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Image: A graphic showing the chemical structure of cannabis

Cannabis for MS on prescription: your questions answered

The Government has announced that cannabis can now be legally prescribed. We answer some of your questions about this news.

How will I be able to get cannabis to manage my MS?

On Thursday 1 November, the Government rescheduled cannabis-based medicinal products to make it legal to prescribe them. This means specialist doctors like neurologists can now 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.

Will I be able to get cannabis to manage pain?

Right now it 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.

Will I be able to get cannabis to manage muscle spasms?

Right now this is also 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.

But what about Sativex, you can already get it?

There’s already a licensed cannabis-based treatment to manage spasticity (muscle spasms and stiffness) in people with MS – Sativex. It’s recommended for use on the NHS in England and Wales for ‘moderate’ to ‘severe’ spasticity. We hope it will become available in Scotland and Northern Ireland soon.

In other parts of the UK you can’t easily get it on the NHS because regulatory bodies say it costs too much. And for many people it’s too expensive to buy privately.

Will it be easier to get Sativex now?

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. We hope it will become available in Scotland and Wales soon.

Where Sativex is available on the NHS this is only to treat spasticity and not pain or any other symptoms of MS.

What forms 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 is made up of the correct compounds.

What about CBD?

Cannabidiol (CBD is one of the compounds that make up cannabis. You can buy it legally as a food supplement (because it's not the part of cannabis that gets you high).

For a doctor to prescribe it would need to be the GMP pharmaceutical standard. And right now there's no evidence that CBD alone works in treating MS symptoms.

Does cannabis really work?

Evidence shows cannabis for medicinal use can work for some people to relieve pain and muscle spasms in MS.