Two medicines derived from the cannabis plant have been recommended for use on the NHS for the first time.
Epidyolex has been approved for two rare types of epilepsy, Lennox-Gastaut and Dravet syndromes, while the spray Sativex has been recommended for muscle spasms in multiple sclerosis (MS).
Charities welcomed the move, but said thousands of other people with a range of conditions who could benefit from cannabis-based medicines were left in limbo.
The National Institute for Health and Care Excellence (Nice) has ruled out prescribing drugs containing THC (delta-9-tetrahydrocannabinol) – the psychoactive ingredient in cannabis – to treat chronic pain.
It also said more research was needed on cannabis-based medicines to treat forms of epilepsy other than Lennox-Gastaut and Dravet.
Millie Hinton, from the campaign End Our Pain, said the guidelines were „a massive missed opportunity”.
„It is particularly devastating that there is no positive recommendation that the NHS should allow prescribing of whole plant medical cannabis containing both CBD (cannabidiol) and THC in appropriate cases of intractable childhood
epilepsy,” she said.
„It is this kind of whole plant extract that has been shown to be life-transforming for a significant number of children, including these involved in the high-profile cases of last year which led to medical cannabis being legalised.”
She added: „This restrictive guidance is condemning many patients to having to pay for life-transforming medicine privately, to go without or to consider accessing illegal and unregulated sources.”
Last year, a change in the law made it legal for doctors to prescribe medicinal cannabis.
However, many doctors have been reluctant to do so, citing a lack of clear guidance on prescribing and issues over funding for the drugs.
This has led some families to go abroad in search of medicines, with some bringing them into the UK illegally.
Simon Wigglesworth, deputy chief executive at Epilepsy Action, welcomed the decision to recommend Epidyolex.
However, he said there were many thousands of people with other complex and treatment-resistant epilepsies who could potentially benefit from cannabis-based medicines.
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And he said there was a lack of high-quality clinical evidence, particularly around products that contain THC.
He added: „Though this is disappointing, we appreciate that clinical research is vital to ensure that any treatment recommended for use in the NHS is safe and effective.”
Nice also recommended Sativex to treat muscle spasms in MS, a common symptom of the disease.
Genevieve Edwards, director of external affairs at the MS Society, said it was „brilliant Nice has finally listened” after it recommended Sativex to treat muscle spasms in MS.
However, she added: „These guidelines are an important first step, but don’t go far enough. No cannabis-based treatments have been recommended to treat pain, a common symptom of MS.”