Which Conditions Get the Most Cannabis Prescriptions in the UK?

Chronic Pain: The Dominant Indication

• Chronic pain of various types accounts for the majority of medical cannabis prescriptions in the UK, estimated at 40-50% of all private prescriptions
• Neuropathic pain, including diabetic neuropathy, post-herpetic neuralgia, and chemotherapy-induced peripheral neuropathy, is the most commonly prescribed pain subtype
• Fibromyalgia, which lacks licensed pharmaceutical options beyond duloxetine, has become a significant and rapidly growing indication
• Musculoskeletal pain including osteoarthritis and back pain also features prominently in private prescribing data

Chronic pain represents the largest single indication for medical cannabis in the UK, reflecting both the enormous unmet need in pain medicine and cannabis’s well-evidenced analgesic properties.

Mental Health Conditions

• Anxiety disorders, including generalised anxiety, social anxiety, and panic disorder, are among the top three indications in most UK clinic datasets
• PTSD is a significant and growing indication, particularly for patients who have not responded to first-line treatments including SSRIs and trauma-focused therapy
• Insomnia and sleep disorders, whether primary or comorbid with anxiety, chronic pain, or PTSD, are commonly addressed by cannabis prescribing
• ADHD is an emerging indication with a growing evidence base; several specialist clinics now offer cannabis prescribing specifically for adult ADHD

Mental health conditions collectively may account for as much as 30-40% of UK medical cannabis prescribing, highlighting the substantial gap between the clinical evidence and the slow progress of NHS commissioning in this area.

Neurological Conditions

• Multiple sclerosis, particularly MS-related spasticity, has the strongest NHS-endorsed evidence base and includes the licensed product Sativex
• Epilepsy, particularly Dravet and Lennox-Gastaut syndromes, is treated with Epidyolex (CBD) on the NHS; other treatment-resistant epilepsies are managed through private prescribing
• Migraine and headache disorders are increasingly being managed with cannabis by specialist prescribers despite the limited clinical trial data specific to this indication
• Tourette syndrome and tic disorders have been the subject of controlled trials showing cannabis efficacy, and are prescribed by paediatric and adult neurologists

Neurological indications represent the most evidence-rich category for medical cannabis prescribing in the UK, with licensed products in two conditions and an expanding body of evidence across the spectrum.

Oncological and Palliative Indications

• Cancer-related pain and nausea are regularly managed with cannabis-based medicines, particularly in patients with refractory symptoms not controlled by standard agents
• Palliative care teams in NHS trusts are among the most progressive prescribing groups, motivated by the quality-of-life imperative in end-of-life care
• Nabilone (Cesamet), a synthetic THC analogue, has been available on the NHS for chemotherapy-induced nausea for several years and represents the most accessible oncological cannabis medicine
• Appetite stimulation and management of cachexia in cancer patients are established indications in the US and Canada and are increasingly prescribed in the UK

Oncological and palliative prescribing represents a compelling area of growth for medical cannabis in the UK, where the clinical need is undeniable and the therapeutic evidence base is substantial.