Evidence note B report V4.5
Justice by Design report analysis; not an independent source. Originals preserved separately.
B.1ACMD recommendation 6 addresses prescription-route information, producers’ directions and no smoking administration. It contains no proposed personal criminal offence. Asked to identify an ACMD passage recommending criminal prohibition, the Home Office’s 13 March 2026 reply says its search did not find a result. The reply and request are reproduced together. Home Office reply/request pp1–2
B.2The distinction is substantive. Professional and product-direction controls can govern practice; a regulation binding a person who self-administers adds a separate legal burden. The comparison uses the actual advisory text with the officials' proposal and enacted rule, rather than inferring legal effect merely from the word “should”. The decision and its patient consequence are set out in Evidence note B2; Evidence note B5.
B.3Reasoning: paragraphs 12–17 recognise possible patient benefit, offer a professional option, and recommend a personal prohibition with an enforcement advantage. That visible decision chain supports the finding that Government imposed an additional patient burden to secure a categorical smoking line. The redacted advice remains unknown.
B.4The enforcement comparison: IA paragraph 76 records existing police and Border Force experience distinguishing medicinal from illegal use of other controlled drugs, including benzodiazepines. DHSC's later response identifies difficulty distinguishing prescribed from recreational cannabis as a reason for the prohibition. Taken together, those records require Government to explain why this distinction was secured by criminalising the prescribed patient's act. Impact assessment p15; DHSC FOI-1712285 p2. Government must produce the evidence that made this additional patient offence preferable to prescription and product checks.
B.5At the encounter: confirming a genuine prescription can establish the prescribing pathway; it does not supply an exception to the prohibited smoking act. The officer must assess the relevant facts and decide a lawful response. The 2018 proposal deliberately made smoking a signal of likely offending while recognising possible patient benefit. The boundary between classification and enforcement response is developed in Evidence note E4.
B.6Under ‘Media handling advice and correspondence lines’, paragraph 25 anticipates a decision that the new rules ‘should not extend to allowing patients to smoke doctor-prescribed cannabis’. It proposes health dangers and police difficulty as the public explanation and anticipates possible patient-group objections. The subsequent passage is redacted. Officials had identified prescribed patients and anticipated their objections before ministers made the final rule.
B.713 September briefing paragraph 4, p3, and paragraph 10, p5, show the proposed 18-month limit and review context. The decision record declined that limit. SI 2018/1055 p1 establishes actual commencement on 1 November 2018, distinct from the 29 October timetable proposed in 13 September briefing. The monitoring and review promises are set out in Evidence note E3.
B.8As an alternative, it is open to you to rely on the professional guidance and regulation to mitigate risks of irresponsible prescribing.
B.9Paragraph 13(b)/(c) specifies the guidance and regulatory mechanisms. The document's p12 annex also lists specials assurances: patient-specific need/specification, licensing, manufacturing/distribution standards, inspection, import notification and adverse-reaction reporting. These were the safeguards Government described to ministers in 2018.
B.10Government had an express professional alternative for irresponsible prescribing. The remaining question was how to respond to patients departing from clinical instructions. F1 explains the case for information, usable treatment and continuing care, and why that calls for removing the additional personal offence.
B.11Diversion and product verification: ACMD's 27 November 2020 covering letter, Conclusion 12, p4, reported little evidence at that time of diversion of unlicensed CBPMs or licensed cannabis medicines into illicit markets. It also reported police observations of illicit cannabis mislabelled as a medicinal product, with the policing impact unclear. Those are different problems. A prohibition on the genuine patient's route of administration does not establish whether a labelled product is genuine. ACMD covering letter Conclusion 12. Government must supply current evidence of any diversion risk it says requires the genuine patient’s additional punishment.