I was walking through the London Underground recently when a glossy advert made me do a double-take. Professionally produced, it was the kind you associate with a wellness brand, yet this one was selling medical cannabis.
The company, Mamedica, a major UK supplier of medical cannabis, is one of several similar firms with adverts across the Tube and elsewhere in London.
This is quite legal but I was nonetheless shocked that a form of cannabis can be advertised in the same way as vitamins or hay fever tablets.
Of course, it is important to recognise that medical cannabis is produced to precise specifications and contains a controlled ratio of THC (tetrahydrocannabinol, responsible for the ‘high’) and the non-intoxicating compound CBD (cannabidiol which has therapeutic properties).
And there are a small number of legitimate medical uses for cannabis, which are widely accepted by professionals in the field.
As a clinician who has seen the devastating effects cannabis can have on the mind, I am deeply concerned that plastering the Underground with glossy hoardings like these implies to those strolling past that it is a safe and effective drug in general.
In my clinic, I am increasingly seeing patients who have legally bought medical cannabis to combat conditions such as depression, anxiety, insomnia and ADHD.
Yet a major review of 54 previous studies published in the Lancet Psychiatry earlier this year found no evidence that medical cannabis helped anxiety, PTSD, or psychosis.
The normalisation of cannabis, whether legal or not, will have repercussions, writes Dr Max
For depression, one of the most common reasons people seek it out, there wasn’t a single randomised controlled trial to assess.
What’s more, concerns have been raised by experts that many of the prescriptions being dished out by some of these firms are for high-potency products with THC content exceeding 30 per cent. One strain, cheerfully named Space Cake, clocks in at 34 per cent THC.
Street skunk typically contains between 14 and 16 per cent. So we are prescribing products considerably stronger than the drug wrecking young minds on our psychiatric wards, to people who are already mentally unwell, with no credible evidence that it does them any good.
Moreover, the normalisation of cannabis, whether legal or not, will, I believe, have repercussions.
In recent years, there has been a quiet cultural shift towards accepting cannabis as normal – anecdotally I hear about mums bringing illegal cannabis gummies to a wedding, where they may once have had a few glasses of Prosecco.
Fruit-flavoured sweets laced with the psychoactive component of cannabis don’t reek of skunk and allow respectable people, yummy mummies included, to tell themselves they’re not really doing drugs because nobody is holding a joint.
But the pharmacology is rather less cheerful. The effects from eating cannabis can take up to two hours to kick in, which is why people often think ‘nothing is happening’ so take a second sweet, then a third, sometimes ending up in A&E in the small hours, terrified when the cumulative effect takes its toll.
And because the dose in each sweet and its contents is essentially uncontrolled, there is no way of knowing what you’ve actually ingested.
‘As a psychiatrist who has spent two decades watching cannabis ruin lives at all levels of society, I fear we have all taken our eyes off the ball where cannabis is concerned’
I have seen patients on psychiatric wards after a cannabis edible they were assured was ‘mild’. One, a teacher in her 40s, had taken a single sweet at a friend’s birthday party but it was four times stronger than she’d been told.
She spent three days convinced her own children were going to attack her. She had never taken a drug before in her life.
Sadly, some patients don’t come back from this state.
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Even more disturbing is what happens further downstream. Essex Police recently warned that illegal cannabis edibles are being used by county lines gangs to lure and recruit children, some as young as ten, into a criminal world from which there is rarely a way back.
The ‘sweets’, packaged to look like Haribo or Skittles, are advertised cheaply over social media and posted through the door in plain envelopes that don’t smell of anything.
The poor parents would have no idea what is in the brightly coloured ‘treats’ at the bottom of the school bag.
To a county lines gang a young child with no previous convictions is the perfect courier for Class A drugs.
Home Office estimates show that about 15,500 children were identified as at risk or involved in county lines gangs in 2025.
However, it conceded that was ‘likely to be a significant underestimate of the problem’.
As a psychiatrist who has spent two decades watching cannabis ruin lives at all levels of society, I fear we have all taken our eyes off the ball where cannabis is concerned.
