Clinical Guidance on Cannabis for Medical Use


The Department of Health published the ‘Clinical Guidance for Medical Use’ document in 2019. This document provides both general guidance to clinicians for prescription of CBD: THC products and specific instructions concerning the three medical indications they can be prescribed for.


The Medical Cannabis Access Programme enables a medical consultant to prescribe a cannabis-based treatment for a patient under his or her care for the following medical conditions, where the patient has failed to respond to standard treatments:

Guidelines for Commencing Treatment with Cannabis for Medical Use
  • Doctor-Patient Relationship: doctors must document that an appropriate doctor-patient relationship has been established.
  • Consultant-led Care: Initial prescribing of medical cannabis can only be done by a medical consultant, with appropriate expertise, in this jurisdiction.
  • Informed & Shared Decision-Making: Doctor will use professional judgment when prescribing medical cannabis and a patient will make an informed decision to accept or decline treatment.  A doctor must discuss the risks, benefits, alternatives, and how the MCAP operates with the patient.  If a patient is a minor, then the patient's parent or guardian will need to give consent to treatment.  If the patient cannot consent, the options outlined in the Assisted Decision-Making (Capacity) Act 2015 should be taken into consideration.
  • Patient Medical History: Before initiation, an accurate and thorough history should be confirmed.  This may include:
    • presenting symptoms
    • medical history
    • past medical history
    • psychological and psychiatric history
    • family health history
    • physical examination
    • clinial investiagions
    • medical review
  • Contradictions: The following contradictions should be considered:
    • history of hypersensitivity to any cannabinoid
    • severe and unstable cardiopulmonary disease (angina, peripheral vascular disease,
      cerebrovascular disease and arrhythmias) or risk factors for cardiovascular disease
    • current, active drug dependence, including illicit drugs, alcohol, and prescription
    • breastfeeding
  • Warnings & Precautions: The following should be considered:
    • patients aged 18 years old and under
    • personal or family history of schizophrenia or any psychotic disorder
    • severe liver or renal disease
    • previous drug dependence, including illicit drugs, nicotine, alcohol, and prescription
    • the patient is planning to become pregnant or during pregnancy
    • concomitant medications
    • whether the patient is elderly
  • Initial Treatment Plan: This will be discussed with the patient and should address the following points:
    • Treatment goals
    • Duration of treatment
    • Risk management processes
    • Monitoring arrangements
    • regular reviews of indications
    • Treatment cessation plan
    • Provide patient with information and risks
    • Patient written consent

Oleo is in the process of creating a mobile application to track and monitor patient usage and adverse effects.  It will provide quick and valuable information for the healthcare professional.

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