The term “medical cannabis” is widely used today and can refer to everything from approved cannabinoid based medicines to cannabis products that lack scientific evidence. This lack of clarity blurs the line between medical treatment and commercial sale and makes both regulation and oversight more difficult.
In the report Prescribed Ambiguity: Medical Cannabis in Europe, authored by WFAD Deputy Secretary Cressida de Witte and published by Narkotikapolitiskt Center, developments across several European countries are examined. The findings show a divided European landscape, where some countries maintain a clear focus on public health, while others have increasingly opened up to commercial interests.
When definitions, guidelines and oversight differ significantly between countries, this creates not only medical and legal grey areas, but also opens up for a market that drives developments faster than the evidence base supports. At the same time, individual doctors and medical associations have raised concerns about unclear guidelines, insufficient training and a development where medical cannabis risks becoming a pathway towards broader legalisation.
Examples from across Europe illustrate these challenges. In France, a pilot programme introduced in 2021 has seen a decline in patient participation, often due to limited effectiveness or side effects, despite plans to introduce a permanent framework. In countries such as Spain, Portugal and the United Kingdom, cultivation and export have in practice focused more on market growth than on medical benefit and patient needs. Germany has developed one of the most far-reaching systems, including digital pathways for prescriptions, which has raised concerns about oversight and led to recent efforts to tighten regulation.
Research in this field and access to approved cannabinoid based medicines are important. However, such products should be handled in the same way as other medicines in terms of evidence, approval, indication and follow up. Without this, they should not be given medical legitimacy through unclear terminology or exceptional arrangements.
In light of these findings, the report highlights the need for a clearer and legally robust definition at EU level that distinguishes cannabinoid based medicines from “medical cannabis”. It also underlines the importance of applying the same requirements for evidence, regulatory approval and follow up as for other medicines, and ensuring that regulation is guided by patient benefit and public health rather than commercial interests.
A special episode of NPC’s podcast also features Cressida de Witte, who discusses the key findings and their implications in more detail.
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