The law changed in 2018 to legalise cannabis prescribing in the UK – but few people know about it, and even fewer people have accessed a prescription. My own interest in medical cannabis policy emerged from my experience of supporting a family member with a cannabis prescription for a chronic illness. As a sociologist, I wanted to understand what life is like for people prescribed cannabis by a doctor in a context where cannabis remains criminalised. I teamed up with Helen, who specialises in drug policy, to conduct the first sociological, qualitative study of UK patient experiences. Our newly published research (along with our forthcoming animated film based on the findings) shares the stories of cannabis patients (Beckett Wilson and Metcalf McGrath, 2023). Many have struggled to access a prescription and, once they do, may encounter stigma and a lack of understanding among professionals such as doctors and the police.

Our research found that patients overwhelmingly found cannabis beneficial, with significantly fewer side-effects than other prescribed drugs. Our participants were taking cannabis for a wide range of physical and mental health conditions and symptoms. The majority found that the cannabis had reduced their need for conventional drugs such as morphine/opiates, epilepsy drugs, anti-depressants, and other painkillers (many of which had caused problematic side effects and negatively impacted quality of life). In our paper, we share participants’ stories of how cannabis medication had facilitated gains in quality of life – for example helping them regain the ability to go outside, to travel, to get back to work or school, or to look after their children.

However, five years on from the legalisation of cannabis prescribing in the UK, fewer than five people have received a prescription on the NHS – despite its potential to enhance quality of life. In our study, only one patient had been able to access an NHS prescription. The majority have no option but to rely on private clinics. As we demonstrate, this has significant ethical, health and social justice implications, particularly for those who cannot afford private medicine. The 2018 legalisation of prescribing is credited to the parent-campaigners of children with intractable epilepsy – such as Alfie Dingley and Billy Caldwell – where cannabis is the only effective treatment for young patients experiencing up to 150 seizures a week. Despite the success of campaigners in forcing a change to UK law, the government’s lacklustre implementation and the barriers to NHS prescribing mean that many other children with epilepsy, along with patients of all ages with a wide range of conditions are still unable to access this life-changing treatment.

Even for those lucky enough to secure a prescription, the ongoing criminalisation of cannabis in the UK contributes to stigma – making it stressful and anxiety-inducing to take their medicine in public spaces. Participants in our study had been nervous telling their family, friends and employers about their medication too, with some choosing to conceal it and others seizing opportunities to educate others. They told us stories of winning over initially concerned family members, whose attitudes towards cannabis were turned around when they witnessed the profound improvement in symptoms experienced by the patient. More than one participant also recalled how their NHS doctors were impressed by the results and curious to learn more when the patient divulged that they had started taking cannabis under the care of a private clinic.

Worryingly, our findings suggest that some professionals such as doctors and the police may need more training about the law regarding prescribed cannabis. Some of our participants perceived a lack of knowledge – and even some stigmatising attitudes – among their healthcare professionals. Some had experienced negative encounters with the police, even after explaining and evidencing their prescription for cannabis. One patient was refused entry to a music event owing to carrying their medication with them. In another patient story, police had contacted social services after smelling cannabis at her home and judging her fitness as a mother. Despite the patient showing evidence of her legal prescription to the police, the issue was only resolved when her clinic intervened to educate both police and social services staff on the law.

As our work demonstrates, people who need cannabis medicine in the UK are subject to multiple social harms (Pemberton, 2016). These harms arise from the lack of access to a beneficial treatment and from the prohibitionist context of the UK that sustains stigma and othering. Like many of our participants, we argue for more education to combat stigma at all levels, including raising awareness among the general public and improved training for police and health professionals. However, stigma is intrinsically linked to power (Tyler, 2020) and cannabis stigma is perpetuated by the UK government’s firm commitment to prohibition. This maintains the construction of cannabis use as ‘deviant’ and cannabis users as ‘criminal’. Education about cannabis prescribing is important, but it needs to go hand-in-hand with policy change to open up access to this medicine and tackle stereotypes and tropes about cannabis use more widely.

Our full research findings are available to download on an open access basis in International Journal of Drug Policy. Our animated short film launches in Medical Cannabis Awareness Week from 3 November 2023. The title of our paper and film are inspired by the words of one of our participants, Gina – a reminder of the fact that cannabis patients are already facing the challenges of living with chronic illness. For them, the contradictions and stigmatising effects of current drugs policy is an additional burden “on top of being so ill”.

References

• Beckett Wilson, H. and Metcalf McGrath, L. (2023) “It’s a big added stress on top of being so ill”: The challenges facing people prescribed cannabis in the UK, International Journal of Drug Policy, 122
• Pemberton, S. (2016) Harmful societies: Understanding social harm, Bristol: Policy Press.
• Tyler, I. (2020) Stigma: The Machinery of Inequality, London: Zed Books