Most UK pharmacy professionals support a greater role for community pharmacy in dispensing medicinal cannabis and advising patients on its use, but the latest results from a survey by C+D – in partnership with medical cannabis experts Curaleaf Laboratories – reveal that regulatory hurdles, persistent stigma, and a lack of formal training around this emotive topic still need to be addressed.
Medicinal cannabis has been legal in the UK for seven years, yet it remains a complex and often misunderstood area, even among healthcare professionals.
To better understand current attitudes and awareness levels, Chemist+Druggist conducted a survey of pharmacists across the UK to find out their knowledge, confidence and views on the role of cannabis-based medicines in clinical practice.
The findings reveal that while there is growing interest in this evolving field, many community pharmacists still feel under-informed and under-prepared to support patients, with significant gaps in training, guidance and clarity around regulation.
What is medical cannabis?
Medical cannabis is a broad term used to refer to any medical products derived from, or related to, cannabis – often referred to as cannabis-based medicinal products (CBMPs). There are a number of products that fall into this category, including whole cannabis flower – which can be vaporised, as well as capsules, oils, and sprays containing cannabinoids.
CBMPs were legalised for use on prescription in November 2018, when medical cannabis was re-scheduled from a schedule 1 drug to a schedule 2 drug. Sativex, Nabilone, and Epidyolex are currently the only licensed medical cannabis products in the UK, yet despite the change in regulation, a lack of true clinical evidence for unlicensed products has seen medical cannabis largely only prescribed privately and dispensed through specialist distance selling pharmacies.
Patient confusion
The results of C+D’s latest Pharmacy Medicinal Cannabis Survey highlight that many pharmacists recognise there are important distinctions between OTC CBD products, prescription-only medical cannabis, and the wider cannabis-based medicinal products (CBMPs), but there is also ongoing confusion among both professionals and the public.
Eighty-nine per cent of pharmacists who responded to the survey agreed that the differences between OTC CBD, wellness products, and prescription cannabis-based medicines are not well understood by the public, with a number of respondents expressing concern that customers often confuse OTC CBD oils and supplements with regulated medical cannabis, expecting similar effects or medical outcomes.
Concerns regarding the quality and regulatory standards of cannabis-based products are not new, particularly in relation to the contrast between food-grade CBD products and EU-GMP (Good Manufacturing Practice) certified medicinal cannabis.
As a result, pharmacists emphasised the need for clearer education and patient messaging to explain that OTC CBD products often have low concentrations of cannabidiol and no regulated medicinal claims.
They also believe that patients need a better understanding that medical cannabis (prescribed via specialist clinicians) must meet strict quality and clinical criteria, and that CBD sold in pharmacies is not the same as the prescription cannabis oils, capsules or flower used in treating conditions including epilepsy, chronic pain or multiple sclerosis.
Clinician support
The survey shows strong professional support for the idea that community pharmacies are well-placed to advocate for medical cannabis, but with less than half of respondents (41%) saying they have some level of confidence when discussing medicinal cannabis with patients, and only 17% of respondents feeling ‘very confident’, there is a clear need for improved training and clinical guidance to help pharmacy teams meet rising patient interest and expectations.
Nonetheless, respondents agreed that pharmacies are well-positioned to advocate for the use of medicinal cannabis under proper clinical guidance, rather than self-medicating with unregulated CBD products – a view that aligns with models such as the Curaleaf Dispensaries Partnership Scheme, which helps pharmacists support patients who may be eligible for medical cannabis by referring them to specialist clinics after an initial consultation in the pharmacy.
Legal hurdles
Despite this agreement on clinical potential, 75% of respondents said the current legal framework does not support pharmacy involvement in medicinal cannabis programs, with regulatory hurdles identified as the biggest challenge to pharmacy engagement with medicinal cannabis, more so than stigma, lack of training, or patient interest.
There is also a strong consensus among pharmacists that medicinal cannabis can be effective for pain management.
Some 88% of respondents believe medicinal cannabis can be an effective option for chronic pain patients, with 81% claiming to have some familiarity with the use of medicinal cannabis for chronic pain management, but respondents stressed that the current legal framework in the UK must change for it to be used more widely and appropriately in this context.
Future progress
“Medicinal cannabis is not this terrifying substance that it’s always been touted as”, says Matty Rawding, medical cannabis specialist pharmacist at Curaleaf Laboratories, “and I think in the years to come, we will start to see a much bigger picture of the true benefit that it can have versus conventional licensed medications.”
As the survey results demonstrate, pharmacists are ready to help patients access medicinal cannabis safely and effectively, but meaningful change will only come if the profession is empowered by an updated legal framework, increased public knowledge, and improved education and training.