How is CBD different from medical cannabis?

Following National CBD Day earlier this month, we explore some of the key differences between CBD-based wellness products and prescribed medical cannabis.

While legalisation of recreational cannabis may seem far off in the UK, medical cannabis has been legal since 2018 – yet over half (52%) the population are unaware of this fact. And over a third (38%) say they’d be nervous trying it.

Five years on, there remains a common misconception that CBD bought from high street retailers and online is the same as the products which are only available via private prescription. Here the team from Sapphire Clinics, a private clinic prescribing cannabis medicines in the UK, discuss six of the key differences…

Medical cannabis and cannabidiol (CBD) wellness products have different uses

Medical cannabis is reserved for those with significant health conditions which haven’t responded to first-line therapies. It can only be prescribed by doctors for people with appropriate health conditions. Over-the-counter CBD products, however, are purchased by people who want to incorporate them into their wellness routine. As these are not pharmaceutical-grade products there is no evidence to support their use for the treatment of health conditions or symptoms. CBD can affect the metabolism of certain medications and people should still seek advice from a doctor before starting CBD wellness products.

Medical cannabis is only available through a prescription

Medical cannabis can only be obtained with a prescription from a specialist doctor. The decision to prescribe medical cannabis must be made jointly by a multidisciplinary team of doctors from different specialties to ensure a patient is not only eligible for medical cannabis, but that it would be the most appropriate therapy for them. CBD products, including oils, capsules, and topicals, can be purchased over the counter or online without a prescription.

Medical cannabis contains THC

The cannabis plant contains in excess of 600 active pharmaceutical ingredients. In addition to CBD, one of the most abundant and which we understand its effects on the human body is tetrahydrocannabinol (THC). THC acts on a number of different receptors within the human body, but its effects on the body’s own cannabinoid system are responsible for its main effects. Medical cannabis prescriptions may contain THC when this is deemed to be in the best interests of a patient. THC, however is a controlled drug as it can cause euphoria or concentration impairment when consumed in sufficient qualities. Therefore, wellness CBD products must contain less than the statutory amount of THC to be available to purchase.

Neither medical cannabis or CBD will get you high

CBD does not cause euphoria or the ‘high’ sensation commonly associated with cannabis, even when consumed at high doses. THC, however, can cause the sensation of euphoria. Medical cannabis may contain THC for some, but not all patients. Therefore if consumed in sufficient doses this is a potential side effect of medical cannabis. However, at Sapphire Clinics we use robust prescribing regimes to reduce the likelihood of this happening by starting appropriate patients on a low dose and gradually increasing this over time.

Quantity and quality of evidence varies

Medical cannabis has been studied for its medical applications, and there is a growing body of evidence supporting its use for specific conditions where people have not had benefit from first-line treatments. There is no robust data on the effects of wellness CBD products on health outcomes.

Medical cannabis and CBD are not produced in the same way

Medical cannabis is manufactured in line with pharmaceutical regulations, just like any other medication. This is to ensure consistency of the medication and that it does not contain harmful levels of bacteria, pesticides, or heavy metals which can be found on cannabis that is not manufactured to these standards. CBD wellness products are regulated by novel foods regulations which do provide protection to consumers, but are not as rigorous as those applied to medical cannabis.

A study performed by the Centre of Medicinal Cannabis of 29 widely available CBD products found that only 11 had CBD content within 10% of that advertised on the bottle. In addition, 16 products had measurable levels of controlled substances such as THC. However, this study was performed prior to the introduction of novel foods regulations, which aimed to improve the standards to which these products are held.

All data is from a study commissioned by Sapphire Medical Clinics with Opinium Market Research in February 2023 among 4,000 UK adults.