This article is a chance to put some of our thoughts down on paper to discuss the Future of Medicinal Cannabis. The three contributors are Steven Tan (CEO of Northern Leaf), Iqra Arif (Pharmacist Prescriber at Wellford Medical Clinics) and Joshua Roberts (Chief Business Officer of Wellford Medical).
At Wellford Medical we are constantly analysing the European and UK medicinal cannabis market to determine where the market is now and where it will be in the next five years. When we started this business in 2019, we anticipated that cannabis laws would evolve more rapidly than they have by 2024. Although progress has been slower than expected, we are seeing encouraging signs of change across Europe and the UK. We remain optimistic about a bright future for patients in need of medical cannabis.
Joshua Roberts on Wellford’s Place in the Market: Filling the Gap
As a company, Wellford occupies a unique position in the evolving medicinal cannabis market. We are an EU GMP and organically certified, vertically integrated (all under one roof) medicinal cannabis company from seed in Canada to patient in the UK and Germany. The difference lies in the fact that we offer the safety and consistency of regulated medical cannabis, while also appealing to patients who value craft products. Wellford is headquartered in London and has operations in both the UK and Germany with sales and distribution operating in both countries. We have partnered with Aqualitas in Canada, an EU GMP cultivator and processor of organically certified medicinal cannabis, grown in living soil, fertilized by living water from 3,000 koi fish. Aqualitas’ dual system of organic and aquaponic cultivation allows us to produce clean and sustainable medicinal cannabis which does not require irradiation or remediation due to its purity.
Aqualitas’ Study on Lack of Microbials, Yeasts, Moulds, Bile-Tolerant Gram-Negative Bacteria
Aqualitas has recently completed a study demonstrating the purity of their products: in the 88 harvests completed since inception, the combined total of the all the microbial, yeast, mould, and bile-tolerant gram-negative bacteria from all 88 harvests would still pass the required level for just ONE batch in Europe.3 As a result their medicinal cannabis does not require irradiation or remediation for the UK or German market which allows their products to be directly compared with the black market freshness, aromas and tastes while also being a medical product.
Standing Apart in a Competitive Landscape
While the medicinal cannabis market is still small compared to the black market, it is growing, and Wellford is poised to be at the forefront of this expansion with safe, craft medicinal cannabis products. We also source products from around the world for our Therismos brand which is currently listed in both the UK and Germany. The Therismos brand has a price point for everyone, whereas the Wellford organic & aquaponic brand is more expensive due to the cost of growing organically.
Another way we stand apart is through our partnerships, particularly with Walgreens Boots Alliance (WBA) in Germany. This partnership allows us to distribute three times daily to over 4,000 pharmacies in the WBA network, making medicinal cannabis more accessible to patients. In the UK, our Wellford Medical Clinic and Newgrove Pharmacy ensure that patients are treated by medical professionals and cannabis experts and can access their medicinal cannabis seamlessly
Looking Ahead
Looking ahead, we believe that the future of medicinal cannabis lies in striking a balance between pharmaceutical rigor and consumer demand for organic medicinal products. As legislation evolves, and as more patients become aware of the benefits of cannabis, we expect the medical market to continue its steady growth. At the same time, we are committed to pushing the industry forward, advocating for higher standards of cultivation and processing that prioritise patient safety and environmental sustainability.
At Wellford, we are not just growing medicinal cannabis—we are growing a movement. A movement towards transparency, integrity, and patient-centred care in the cannabis industry. While the black market continues to dominate in the UK, we believe that as more consumers become educated about the risks of PGR-grown cannabis and the benefits of organic cultivation, they will increasingly turn to trusted sources like Wellford for their medicinal needs.
Wellford and Aqualitas will stay relevant in the medicinal cannabis market by innovating and constantly looking for ways to improve our level of transparency, patient-care and partnerships. Aqualitas already manufacture many alternative forms of cannabis medication in Canada and if doctors in the UK believe these products will be helpful for their patients in the UK there is scope to import them.
Our journey is just beginning, and we invite you to join us as we work to build a healthier, more sustainable future for the medicinal cannabis industry. Whether you are a patient seeking an alternative to pharmaceuticals or a medical professional looking for reliable products for your patients, Wellford is here to provide the service or product for you.
Iqra Arif on Cannabis Prescribing in the UK and Any Predicted Changes in the Future
Despite being technically available on the NHS in the UK, we believe there are only five patients who have received funding through the NHS, this is mainly due to a lack of funding but also partly due to a lack of education within the medical community. Access is mainly through private clinics.
The current Labour Government have reported they will not prioritise changes to drug laws and reform is not a subject of significant debate within the party at this time. Therefore, it is unlikely that there will be any changes to the prescribing of medicinal cannabis soon.
It’s important that patients understand medicinal cannabis is accessible for those with long term medical conditions where other trialled therapies have failed. Clinics such as Wellford Medical have systems in place where medicinal cannabis can be prescribed for appropriate patients, and the medication delivered to the patients’ home address. We are also aware that patients have different price points that they can access for medication obtained privately, and we work with the patient, to ensure that we make their medication as accessible as possible to meet their needs.
Lastly there is also a need for more robust and mainstream clinical evidence, to support widespread prescribing should there be any changes in legislation in the future.
Iqra on the Future of the Medicinal Cannabis Market from Medical Perspective
We are seeing more patients access medicinal cannabis as awareness and education grows. Medically we act as a safety net for patients, ensuring that prescribing is appropriate, and we see the patient through a journey, by initiating treatment appropriately and regularly checking in to ensure that their medical condition is being treated and that the patient is seeing clear therapeutic benefits.
There are many benefits of accessing medicinal cannabis; the patient has a copy of their prescription, and a medication labelled by their dispensing pharmacy, which act as proof and legitimisation of their treatment with medicinal cannabis. This is important for patients if for example they are stopped by the police.
Also, by accessing medicinal cannabis, patients can be ensured that the cannabis itself is safe, as this is an approved medication, brought in to the UK via the Medicines Health and Regulatory Agency (MHRA), the same as any other medicine available on the market. Therefore, patients can be assured the cannabis has not mixed with any unsafe ingredients, and the microbial, yeast, mould and bacteria contents are within safe and legal limits.
The quality of strains is improving as knowledge amongst the industry grows, such truly organic strains can be medically prescribed under the direction of a specialist Consultant.
Steven Tan on Using Canada as a Proxy: The Future of the UK and European Medical Cannabis Market
Canada, as a G7 Commonwealth nation with a developed regulatory framework for cannabis, offers useful insights into the future of the medical cannabis markets in the UK and Europe. However, differences in culture, legislation, and market dynamics may lead to variations in how these regions evolve.
How Far Behind Are the UK and Europe?
Canada legalized medical cannabis in 2001, giving it almost a two-decade head start over the UK and Europe. In 2018, Canada fully legalized recreational cannabis, creating a unified system that enables broad access for both medical and recreational users. The UK legalized medical cannabis in 2018, but access remains extremely limited, with only a small number of NHS patients receiving treatment. Private clinics dominate the landscape and there are some estimated 30,000-50,000 patients in the UK. In Europe, some countries like Germany have more developed systems with quasi adult-use legislation going into force on 1 April this year and between 300,000-500,000 medical patients, but overall, the market remains fragmented.
The UK and Europe are estimated to be five to 10 years behind Canada in terms of regulatory development, patient access, and the market’s sophistication.
Public Perception and Stigma
In Canada, public perception of cannabis has evolved positively since legalization, with both medicinal and recreational cannabis becoming widely accepted. In the UK and many European countries, cannabis still carries significant stigma. However, public perception is slowly shifting as more evidence emerges about its therapeutic benefits. Over the next decade, stigma will likely decrease, but it may take longer in more conservative countries.
The Next Five to 10 Years
In the next decade, the UK and Europe will likely see significant developments in the medicinal cannabis space. Patient access will expand as regulations are streamlined and more products enter the market. Europe may also move towards greater regulatory harmonization, similar to Canada’s federal system. While the UK and Europe are still behind, they are poised for growth as public perception shifts, more healthcare professionals become educated, and regulations evolve.
Steven Tan on the Black Market vs Current Medicinal Market
Currently the black market accounts for the majority of cannabis consumed in the UK. A recent YouGov poll suggested there are 1.8m people in the UK using black market cannabis regularly for medical purposes.1 With a small but growing medical market, the first group of medicinal cannabis patients are already medicating with cannabis from the black market and they are looking for a legal alternative medicine for pain, insomnia and/or mental health issues like depression, anxiety and ADHD.
Medicinal Cannabis Production
Medicinal cannabis produced legally differs from black market cannabis and is often considered to be of lower quality because of the way it is grown and treated to meet strict pharmaceutical specifications. More often than not, to reach these standards, medicinal cannabis is overly dried and treated with irradiation or remediation and reportedly lacks the experiential qualities of freshness, aroma and flavour of black market cannabis. Patients and consumers refer to cannabis that has been treated with irradiation or remediation as “muted” as many of the aromas and tastes have been reduced. The aroma and taste of cannabis is produced by the terpenes and flavonoids and these compounds can potentially burn off during the irradiation and remediation process if those processes use heat to sterilise the product.
Black Market Cannabis Production
Black market cannabis is often associated with organised crime and can be contaminated with pesticides and other dangerous chemicals used to grow the plant faster and with more yield – like Plant Growth Regulators (PGRs). Although dried cannabis flower products grown this way may be filled with chemicals, the cannabis is reported to be more fresh and less dry than the medical market and as such some patients still prefer it as they are unaware of the contaminants like PGRs.
There is credible evidence suggesting that synthetic PGRs used in cannabis cultivation may have negative health effects, especially when the plant is consumed via inhalation.2 Some of these chemicals have been linked to carcinogenicity, liver toxicity, and endocrine disruption. As the cultivation inputs are not regulated in the black market, additives like heavy metals and pesticides, not designed for a vaporised product, are also used. Another point of risk for patients consuming black market cannabis is regarding microbial, yeast, mould and bile tolerant gram-negative bacteria levels. These contaminants are not tested either and pose a risk for some individuals, e.g. immune comprised individuals. Immuno-suppressed patients can have serious if not life-threatening issues inhaling vaporised dried flower which is contaminated in this way.
Although the majority of black market cannabis is associated with large scale organised crime there are also small scale, illegal craft cannabis cultivation sites dotted across the country. Craft cannabis producers in the black market use organic inputs and usually with unique elite cultivars that are grown for their flavour and unique psychoactive sensory experience. Perhaps an accurate comparison is heirloom tomatoes versus Dutch hothouse commercial varieties. It is reported that when grown in this way, craft cannabis from the black market still outpaces almost all of the cannabis available on the medical market.
The Major Problem
Given the two black market cultivation sources of cannabis described above, the major problem, outside of legal issues, is that patients/consumers will never know, before they buy, where their dealer is obtaining the cannabis. Many people buying cannabis from the black market for medical reasons assume their dealer is sourcing product from the craft cannabis section of the black market but it is likely being produced by organised crime.
Patients consuming from the black market may consider switching over to the medical market when there are medical products available which are produced using organic inputs without irradiation or remediation.
References
YouGov Reference
PGR Reference
- https://pubmed.ncbi.nlm.nih.gov/30168961/
- https://www.sciencedirect.com/science/article/abs/pii/S004835752300305X
- https://leafwell.com/blog/pgr-weed
