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What does the medicinal cannabis landscape look like today?

Sep. 13, 2023 by SOMAÍ

What does the medical cannabis landscape look like today?

Over the last couple of decades, there has been a gradual, widespread endorsement of using cannabis for its medicinal properties. In fact, the United Nations (UN) Commission on Narcotic Drugs reclassified cannabis to acknowledge its therapeutic uses in 2020.  Cannabis is increasingly being legalised for medical purposes across Europe and the rest of the world. However, the individual regulations for cannabis-based medical products vary considerably between countries.

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Cannabis-Based Products for Medicinal Use – An evolving Regulatory Landscape

The regulations for cannabis-containing medicinal products vary considerably between European countries.  Some countries allow the use of medicinal cannabinoids, while others allow the medicinal use of unauthorised products or preparations. In terms of manufacture and import, some countries allow cannabis product manufacture; others allow import but do not allow manufacture, and some countries allow manufacture and import.

Clearly, there is no common regulatory pathway to European markets, which makes marketing cannabis products across Europe challenging. Ideally, there should be clear and consistent policies and regulations across countries.

In the UK, only clinicians listed on the Specialist Register of the General Medical Council can prescribe cannabis-based products for medicinal use if exceptional clinical needs cannot be met by licensed or off-label medicine.

In Germany, every doctor is permitted to prescribe medicinal cannabis to those with serious illness.

As of August 2022, three three broad legal frameworks exist among European countries:

  1. Established medicinal cannabis legislation
    For example the UK, the Netherlands, Poland, Portugal, Greece, Germany, Italy, Switzerland, Czechia, Malta and Luxembourg. In these countries the use of medicinal cannabis is legally permitted and comes with the usual pharmacovigilance regulations as for other medicinal products, ensuring patient safety measures are implemented. However, the specific access scheme for medicinal cannabis is variable between countries and typically limited to a restricted set of medicinal conditions.
  2. Supply of specific cannabis products permitted under specific conditions
    This includes countries with ongoing trial periods or pilot schemes investigating the potential benefit/risk of medicinal cannabis, for example France, Ireland, Denmark, and Finland. Often, the importation and/or use of medicinal cannabis is allowed at the discretion of physicians, usually for a specific treatment for a named patient.
  3. Medicinal cannabis is strictly prohibited
    For example countries such as Sweden, Latvia, Belgium, and Albania. It is illegal to use, buy or sell cannabis in these countries, including medicinal cannabis.