One number has come to dominate the latest discussion about medical cannabis in Britain: 1.7 million.
That is the number of private unlicensed cannabis prescription items recorded for 2025 in a new NHS Business Services Authority disclosure. It is a remarkable total. It also needs careful handling.
It does not mean 1.7 million people received medical cannabis. It does not describe NHS prescribing. It does not tell us whether treatment worked. What it does show is that a large, almost entirely private system has expanded far faster than the public conversation around it.
The raw data deserves attention precisely because the distinction matters. Growth is real. So are the gaps in what Britain measures about the people behind it.
What the NHSBSA data records
The disclosure, FOI-03941, covers private prescriptions for unlicensed cannabis medicines dispensed through community pharmacies in England. The files list the number of times a product appeared on a prescription form, aggregated by month, product name, strength, presentation and volume.
Adding the item counts in the NHSBSA files produces totals of 668,511 items in 2024 and 1,701,064 in 2025. That is an increase of approximately 154% in one year.
The 2025 monthly total rose from 92,136 items in January to a peak of 195,410 in October. December remained substantially higher than the beginning of the year at 158,791 items.
Those numbers provide unusually concrete evidence of scale. They show that private dispensing is no longer a marginal activity measured in a few thousand items. But “item” is the operative word.
A patient may receive more than one product on a prescription and may receive repeated prescriptions across the year. A single item is not a person, a consultation or a course of treatment. The dataset cannot be divided by twelve to produce a reliable patient count, because prescribing frequency and the number of products supplied vary.
The NHSBSA also warns that the data is manually recorded, often from handwritten prescriptions, and that product names, strengths and volumes are not standardised. Late submissions can change recent totals. February 2026, for example, contained only 162 items in the released file because processing was incomplete; January's 80,331 items is therefore the latest month that can be read with more confidence.
The honest headline is not “1.7 million patients”. It is that English community pharmacies recorded 1.7 million private unlicensed cannabis items in 2025, more than two and a half times the previous year's total.
A private system growing in public view
The data concerns private unlicensed medicines, not routine NHS access. That distinction exposes the central contradiction in UK medical cannabis policy.
Cannabis-based products for medicinal use have been available on prescription since November 2018. In practice, the NHS says only a small number of people are likely to receive a cannabis-based medicine through the health service. Most of the expansion has taken place through private clinics, paid for by patients.
The new figures therefore describe market access more clearly than equitable access. They tell us that medicines are being dispensed at scale, but not who can sustain the cost, who stops treatment because of it, or which conditions and outcomes account for the growth.
The Care Quality Commission expects providers prescribing unlicensed cannabis medicines to demonstrate specialist oversight, informed consent, safe prescribing, ongoing monitoring and clear communication with the patient's usual healthcare professionals. As the number of items grows, those requirements become more important—not less.
Volume alone cannot show whether that standard is being met consistently.
New research complicates the picture
A peer-reviewed UK study published in Psychological Medicine adds another layer. Researchers from the University of Bath and University of Waterloo analysed national surveys from 2023 and 2024 involving 4,414 people aged 16 to 65 who had used cannabis in the previous year.
Among that survey population, 12.9% reported having a medical cannabis prescription, 35.9% reported using cannabis for medical reasons without a prescription, and 51.2% reported no medical use.
Only 10.9% of respondents with prescriptions said that all of their cannabis came from their prescription. Prescribed users were also more likely than non-medical users to report frequent use of several processed product types and to screen positive on the study's measure of higher-risk use.
This should not be reduced to the claim that prescriptions cause problematic use. The study was cross-sectional, meaning it measured associations rather than proving a direction of cause. People entering treatment may have more severe symptoms, longer histories of cannabis use or different patterns before receiving a prescription.
It does, however, challenge a simplistic division between a perfectly contained medical market and an entirely separate illicit one. Some people appear to move between multiple sources and products. That creates practical questions about affordability, continuity of supply, dose, product strength and whether clinical conversations capture cannabis obtained outside the prescription.
The researchers argue that prescribing encounters should include clear discussion of product risks, potency and adverse effects, including cannabis-use disorder. That is not an argument against access. It is an argument for treating medical cannabis as medicine: with monitoring, evidence and candid conversations about benefit and harm.
What the figures still cannot tell us
Britain now has detailed records of products moving through pharmacies, but a much thinner national picture of patient outcomes.
The NHSBSA disclosure does not include diagnoses, age, sex, treatment response, adverse events, treatment duration, household cost or reasons for stopping. It cannot show whether a person slept better, returned to work, reduced another medicine or experienced an intolerable side effect.
Nor can it explain the apparent mix of presentations cleanly. The 2025 file contains flower, flos, dried flower and cultivar as separate presentation labels, alongside many blank or inconsistent entries. That is a data-quality problem as well as an administrative inconvenience. A system cannot evaluate prescribing trends confidently if the same kind of product is recorded several different ways.
The Advisory Council on the Misuse of Drugs is reviewing the impact of the 2018 regulatory changes. Its published scope includes whether the legislation achieved its intended effect, what unintended consequences emerged and how those consequences might be mitigated.
The 2025 dispensing total should make one point unavoidable: the next review is assessing an established healthcare market, not a small experiment.
The questions policymakers should now answer
First, how many individual patients are receiving private and NHS prescriptions? Item counts are valuable, but patient-level totals are necessary for understanding access, continuity and safety.
Second, what outcomes are being measured consistently across providers? Clinics should not need identical treatment models, but the country needs a common minimum dataset covering indication, formulation, dose, patient-reported benefit, adverse events and discontinuation.
Third, how concentrated is prescribing? The public should be able to understand whether rapid growth is distributed across many specialist teams or driven by a smaller number of high-volume services.
Fourth, what is the financial burden? A private prescription is not meaningful access if a patient repeatedly interrupts treatment because consultation, repeat-prescription and medicine costs are unaffordable.
Finally, how should information flow between private clinics, GPs, hospitals and pharmacies? Patients should not be expected to act as the sole messenger between disconnected parts of the healthcare system.
The editorial view
The rise from 668,511 items to 1.7 million in a year is not a statistical curiosity. It is evidence that patient demand and commercial provision have moved far ahead of the public infrastructure built to understand them.
That growth should not be used as a substitute for evidence of effectiveness. Nor should incomplete outcome data be used to pretend that the patients do not exist.
Britain needs a national view that joins scale to safety: accurate patient counts, standard product data, meaningful outcomes, adverse-event reporting and transparent separation of private and NHS access.
The milestone is not that a market became large. It is that the case for measuring it properly became impossible to ignore.
Key takeaways
- NHSBSA data records 1,701,064 private unlicensed cannabis prescription items in England in 2025, compared with 668,511 in 2024—an increase of approximately 154%.
- An item is a product appearing on a prescription form. It is not a patient, consultation or complete treatment course.
- The figures relate to private dispensing through English community pharmacies, not routine NHS prescribing.
- The NHSBSA warns about manual recording, inconsistent product descriptions, late submissions and other data-quality limitations.
- A new UK survey study found substantial medical use without prescriptions and mixed sourcing among some prescribed users, supporting better conversations about potency, products and risk.
- Rapid growth strengthens the case for national patient-level data, consistent outcomes reporting and better coordination between private clinics and the wider health service.
Sources
- FOI-03941: private unlicensed cannabis prescribing data — NHS Business Services Authority — data reused under the Open Government Licence; ePACT2, NHSBSA Copyright 2026.
- The use of cannabis for medical reasons in the UK: prescriptions, sources, products and high-risk use — Psychological Medicine
- Cannabis-based products for medicinal use: call for evidence — Advisory Council on the Misuse of Drugs
- Cannabis-based medicinal products: what CQC expects from providers — Care Quality Commission
- Medical cannabis and cannabis oils — NHS
