The short answer
Three categories that share a plant but very little else. Medical cannabis is a prescription medicine: regulated, specialist-prescribed, controlled. CBD products are over-the-counter food supplements with strict THC limits and no medical claims. Recreational cannabis is a Class B controlled drug. Confusing the three is the most common conversation we have with new patients.
Prescription → medical cannabis; pharmacy shelf → CBD; corner shop → still illegal.
Medical cannabis (CBPMs)
What it is. A prescription medicine called a cannabis-based product for medicinal use (CBPM). Contains controlled cannabinoids — typically THC, CBD, or both — at clinical doses.
Legal status. Schedule 2 controlled drug under the Misuse of Drugs (Amendments) Regulations 2018. Prescription-only.
Who can prescribe. Only doctors on the GMC’s Specialist Register, working within their area of training, prescribing on a named-patient basis. The legal framework sets the rules tightly.
Where you get it. A private specialist consultation, then a private prescription dispensed by a licensed pharmacy. In rare cases, NHS specialists prescribe under NICE-approved indications.
What it costs. Consultation fee plus medication cost. We’ve written a transparent pricing guide.
CBD products
What they are. Over-the-counter products containing cannabidiol (CBD), with the controlled cannabinoid (THC) removed or reduced below regulatory limits. Sold as oils, capsules, drinks, balms, cosmetics, and food supplements.
Legal status. Not a controlled drug. Regulated by the Food Standards Agency as a Novel Food. To be legally sold in England and Wales, an ingestible CBD product must contain no more than 1 mg of THC per container — a much tighter limit than is generally believed.
Who can sell it. Any retailer. Boots, Holland & Barrett, supermarkets, online. No prescription needed.
What it claims (or doesn’t). Under UK advertising law, an OTC CBD product cannot make medical claims. Sellers can describe it as a “wellness” or “food supplement” but cannot say it treats anxiety, pain, or any condition. The Home Office’s drug licensing factsheet sets out the distinction.
What it costs. £20–£120 a month for typical doses. No clinical supervision.
Recreational cannabis
What it is. Cannabis used outside a clinical context — for relaxation, social use, or self-medication without a prescription.
Legal status. Class B controlled drug under the Misuse of Drugs Act 1971. Unauthorised possession, supply, and cultivation remain criminal offences. The 2018 reclassification explicitly did not change this.
Penalties. Up to 5 years for possession, up to 14 years for supply or production.
The grey area. Patients who self-medicate without a prescription — because private clinics are unaffordable, or the NHS pathway is closed to them — are technically committing a criminal offence. We are not blind to this. The legal route remains the safer one.
Side by side
- Regulator. CBPMs: MHRA + + GMC. CBD: FSA + Trading Standards. Recreational: Home Office.
- Prescription needed? CBPMs: yes. CBD: no. Recreational: not legal regardless.
- THC content. CBPMs: clinical doses. CBD: ≤1 mg per container. Recreational: typically 10–25%.
- Medical claims allowed? CBPMs: yes, by the specialist. CBD: no. Recreational: irrelevant — illegal.
- Quality control. CBPMs: pharmaceutical standards. CBD: variable. Recreational: none.
Common misconceptions
“CBD is just low-dose medical cannabis.” No. Medical cannabis is a controlled prescription medicine; CBD is a food supplement. Different regulators, different legal categories.
“If CBD didn’t work, medical cannabis won’t either.” Often the opposite. Many patients who get little from CBD respond to formulations with clinically dosed THC — because THC is the cannabinoid doing much of the analgesic and sleep-modulating work.
“Medical cannabis is just legalised recreational cannabis.” No. The two are different categories in UK law.
How Xen Health fits in
If you’ve been trying CBD and it isn’t quite enough, a specialist consultation is the right next step — not more CBD. Xen Health offers a complimentary first consultation with a doctor on the GMC’s Specialist Register, with no GP referral required.
This article is for general information. It is not medical advice and is not a substitute for a consultation with a qualified specialist. Whether medical cannabis is appropriate for any individual is a clinical decision that rests with the prescribing doctor on the basis of medical history and a full assessment.