For people living with multiple sclerosis (MS) who struggle with moderate to severe spasticity, cannabis-based products like THC:CBD sprays have generated substantial interest. But what is the reality of accessing these treatments on the NHS? Are they legal, funded, or both? What was the impact of the 2018 rescheduling of cannabis-based medicines? This article cuts through the jargon, explaining in clear terms what NHS patients with MS can expect when considering a THC:CBD spray for spasticity.
Understanding MS Spasticity and THC:CBD Spray
Spasticity is a common symptom in MS, causing stiffness, muscle spasms, and sometimes pain. It can significantly affect quality of life. THC:CBD sprays, such as Sativex — an oromucosal spray containing both tetrahydrocannabinol (THC) and cannabidiol (CBD) — have gained attention for potentially easing spasticity symptoms where other treatments have failed.
What Does the Evidence Say?
The National Institute for Health and Care Excellence (NICE) recognises THC:CBD spray for MS spasticity as a licensed medicine supported by moderate evidence, typically offered after a four-week trial to assess how well it controls symptoms.
The 2018 Rescheduling: What Changed?
Before 2018, cannabis-based products were classified as Schedule 1 drugs in the UK, which meant they were deemed to have no medical use and were illegal to prescribe. In November 2018, this changed: the UK government rescheduled certain cannabis-based medicines to Schedule 2. This means that:
- Specialist doctors can legally prescribe licensed cannabis-based medicines, including cannabis-derived pharmaceutical products like THC:CBD sprays. Doctors prescribing these medicines must have specialist knowledge of conditions the medicine treats, such as neurological disorders.
In practice, this rescheduling allows more patients with conditions like MS spasticity to be prescribed THC:CBD sprays legally. However, legality does not automatically guarantee NHS funding or https://vergemagazine.co.uk/can-you-get-medical-cannabis-on-the-nhs-a-guide-to-the-uk-system/ accessibility.
Legal Prescribing vs NHS Funding: What’s Allowed and What’s Paid For?
One of the biggest misunderstandings is the difference between legal prescribing and NHS funding. To clarify:
- Legal prescribing: Since 2018, specialist doctors can legally prescribe licensed cannabis-based medicines such as THC:CBD sprays. NHS funding: NHS England decides whether the medicine will be routinely funded for specific indications.
In the case of THC:CBD spray for MS spasticity, NHS England has strict criteria about who can get this treatment funded.
What Does NICE Say About NHS Funding for THC:CBD Spray?
NICE has issued guidance recommending THC:CBD spray as an option for treating moderate to severe MS spasticity, but only after patients have not responded adequately to other therapies like baclofen. Their guidance specifies:
A four-week trial to see if the spray helps reduce symptoms by at least 20% using a validated spasticity scale. If the trial is successful, continuation of treatment is advised. If not, the NHS should stop funding the treatment.Despite NICE backing, NHS funding is not always guaranteed at the local hospital or trust level, meaning some patients might have to pay privately.
Specialist-Only Prescribing: What You Need to Know
THC:CBD sprays can only be prescribed by specialist doctors who are familiar with MS and its treatment. These specialists:
- Review patient suitability carefully before starting treatment. Monitor patients during the four-week trial and ongoing therapy. Are usually neurologists or MS nurse specialists working in secondary or tertiary care settings.
This referral and specialist-prescribing requirement means patients cannot get THC:CBD spray on the NHS from general practitioners (GPs) or community clinics.
Unlicensed Cannabis-Based Medicines and NHS Caution
Aside from licensed products like THC:CBD sprays, there are unlicensed cannabis-based medicines available. These include bespoke cannabis oils or edibles not authorised by the Medicines and Healthcare products Regulatory Agency (MHRA).
The NHS takes a cautious approach to these due to:
- Lack of robust clinical trial data. Variability in product quality and content. Concerns about safety and dosing.
As a result, these unlicensed cannabis medicines are not routinely prescribed or funded by the NHS for MS spasticity. Patients sometimes seek them privately through clinics listed on medicalcannabis.co.uk, a clinic directory and comparison site. But beware: private prescribing can be expensive, and prices vary widely.
Practical Access: How to Pursue THC:CBD Spray for MS Spasticity on the NHS
If you believe a THC:CBD spray might help your MS spasticity, here’s what to expect on the NHS pathway:
See your GP and explain your symptoms. Ask for a referral to a specialist neurologist or MS specialist nurse. Specialist assessment will determine whether you meet NICE criteria for a four-week THC:CBD spray trial, typically requiring moderate to severe spasticity unresponsive to standard treatments. If authorised, the specialist will initiate the trial, monitoring effectiveness and side effects carefully. If after four weeks you experience meaningful improvement, the treatment can continue under NHS funding.Remember:
Even when prescribed legally, THC:CBD sprays are not a guaranteed NHS-funded treatment for all MS patients. If local funding policies do not cover it, patients may be advised to consider private purchase, which can be expensive.
Price Example and Private Access
No specific prices for THC:CBD sprays on the NHS are published since NHS patients are charged according to normal NHS prescriptions fees (£9.65 per item as of 2024). However, private clinic prices can exceed several hundred pounds per month depending on dosage, brand, and provider.
If NHS access is limited or unavailable, the medicalcannabis.co.uk site offers a directory of private clinics, but prices should be requested upfront and quoted exactly to avoid surprises.
Summary: Can You Get THC:CBD Spray on the NHS for MS Spasticity?
Question Answer Is THC:CBD spray legal to prescribe? Yes, since the 2018 rescheduling, specialists can legally prescribe licensed THC:CBD sprays. Is it routinely funded by the NHS? It is funded only under strict criteria for moderate to severe MS spasticity after failure of other treatments and following a four-week trial. Who can prescribe it? Specialists only, such as neurologists or MS nurse specialists. Are unlicensed cannabis-based medicines available on the NHS? No, the NHS is cautious and does not routinely prescribe or fund unlicensed cannabis products. Can I get it privately? Yes, through private clinics listed on medicalcannabis.co.uk—but prices vary and may be substantial.Final Thoughts
Getting a THC:CBD spray on the NHS for MS spasticity involves a series of clear but strict steps. It is legally prescribable and NICE-approved with a requirement for specialist supervision and a documented trial period. However, NHS funding and local trust policies influence real-world access. Patients should remain informed about the differences between legality, funding, and private availability to navigate their treatment options wisely.
For more information, visit Releaf’s explainer on MS spasticity and cannabis-based treatments and explore trusted private clinics on medicalcannabis.co.uk.