Words by Dave Barton, founder, Patient Panel and thermidor<
As the British medical cannabis market continues to grow, this year’s Cannabis Europa brought together policymakers, investors, operators, and clinicians to discuss the future of medical cannabis. However, patients were asking a much simpler question: why can’t they reliably access the products they know work?
UK medical cannabis continues to expand. Patient numbers are rising (100K+), flower imports reportedly doubled between 2024 and 2025, and new cultivars, brands and suppliers continue to enter the market. Yet despite all this growth, many patients still struggle to access the products that provide them with stability.
Recently, during an industry discussion about supply continuity, someone suggested that “patient promiscuity” was partly responsible. Patients, it was argued, constantly switch products, encouraging growers and distributors to pursue novelty rather than continuity.
The more I thought about it, the more the phrase seemed to reveal something deeper about how the UK medical cannabis system still views patients. Because what if patients are not being promiscuous at all? What if they are simply adapting to the market they’ve been given?
Fickle consumers or patients adapting?
Medical cannabis patients are often framed as consumers chasing the next interesting strain, but that overlooks how many people actually navigate treatment.
Some patients are still exploring. They are trying different cultivars, terpene profiles, cannabinoid balances and formats to understand what works best for them. Others have already found products that provide stability and simply want continuity. Then there are those who are forced to adapt because products disappear, go out of stock, become reformulated or are replaced by whatever happens to be available.
These are not the same behaviours, yet they are often collapsed into a single narrative that patients are somehow fickle or impossible to satisfy. From conversations I’ve had with the patient community (which I, myself, am part of) many people are not switching because they want to. They are switching because they have to.
That raises a more uncomfortable question: why are patients criticised for self-directing treatment when the system itself often provides very little guidance around how treatment should actually work?
Patients often end up doing work that, in other therapeutic areas, might sit more formally inside clinical support systems. In practice, many medical cannabis patients are carrying clinical load and therapeutic navigation work that sits outside formal care pathways.
They track outcomes. They compare products and cultivars. They interpret effects and monitor changes in symptoms. They manage substitutions when products disappear, adapt routines when supply changes and build their own dosing, timing and consumption practices.
Beyond that, patients also share protocols, educate new patients entering the system and collectively build experiential knowledge that others rely upon.
In other words, they are not simply consuming treatment. They are helping interpret it. They are not just participants in this market; increasingly, they are co-creators of it. Perhaps that is the uncomfortable truth sitting beneath all this discussion around “promiscuity”: patients may be carrying clinical and therapeutic labour that nobody ever formally assigned to them.
I have never seen a meaningful treatment pathway for medical cannabis in the UK. Patients receive prescriptions, but many are then left to navigate strain selection, substitutions and optimisation largely on their own. They become researchers, pharmacists and clinicians in their own lives, building treatment approaches through experimentation and lived experience.
The irony is that the same behaviour keeping many patients functional is then reframed as “promiscuity”.
Patients know their stuff. Research has repeatedly shown high levels of cannabis literacy within the UK community, with many people describing themselves as highly knowledgeable about the plant, while substantial numbers continue to navigate both medical and non-medical channels to obtain the products they need. These are not passive recipients of care. They are active participants in treatment and, increasingly, co-creators of knowledge around it.
Patients are not failing the system, the system is still failing patients. If imports have doubled, where is the continuity? Where are the products patients repeatedly ask for? Why are so many people still substituting medicines they know work because supply remains inconsistent?
Defining what ‘success’ actually means
The UK market increasingly feels trapped in a contradiction. Imports continue to rise, yet continuity remains elusive. Which brings us to a bigger question: What does the next stage of market maturity actually look like? More products? Or better therapeutic navigation?
Because if imports doubled, and patients still rely heavily on each other to interpret treatment, optimise outcomes and navigate change, then perhaps growth alone is not the metric we should be celebrating?
Behind that sits another question that feels increasingly difficult to ignore. Why are we importing so heavily when the UK remains one of the world’s largest exporters of cannabis?
Why build a system dependent on imported surplus when domestic production could create resilience, reduce costs, and shorten supply chains? Why increase the miles, the intermediaries and the complexity when patients are already struggling with consistency?
Medical access should also include discussions around home cultivation for personal medical use. Instead, patients remain almost entirely dependent on clinics, pharmacies, distributors and cultivators to determine market terms.
The next phase of international market development may intensify this further. Reform in the United States could eventually unlock new export pathways and introduce even more product into global markets.
On paper, that sounds positive. More supply should mean better access and lower prices. But quantity alone is not the answer. The UK does not necessarily need endless novelty. It needs continuity, patient-centred product strategies and companies willing to integrate with the needs of British patients rather than simply offloading surplus from larger markets.
What works in California doesn’t (yet) work in Coventry
The UK patient community has developed under unique conditions: fragmented supply, high treatment costs and limited clinical guidance. In response, patients have become informed, self-directed, and deeply outcome focused. The industry should recognise that for what it is: resilience.
Perhaps what we need is a Medical Cannabis Market Access Scheme; a set of expectations for companies entering the UK market that includes commitments around supply continuity, patient engagement, treatment guidance, outcome collection, and transparency around product lifecycles.
Patients are not the problem here. The problem is a system that still struggles to understand the people holding it together. UK medical cannabis patients are not promiscuous. They are adaptive. Perhaps it’s time the industry caught up.
The post ‘Patient Promiscuity’: Is the Medical Cannabis Industry Blaming Patients For Its Own Failures? appeared first on Cannabis Health News.
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