Britain now runs one of the fastest-growing medical cannabis markets in Europe. In 2025, pharmacies in England handed out 1,701,064 prescription items of cannabis medicine. Six years earlier, that number was 278. Not 278,000 — two hundred and seventy-eight. The entire system has grown by a factor of more than six thousand in the time it takes a child to get through primary school, and almost nobody in Westminster has noticed.
The figures come from the NHS Business Services Authority, which released them on 30 July 2026 in response to a Freedom of Information request. The full dataset is published as FOI-03941 on the NHSBSA open data portal, and it was first analysed in detail by Business of Cannabis, with additional import data obtained by Prohibition Partners from the Home Office. Together they give the clearest picture yet of a market that has been growing quietly, expensively, and almost entirely outside the National Health Service.
Key Takeaways
The headline number is real but it needs translating. England dispensed 1.7 million cannabis prescription items in 2025, up 154% on the year before — but “items” are not people. Roughly 100,000 patients were actually being treated, because one person on two or three different products with monthly repeat scripts generates a dozen or more items a year. Of those patients, more than 60,000 pay privately, out of their own pockets. Only around 1,000 are treated through the NHS, and mostly with the three licensed products the health service recognises. Supply follows the same curve: the UK imported 30,120 kg of cannabis flower in 2025, double the previous year, with Canada alone supplying 57% of it. All of this has happened under rules drafted in 2018 for a market nobody expected to reach this size, and a government advisory review due within weeks may be the first serious attempt to catch up.
From 278 Items to 1.7 Million in Six Years
The growth curve here is unusual even by cannabis-industry standards. In 2019, the first full year after Britain rescheduled cannabis-based medicines, English pharmacies dispensed 278 items. The following year it was 4,469. Then 43,932 in 2021, 124,247 in 2022, 282,979 in 2023 and 668,511 in 2024. Each of the last three years roughly doubled or better: growth of 128%, then 136%, then 154%.
Curves like this usually flatten. This one has been getting steeper. January 2026 alone accounted for 80,331 items — and that figure should be read as a floor rather than a ceiling. The way the NHS captures these prescriptions is genuinely clumsy: unlicensed products first enter the system as an “unspecified drug” and are only identified as cannabis during a later manual review. The NHSBSA warns openly that its own numbers can move as late paperwork arrives. Even taken conservatively, January’s total points to an annual run rate approaching a million items.
One important caveat about geography: this dataset covers community pharmacies in England, not the whole of the UK. Scotland, Wales and Northern Ireland report separately. The trend is the story here, not a precise national headcount.
Why 1.7 Million Prescriptions Is Not 1.7 Million Patients
This is where most coverage of the figures goes wrong, so it is worth slowing down.
A “prescription item” is one product on one prescription, dispensed once. A patient using a flower variety for daytime, a different one for night, and an oil alongside them, all renewed monthly, will generate more than thirty items in a year without anything unusual happening. The real number of people receiving cannabis medicine in Britain in 2025 was somewhere around 100,000.
That gap matters because the two numbers get used to argue opposite things. The million-plus figure sounds like an explosion of use; the hundred-thousand figure describes a patient population smaller than the number of people in Britain with epilepsy alone. Both are true. Only one of them is a headline.
The £1,500-a-Month Problem Nobody Voted For
The most revealing part of the British data is not the growth. It is who is paying for it.
Of roughly 100,000 patients, more than 60,000 are private self-payers. Around 1,000 are treated through the NHS, essentially limited to the three products the health service has licensed and approved: Sativex, Epidyolex and Nabilone. Everyone else buys their medicine the way you would buy a private dental crown.
For some families, that arithmetic is brutal. Parents of children with treatment-resistant epilepsy have reported paying around £1,500 a month out of pocket — for products the government’s own 2020 advisory review acknowledged had no established evidence on cost-effectiveness. It is a strange position for a country with universal healthcare to end up in: the medicine is legal, prescribable and widely dispensed, and almost none of it is funded.
The evidence picture explains part of the reluctance without excusing the outcome. When researchers recently screened close to four thousand studies on cannabidiol across neurological conditions, only one indication cleared the bar for solid clinical evidence — and that indication was childhood epilepsy, which is precisely where the licensed NHS product exists. Outside that narrow window, the trials that funders want simply have not been run at the scale required, and a market built on private prescriptions generates revenue rather than randomised data.
Canada Now Supplies More Than Half of Britain’s Cannabis
The supply side, disclosed separately by the Home Office, tracks demand almost exactly. Britain imported 30,120 kg of cannabis flower in 2025, up from 15,025 kg in 2024. Divide 30 tonnes by 1.7 million items and you get just under 18 grams per item — consistent with a market built on 10-gram and 28-gram flower units. Supply and demand data collected by two entirely separate government bodies landing on the same answer is a good sign that both are roughly right.
What has changed is where it comes from. Canadian producers shipped 17,067 kg directly to the UK in 2025 — 57% of the total, up from 2,579 kg the year before. They did it by processing product in their own EU-GMP facilities and shipping direct, rather than routing through the Spanish and Portuguese converters that used to dominate. Portugal has grown ten-fold since 2023 and now supplies about 13%. Spain, once the hub, saw quarterly volumes fall from 1,570 kg in early 2025 to 252 kg by the end of it.
Extracts — oils, tinctures, vape cartridge preparations — are the smaller but faster-moving category, rising from 114.3 kg to 395.5 kg, a 246% jump. Canadian extract shipments went from 4.8 kg to 152.3 kg in a single year.
That shift towards processed formats is not accidental. Spain’s new medical cannabis framework excludes raw flower entirely in favour of extract-based preparations, and France’s 2026 rules restrict flower to sealed vape formats. Europe is drifting away from dried flower as a medicine, and the supply chain is repositioning ahead of the regulators.
10,190 Product Names and One Very Confused Database
Buried in the FOI release is a detail that says more about the system than any growth chart. The raw dataset contains over 375,000 line items across seven years. In 2025 alone, it recorded 10,190 distinct product names.
Most of those are not distinct products. They are the same medicines typed slightly differently — variations in spelling, potency notation and volume — because unlicensed prescriptions are captured as free text, often from handwritten scripts, and only sorted out later by hand.
For a clinician, that means no shared reference list between clinics, no generic equivalents, and no standardised way to prescribe. For a regulator trying to assess whether the system works, it means the underlying data is close to unusable at the level of detail a formal evidence review would need. The 2020 advisory review recommended a national patient registry precisely to fix this. The registry finally launched in mid-2025, four years late, capturing around 1,000 NHS patients — and explicitly excluding the tens of thousands of private patients through whom the market has actually grown.
Fragmented rules producing fragmented data is a familiar European story. A recent comparison found that CBD regulation across nine European countries follows nine different rulebooks, with barely any trained professionals to interpret them. Britain’s version of that problem is simply larger, because Britain’s market is larger.
The Review That Lands in a Few Weeks
Hanging over all of this is the Advisory Council on the Misuse of Drugs. More than a year ago it was commissioned to conduct a formal review of Britain’s medical cannabis sector. It issued a call for evidence and has said very little since. Publication is expected by the end of summer 2026 — which is to say, imminently.
The last comparable review was published in November 2020, when the market was more than thirty times smaller. Whatever the ACMD recommends will therefore land on a completely different landscape from the one it last examined. Industry sources describe growing unease within the ACMD and the medicines regulator about how much of the British market is dried flower, particularly products carrying branding borrowed from recreational markets.
What Britain’s Numbers Mean for Everyone Else
For the rest of Europe, the British case is a natural experiment in what happens when a country legalises medical access but leaves the funding question unanswered.
Germany offers the contrast. Its imports crossed 200 tonnes in 2025, several times Britain’s volume, and its data quality has its own problems — earlier this year a 17-tonne correction turned an apparent German market collapse into a record quarter. But Germany has spent the past two years fighting publicly over reimbursement rules, precisely because the alternative is visible across the Channel. Britain shows that restricting public funding does not reduce demand. It relocates demand into the private sector, where it grows faster, costs patients more, and produces worse data.
Six years ago, Britain was still debating whether to hold a referendum on cannabis legalisation. Today it treats six-figure patient numbers under a framework that was never designed for them, with no change to the underlying law on recreational use. The medical market has grown past the politics. Whether the coming review closes that gap or merely describes it will be clear within weeks.
Frequently Asked Questions
Around 100,000 patients received cannabis medicine in 2025. The widely quoted figure of 1.7 million refers to prescription items dispensed, not individuals. A single patient using several products with monthly repeats can account for dozens of items in a year.
Only in a small minority of cases. Roughly 1,000 patients are treated through the NHS, mainly with the three licensed products — Sativex, Epidyolex and Nabilone. Everyone else is a private patient covering the cost themselves, which for some families runs to around £1,500 a month.
Almost all of it is imported. In 2025 the UK brought in 30,120 kg of flower, roughly double the previous year. Canada supplied 17,067 kg, about 57% of the total, with Portugal and Spain accounting for most of the European share.
The Advisory Council on the Misuse of Drugs is the body that advises the UK government on drug policy. It was commissioned over a year ago to review the medical cannabis sector and is expected to report by the end of summer 2026. Its last review of this kind was published in November 2020, when the market was more than thirty times smaller — so its recommendations will apply to a completely different situation from the one it previously assessed.
Disclaimer
This article is journalistic reporting on published government data and is provided for general information only. It does not constitute medical advice, legal advice, or a recommendation regarding any treatment or product. Cannabis laws and access routes to medical cannabis differ substantially between countries and may change. Decisions about medical treatment should be made only in consultation with a qualified healthcare professional. Figures cited reflect data published as of August 2026 and may be revised by the issuing authorities.
