On the face of it, the European medical cannabis scene looks rosy – people often state that over 20 EU countries have legalised medical cannabis in some form or another. Dig a little deeper and you discover in many cases ‘some form or another’ can be a far cry from what a patient actually needs.

According to MJBiz Daily, once you exclude Sativex or synthetic cannabinoids, only three countries in Europe – Germany, Italy and the Netherlands – have any meaningful sales of medical cannabis.

Depending on where you live in Europe, being a medical cannabis patient – or someone in need of medical cannabis – can vary wildly. For some, they are lucky enough that their healthcare system provides medical cannabis for their illness. For others, they are forced to break the law and turn to illegal markets to meet the standard of living that others with the same illness in a neighbouring country can.

Let’s use Belgium as an example. In comparison to the bordering Netherlands, they’ve had legal medical cannabis available since 2015, while the Netherlands has had legal medical cannabis since 2003. Only there’s ‘legal medical cannabis’ and there’s ‘legal’ medical cannabis. In Belgium, you can only be prescribed medical cannabis for treating the symptoms of MS and even then, your only option is Sativex.


Many Belgians could benefit from medical cannabis for a variety of reasons (including chronic pain, glaucoma, nausea and vomiting associated with chemotherapy, epilepsy, migraine and many other well documented conditions) but can’t get access their medicines. As a result, they are either forced to take pharmaceutical drugs they find to be less effective (with damaging side effects), buy cannabis from a criminal market, travel over the border to a Dutch coffeeshop (which is likely still supplied by a criminal market) or grow their own (and become a criminal).

Meanwhile in the neighbouring Netherlands, patients can legitimately (but not as easily as many assume) get a prescription and pick up dried cannabis flowers from their local pharmacy. Many can even get their health insurance to contribute to the cost.


Harmonisation of the cannabis industry at a European level is a long way off. This would require it passing through the European Parliament, having no objections from member states within the European Council and finally having the bureaucracy of the European Commission define the directive.

As one MEP told us – in the absolute best case scenario – European wide harmonisation could take six years, more likely ten. The difficulty for gaining consensus at so many levels and across so many institutions, countries, departments and ministries is compounded by the fact that it’s – well, that it’s cannabis.

The chances are, within ten years, the majority of European countries will have passed their own laws on medical cannabis in any case – maybe even a few bold EU states will have legalised recreational use – so the final blessing of the European Commission could be somewhat of a formality. Though it would ease issues such as cross border distribution, transportation of medicine by patients and give local companies access to the common market.


As we’ve seen around the world, recreational use is usually not far behind a medical market. As the medical markets currently vary so wildly across Europe, a large amount of patients who are unable to access medicine under their country’s programme may miss out on the medical market completely, going straight to cannabis intended for adult recreational use once it’s legalised in their country. Although recreational cannabis products will still have regulatory hurdles to pass through to come to market, these are less strict than the requirements for medicines, resulting in more products with a greater variation and a lower price point.

Should that happen, you’d be hard pushed to imagine that people who are chronically ill are going to suffer and wait for the European Commission to harmonise the market and then wait for their departments of health to integrate cannabis into their healthcare systems when they could just pop to their local dispensary – or whatever the European equivalent would be (coffeeshops in the Netherlands or Cannabis Social Clubs in Spain etc). Countries are losing their opportunity to be in control of this situation by the day.


On a high level it’s fairly simple. Countries need to legalise medical cannabis as soon as possible and then ensure all patients that would benefit from medical cannabis can get access. To drag their feet on this is going to create a set of circumstances that will be extremely difficult to reverse. Of course on a practical level that is not going to be at all easy.

Join us at Cannabis Europa London, on 24th and 25th June to debate solutions to the challenges of the European cannabis market. Our policy and politics panels will look at both the granular and regional issues relating to cannabis in the realm of politicians and policymakers to help define a clear, safe and regulated path to product, for patients across the continent.

For more information on our upcoming programme click here.


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