Beyond the Few: Which Conditions are Driving UK Medical Cannabis Demand, and Why Access Still Lags

Medical cannabis has been legal in the UK since 2018, yet access on the NHS remains restricted to a very small group of conditions. Most people are surprised to learn how narrow the approved list actually is. In practice, this gap between clinical need and real-world eligibility has pushed thousands of patients toward the private sector, where prescriptions are far more common.

Understanding why demand is rising, who is seeking treatment, and why access still falls short is important for patients and clinicians trying to navigate the system.

The NHS list is still extremely limited

Despite years of campaigning, NHS prescribing has barely expanded. Currently, cannabis-based medicines are typically approved only for three tightly defined uses:

• Rare forms of severe childhood epilepsy
• Spasticity related to multiple sclerosis
• Chemotherapy-induced nausea and vomiting that does not respond to standard treatments

Outside these categories, NHS access is almost non-existent. Most GPs still do not feel confident discussing cannabis, and specialist clinics often avoid prescribing due to limited guidance, medicolegal concerns, and pressure to follow conservative protocols.

What patients are actually seeking treatment for

The private sector presents a distinct perspective. Clinics working under CQC regulation report that people seek treatment for a much wider range of conditions. The rising demand is not driven by experimentation but by clear gaps in symptom control and quality of life.

Chronic pain

Using cannabis for chronic pain remains the most common reason patients explore medical cannabis privately. Many are living with back pain, neuropathic pain, arthritis, or long-term post-injury symptoms. Patients often report trying multiple medications with little benefit or intolerable side effects.

Psychiatric and neurological conditions

Increasing numbers of adults seek treatment for anxiety disorders, PTSD, ADHD symptom management, and sleep disturbance. Evidence varies by condition, but many clinics note consistent patient-reported improvements.

Women’s health

Women are one of the fastest-growing patient groups. Conditions include endometriosis, PMDD, menopause-related symptoms, pelvic pain, and migraines. Many women feel their symptoms were previously dismissed or poorly treated.

Gastrointestinal and inflammatory disorders

IBS, Crohn’s disease, ulcerative colitis, and functional gut issues also commonly lead people to explore cannabis-based options, especially when standard therapies have not worked well.

This widening interest reflects real unmet need rather than trend-following. Patients frequently reach the private sector after exhausting conventional options.

Why access continues to lag behind demand

Even though the private route is fully legal and regulated, several barriers stop patients from receiving timely help.

Regulatory caution

The UK takes a highly conservative approach to cannabis-based medicines. Many doctors worry about deviating from established NICE guidance, even when evidence for certain conditions has grown.

Cost

Private cannabis prescriptions remain expensive for many households. Initial consultations, repeat appointments, and ongoing prescriptions can add up, even though prices have fallen since 2019.

Awareness

A significant number of patients still do not realise that medical cannabis is legal. Others assume it is only for cancer patients or that the NHS must approve every prescription.

Stigma

This remains one of the biggest hidden barriers. Some patients feel embarrassed raising the topic with family members or medical professionals. Others worry how employers or colleagues might react, even when prescriptions are fully legal and monitored.

What this means for patients today

The result is a large population stuck between ineffective treatments and an NHS system that cannot meet their needs. Many individuals attempt to self-manage their symptoms, resorting to potentially contaminated or inconsistent black-market products. The result increases the risk of unpredictable effects, poor dosing, and unsafe compositions.

Private clinics are helping to close this gap, but accessibility issues remain. High demand and continued uncertainty mean patients often have to navigate the system largely by themselves.

A path forward: What needs to change

Improving access will require more than a single policy update. Several practical steps could make a tangible difference.

More research

High-quality UK-based studies are essential to provide clinicians confidence in prescribing. Although real-world evidence is increasing quickly, many doctors want large-scale trials before expanding use.

Education for healthcare professionals

Most GPs receive no structured training on medical cannabis. Better education would help them advise patients instead of avoiding the topic altogether.

Clearer guidance

Updated NICE recommendations and broader acceptance of real-world data could support greater prescribing flexibility.

Reducing stigma

Public awareness campaigns, patient support groups, and transparent communication from clinics can help shift outdated perceptions and encourage open conversations.