Off-licence use of medical cannabis means prescribing a cannabis-based medicine for a condition or in a way that is not officially listed in its licence or approved guidelines. This is legal and common in medicine, but it means the doctor is using their clinical judgement to prescribe the medicine based on evidence and patient need, rather than official NHS guidance. For medical cannabis, this often happens because most cannabis-based medicines don’t yet have full licences for many conditions, so they are prescribed off-licence by specialists in private clinics.