TREATMENTS
A number of our patients come to Wye Sanctuary asking whether cannabis-based medicinal products (medical cannabis) might help. The answer is different for everyone. Cannabis-based medicinal products are not a cure for chronic pain, and it is not suitable for everyone. However, for carefully selected patients with an unmet clinical need, it may form a useful part of a broader, personalised pain management plan. At Wye Sanctuary, we believe CBMPs should never be viewed as a last resort or a miracle treatment. Instead, they is one of many options that may help improve pain, sleep, function and quality of life.
Cannabis-based medicinal products (CBMPs) are specialist prescription-only medicines. Although CBMPs have been legal in the UK since 2018, they remain subject to strict prescribing regulations. For chronic pain, these medicines are not available through the NHS, meaning that most patients who are suitable for treatment access them through specialist private clinics. At Wye Sanctuary, we have chosen to partner with Leva Clinic, one of the UK’s specialist medical cannabis services. If CBMPs appear to be an appropriate option after your assessment, we can arrange referral to Leva Clinic for specialist prescribing and ongoing follow-up within a robust clinical governance framework.
What does the evidence say?
Research into cannabis-based medicines for persistent pain is still developing. Studies suggest that some people may experience improvements in pain or related symptoms, but the average benefit seen across groups of patients is generally modest and not everyone responds.
This is one reason CBMPs are not considered a routine first-line treatment for chronic pain. At Wye Sanctuary, we consider them in the same way as other treatment options: what has already been tried, what the individual hopes to achieve, what the potential risks are, and whether a carefully monitored trial is reasonable.
The aim is not simply to reduce a pain score. Improvements in sleep, function, activity and quality of life may also be important when deciding whether treatment is worthwhile.
“Cannabis-based medicinal products have received enormous attention in recent years, but it is important to separate evidence from expectation. Like every treatment we recommend, it has potential benefits, limitations and risks. My role is not to persuade patients to take CBMPs, but to help them decide whether it is the right option for their individual circumstances. Through our partnership with Leva Clinic, patients who are suitable can access safe, specialist prescribing within a carefully governed clinical service, while remaining supported through their wider pain management journey.”
Dr Charlotte Small is a Consultant in Anaesthesia and Pain Medicine and also works as Chief Medical Officer for Leva Clinic. Where appropriate, Wye Sanctuary patients may be referred to Leva Clinic for specialist CBMP assessment and prescribing.
Cannabis-based medicinal products contain cannabinoids, naturally occurring compounds found within the cannabis plant. Unlike illicit cannabis, prescribed CBMPs are manufactured under strict quality controls, prescribed by specialist clinicians, individually tailored, legally supplied through licensed pharmacies and regularly reviewed for safety and effectiveness. They are prescribed in a number of formulations including oils, capsules and flower which can be inhaled via a medically approved vaporiser.
CBMPs may be considered for adults living with chronic pain who have tried appropriate conventional treatments, continue to experience significant pain or disability, have an unmet clinical need and have no significant contraindications. Conditions where treatment may be considered include fibromyalgia, chronic neuropathic pain, chronic low back pain, chronic pelvic pain, persistent post-surgical pain, CRPS, hypermobility-related pain and painful diabetic neuropathy.
CBMPs interact with the body’s endocannabinoid system, a network involved in regulating pain, sleep, mood, inflammation and many other bodily functions. Some patients report improvements in pain intensity, sleep quality, muscle tension, anxiety associated with pain, physical function and overall quality of life.
Like any medicine, CBMPs can cause side effects. The most common include drowsiness, dry mouth, dizziness, temporary impairment of concentration, increased appetite and occasional anxiety. Most side effects improve by starting with a very low dose and increasing gradually. Regular follow-up allows treatment to be adjusted to achieve the best balance between benefit and side effects.
CBMPs are not appropriate for everyone. Treatment may not be recommended if you have a history of psychosis or certain severe mental health conditions, pregnancy or breastfeeding, significant uncontrolled heart disease, certain substance use disorders or important medication interactions. A full medical assessment helps determine whether treatment is safe and appropriate.
The goal of treatment is not intoxication. CBMPs are prescribed using carefully selected formulations and doses to improve symptoms while minimising unwanted psychoactive effects. Many patients receive products containing both CBD and THC in carefully balanced ratios. Treatment always begins slowly, allowing your body to adjust safely.
Many patients are able to continue driving legally while taking prescribed CBMPs. However, you must take your medication exactly as prescribed, never drive if you feel impaired, meet DVLA requirements and be able to demonstrate that your medication has been legally prescribed if required. Driving is discussed individually as part of every assessment.
No. Patients referred for CBMP treatment through Leva Clinic are expected to stop using illicit cannabis before treatment begins. Illicit cannabis has unpredictable strength and composition, may contain harmful contaminants, makes it impossible to accurately assess prescribed treatment and creates additional safety concerns.
Like many medicines, CBMPs have the potential to cause dependence in some people. Treatment is carefully monitored, prescribed at the lowest effective dose and reviewed regularly. The aim is always to improve quality of life while minimising risks.
CBMPs are never viewed as a replacement for comprehensive pain management. They works best when combined with other evidence-based treatments such as lifestyle medicine, medication optimisation, injection treatments, physiotherapy, Pain Reprocessing Therapy, pain education and psychological support. The most successful treatment plans usually involve several approaches working together.
At Wye Sanctuary, our role is to help you decide whether CBMPs are likely to be an appropriate part of your treatment—not to recommend it for everyone. During your consultation, we’ll explore your symptoms, previous treatments, medical history and personal goals. If CBMPs appear to offer potential benefit, we can refer you to our trusted partners at Leva Clinic, where specialist assessment, prescribing and ongoing monitoring take place within a highly regulated clinical service.