Medical cannabis now prescribed to 17,000 in UK – but many are still using black market
Around 17,000 people in the UK are now thought to have received legal medical cannabis for a range of conditions including chronic pain, depression, insomnia and Parkinson’s.
But still many otherwise law-abiding citizens across the country are using the black market as they are unaware the law changed in 2018.
A mum-of-one with Crohn’s disease from South Wales told Metro.co.uk how she barely had the strength to look after her child before deciding to access the plant illegally.
She now has a legal prescription and says cannabis alleviates her pain and stomach cramps, allowing her to be more active, work and spend quality time with her family.
A natural medicine specialist with a background in clinical research says cooking cannabis into brownies helped reduce his dad’s Parkinson’s related tremors and drastically improved his quality of sleep.
A DJ and director from north London who previously suffered from Hodgkin lymphoma – a rare form of cancer – told how accessing the drug eased her discomfort.
It proved even more important after chemotherapy caused corrosion in her hip bones, meaning she was in pain and required a replacement.
One thing all of these people have in common is that despite doing their research on the medicinal benefits of cannabis, it took them some time to realise it was legally available to them since 2018.
The law changed that year after parents of severely epileptic children successfully campaigned for the government to let their children access medical cannabis oils – although many are still facing barriers.
It was a big story at the time, but what didn’t follow was lots of coverage about people using the drug to treat conditions like ADHD, anxiety or multiple sclerosis.
The drug’s availability even came as a surprise to Jon Robson, who is now managing director of private medical cannabis clinic Mamedica.
‘About a year ago, when my old colleague informed me that there were 10,000 privately paying medical cannabis patients, I just could not believe that they were sending flower in the post,’ he tells Metro.co.uk.
‘Even for someone like me who could see the benefit of what was going on in America and was biding my time and waiting for the framework for it to become available in the UK, even I was surprised last year when someone told me about it.’
Part of the reason, Jon says, is that the NHS are still very reluctant to prescribe, claiming more strong evidence is needed before advising mass prescriptions.
And in 2019 there were only 250 privately paying medical patients, as there were a number of stumbling blocks related to importation and red tape.
Patients ‘clearly didn’t feel like they were getting value for money and weren’t talking about how it was benefiting them,’ adds Jon.
‘Over the course of the last four years, when patient numbers have gone from zero to around 17,000 – roughly where they are now – the quality and volume of the product has come up and the price has come down.’
He says more patients are talking about medical cannabis has helped their conditions, while more consultants are prescribing and seeing patients come back with positive results.
Jon says out of the estimated 17,000 medical cannabis patients in the UK, 10,000 will be coming back on a regular basis, and 60-70% are receiving the flower of the plant, rather than oils or other products.
He stresses that Mamedica’s flower prescriptions are strictly for the use of dry-herb vaporisers – devices that let you heat the plant and inhale its ingredients as a vapour – rather than smoke.
Jon says 60-70% of patients coming to Mamedica are suffering from chronic pain, many of whom are looking for a less addictive and potentially more effective alternative to other medicines.
‘The NHS’s arms are tied in terms of what they’re able to prescribe, and if you come with pain it’s quite likely you will get some quite heavy addictive painkillers or opioids.
‘The Department of Health came out about six weeks ago and said there are eight million chronic pain sufferers in the UK, 24% of whom are being prescribed opioids, probably about three million of whom could qualify for our service.
‘There were 23.9million prescriptions written for opioids last year in the UK. They’re well known among the medical community to be addictive and potentially to lead to dependence.
‘We want to bring awareness to the people who are having to resort to opioids that there is an alternative which specialists do recommend.’
For people coming to the clinic with psychiatric issues, prescribing strains of cannabis with higher THC could be detrimental, but those with CBD – another compound in the plant – could be ‘extremely beneficial’, Jon says.
THC is the main compound of weed that gives users a high, while CBD does not cause intoxication, and emerging research shows it has anti-psychotic effects.
So strains developed to have lower doses of the former and more of the latter could be more appropriate for some patients.
Before patients sign up, they need to have tried at least two licensed medications or treatments and must not have had previous experiences of schizophrenia or psychosis.
They have to provide their medical records and details about their family medical history to check for any potential risks.
Consultants also ask if they’d relied on the black market before coming to them, as learning what varieties of cannabis have or haven’t worked for them could help their treatment plans.
‘I was confident in the fact that it was pure, clean and wasn’t going to be sprayed with any glass,’ says Savannah
‘Clearly if something is working for them, we would want to prescribe something similar but at a pharma grade pharma standard,’ says Jon.
‘I would say 50% of patients who are coming to us are what we’d call cannabis experienced patients.
‘These are people who’ve been purchasing from the illicit market for many years, very knowledgeable, understanding of the different categorisation and families of cannabis strains and which ones will help to be a sedative and which ones will help to be uplifting.
‘In the early days, patients were effectively educating consultants on what would be effective and what would not be. It’s been a learning curve for them.’
One patient who initially relied on the black market was Savannah King, a musician, scriptwriter, director and actor from north London.
The 26-year-old DJ and singer was diagnosed with Hodgkin lymphoma in 2018 and has since gone into remission.
When she was unwell, she found using illegally obtained cannabis eased her pain and the anxiety that came with it.
It wasn’t until June this year that someone told her about Mamedica, and she paid £250 for a consultation and 20 grams of cannabis.
‘I found comfort in the fact that it was a medically graded plant. I was confident in the fact that it was pure, clean and wasn’t going to be sprayed with any glass.’
‘People that are smoking who are getting from street dealers are obviously just comfortable doing that.
‘This way, you don’t have to faff about with ringing anyone, it just comes to your door. For the most part I think it’s nicer to do it this way.’
After she was diagnosed with Crohn’s disease in 2002, Sam Ashton, 50, from Barry, south Wales, says the condition ‘destroyed her life’.
The mum-of-one suffered from severe nausea, vomiting, bowel symptoms, pain, cramping and chronic fatigue.
‘It destroyed my career. When my daughter was two, I had to have family members live with me for six months to help me look after my child, I was that poorly,’ she says.
‘I went through a whole list of medications to get this under control, including steroids, which impacted my mental health, and for the first time ever I suffered from depression and anxiety.
‘Over the course of the next eight years I went through different treatments, nothing worked, and I finally had surgery in 2010 which removed 10 inches from my bowel.’
Sam had discovered smoking pure cannabis in a little pipe helped relieve her nausea and painful bowel cramps, and decided to carry on doing it after the procedure – just small amounts in the evening before bed.
‘I’d already been speaking to my gastro-consultant over a period of three or four years about using cannabis for medical purposes, so he was aware and he was supportive.’
Not being the sort of person who would have taken drugs previously, she was only able to find one connection in the black market.
The seller insisted on dealing in large quantities, meaning she had to fork out £700-£900 at a time, and says knowing she was breaking the law was ‘anxiety’ inducing.
Sam only discovered medical cannabis was an option a year ago, and her consultant supported her for a treatment plan.
Depending on how much she uses, she spends about £280 per month on CBD oil for her anxiety, THC oil for her chronic fatigue, and cannabis flower.
Even medical professionals who’ve worked for the NHS have been prepared in the past to break the law in order to use cannabis as a medicine.
A natural medicine specialist, who asked to remain anonymous, told Metro.co.uk how he used to get the drug illegally for his dad after he developed Parkinson’s five and a half years ago.
While a number of conventional treatments did work for him, they still weren’t doing quite enough to reduce his tremors and improve his sleep.
‘The more research we did, he more it became a no-brainer that we wanted to go down that avenue,’ the doctor says.
‘People talk about cannabis as being a drug and that sets up the wrong connotation straight off the bat.
‘Cannabis is a plant and a herbal medicine. So whether we’re talking about echinacea or chamomile or cannabis, these are herbal medicines, and if they’re used in the right way and the right dose, then they’re safe.
The doctor says it was frustrating that ‘90% of the herbal medicines that have clinical evidence are legal to buy and easy to source’ but that the one that worked for his 69-year-old father was illegal.
‘My biggest concerns were to do with health rather than legality. Is this cannabis pure? Is it laced with chemicals? How’s it been grown? Has it been grown in the right way to protect the medicinal compounds within it?
For around two-and-a-half years, his dad took cannabis by making a variety of brownies, claiming this made it easier to preserve it and standardise the dose.
Sleep is a big problem for people with Parkinson’s as the muscle rigidity it causes means people can’t unconsciously adjust their positions at night, meaning they have to wake up to move.
‘If they have a bad night’s sleep that drastically enhances the severity of their symptoms the next day, that then reduces sleep the next night and it creates a vicious circle,’ the doctor says.
Describing the ‘profound knock-on effect’ cannabis had on his dad, he adds: ‘The sleep was better, so he woke up better in the morning, had more energy throughout the day, his neurological and physical symptoms were much better.’
The doctor adds that his dad experiences ‘resting tremors’ – which come on when he is inactive – and that using cannabis reduced the severity in the long term.
However, as it was coming from the black market, the father-of-three says there was no way of ensuring the same consistency of quality.
‘If you’re getting cannabis from a licensed medical clinic, the dosing is very specific, it’s very accurate. So you can be sure you’re getting the right dose, at the right time in the right way.
‘The problem with doing it the way we were forced to do it – illegally – the dosing is much more hit and miss, you can’t standardise it, and we saw problems with that.
‘If the does was a little bit too big in the evening, maybe the sleep would be too sedated and he’d wake up very groggy. If the dose was too low it might not be impacting upon him enough.’
The doctor, in his late-30s, who now works in a private clinic, says he can’t get his head around the barriers people have faced to get this medicine.
‘If we compare this to opioids. If we think about the poppy and the morphine and heroin that come from it.
‘Why is it that that trajectory from highly toxic and highly addictive drug into the most commonly used form of painkiller was so swift and so easy?
Joshua Cuby, CSO, Cantourage Clinic, told Metro.co.uk: ‘People are being forced into criminal activity, simply because there is a lack of awareness around the change in legislation.
‘Cannabis is a complex plant that contains many different cannabinoids and terpene profiles and knowledge around the levels contained within the strain is key to understanding how to use cannabis as a medicine.
‘When consuming cannabis derived from the black market for medicinal purposes, you do not have enough information to control dosing or to know what’s helping to treat your condition.’
