Can You Get CBD on Prescription from the NHS

Cannabidiol has moved from fringe supplement to mainstream remedy in little more than a decade. Chemists display oils beside vitamin C, supermarkets stock gummy bears infused with hemp extract and private pain clinics promote vape cartridges that claim to calm nerves and soften chronic aches. Amid that boom many patients wonder if the National Health Service will supply CBD on prescription. The answer is nuanced. Prescription access exists but it follows strict criteria, involves specialist oversight and rarely covers the high street products most people recognise. This article explains the current NHS position, the legal framework for medical cannabis, the role of private clinics and the practical steps patients must take if they hope to receive cannabidiol through official channels.

What the Law Allows

The United Kingdom rescheduled certain cannabis-based medicines in November twenty eighteen. This change moved medical products containing THC and CBD from Schedule One to Schedule Two of the Misuse of Drugs Regulations. Schedule Two permits prescription but only by a doctor listed on the General Medical Council specialist register. General practitioners are not allowed to initiate treatment, though they can issue repeat prescriptions through shared care once a consultant sets up the plan. The Medicines and Healthcare products Regulatory Agency approves each product case by case. At present only two licenced medicines containing CBD hold a marketing authorisation.

Licensed CBD Medicines on the NHS Formulary

The first is Epidyolex, a purified cannabidiol oral solution produced by Jazz Pharmaceuticals. Hospitals can prescribe it for severe childhood epilepsies such as Lennox Gastaut syndrome and Dravet syndrome. NICE guidelines recommend Epidyolex alongside clobazam when standard anticonvulsants fail. Clinical trials showed that adding the CBD solution reduced seizure frequency by around forty per cent in a significant minority of patients. Because the evidence is robust NHS England funds Epidyolex for eligible children and adults under hospital supervision.

The second product is Sativex or nabiximols, an oromucosal spray that contains a roughly equal mix of THC and CBD. The spray treats moderate to severe spasticity in multiple sclerosis when first line oral medicines like baclofen give inadequate relief. NICE guidance advises that clinicians should continue Sativex only if the patient shows at least a twenty per cent improvement on validated spasticity scales after four weeks. This stopping rule helps the NHS manage cost while ensuring benefit.

Unlicensed Cannabis Oils and Specialist Approval

Beyond these two products, consultants can prescribe unlicensed whole plant extracts under strict conditions. The cannabis-based medicine must be supplied by a pharmacy with a Home Office controlled drug licence and the consultant must accept full responsibility for safety. Hospital formularies rarely approve these oils because randomised controlled evidence remains limited. In practice the vast majority of NHS prescriptions issued since rescheduling cover either Epidyolex or Sativex.

Why GPs Cannot Prescribe High Street CBD

Over the counter oils vary widely in strength, purity and label accuracy. Some contain trace THC while others include flavour solvents that lack toxicology data. The NHS works on evidence and quality assurance. Unless a product carries a pharmaceutical licence physicians will not add it to repeat scripts. That stance protects patients from inconsistent dosing and shields prescribers from legal liability.

The NICE Economic Calculus

The National Institute for Health and Care Excellence evaluates treatments on both clinical and economic grounds. Epidyolex passed after the manufacturer offered a confidential discount that aligned cost with the benefits observed in trials. Many unlicensed oils cost more per milligram of cannabidiol without comparable evidence. Until rigorous trials show meaningful advantages the health service is unlikely to fund them.

Private Clinics and Shared Care

Patients who do not meet NHS criteria sometimes turn to private medical cannabis clinics. Consultants in these centres can prescribe full spectrum CBD oils that include minimal THC or balanced THC CBD formulations. Fees cover consultation, import pharmacy charges and the medicine itself. Some NHS trusts accept a shared care arrangement if a private specialist stabilises a patient on a regime that proves effective and safe. In that scenario the general practitioner can continue prescribing at NHS expense. The GP must agree voluntarily and many decline because local prescribing committees advise caution. Success therefore hinges on clear documentation, demonstrable clinical benefit and an open line between private consultant and NHS doctor.

Practical Steps for Patients

Parents of children with intractable epilepsy should request a referral to an NHS tertiary neurology centre. Consultants there can assess eligibility for Epidyolex and arrange funding through regional medicines optimising committees. People with multiple sclerosis who experience disabling spasticity should ask their neurology team for a trial of Sativex, especially if they have already tried baclofen or tizanidine. Patients seeking CBD for anxiety, insomnia or chronic pain without neurological disease will find NHS access unlikely at present. They can either buy regulated novel food oils from reputable retailers or pursue private assessment, understanding the financial commitment involved.

Monitoring and Safety

Prescription CBD can interact with anticonvulsants, immunosuppressants and anticoagulants by inhibiting cytochrome P four five zero enzymes. Hospital pharmacists run interaction checks before issuing supply and consultants order liver function tests during the first three months of Epidyolex treatment. Such safeguards rarely exist with high street purchases. Anyone self-dosing should inform their GP to avoid hidden interactions.

Future Outlook

Ongoing randomised trials are exploring CBD for psychosis relapse prevention, Parkinson tremor and inflammatory bowel disease. Positive results could shift NICE cost effectiveness models, opening new indications within the NHS in the next three to five years. A cross-party parliamentary group on medical cannabis has urged the Department of Health to streamline evidence requirements for severe chronic pain, though no policy change is imminent.

Conclusion

You can obtain CBD on the NHS but only in two tightly defined situations. Epidyolex treats certain severe epilepsies and Sativex helps multiple sclerosis spasticity when standard options fail. All other uses currently sit outside routine NHS prescribing. Private clinics provide broader access but at personal cost and without guarantee that GPs will continue scripts. Patients should approach CBD with realistic expectations, consult qualified specialists and rely on products backed by transparent quality data.