UK Medical Cannabis Prescriptions Hit 1.7 Million in 2025 as ACMD Review Approaches

New Freedom of Information data shows English community pharmacies dispensed 1,701,064 private unlicensed cannabis items in 2025, up 154% from 2024. UK imports of unlicensed cannabis flower reached 30,120 kg, with Canada supplying 57%, and THC extract imports rose 246% to 395.5 kg. The figures land as the Advisory Council on the Misuse of Drugs nears its scheduled summer 2026 review of the UK medical cannabis framework.

More than a year after the Advisory Council on the Misuse of Drugs was commissioned to review the UK medical cannabis industry, new Freedom of Information data reveals the scale of a market that has continued to expand with minimal political scrutiny. The private unlicensed specials market grew by 154% between 2024 and 2025, from 668,511 items to 1,701,064 dispensed in English community pharmacies, according to NHS Business Services Authority data secured by Prohibition Partners.

The growth curve has steepened since 2019, when just 278 items were dispensed in the first full calendar year of private unlicensed cannabis at scale. By January 2026, the most recent month of complete data, English community pharmacies dispensed 80,331 items, suggesting an annualised run rate of just under one million items. The NHSBSA cautions that figures may be revised upward as prescriptions are submitted in later months.

Supply-side data from the Home Office tracks the same trajectory. UK imports of unlicensed cannabis flower reached 30,120 kg in 2025, up from 15,025 kg in 2024. Canada is now the source of 57% of that volume, shipping 17,067 kg directly to the UK, up from 2,579 kg the year before. Portugal grew its shipments ten-fold since 2023 to 3,971 kg, while Spain, once the dominant European processing hub, saw quarterly volumes fall from 1,570 kg in Q1 2025 to 252 kg in Q4.

For the first time, Home Office data also captures Δ9-tetrahydrocannabinol extracts, tracked separately only since 2024 following changes to INCB international reporting standards. Extract imports rose from 114.3 kg in 2024 to 395.5 kg in 2025, a 246% year-on-year increase. Spain led on volume with 156.1 kg, but Canadian extract shipments rose 32-fold from 4.8 kg to 152.3 kg in a single year.

Comparing the two datasets, community pharmacies dispensed approximately 19.4 tonnes of flower to patients across 1.4 million flower items in 2025, an average of 13.7 grams per item. Against 30.1 tonnes imported, the roughly 10.8-tonne gap maps closely to Q4 2025's import volume of 11,898 kg, pointing to wholesale-scale year-end build-up in the supply chain ahead of Q1 2026 dispensing.

The raw NHSBSA dataset contained more than 375,000 line items across seven years and captured 10,190 distinct product name entries in 2025 alone. Most are duplicates of the same underlying products entered under slight variations in spelling, potency notation and volume, because unlicensed prescriptions are captured as free-text on the NHS system and only identified as cannabis through subsequent manual review.

The ACMD's November 2020 review recommended a CBPM patient registry as crucial for future assessments, but when the registry launched in mid-2025 it captured around 1,000 NHS patients on Sativex, Epidyolex and Nabilone and explicitly excluded the estimated 60,000-plus private patients through which the market has actually grown. For an estimated 100,000 UK patients receiving treatment in 2025, the 10,190 distinct product-name variants describe a therapeutic landscape without cross-clinic pharmacopoeia or generic equivalence.

If the ACMD review is published on schedule at the end of summer 2026, it will coincide with the two most consequential years for the UK medical cannabis industry since 2018. The ecosystem has evolved around guidelines that were never intended to regulate a market of this scale.