substance abuse or addiction

• Have a family history of addiction or mental health disorders

• Use cannabis at a young age

It's important to note that not everyone who uses medical cannabis will develop a dependence, and the risk can be minimised by using it under the guidance of a clinician, sticking to a recommended dosage, and avoiding frequent or high-dose use.

Note: all medications carry a risk of addiction.

While medical cannabis may have potential therapeutic benefits, it's not without risks.

The primary risks associated with medical cannabis include short-term side effects such as dizziness, impaired coordination, dry mouth, and impaired memory and attention.

Long-term use may result in respiratory problems, dependence, and potential impacts on mental health. Additionally, cannabis may interact with other medications and increase the risk of adverse reactions.

Talk to your doctor or pharmacist before taking medical cannabis if you:

• Have a personal or family history of schizophrenia or any psychotic disorder

• Have severe liver or renal disease

• Have previous drug dependence, including illicit drugs, nicotine, alcohol and prescription medications

• Are planning to become pregnant or during pregnancy

• Are taking other medications, especially sedatives such as opioids and benzodiazepines and medicines metabolised by cytochrome py450 enzymes.

• Are elderly, as breakdown of the product in the elderly is slower. It is likely older patients will be more sensitive to the pharmacological effects of cannabis.

Medical cannabis is prescribed at Leva Clinic in two forms: as an oil or as a vaped flower.

If during your appointment with your consultant it's agreed that medical cannabis is a suitable treatment option for you, they will prescribe you either cannabis oil, cannabis flower or a combination of both.

Oils are administered as droplets on your tongue whilst flowers will need to be vaped in a medical device inhaler.

If you are prescribed a flower product, you will need to order a medical device inhaler.

A popular vaporiser is the Storz & Bickel Mighty Medic, which is a medically approved portable medical cannabis vaporiser (approved by the MHRA). Other medical devices are available.

Pricing is very much dependent on the form (flower or oil), dosage, the balance of THC and CBD, and other factors.

You can typically expect to pay ~£150 per month for medical cannabis.

Medical cannabis is available on prescription by clinicians who are registered with the General Medical Council's Special Register.

In order to get a prescription you'll need to have an unmet clinical need - such as chronic pain - and tried at least 2 treatments.

Once you've been issued a prescription, you’ll be able to select from a number of pharmacies who can dispense your medication and deliver it to your home address.