Cannabis Health Symposium 2025 – Key Takeaways Part 2
November 27, 2025
The afternoon sessions at Tuesday’s inaugural Cannabis Health Symposium 2025 moved beyond the fundamentals of cannabis medicine and its potential, to the practical realities of prescribing this relatively new medicine in the UK.
These in-depth talks spanned everything from pharmacy standards and product quality to the specific challenges of prescribing for women’s health, pain management, and vulnerable patient groups.
What became abundantly clear throughout the day was that this is, and always has been, an industry driven by patients and their powerful stories, a theme that came into sharp focus during the day’s closing panel discussion.
The Role of the Pharmacist: Best Practice for Dispensing CBPMs
Zul Mamon, Partner at Pharma Experts and Senior Responsible Person, opened the afternoon by illustrating the fragility of the current patient experience through the story of Sarah, a 45-year-old patient with chronic pain.
After finally securing a prescription, Sarah was left with delays, silence from both clinic and pharmacy, and no idea how to use her medication. Mamon stressed that her journey is “far more common than we like to admit.”
Key findings from the GPhC report
Referring to the October 2025 General Pharmaceutical Council inspection report, Mamon noted:
- 24 CBPM pharmacies were inspected
- 68 concerns were identified across them
- Major issues centered on lack of access to clinical records, incomplete risk assessments, poor communication, and inappropriate prescribing, which pharmacists were unable to challenge
Without access to patient history, Mamon warned, pharmacists cannot reliably identify contraindications, drug interactions, or duplication of therapy.
Pharmacists as clinical gatekeepers
Mamon outlined that the pharmacist’s role begins long before dispensing:
- Prescription verification: Legality, completeness, prescriber legitimacy
- Clinical safety checks: Interactions, contraindications, product suitability
- Patient education: Dosing, administration, side effects, storage, red-flag symptoms
- Monitoring and intervention: Encourage reporting, liaise with prescribers, adjust plans
Currently, CBPM dispensing has ‘devolved into putting it in a box and shipping it,’ with little or no pharmacist-patient contact.
Training, supply chain, and communication gaps
- Training is often based on unverified sources; some teams had no CBPM-specific training
- Frequent stock shortages, due largely to complex imports and short-dated products
- Poor communication meant clinics were unaware of issues, and patients were left confused
Solutions included digital stock-tracking, proactive clinic-pharmacy communication, robust procurement processes, and shared patient information resources using plain-language explanations.
Three pillars for raising standards
Mamon proposed a sector-wide framework built on:
- Continuous clinical education: Professional networks (MCCS, symposiums, peer forums)
- Quality assurance: Audits, documentation standards, and safeguarding
- Patient-centred care: Active pharmacist involvement throughout treatment journey
He closed by reimagining how Sarah’s journey would have changed if she had been supported by a well-trained pharmacist with clinical records, clear communication lines, and an active role in care.
Exploring the Evidence Base: CBPMs in Psychiatry & Neurodiversity
Dr Niraj Singh explored the use of CBPMs in mental health and neurodivergent populations, an area he described as promising but complex.
Psychiatric and neurodevelopmental conditions
Singh outlined that psychiatric presentations vary widely and often overlap with neurodevelopmental disorders, including anxiety and depression, PTSD, OCD, autism, ADHD, intellectual disability, and dyspraxia. These conditions rarely exist in isolation, and individuals often present with intertwined biological, psychological, and environmental factors.
What the evidence shows
The evidence base is heterogeneous but growing, with studies covering anxiety, PTSD, ADHD, agitation, mood instability, and autism-related symptoms. Real-world data suggest meaningful improvements for selected patients.
THC and CBD show different benefit-risk profiles, and matching patient phenotype to formulation is critical.
Singh cautioned that psychiatric patients may respond in non-linear or unexpected ways, so careful titration and monitoring are essential.
Clinical lessons from practice
Key insights:
- Some neurodivergent patients experience paradoxical reactions (e.g., CBD causing sedation or agitation)
- Many benefit most from balanced oils or high-CBD daytime formulations
- Women, on average, may require lower THC doses than men, though not universally
The emphasis was on personalisation and recognising that ‘one size does not fit all.’
Ethical and safety considerations
Singh highlighted the need for clinicians to understand vulnerabilities such as co-morbid trauma, emotional dysregulation, or sensory sensitivity. The importance of informed consent and close follow-up cannot be overstated, and future research should focus on granular subgroups, not broad diagnostic labels.
From Plant to Patient: Safety, Quality & Consistency in CBPMs
Dr Callie Seaman, plant scientist and formulation chemist, delivered a densely informative deep-dive into how pharmaceutical-grade cannabis is grown, processed, and standardised.
Chemotypes and cannabinoid profiles
Seaman outlined three core chemotypes:
- Type I: High THC
- Type II: Balanced THC:CBD
- Type III: High CBD, low THC
She noted emerging Type IV/V products rich in minor cannabinoids (e.g., CBDV), though few appear on UK formularies.
Why only the female flower matters
Male plants produce little biomass and minimal cannabinoids. The medically relevant compounds reside in glandular trichomes of unfertilized female flowers, which contain cannabinoids, terpenes, flavonoids, lipids, and other secondary metabolites.
Environmental influence and stress response
Cannabinoid and terpene expression is highly dependent on light spectrum and intensity, temperature, nutrient availability, abiotic and biotic stress, and genetics. Stress triggers increased production of defensive secondary metabolites—many of which have therapeutic activity.
Cannabinoids, terpenes, and flavonoids
Seaman highlighted:
- 147+ cannabinoids, many of significant pharmacological interest
- Over 200 terpenes with roles in synergy and anti-microbial defense
- Under-researched flavonoids, including cannabis-specific cannflavins A, B, and C
Flavonoids, she noted, warrant far more attention given their potential therapeutic relevance.
Cultivation, harvesting, and production
Seaman compared cultivation methods:
- Indoor: High control, high cost
- Greenhouse: Blended natural/supplementary light
- Outdoor/field: Cheaper but high contamination risk
She detailed processes including phenohunting, cloning, flowering, trimming, curing, moisture control, extraction, and GMP packaging.
Why full-extract matters
Seaman contrasted full-plant extracts (retaining secondary compounds) with isolates:
- Isolates often require higher doses for similar effect
- Full-spectrum preparations display more durable outcomes due to synergy
Patient expectations vs clinical reality
Seaman warned clinicians to understand what patients may be used to from the illicit market—”bag appeal,” frostiness, certain aromas—and prepare them for differences in pharmaceutical-grade products.
November 25, 2025
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Panel: The Future of Cannabis Medicine in the UK
This forward-looking discussion brought together Dr Richard Hazlett, Berta Kaguako, Matty Rawding (Curaleaf), and Nabila Chaudhri, covering prescriber recruitment, scaling private practice responsibly, and the path to mainstream adoption.
What does success look like in five years?
Panelists envisioned:
- An integrated pathway including social care
- Reduced barriers for GPs (“GP-initiated prescribing”)
- Greater NHS engagement
- More accessible, standardised formats (pastilles, vaporisers, transdermals)
Education: the biggest bottleneck
The panel described a lack of ECS education in medical training, reliance on self-study and industry-led learning, and widespread stigma among clinicians. They urged anchoring education in physiology, ‘teach the ECS first,’ rather than ‘teaching cannabis.’
Concerns about conflict of interest
Because most education currently comes via private clinics, some clinicians outside the sector perceive bias. Panellists suggested impartial bodies like MCCS should lead guideline development, and noted that published dosing frameworks have already begun to improve confidence.
Regulatory engagement
Consensus emerged that regulatory involvement is currently limited due to an under-resourced NHS and regulators, low political priority, and a small relative market size. However, rising patient numbers will eventually force engagement.
Public perception and stigma
- Sharing clinician and patient lived-experience stories
- Demonstrating functional, high-performing cannabis patients
- Clear differentiation between medical and recreational use
Research: Can we reach the threshold?
RCTs are challenging for flower, but real-world datasets, new digital research platforms, and more standardised non-flower products could bridge the evidence gap.
Cost and NHS feasibility
A striking example was cited: cluster headache treatments costing the NHS £35m/year, whereas CBPMs could dramatically reduce costs if widely prescribed. Cost-savings from reduced polypharmacy and return-to-work outcomes were also highlighted.
If you could make one change today…
Ideas included:
- Allowing specialist GPs to initiate prescribing
- Expanding formats beyond flower
- Standardising metered-dose devices
- Developing robust training pathways
Exploring the Evidence Base: CBPMs for Pain Management
Professor Mike Barnes returned to deliver a detailed review of the evidence supporting cannabis for chronic pain, the most common UK indication, accounting for approximately 55% of prescriptions.
Key takeaways
- Cannabis is analgesic across all pain types, including neuropathic, spasticity-related, arthritic, post-surgical, and cancer pain
- Numerous formulations are effective (oils, flower, extracts)
- Evidence includes 66 randomised controlled trials and 20,000+ participants, with a large evidence review booklet due for publication
Analgesic components
The primary analgesic cannabinoid is THC, but CBN, CBC, CBD, THCV, and various terpenes and flavonoids (e.g., myrcene, pinene, quercetin) also contribute. CBD aids pain indirectly via sleep and anxiety improvements.
Dosing in studies
- Typical starting THC dose in trials: 1–2 mg
- Effective range: 10–30 mg/day
- Upper end seen in studies: 50 mg/day
- Real-world average: ~15 mg/day THC
- Studies show no evidence of tolerance escalation
Opioid reduction
Barnes cited consistent findings:
- Approximately 50% of patients reduce opioids by half
- Population-level modelling suggests a 25% reduction in opioid deaths
Safety
In a study of 3-month prescribing:
- 97% reported no significant side effects
- Mild effects included dry mouth, dizziness, and (at higher doses) transient anxiety/sedation
Cost effectiveness
Health economic modelling from the University of York indicates:
- Potential £4bn annual NHS savings
- Reduced medication burden
- Improved return-to-work rates
- Decreased secondary care utilisation
Barnes concluded plainly: ‘Cannabis for pain works. Cannabis for pain is safe.’
Practicalities for Prescribing CBPMs in Women’s Health
Dr Dani Gordon, an integrated medicine specialist, explored how CBPMs fit into complex female health across the lifespan.
Where CBPMs help
Gordon highlighted benefits seen in menopause (sleep, anxiety, hot flashes), PMDD, endometriosis, chronic pelvic pain, postpartum symptoms, and neurodivergent women with multi-system presentations. Often, women present with interconnected issues: fatigue, immune dysregulation, pain, anxiety, gut dysfunction, and hormonal variability.
Mechanisms
Cannabinoids modulate pain pathways, inflammatory pathways, the HPA (stress) axis, sleep-wake regulation, and mast cell activation (emerging research for endometriosis).
Real-world observations
- Many endometriosis patients report increased energy, reduced constipation, better function
- PMDD patients often benefit most from high-CBD daytime oils and adjusted dosing around ovulation
- Some neurodivergent women have atypical responses (e.g., paradoxical reactions to CBD)
Prescribing considerations
- Women may require lower THC doses on average
- Treatment often sits alongside HRT, lifestyle medicine, and nutritional strategies
- Tracking symptoms across the menstrual cycle is critical
- Oils are usually first-line; inhaled options remain valuable for acute symptoms
Panel: Learning from Lived Experience – Patient Perspectives
This closing panel centred the voices of patients. Liam O’Dowd, Dr Michelle Nyangereka, Heidi Whitman, Louis Petit, and Robyn Noone, all of whom have extensive personal experience using cannabis to manage illness, often long before formal medical access existed.
Cannabis as a lifeline in complex illness
Patients described using cannabis for epilepsy, fibromyalgia, autoimmune symptoms, perimenopause and menopause, dementia and sundowning, chronic pain and fatigue, and neurodivergence-associated symptoms. For some, it replaced multiple medications; for others, it allowed basic functioning or prevented crisis episodes.
The gap between illicit use and medical prescribing
Many panellists had used cannabis for years before medical access existed. Formal prescribing brought safety, consistency, reduced stigma, and transparent information about cultivars, THC/CBD content, and contaminants. However, some found the process too easy or too narrowly focused (e.g., only on chronic pain), missing the full range of their symptoms.
Dementia care: a powerful case study
Heidi Whitman described caring for her mother with early Alzheimer’s/vascular dementia. Medical cannabis improved agitation, appetite, sleep, and sundowning. A balanced oil given in food or sublingually stabilises symptoms where other medications failed. She stressed the need for elder-friendly delivery formats and a better understanding of geriatrics.
Stigma in mainstream healthcare
Patients reported long-term dismissal of symptoms, fear of disclosing cannabis use, GPs questioning the legitimacy, then later validating their illnesses only after sustained medical cannabis use, and social stigma around inhaled flower.
Access, cost, and inequality
Cost remains the biggest barrier. Many cannot afford long-term prescriptions, some moved between clinics multiple times seeking affordability or more holistic care, and others raised concerns about medical schemes being “too easy to access” for those without genuine clinical need.
Patients want partnership, not gatekeeping
Patients asked clinicians to:
- Treat cannabis as a legitimate medicine
- Recognise complex multi-system illness
- Allow flexible dosing
- Address peri- and post-menopausal needs
- Provide ongoing, not one-off, follow-up
- Offer informed discussion instead of stigma
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