Do doctors write prescriptions for cbd oil

Do doctors write prescriptions for cbd oil

Despite last year’s change in the law legalising the supply of medical cannabis, NHS patients in need are still being refused prescriptions

May 22, 2019

Stephen can’t work. In fact, he can barely walk. He describes the pain he feels as persistent torture. “It started in my shoulder four weeks after the birth of my first child,” he says. “I didn’t know what was causing it, just that the pain was excruciating.”

After a battery of tests, Stephen was diagnosed with facioscapulohumeral muscular dystrophy, a muscle-wasting condition which affects between 2,000 and 2,500 people in the UK.

I can sleep, eat; my mobility is better and I can feel like and be me. Cannabis gives me hope of some sort of a normal life

Stephen, who also suffers from fibromyalgia, which affects his right arm, both hands, lower back, hips, legs and both feet, was given a range of strong pain-killing drugs, including co-codamol, pregabalin and tramadol. But he stopped taking them after being unable to cope with terrible side effects, which put him in a zombie-like state and left him with suicidal thoughts.

Sufferers of chronic pain still have to buy cannabis illegally

It was then that Stephen turned to cannabis. He has been using it for nearly five years to treat all his symptoms. He calls it a miracle drug: “It saved my life. I can sleep, eat; my mobility is better and, most importantly, I can feel like and be me. Cannabis gives me hope of some sort of a normal life.”

But there’s a problem. Stephen uses one gram of cannabis a day to treat his condition and says he has no choice but to buy it from a drug dealer. “I hate the fact that I have to break the law to get my supply and, because this is unregulated, it is very costly,” he says.

However, why are Stephen and thousands of others in the UK still risking their liberty to buy cannabis? Last October, the Home Office changed the law, giving specialist doctors the go-ahead to prescribe cannabis-based medicines legally. Yet, curiously, seven months on, despite there being 80,000 UK doctors who are legally certified to prescribe medical cannabis, not a single NHS prescription has been given out, according to Jon Liebling, chief researcher at the Centre for Medicinal Cannabis.

Mr Liebling, who is also co-founder and director of Cannabis Patient Advocacy and Support Services, says apparent intransigence by the NHS and local authorities has only served to stigmatise and alienate patients.

“We’ve seen doctors being very strongly encouraged not to write prescriptions,” he says. “Patients have been banned from trust hospitals and we know of at least two doctors who have been threatened with being reported to the General Medical Council, or getting into severe difficulty, should they even submit a prescription.”

Why aren’t doctors prescribing medical cannabis?

So why do doctors, who have been licensed to do so, still feel unable to prescribe medicinal cannabis?

Mr Liebling explains: “Firstly, a lack of clinical evidence and a paucity of medical professional knowledge of cannabis and cannabis-based medicinal products (CBMPs) has had a paralysing effect on the NHS. Secondly, because all CBMPs, with the exception of Sativex, which is a fully licensed drug, doctors are not insured to prescribe them, meaning if a patient were to have an adverse reaction, that doctor or the trust, where he or she works, could be deemed culpable.”

However, Royal College of Physicians’ president Professor Andrew Goddard says doctors may be reluctant to prescribe cannabidiol (CBD), with or without tetrahydrocannabinol (THC), for adults with chronic pain because of the weakness of the evidence for benefit as opposed to harm.

“Recent studies show that only 29 per cent of adults with chronic pain would experience a 30 per cent improvement in pain or, put another way, you would need to treat twenty four people to see benefit in one person. When it comes to the harms of those drugs, you only need to treat six people to see significant harms,” he says. “Furthermore, none of the studies has shown whether or not quality of life has been improved.”

Mr Liebling disagrees, doubting current randomised controlled trials which, he says, only test one strain of medical cannabis against a placebo. “If a more varied and nuanced cycle of trials was conducted, which tested varying of levels of THC and CBD together, we would probably see a much larger proportion of adults benefiting; maybe as many as 80 per cent,” he claims.

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There are a range of medicines based on cannabis out there

Another limiting factor is cost. According to the Royal College of Physicians, figures presented to MPs on the Health Select Committee range from £500 a month to £25,000 a year. However, Mr Liebling says there are cheaper, and effective, CBMPs available.

The National Institute for Health and Care Excellence is due to publish guidelines in the autumn, which it is hoped will give doctors the information they require to consider prescribing medical cannabis.

Also the University of Birmingham is working with the NHS to produce an education programme, while the University of Bath and University College London have written a review for The BMJ, which provides advice for doctors who may wish to prescribe medicinal cannabis products to treat their patients in the interim.

Tom Freeman of the University of Bath’s Addiction and Mental Health Group says: “In the review, we looked at a range of studies which revealed how cancer patients, and those suffering from MS, epilepsy and chronic pain responded to cannabis-based medicines. The studies demonstrate that medicines based on cannabis and cannabinoids are diverse.

“One of the key takeaway messages is that different cannabinoids have different uses. Take THC and CBD. Several studies have shown that used in combination, THC and CBD can alleviate chronic pain. Others reveal CBD on its own can be used to treat epilepsy, while THC could prove to be an effective drug to treat vomiting brought on by chemotherapy.”

Will doctors ever feel confident prescribing cannabis?

So how long before the stigma attached to medical cannabis disappears and doctors feel confident to prescribe it?

Dr Freeman says: “Now medical cannabis is no longer categorised as a schedule 1 drug, the National Institute of Health Research has announced a specific funding call dedicated to cannabis-based medicines. While research takes time, as a result of these changes in legislation, more funding will be released, the results of which will shed new light on possible future use-cases.”

Mr Liebling agrees that trials are the only way to resolve the impasse and thinks one comprehensive, randomised controlled trial could be enough.

“I believe that if the trial is robust, fully randomised and stakeholders agree it could end early, should results prove conclusive in favour of medical cannabis at an early stage, we could see changes within 18 months, rather than three to five years,” he says.

For Stephen, just one of many hundreds of thousands in the UK who suffer from chronic pain, it’s a change that can’t come soon enough.

Do You Need a Prescription for CBD Oil?

You will find CBD infused into everything from candy to bath salts these days. However, CBD oil is one of the most popular ways of taking the substance. A growing number of companies are springing up offering their take on CBD oil, but the legality of this is somewhat hazy.

In 2018, the updated Farm Bill ensured that the cultivation of Cannabis sativa L. plants containing less than 0.3% THC became federally legal. Following this, hemp was removed from the Controlled Substances Act, and the market exploded unprecedentedly.

Yet, while CBD companies and consumers celebrate this important change, there is just one small catch. The Farm Bill also preserved the rights of the Food and Drug Administration (FDA) to regulate all cannabis-based products under the Food, Drug, and Cosmetic Act. So, while many companies state that their CBD is legal in all 50 states, this is not necessarily the case.

This article explores the confusing laws surrounding cannabis-based medicine and whether you need a prescription for CBD oil. Read on to find out more.

Is CBD Oil Legal?

Technically, the 2018 Farm Bill didn’t legalize CBD or any other cannabinoids. Instead, it permitted the growth of industrial hemp containing a maximum THC content of 0.3%. Therefore, CBD is not a federally legal substance, but hemp is.

Consequently, states are free to set their own CBD laws. In general, most locations follow the lead of the 2018 Farm Bill and tolerate the sale of low-THC CBD products derived from hemp.

However, a couple of states have different rules. In Idaho, CBD products must not contain any THC whatsoever. In Kansas, such items can’t include more than 0.1%. Every other state seems to allow the sale and use of hemp-derived CBD oil with an upper limit of 0.3% THC by dry weight.

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To confuse matters, some states have medical marijuana laws that permit patients to access low-THC oil with a doctor’s recommendation. Products can contain more than 0.3% THC in these locations but less than a specific percentage. Let’s find out more below.

Do You Need to Get a Prescription for CBD Oil?

At the time of writing, a significant majority of states have medical marijuana laws in place. If you are lucky enough to live in one of these states, you can apply for a medical card and get access to a whole range of different cannabis-based products.

However, if you are in one of the remaining states, CBD oil may be your only option.

It is not usually necessary to obtain a prescription or a recommendation from a doctor for hemp-derived CBD that contains less than 0.3% THC (see above for exceptions). However, in some states, patients can use CBD oil that contains more than 0.3% THC if they have a medical marijuana card or exception.

For example, in Georgia, the Low THC Oil Registry allows qualifying patients to possess CBD oil with a THC content of up to 5%. In Tennessee, the maximum THC limit is 0.9%.

However, please note that various states’ CBD and MMJ laws change regularly. If you want to know whether you need a written recommendation for CBD oil in your area, we recommend that you contact your local health department for further information.

How to Get a CBD Prescription Legally

Both hemp and marijuana come from the Cannabis sativa L. plant. The main differences relate to THC content and legality, with one dictating the other. While hemp is no longer a controlled substance, marijuana still is.

Any cannabis plant that contains more than 0.3% THC is considered marijuana and is, therefore, federally illegal. Consumers can only use such products in states where recreational marijuana is legal or if they live in a state with a medical marijuana program and have a valid MMJ card.

Obtaining an MMJ card varies depending on where you live. The type of product you can get may also vary.

The MMJ application process varies according to where a person lives. However, in most cases, the process begins with a doctor’s consultation. They ask questions about the person’s health and determine whether marijuana will help them. It is only possible to proceed with an MMJ card application once the individual has received the physician’s certification.

Most states enable patients to apply via an online registry. If their application is approved, the state’s Department of Health sends them a medical marijuana card. Then, they can finally buy CBD products containing more than 0.3% THC, otherwise known as marijuana products.

If the above sounds long-winded, remember that consumers don’t need a prescription for hemp-derived CBD with 0.3% THC or less!

Can Doctors Prescribe CBD Oil?

No. Doctors in the United States are not allowed to prescribe any CBD product. It is the same situation as medical marijuana. Neither CBD nor THC are federally legal substances. Therefore, a physician can recommend CBD oil or MMJ but isn’t permitted to write a prescription for either.

They can also recommend a certain dosage in states where the maximum marijuana limit isn’t set in stone. Some states also permit doctors to recommend increasing a patient’s marijuana dosage depending on the medical condition.

Which CBD Products Are Approved by the FDA?

The only cannabidiol product that the FDA currently approves is Epidiolex. GW Pharmaceuticals developed this medicine. It is approved to treat drug-resistant forms of epilepsy such as Dravet syndrome, Lennox-Gastaut syndrome, and also tuberous sclerosis complex (TSC). As the product has undergone rigorous testing, the FDA has deemed it safe and effective. Sadly, this is more than can be said for other forms of CBD.

Thanks to the illegal status of cannabis for the last century, research into the plant has been severely lacking. Its use as a supplement or food additive is also currently unapproved.

The FDA does allow the use of CBD in cosmetic products, although this is also subject to strict regulations. The actual legality of CBD depends on how it is labeled and marketed, which is where many companies fall foul of the law.

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Aside from the dubious legality of many CBD products, customers are presented with another significant problem. Until the FDA fully approves CBD oil as a medicine or supplement, the market will remain completely unregulated. This lack of scrutiny leaves manufacturers free to produce low-quality oils, which at best may have no effect, and at worst, might damage consumer health.

Therefore, if you intend to use CBD, be sure to find a reputable source.

Where Can You Buy CBD Oil Over the Counter?

While CBD oil is widely available online, consumers in select states can purchase over-the-counter CBD at drugstores such as CVS and Walgreens. However, many stores play it safe by only stocking topical products that comply with the FDA’s stringent guidelines.

If you live in a more liberal state, you may also find CBD in specialist stores. There have even been reports of the cannabinoid being sold at gas stations in some states! Whether these products are reliable or not is an entirely different matter, though.

Remember to buy CBD from a reputable brand and not get sucked in by low prices. You get what you pay for in the CBD world, and if the cost of a product seems too good to be true, it probably is.

For some of our top-rated CBD oils, check out this article on the Top CBD Oil Brands for 2021.

All the answers in one post…

Can You Order Cannabis Oil Online Without a Prescription?

The answer is ‘yes’ if the oil in question contains a maximum of 0.3% THC and is deemed to come from industrial hemp. In that case, top-rated brands such as PureKana have you covered as they ship CBD products to most states.

Things get more complicated regarding cannabis oil classified as marijuana products. If consumers can legally buy marijuana in their state, they can purchase it online from a licensed dispensary within the same state. Some dispensaries offer curbside delivery, while others allow online orders for pick-up only.

As marijuana is federally illegal, it remains a crime to transport it across state lines. It doesn’t matter if a person is traveling from one legal state to another. Therefore, ordering high-THC cannabis oil from a vendor in another state could result in federal criminal prosecution.

However, there are cannabinoids offering an intoxicating high that aren’t yet federally illegal. For instance, there is no federal regulation of delta-8-THC, although numerous states have banned it. Delta-8 provides approximately half the level of intoxication as the delta-9-THC found in marijuana. Brands such as Premium Jane are considered among the most reputable sellers of Delta-8.

Further examples of cannabinoids offering varying levels of intoxication that aren’t yet federally illegal include:

If interested in any of the above, Binoid is regarded as one of the most trustworthy vendors.

However, please note that there are calls to ban all of the above federally. Already, there’s a decent chance that for some readers, their state has already made some, if not all, of these cannabinoids illegal. Make sure to check your state’s laws before considering a purchase.

Do You Need a Prescription for CBD Oil? Final Thoughts

Although CBD and cannabis-based medicines are becoming more widely available, residents of certain states may still have some difficulty accessing them. For example, if you reside in a state with a CBD oil registry, you will need to have one of the listed qualifying conditions and get approval from your doctor.

However, most Americans can now enjoy easy access to CBD oil, either online or in retail stores. While this news is undoubtedly positive, it does highlight the need for caution when choosing products. Some brands offer high-quality CBD in a largely unregulated market, while others fail to make the grade.

Until the FDA relaxes its stance on cannabis-based products, this situation is unlikely to change. So, however you get hold of your CBD, be sure to choose a brand that you can trust. Don’t get lured in by flashy packaging or low prices. Instead, look for a well-established, reliable company with positive customer reviews.

Finally, ensure that you are familiar with your area’s CBD rules and regulations. There is a lot of misinformation out there, so do your own research and stay on the right side of the law.