Why Hundreds of UK Patients are Buying their Medical Cannabis Illegally

In theory, medical cannabis has been legal in the United Kingdom since 2018. In practice, hundreds of families still find themselves turning to the black market to obtain life-saving treatment for their children. A 2025 BBC report revealed that at least 382 families, identified through online forums and interviews conducted by the parent support charity MedCan, are sourcing cannabis medicines illegally—many to manage severe forms of epilepsy that conventional treatments have failed to control. Campaigners believe this number is only a glimpse of a much larger, hidden population.

These patients and their stories raise urgent questions about the UK’s medical cannabis system: Why must so many severely ill individuals break the law to access medicine? What does this say about the structure and limitations of the UK’s legal medical cannabis system? And how are patients weighing the risks and benefits of illicit cannabis in the absence of affordable, legal alternatives?

This article explores the history and structure of the UK’s medical cannabis framework alongside information comparing full-spectrum cannabis therapies to legal medicinal cannabis products. We also consider the ethical and practical dilemmas posed by the illegal market to patients and the industry in the UK system. Through personal accounts, policy analysis, and a closer look at the cannabis compounds involved, we examine both the successes and failures of the current UK medicinal cannabis system and what must change therein for the country’s promise of medical cannabis to become an accessible reality.

UK Medicinal Cannabis: An Overview

In November 2018, the United Kingdom legalized the use of medical cannabis products by prescription for a restricted number of disorders, which include:

• individuals with rare, severe forms of epilepsy (Lennox-Gastaut syndrome and Dravet syndrome)
• adults with vomiting or nausea from chemotherapy
• people experiencing muscle stiffness and spasms caused by multiple sclerosis (MS)

The medications prescribed for these conditions are specific to each disorder. Some exclusively contain cannabidiol (CBD), whereas others contain limited therapeutic doses of synthetic tetrahydrocannabinol (THC). Approved cannabis medications in the UK are the following:

• Epidiolex, a highly purified CBD extract used to treat severe seizure disorders.
• Nabilone, a synthetic drug designed to act like THC, is used to treat nausea in chemotherapy patients.
• Sativex, an oral spray containing a drug with a 1:1 CBD to THC ratio used to treat muscle spasms in people with MS.

For individuals with other conditions, such as chronic pain, anxiety, PTSD, or fibromyalgia, patients must instead seek private prescriptions for medical cannabis through specialized clinics. Although patients can pay for a private prescription through these services, they are often prohibitively expensive for families, costing up to ₤2,000 (or about $2,600) for a prescription to access comparably expensive medicine products. In comparison, a bottle of illegal cannabis oil can cost as little as ₤55 (around $73). 

These private cannabis prescriptions are unique because they can include full-spectrum cannabis oils, which contain the full range of cannabinoids, including THC and CBD, as well as terpenes and other plant compounds. This form of cannabis is considered more similar to traditional herbal cannabis as it contains the full phytochemical profile of the plant. To obtain a prescription, patients must demonstrate that conventional treatments have failed and undergo assessment by a doctor registered with the General Medical Council who specializes in the relevant condition.

While technically legal, this private prescribing system is out of reach for many due to cost, limited public awareness, and a scarcity of prescribing doctors. The UK has profoundly failed in implementing its medical cannabis system: today, overly restrictive regulations limit the small legal market, fuel a large and growing illicit trade, and create tensions around accessibility, criminalization, and public health.

Patients Turning to Illegal Cannabis in the UK

Yet, despite allowing medical cannabis use, the country’s National Health Service (NHS) has issued only a limited number of prescriptions, forcing potentially over one million patients to turn to the illicit market for vital therapeutic products.

Many patients with severe, rare seizure disorders report enhanced benefits from full-spectrum CBD oil products, which are not officially available to seizure patients in the United Kingdom under the NHS.This forces such patients to choose between continuing to suffer from debilitating, even life-threatening, symptoms or buying full-spectrum products from illegal purveyors.

For example, one parent of a child with severe seizures spent two years attempting to secure an NHS prescription for unlicensed full-spectrum cannabis medicine. Her efforts were unsuccessful. So, unable to get a prescription from the NHS, she now purchases illicit full-spectrum cannabis oil. Since taking daily doses of this oil, the daughter has been able to dramatically reduce the frequency and severity of her seizures.

Another woman of age 30 living with severe epilepsy saw her seizures decline from about 200 per month to around 8 with the administration of illegal full-spectrum products. People with such disorders can potentially die from these seizures, and cannabis medicine can be a life-changing and life-saving treatment for people who experience such diseases. 

READ: What Does Cannabis Legalization Look Like in the UK

What is Different about Full-Spectrum Cannabis Products?

Cannabis-based medicines in the UK vary widely in their chemical compositions and therapeutic applications. Full-spectrum cannabis products, typically prescribed through private clinics, contain the entire range of naturally occurring compounds found in the cannabis plant. This includes multiple cannabinoids (like THC, CBD, cannabigerol (CBG), and others), terpenes (compounds that contribute to cannabis aromas and may have therapeutic effects), and flavonoids. These compounds are thought to work synergistically throughout the body’s self-made cannabis receptors and compounds in the endocannabinoid system via a process called the “entourage effect,” a phenomenon which is understood to enhance the therapeutic outcomes of cannabis medicine beyond the effects achieved by isolated compounds alone.

In contrast, licensed cannabis medicines like Epidiolex, Sativex, and Nabilone contain standardized, often isolated or synthesized compounds:

• Epidyolex is a purified form of CBD with no THC, used for rare forms of epilepsy.
• Sativex contains an equal ratio of THC and CBD, but it is highly standardized and formulated as an oral spray.
• Nabilone is a synthetic THC analogue, lacking the complex chemical diversity of the plant.

These licensed medications offer consistent dosing and are approved for limited medical use under the NHS. However, they lack the broad chemical profile of full-spectrum cannabis flower, which some patients and clinicians believe is more effective for certain conditions, especially when managing chronic pain, insomnia, or anxiety.

Illegal Medical Cannabis: Risks and Benefits

Most illegal cannabis products are obtained via internet vendors. These suppliers not only provide treatments that families are unable to obtain with a legal prescription, but they also provide medicines at a much cheaper price than private prescriptions that are available for those attempting to use medical cannabis for unlicensed purposes. 

However, some caution that patients are risking their safety by purchasing unregulated and potentially untested substances from illegal dealers. There have been reports of illegal products having bad side effects or being contaminated with adulterants. There are also concerns about the lack of testing standards across the illegal market, which increases the possibility that customers may not be getting exactly what they think they are buying. 

Other methods of obtaining illegal products, such as smuggling products from another country like the Netherlands, also put patients at risk of serious legal charges. This method of bringing cannabis products into the UK comes with international drug smuggling penalties, which can involve relatively heavy prison sentences. 

However, some illegal sellers are committed to making therapeutic-grade products available to patients in need who have been failed by the legal cannabis system in the UK. One dealer interviewed for the BBC article claims to provide lab-tested medical-grade cannabis to families for free or for a donation in what he calls a “compassionate use programme.”

On the one hand, the illegal market for therapeutic cannabis products fills a gap left by the UK system that has failed to deliver on the promise of medical legalization. On the other hand, it highlights the urgent need for reform. It is a failure of the system to put patients in a position where they must choose between affordability and legality, or between professional support and effective treatment. For such individuals, given the severity of the illnesses that are treated by these cannabis products, the stakes are especially high. So, although the illegal cannabis market is not without its risks, its persistence signals a fundamental mismatch between legal policy and patient needs. 

Final Takeaways

The UK’s current approach to medical cannabis attempts at progressive policy, but the system is marked by contradiction. Cannabis as medicine in the UK appears to be legal in principle, but largely inaccessible in practice. 

While full-spectrum cannabis is available through private clinics, high costs and regulatory limitations have left many patients behind, bringing more business to the illegal market as patients and their families seek to access the relief they need. This unlicensed cannabis economy, despite the risks associated with a lack of regulation, has become a lifeline for thousands. Yet, unlicensed cannabis can also expose users to inconsistent product quality, potentially severe legal consequences, and products that lack official medical oversight.

The UK has taken a cautious, incremental approach to cannabis-based medicine, but seven years after legalization, this caution has evidently come at the cost of patient accessibility. The success of privately prescribed full-spectrum products for many patients suggests a promising future for a wider range of allowable cannabis-based therapeutics. For the future of these medicines to be equitable and sustainable, the UK will need to take further action to expand NHS access to medical cannabis, educate healthcare providers, and confront the entrenched cultural stigma surrounding cannabis use.