Cannabis Health Symposium 2025 – Key Takeaways Part 1
November 26, 2025
On Tuesday, November 25, nearly 200 healthcare professionals, patient advocates, cannabis educators, and industry leaders converged on London’s Conway Hall for the inaugural Cannabis Health Symposium.
The event embodied the UK medical cannabis industry’s collective drive to push beyond its own barriers and reach out to the wider medical community to inform, educate and illuminate cannabis medicine.
A collection of the industry’s best-informed voices explored everything from the endocannabinoid system to the current evidence base and the real-world impact treatment has had, and continues to have, on patients.
With nearly 100 doctors in attendance, 50 of whom had never prescribed medical cannabis before, the day provided a data-rich crash course for clinicians considering prescribing cannabis-based products for medicinal use (CBPMs).
More importantly, it extended an open invitation for them to engage with the industry and those whose lives it has changed.
From the outset, the focus centred on bridging the gap between the growing body of evidence and clinical practice, addressing the persistent challenges of NHS integration, and equipping healthcare professionals with the foundational knowledge needed to prescribe safely and effectively.
We’ve laid out our key takeaways from each of the talks throughout the day below.
Opening Remarks: Education, Access and Recognition
Sarah Sinclair, editor of Cannabis Health, opened the symposium by reflecting on her vision to bring the medical cannabis community together to this landmark in-person event.
She paid tribute to Hannah Deacon, an instrumental figure in the legalisation of medical cannabis in the UK, co-founder of the Medical Cannabis Clinicians Society (MCCS), and a tireless advocate for education and access to cannabis medicine.
“Hannah would have loved to see you all here today. She was passionate about educating doctors and medical professionals, and it’s amazing to see all of you here today. “
Jan Armstrong from the event’s headline sponsors Curaleaf Laboratories, set the tone for the day with a rallying call to action, emphasising that the symposium was about igniting a movement to ensure anyone who could benefit from medical cannabis has access to it.
“Medical cannabis is not a trend; it is a therapeutic revolution, and revolutions require leaders. Let us be those leaders.”
Building Prescriber Confidence: Best Practice, Training, and Governance
Consultant Neurologist and medical cannabis stalwart Professor Mike Barnes, Chair of the MCCS) delivered the symposium’s first major session, outlining the MCCS Good Practice Guide and addressing variations in clinical standards across the sector.
Current landscape and key statistics
- Approximately 80,000 patients are currently being treated with CBPMs by around 160 prescribers
- Only six or seven NHS prescriptions are being issued, 99% of prescribing takes place in the private sector
- While most clinics operate to high standards, some cut corners in ways that compromise patient safety
Regulatory challenges
- Cannabis prescriptions must be issued by a doctor on the GMC Specialist Register, a requirement Barnes believes is misplaced
- The first prescription must be approved by a panel, though this is often not enforced in practice
- Some clinics conduct consultations as short as 10 minutes, which Barnes considers insufficient for patient safety
- Communication with GPs is ‘basic, sensible medical communication’, but doesn’t always happen, especially problematic for psychiatric cases
Common misconceptions
- Patients do not need to have tried two ‘licensed’ treatments first, only ‘established treatments,’ which may include non-pharmacological interventions
- There are no absolute contraindications to cannabis use, though active psychotic episodes remain a major red flag
- Fewer than 5% of patients are turned away
- Cannabis does not cure anything, it is a symptom and quality-of-life treatment
Product selection and prescribing
- Anything available through licensed pharmacies has been approved and is safe, despite isolated contamination incidents
- Recreational strain names and sativa/indica classifications are meaningless in medical contexts and should be scrapped
- Clinicians should focus on chemovars and Certificates of Analysis
- FSA’s recommended 10mg daily intake is ‘complete and utter nonsense’ with no human evidence base
Dosing and formats
- Medical cannabis requires a “start low and go slow” approach
- UK relies too heavily on flower (80% of prescriptions vs 50-60% in other markets)
- Barnes recommends peer approval for prescriptions exceeding 2g per day or 25% THC content
- Clinic management must not interfere with clinical decisions, and economic drivers should never dictate product choice
Systems and training
- Paper-based prescribing and postal dispensing are outdated and unsafe, electronic prescribing is needed
- MCCS is now offering specialist training alongside basic training
- Goal is to make medical cannabis more commonly accepted across healthcare
The Value of Real-World Evidence in Cannabis Medicine
Dr Anne Schlag from Drug Science presented a compelling case for the importance of real-world evidence (RWE) in advancing the understanding and acceptance of cannabis-based medicines.
The limitations of RCTs
- RCTs remain the gold standard, but are poorly suited to cannabis medicine due to product variety and patient complexity
- RCTs would not allow for the personalised treatment CBPMs require
- Rigid structures exclude the very patients who stand to benefit most
The UK’s largest registry
- Drug Science operates the UK’s largest non-profit medical cannabis registry with over 4,500 patients followed for up to five years
- Includes a broad range of indications, detailed demographics, comorbidities, concomitant medications, and standardised outcome measures
- Very few patients have no secondary diagnoses; most present with multi-morbidity, often up to 10 conditions
PTSD and comorbid depression
- Patients with higher baseline depression often experienced greater symptom reduction with medical cannabis
- Significant reduction in PTSD symptoms at three months, with those with comorbid depression showing even greater improvement
- These patients would be excluded from traditional trials, leading to unrepresentative results
Paediatric epilepsy
- Case series of 10 paediatric patients with treatment-resistant epilepsy showed substantial seizure reduction on CBPMs
- Despite this evidence, many families still struggle to obtain funded prescriptions
- Qualitative interviews with parents highlighted broader quality-of-life impacts beyond seizure reduction
Advantages of RWE
- Larger and more diverse patient cohorts
- Inclusion of rarer conditions
- Higher ecological validity
- Ability to track outcomes over much longer periods
- Significantly lower costs compared to RCTs
Regulatory implications
- Growing recognition of RWE by agencies such as the European Medicines Agency
- Regulators must give greater weight to high-quality real-world data when making licensing and reimbursement decisions
Panel Discussion: NHS Integration – Bridging the Gap Between NHS and Private Providers
Despite over 60,000 patients now receiving CBPM prescriptions, NHS access remains extremely limited. This panel explored how private clinics and NHS providers can collaborate more effectively.
The two-tier system
- The hundreds of thousands of private prescriptions vs a handful on the NHS creates an entrenched two-tier system with gaps in continuity of care, information sharing, and governance
Where responsibility lies
- Dr David Tang: Private prescribers must do more proactive outreach—Grand Rounds, college events, GP teaching, medical school education
- Nitin Makadia: How can clinicians prescribe when CBPMs aren’t supported by insurance, NICE guidance, or institutional frameworks?
- Sal Aziz: Stigma remains a significant barrier, with patients reluctant to disclose CBPM use for fear of being labelled substance misusers
- Dr Rob Forbes: NHS uptake requires both confident clinicians and formal pathways, NICE guidance offers no advocacy for CBPMs
NHS prescribing barriers
- For unlicensed medicines like CBPMs, every single licensed medicine must have been tried first, not just two
- NHS is short of time and money, introducing something new remains a low priority
- NICE guidance and Trust policies create a ‘do not touch’ signal for NHS clinicians
Individual Funding Requests
- Forbes recounted successful IFR cases, including chronic pain and a terminal patient who returned to work
- However, single-patient successes haven’t translated into broader policy change
- IFR processes are administratively heavy and difficult to scale
Communication failures
- Private clinics often struggle to access NHS patient records, relying on patients to provide medical histories
- CBPMs are often recorded as ‘cannabis misuse disorder’ on NHS records, causing patients to lose access to mental health services
- GPs are reluctant to share data with private providers
- NHS systems remain chaotic and vary between hospitals and trusts
Solutions needed
- Standardised service specifications and documentation aligned with NHS expectations
- Consistent templates for clinic letters and prescribing information
- Digital systems built to be interoperable with NHS infrastructure
- Integrate ECS and CBPM content into medical curricula
- Focus on clinically relevant outcomes and health economic metrics
- Private clinics must “get their house in order” on data standards
- More coherent national guidance on NHS-private integration
November 25, 2025
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November 21, 2025
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Exploring the Endocannabinoid System
Dr Rowan Thompson delivered an accessible exploration of the endocannabinoid system (ECS), a fundamental component of human physiology that remains absent from UK medical school curricula.
Core ECS components
- Three key elements: endocannabinoids (anandamide, 2-AG) synthesised on demand from membrane lipids; CB1 and CB2 receptors; enzymes that rapidly degrade endocannabinoids
- Maintains balance across pain, mood, appetite, sleep, and immune function
- Acts locally and transiently at synapses with precise control
Retrograde signalling
- Postsynaptic activation leads to endocannabinoid synthesis, which travels backwards to CB1 receptors on presynaptic terminals
- Reduces neurotransmitter release, prevents overstimulation
- Modulates pain transmission, memory encoding, and cognitive processing
Why cannabis is not an opioid
- CB1 receptors are densely expressed in basal ganglia, cerebellum, and cortex
- Only sparsely present in brainstem respiratory centres
- This explains why cannabis does not cause opioid-type respiratory depression, a critical safety distinction
- CB1 receptors act as circuit breakers for multiple systems
Diet and ECS tone
- Endocannabinoids are lipid-derived, and diets high in omega-6 fatty acids may drive ECS hypertonia
- Greater endocannabinoid production observed in Western populations
- Altered ECS tone contributes to obesity, metabolic syndrome, and non-alcoholic fatty liver disease
ECS dysregulation across conditions
- Implicated in: chronic pain and central sensitisation, IBS and GI motility disorders, migraine (lower CSF anandamide levels), fibromyalgia, cardiovascular disease, substance use disorders
- ECS dysfunction is a cross-cutting mechanism for many conditions treated with CBPMs
Individual variability
- THC acts differently in patients with low vs high ECS tone, explaining highly varied responses
- CBD involves negative allosteric modulation at CB1 and multiple off-target interactions
- Blocking CB1 receptors entirely can have serious unintended consequences
Beyond symptom control
- Medical cannabis should be recognised not just for symptom treatment but as a tool for metabolic regulation
- ECS influence extends far beyond symptom control
Education gap
- Not a single UK medical school currently teaches the ECS
- This is a critical barrier that must be addressed for safe, effective prescribing
Exploring the Evidence Base: CBPMs in Dementia & Neurodegenerative Conditions
Dr Laura Booi, a social gerontologist and dementia researcher, explored the potential role of cannabis in dementia care, positioning herself as a researcher rather than a prescriber.
The scale of the challenge
- 55 million people worldwide living with dementia, nearly one million in the UK
- Numbers expected to double and triple in the coming decades
- Everyone will either live with or care for someone with dementia, women are disproportionately affected
- Costs the UK over £24 billion per year
Understanding dementia
- Dementia is an umbrella term—Alzheimer’s may encompass up to 200 distinct types
- Not a normal part of ageing
- Genetic links are very low for late-onset cases
- Memory loss is just one symptom, affects multiple cognitive and functional domains
The preclinical window
- Signposts present up to 40 years before symptoms emerge
- Pre-clinical brain changes occur 20 years before diagnosis
- This long prodromal period presents opportunities for prevention and early intervention
Prevention and modifiable risk
- 45% of all dementia cases are attributed to 14 modifiable lifestyle factors
- Prevention and risk reduction are the main opportunities
- If CBPMs play a role in disease modification, interventions may need to target the preclinical window, not just late-stage symptom management
Evidence base: promising but thin
- Limited and fragmented: small clinical trials, case reports, and real-world experiences
- Potential target symptoms: agitation and aggression, sleep disturbance, anxiety and mood, pain and appetite loss
- Heterogeneity in study designs, products, and dosing makes firm conclusions difficult
- Alzheimer’s Society states no strong evidence that cannabis helps dementia
Chemical restraint warning
- Double stigma around both dementia and cannabis discourages open discussion
- CBPMs must not become a new form of chemical restraint used to make care more convenient
- Should be a potentially safer alternative that improves the quality of life and supports autonomy
- Antipsychotic drugs, currently used to make patients ‘easier to manage’ have serious side effects
Research priorities
- Systematic review: Rigorous synthesis of all existing trials and observational data
- Qualitative studies: In-depth interviews with patients and carers to capture lived experience and inform NICE guidance
- Longitudinal cohorts: Add CBPM variables to major ageing studies to assess long-term associations with cognition and brain health
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