Recent debates over medical cannabis offer fascinating examples of the interplay of various forms of power and morality with different policy constellations. The bare facts of the case are that cannabis-based medical products were moved from schedule 1 to schedule 2 of the Misuse of Drugs Regulations in November 2018. Schedule 1 is the place for drugs which have no medical purpose. By moving these products to schedule 2, the government enabled some forms of cannabis to be provided legally as medicine. These bare facts overlay a much more complex and interesting story, a tale that involves the use of different epistemic understandings of what cannabis does and some striking examples of the use of economic, affective, media and savvy social power to change policy. It also shows the ongoing capacity of the most influential policy constellations to use their institutional power to limit the scale of change.

The change in policy was triggered by media “uproar” over the cases of two boys – Billy Caldwell and Alfie Dingley – who suffer from rare, treatment-resistant forms of epilepsy. Mark Monaghan and colleagues have called this a case of a manufactured scandal (Monaghan, Wincup and Hamilton, 2020). I see it as also being an example of political cornering: the skilful manoeuvring of politicians by other policy actors into a position where they have little choice but to make the desired decision. In this case, the think tank Volteface and its founder Steve Moore were key policy actors, along with Charlotte Caldwell, Billy's mother. They were able to use affective power, together with their social connections, financial backing and media power, to change policy. Their ability to do so depended on previous exercises of epistemic power to undermine the case for continued prohibition.

In the aftermath of the 2018 legalisation, the Home Office – in concert with official bodies like the Advisory Council on the Misuse of Drugs (ACMD) and the National Institute for Health and Care Excellence – used its institutional power to limit access to cannabis-based medical products. This successful rearguard action is described in the final section of this chapter.