Why medical cannabis is regulated differently from recreational cannabis in the UK
Legislation
Jan 13
Medical cannabis and recreational cannabis are treated very differently under UK law. While recreational cannabis remains illegal, cannabis-based medicines may be prescribed in limited circumstances under specialist care. This distinction reflects how medicines are regulated in the UK, rather than a general acceptance of cannabis use.
Understanding why medical cannabis is regulated separately requires looking at the UK medicines framework and the safeguards that apply to prescription-only treatments.
In the UK, substances used for medical purposes are regulated under medicines legislation. Cannabis-based medicines are classified as prescription-only medicines (POMs), meaning they can only be supplied following a clinical assessment by a qualified prescriber [1].
These medicines are prescribed within a healthcare setting, subject to professional oversight, record-keeping and ongoing monitoring. The legal status of medical cannabis is therefore determined by its medical use under specialist supervision, not by the substance itself.
Recreational cannabis, by contrast, is not recognised as a medicine and remains prohibited under UK drug legislation [2].
Cannabis-based medicines prescribed in the UK are currently classed as unlicensed “specials”. This means they have not undergone the full licensing process required for most medicines, although they may still be prescribed where a specialist doctor determines there is a clear clinical need [3].
Because of this status, additional safeguards apply. Prescribing is restricted to doctors listed on the General Medical Council’s Specialist Register, and each patient is assessed on an individual basis. These controls are intended to ensure patient safety and responsible clinical use.
Oversight is provided by bodies including the Medicines and Healthcare products Regulatory Agency (MHRA), the Home Office and the Department of Health and Social Care, which together regulate how cannabis-based medicines may be prescribed, supplied and monitored in the UK [1][4].
Recreational cannabis is not prescribed, clinically assessed or monitored as part of medical care. As a result, it does not fall within the UK medicines regulatory framework and remains illegal.
UK policy draws a clear distinction between substances used as medicines under professional supervision and substances used outside a clinical context. This reflects wider principles of medicines regulation, which prioritise evidence, quality control and patient safety [2].
The regulation of medical cannabis should not be confused with broader cannabis legalisation. The current framework permits the use of cannabis-based medicines in specific medical circumstances, while recreational cannabis remains unlawful.
For a detailed explanation of the legal framework and access pathways, see our guide to the legal status of medical cannabis in the UK.
Disclaimer
This article is for general informational purposes only and does not constitute medical or legal advice. Treatment suitability is determined by a qualified clinician. UK cannabis regulation and clinical evidence continue to evolve.
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