Spain drafts medicinal cannabis regulations, contrasting with varied international approaches to its use and access.
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Spain is advancing its medicinal cannabis legislation by releasing a draft royal decree for public consultation, which will regulate the dispensing of magistral formulas. This draft specifies that therapeutic marijuana will be considered for conditions such as spasticity from multiple sclerosis, severe refractory epilepsy, nausea and vomiting from chemotherapy, and chronic refractory pain, though this list may change based on scientific evidence. Unlike some other countries, in Spain, only specialists can prescribe it, and dispensing will occur exclusively at hospital pharmacies. The Spanish Medicinal Cannabis Observatory (OECM) views these measures as restrictive, suggesting broader availability in street pharmacies and inclusion of primary care physicians for prescribing. They also advocate for including conditions like loss of appetite due to cancer, stress, anxiety, insomnia, anhedonia, and lack of motivation, and support the use of vaporization over oral administration. In contrast, other European countries have varied approaches: Germany allows prescription by any doctor as a standard medication; Portugal permits vaporizing and has no prescription requirement for low-THC CBD; Greece requires patient payment and uses street pharmacies; Italy limits treatment to three months; the UK restricts availability to three specific products prescribed by specialists; the Czech Republic faces significant access issues despite legalization; Hungary shows little improvement in patient access; and France’s situation remains uncertain, with general use expected after 2026.
