Can you get CBD oil on the NHS?
CBD, or cannabidiol, is an extract of the hemp plant that does not create the 'high' associated with smoking cannabis.
If you're aware of the increasing interest in CBD oil as a natural remedy, and the mounting evidence that it may help symptoms of a number of health conditions, you may be wondering whether it's available by prescription on the NHS.
The answer is yes... and no. There are medications containing CBD that have been approved for use in the UK (and in other countries) and they can be prescribed. However, the circumstances in which this happens are very specific.
Can you get a prescription for CBD on the NHS?
There are currently two drugs containing CBD that have been cleared for use in the UK. They are Epidyolex (spelt Epidiolex in the US), which is used to treat two rare forms of childhood epilepsy, and Nabiximols, brand name Sativex, which can help with some symptoms of multiple sclerosis.
Neither of these drugs can be prescribed by a GP, only by a specialist doctor, and only for patients with these illnesses.
There are no other CBD-based medicines available by prescription on the NHS. CBD products currently available in the shops, meanwhile, are sold as natural supplements and are not legally allowed to make any medical claims.
Epidyolex is a solution containing purified CBD used to treat people with two types of early-onset epilepsy, Lennox-Gastaut Syndrome and Dravet Syndrome. Epidyolex is taken orally and has been shown to significantly reduce seizures in some patients.
It can prescribed on the NHS only by a specialist hospital doctor and not by a GP. However, recent changes to UK law have made it legal to buy Epidyolex over the counter and to possess it without a prescription.
Known by a different spelling, Epidiolex is also approved for use in the US by the Food and Drug Administration (FDA).
Nabiximols / Sativex
Nabiximols, brand name Sativex, is a drug containing almost equal parts CBD and THC, the psychoactive compound responsible for the 'high' associated with smoking cannabis. The CBD in Sativex moderates the potentially intoxicating effects of the THC.
Nabiximols is taken as an oral spray, providing 2.7mg of THC and 2.5mg of CBD per spray. It is used to treat certain symptoms of multiple sclerosis, including spasticity – the stiffening and spasming of muscles, which can effect movement and speech – in patients who do not respond adequately to existing medication.
Like Epidyolex, Nabiximols can only be prescribed on the NHS by specialist doctors. But because of its high cost and questions over its efficacy, local health authorities will not always agree to fund it. In these cases, patients can apply for a private prescription that they pay for themselves, although the cost may be prohibitive for many.
Epidyolex is available in a number of other countries including the US and Canada, where it is also prescribed for cancer pain.
The extent of Nabiximols' effectiveness has been the subject of debate but a non-clinical study in Germany showed it significantly reduced spasticity in almost 75% of patients after one month of use.
Can you get other cannabis-based medicines on NHS prescription?
Nabilone, sometimes referred to as “man-made cannabis”, is designed to act in the same way as the psychoactive cannabinoid THC but it does not contain actual THC or any CBD.
Nabilone is used to treat nausea and vomiting in chemotherapy patients and can only be prescribed by a specialist.
There are no other cannabis-based medicines approved for use in the UK, however in specific circumstances patients may be able to get a private prescription allowing them to obtain medical cannabis products from abroad to treat symptoms including pain caused by conditions like fibromyalgia.
Although it can only be prescribed on the NHS in the very specific situations laid out above, CBD is widely available to buy in shops and online. It comes in a variety of products, from bottled oils to vaping liquids, capsules, tablets and chewable gummies to creams and cosmetics.
However, a recent investigation for the Centre for Medical Cannabis demonstrated that the quality of CBD products in the UK can vary hugely, with the best deemed “very high quality and… good options for today’s consumers” and the worst shown to contain far less CBD than claimed on their packaging, along with illegal levels of THC.
It’s therefore important to choose a trustworthy CBD brand that can demonstrate good traceability of its ingredients, rigorous processing and a high-quality end product.
Jersey Hemp is the premium producer of CBD oil in the British Isles and grows and harvests its own hemp. Every batch is tested for CBD and THC content by an independent laboratory, with the results made available to view on the website.
The Centre for Medical Cannabis called Jersey Hemp “one of the most compliant, high quality and accurately labelled products that we tested.”
CBD oil users take it for a variety of reasons, including to promote a general sense of wellbeing. Scientific research has produced evidence suggesting CBD may be able to help with a range of conditions, including pain, anxiety, sleeping problems and some cancer-related symptoms.
To find out more about the potential benefits of CBD, read our dedicated article.
Is CBD oil safe? What are the side-effects?
CBD is generally considered ‘well tolerated’ by clinicians, meaning that patients rarely drop out of medical trials due to its adverse effects. In fact, it is often seen as a good prospect for further research precisely because of its low level of side-effects compared with some traditional pharmacological treatments.
Nevertheless, a small proportion of CBD users do experience minor side-effects. These include dry mouth, drowsiness or fatigue, changes in appetite and in some cases diarrhoea, nausea and mood changes.
In terms of its general safety, CBD is recognised by the World Health Organization as having “a good safety profile” and posing no discernible risk to public health. The Court of Justice of the European Union recently made a landmark ruling in which it concluded that CBD “does not appear to have any psychotropic effect or any harmful effect on human health”.
However, there is one area of concern that it is important to be aware of – CBD’s potential interaction with medication. Because it can inhibit certain enzymes that help metabolise a range of drugs, CBD may increase the levels of those drugs in the body. This could increase its effects beyond what is required or safe and accentuate any side-effects of the drug.
One of the enzymes that CBD influences is also inhibited by the ingestion of grapefruit and other related citrus fruits, so you should not take CBD with any medication that carries a 'grapefruit warning'. However, CBD may adversely interact with other medicines too, so you should talk to your doctor before using CBD if you are taking any medication.
The author of this article is not a medical expert and nothing in this article constitutes medical advice or gives rise to a medical practitioner/patient relationship. You should seek specialist medical advice where required. Never disregard professional medical advice or refrain from seeking it because of something you have read here.