Talking to health professionals about cannabis
Cannabis-based products can be prescribed by your neurologist or a specialist in pain, rehabilitation or spasticity.
You can also speak to your MS nurse or GP about cannabis, but they can’t actually prescribe cannabis products.
Can I get cannabis for my MS?
In November 2018 the law changed in the UK on using cannabis as a medicine. A very small number of people can now get a prescription for unlicensed cannabis-based products. If these are made available to people, they’re most likely to be oils, capsules or sprays. Cannabis products won’t change your MS in the long run. But they could ease the common symptoms of muscle stiffness and spasms (spasticity) and pain.
There’s a cannabis-based drug called Sativex that’s used to treat ‘moderate’ to ‘severe’ muscle spasms and stiffness (spasticity). Because of the way it's legally classified, Sativex wasn't directly affected by the change in the law around cannabis. It’s approved for use on the NHS in England, Wales, Scotland and Northern Ireland if other treatments haven’t worked.
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.
Despite the law changing, apart from Sativex, other forms of cannabis as a medicine are no easier to get than they were before. Very few prescriptions have been issued on the NHS for unlicenced forms of medical cannabis.
How can I get cannabis for my MS?
You may have a chance of getting a prescription for a cannabis product if your MS causes muscle stiffness and spasms (spasticity), and you and your health care professional believe all other treatment options aren’t suitable for you.
There are no legal restrictions to getting medicinal cannabis if you experience pain. But the guidance for specialist doctors recommends against prescribing cannabis for this symptom. So it’s very unlikely you’d be prescribed medicinal cannabis for pain alone.
Some people with MS say cannabis helps with symptoms like sleep problems, anxiety, depression, fatigue, walking, balance, tremor, bladder or bowel problems, memory and thinking, or swallowing and speech difficulties. There’s no hard evidence to support this, so it’s very unlikely cannabis products will be prescribed for any of these symptoms.
Tips on discussing cannabis with your health professionals
If you suffer from spasticity or pain, and have explored all your other treatment options, it might be worth bringing up cannabis with your health professionals.
Here are some things we suggest you do and don’t do:
- Before you bring the subject up, do some research. You can read our pages about cannabis or download our cannabis factsheet (PDF 180KB)
- Try to avoid using words like ‘smoking weed’ or ‘having a spliff’ or ‘joint’. Instead, talk about ‘medicating yourself with’ (or ‘using’) ‘cannabis-based products’, ’medicinal cannabis’ or ‘cannabinoids’
- If you're thinking of taking a product like CBD oil, bring it with you to the appointment
- Bring something to write with if you'd like to take notes
- Don't worry if your health professional says something you don't understand, just ask them to explain
- Take a friend, partner or relative with you to the appointment for extra support
- Let your health professional know if you’ve had things like anxiety, depression or other mental health issues, or if members of your family have. That's because cannabis can trigger some mental health problems or make them worse
- If you're not satisfied after your chat, try talking to another member of your health care team.
The facts about prescribing cannabis
It's useful to know the facts about cannabis so you can be prepared in your appointment.
To help you, here are some of the things people have told us health professionals say when they ask about cannabis. But are these true?
True or false
“You don’t have any right to get a prescription for medicinal cannabis”
True. But official guidelines say you do have a right to ask your health professional about it.
“We can’t give anyone cannabis because we’ve not been sent information or guidelines about it”
There's guidance for people who can prescribe cannabis in all 4 UK nations.
- In England: read the NHS support for prescribers and the NICE guideline for cannabis products
- In Scotland: read the letter to doctors and nurses from Scotland’s Chief Medical Officer (October 2018)
- In Wales: read the guidance for prescribers from the All Wales Therapeutics and Toxicology Centre (AWTTC)
- In Northern Ireland: read the support and guidance for prescribers from the Northern Ireland government
“Cannabis is only for people with epilepsy or cancer, not MS”
The cannabis-based drug Sativex is approved for use on the NHS in England, Wales, Scotland and Northern Ireland for some people with MS. Read more about access to Sativex
There's also some evidence that other cannabis-based medical products could help people with MS. But these products aren't licensed or approved for NHS use, so it's harder for doctors to prescribe them.
“We can’t legally prescribe cannabis to people with MS”
There’s now a system in place that allows specialists to legally prescribe medicinal cannabis to people, including those with MS. But, apart from people who meet the criteria for the licensed product Sativex, it’s very unlikely people will get a prescription for any other kind of medical cannabis. This is because of the restrictive guidelines given to specialists.
“You can only get cannabis for spasticity if you’ve tried all other alternative treatments”
NHS guidelines say you and your doctor must ‘consider’ all the other treatments. It doesn’t say you need to try them all.
“Neurologists aren’t allowed to give patients cannabis or cannabis products”
They can. But it might take a long time.
Even if your neurologist wants to give you a prescription, it can take months for them to get permission. They might need to get a hospital committee to agree to pay for it.
So if your request is taking a long time, or is turned down, it might not be the fault of your neurologist, but could be down to lack of funding.
I want a second opinion
Have you spoken to someone about getting medicinal cannabis but still aren’t happy? Then you have a right to a second opinion or to complain.
When it comes to cannabis-based products, a new way of getting a second opinion is being worked on. Until this is ready, follow the standard way of getting a second opinion from the NHS.
If you're in England, you can find out more about getting a second opinion from your local hospital or NHS primary care trust (for GPs).
- Read NHS information about second opinions in Wales
- Read NHS information about second opinions in Scotland
If you’re turned down for a prescription, or you’re unhappy with what happens as a result of talking to your health professional, you can also raise this with:
- in England and Wales your local PALS (Patient Advice and Liaison Service). You can find your local PALS in England on the NHS website
- in Wales your local hospital or health board
- in Scotland your local PASS (Patient Advice and Support Service). You can also complain through the mygov.scot website
- in Northern Ireland the Patient and Client Council
You can also bring this up with your political representative - your MP, AM or MSP. Find out who yours is at writetothem.com.
Or if you live in England, take it to your local Healthwatch.
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