A survey of 17 European countries found that Sativex (nabiximol spray) dominates medical cannabis in Europe, with much less use of whole-plant cannabis or synthetic cannabinoids compared to the US.
Read this if you are interested in how medical cannabis regulation differs between Europe and the United States.
Sativex dominates European medical cannabis; no country allows home growing for medical use
What the researchers found
The European Federation of Addiction Societies surveyed its member organizations across 17 countries to assess the state of medical cannabis in Europe. The landscape differed markedly from the United States.
The cannabis extract nabiximol (Sativex), a mouth spray containing THC and CBD, was the most widely available cannabis-based medical product across Europe. Synthetic cannabinoids and standardized cannabis flower were far less prevalent. No European country allowed growing cannabis for personal medical use.
Cross-border transport of medical cannabis products was quite limited. Medical cannabis use was restricted to specific central medical conditions in most countries, though off-label prescribing was prevalent in some.
The European Federation of Addiction Societies issued a position statement stressing the need for further efficacy studies, warnings about dangers of increasing popularity, and calling for European-level regulations covering registration, medical indications, product standardization, and sales rules.
Why it matters
Understanding how medical cannabis is handled in Europe provides contrast to the US approach and highlights alternative regulatory models. The European emphasis on standardized pharmaceutical preparations (like Sativex) over whole-plant cannabis reflects a different risk-benefit calculation and regulatory philosophy.
The numbers in context
28 responses from 17 European countries. 34 EUFAS member societies in 19 countries surveyed. Sativex most prevalent cannabis-based product. No country allows personal medical growing. Two FDA-approved synthetic cannabinoids mentioned. Off-label use prevalent in some countries.
How the study worked
A web-based survey was sent to all 34 member societies of EUFAS in 19 European countries during summer 2017. Twenty-eight responses were received from 17 countries covering the availability, prescription patterns, and regulatory status of medical cannabis products.
What this study cannot tell us
The survey relied on responses from addiction society representatives, who may not fully represent all medical specialties prescribing cannabis. Not all member societies responded. The survey captured a snapshot from 2017 and the landscape has evolved since. Some countries may have been underrepresented.
How to read the evidence
This is a multi-country survey providing moderate evidence on the regulatory landscape, limited by respondent selection and the rapidly evolving policy environment.
When this study was published
Published in 2018 with 2017 data. Several European countries have expanded medical cannabis access since.
The bigger picture
The contrast between European and American medical cannabis approaches highlights different regulatory philosophies. Europe has generally favored pharmaceutical-grade, standardized products with traditional drug approval pathways, while the US has seen a proliferation of state-level programs allowing whole-plant cannabis with varying levels of medical oversight.
Questions still open
- Will European countries move toward allowing whole-plant medical cannabis, or maintain the pharmaceutical-only approach? How do patient outcomes compare between the European and American medical cannabis models? Should European-level regulations supersede national approaches?
Common questions
Can you get medical marijuana in Europe?
What is Sativex?
Read the original research
A Survey on the Medical Use of Cannabis in Europe: A Position Paper.
European addiction research, 24(4), 201-205
Citation
Bramness, Jørgen G; Dom, Geert; Gual, Antoni; Mann, Karl; Wurst, Friedrich Martin. (2018). A Survey on the Medical Use of Cannabis in Europe: A Position Paper.. European addiction research, 24(4), 201-205. https://doi.org/10.1159/000492757
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