Medical cannabis in Europe is mostly limited to the spray Sativex, with little whole-plant use
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- Sativex dominates European medical cannabis; no country allows home growing for medical use
- Evidence Grade:
- This is a multi-country survey providing moderate evidence on the regulatory landscape, limited by respondent selection and the rapidly evolving policy environment.
- Study Age:
- Published in 2018 with 2017 data. Several European countries have expanded medical cannabis access since.
- Original Title:
- A Survey on the Medical Use of Cannabis in Europe: A Position Paper.
- Published In:
- European addiction research, 24(4), 201-205 (2018)
- Authors:
- Bramness, Jørgen G(4), Dom, Geert(2), Gual, Antoni(2), Mann, Karl, Wurst, Friedrich Martin
- Database ID:
- RTHC-01601
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Can you get medical marijuana in Europe?
As of this 2017 survey, most European countries restricted medical cannabis to standardized pharmaceutical products, primarily Sativex (nabiximol spray). Whole-plant cannabis and home growing were much less available than in the US. The landscape has evolved since.
What is Sativex?
Sativex (nabiximol) is a mouth spray containing standardized amounts of THC and CBD extracted from the cannabis plant. It is the most widely available cannabis-based medical product in Europe, primarily prescribed for multiple sclerosis spasticity.
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Cite This Study
https://rethinkthc.com/research/RTHC-01601APA
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
MLA
Bramness, Jørgen G, et al. "A Survey on the Medical Use of Cannabis in Europe: A Position Paper.." European addiction research, 2018. https://doi.org/10.1159/000492757
RethinkTHC
RethinkTHC Research Database. "A Survey on the Medical Use of Cannabis in Europe: A Positio..." RTHC-01601. Retrieved from https://rethinkthc.com/research/bramness-2018-a-survey-on-the
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.