Cannabis for MS on prescription: your questions answered
Since November 2018, cannabis-derived medicinal products can be legally prescribed. We answer some of your questions about getting cannabis prescribed if you have multiple sclerosis (MS).
How can I get cannabis to manage my MS?
On Thursday 1 November 2018, the UK government rescheduled cannabis-based medicinal products to make it legal to prescribe them. This means specialist doctors like neurologists can prescribe unlicensed cannabis-based treatments grown to a certain pharmaceutical grade.
But even this type of cannabis can only be prescribed after all licensed treatment options have been considered. And GPs can't prescribe it, though they may be able to refer you to a specialist.
Guidance published for specialist doctors is very restrictive and discourages them from prescribing medicinal cannabis. So even if your doctor feels you could benefit from cannabis, they may find it hard to secure funding and permission from their hospital.
We’ll be talking to NHS England to make sure this guidance is revisited urgently and they listen to people with MS.
Can I get cannabis to manage pain?
For unlicensed forms of medical cannabis, right now this looks unlikely. Guidance for specialist doctors recommends against prescribing medicinal cannabis for people with pain. We disagree with this recommendation. We believe evidence for cannabis helping with pain has been ignored.
Can I get cannabis to manage muscle spasms?
For unlicensed forms of medical cannabis, right now this looks unlikely. You might be able to access cannabis-based treatments for muscle spasms, but only once all other options have been considered.
And the guidance for specialist doctors says very little about spasticity in MS.
Can I get Sativex?
You might be able to get Sativex, which is a licensed cannabis-based treatment to manage spasticity (muscle spasms and stiffness) in people with MS.
In late 2019 the National Institute for Health and Clinical Excellence (NICE), who decide which drugs are available on the NHS, decided that Sativex could be available in England for ‘moderate’ or ‘severe’ spasticity (it was already available in Wales). This was after the company that make Sativex lowered its price.
In Northern Ireland the Health and Social Care Board process for the Managed Entry of Medicines accepted Sativex for use in April 2021. In September 2022 the Scottish Medicines Consortium approved Sativex for use on the NHS in Scotland.
Where Sativex is available on the NHS this is only to treat spasticity, and not pain or any other symptoms of MS.
But getting treatments on the NHS doesn’t just depend on a recommendation from NICE or from the Scottish Medicines Consortium (which makes these decisions in Scotland). It might still be difficult to get because the NHS in some regions might not agree to pay for it, or local prescribers decide not to give it to people.
All the same, it could still be worth talking to your doctor about your chances of getting a prescription for Sativex.
What kinds of cannabis are likely to become available?
Legally speaking, unlicensed medicinal cannabis can be prescribed if it passes a pharmaceutical standard called Good Manufacturing Practice (GMP). This is to make sure it passes safety standards and contains the right chemical ingredients (called compounds).
Does cannabis really work for MS?
Evidence shows cannabis for medicinal use can work for some people to relieve pain and muscle spasms in MS.
Does CBD (cannabidiol) work for MS?
Right now there's not enough evidence that CBD alone works in treating MS symptoms.
CBD (cannabidiol) is one of the compounds that make up cannabis. You can buy it legally as a food supplement. It's not the part of cannabis that gets you high.
For a doctor to prescribe CBD, it would need to meet the GMP pharmaceutical standard.
Can I get things like CBD oil from my doctor, as well as Sativex?
After the law changed, the Department of Health asked NICE to develop guidance on prescribing "medical cannabis" or "cannabis-based products for medicinal use (CBPMs)". NICE looked at unlicensed forms of medical cannabis (like CBD oils), as well as licensed ones like Sativex.
The guidance that NICE then wrote only recommended Sativex for use in MS. It didn't recommend any unlicensed types of medical cannabis.
NICE also said that, although doctors should take their guidance into account, the choice to prescribe medical cannabis is, at the end of the day, the choice for individual specialist doctors to make.
