Much has been written about the impact of cannabis laws on society, a topic that often overshadows science in debates concerning cannabis’ worth as a medicine. Even “first world” countries and countries that are in the G8, such as the UK, or France have practically no regulation in terms of medicinal cannabis, although the therapeutic use of Cannabis and cannabis-based products is thus, decriminalized. Recently, there have been some advances in certain countries such as Germany.
The medicalization and/or incorporation of Cannabis into medicine is complex for a number of reasons, including that (i) it is a plant rather than a pharmaceutical product, and (ii) knowledge of its properties and effects is still limited. However, in light of the recently and largely reported pharmacological discoveries and therapeutic benefits of Cannabis, the controlled and medicinal use of Cannabis for some pathological conditions has been enforced. Many countries now have legal programs for patients to access cannabis.
The World Health Organization has made several recommendations on cannabis and cannabis-related substances including the status of these compounds under the United Nations Single Convention on Narcotic Drugs of 1961, which should be limited to medical and scientific purposes exclusively.
We will not attempt to address this complex subject, nor do we provide anything remotely resembling legal advice, which should be sought from a professional. The aim here is simpler: to give an overview of laws surrounding cannabis’ use as a medicine.
Medical cannabis is well accepted and small-scale possession is officially decriminalized. Many cities are looking for ways of legal distribution to combat high levels of street dealing. Cannabidiol (CBD) products are available widely in Germany.
The first law of medical cannabis, approved in 2017, establishes a framework for the medical use of the cannabis plant and derivatives. Legal regulation for clinical research came in 2018 at Hospital de Pediatria Garrahan in Buenos Aires. This specifically is evaluating the efficacy of CBD oil for treatment of pediatric patients with epilepsy. Otherwise, law in Argentina still includes cannabis sativa as a prohibited drug.
Uruguay was the first country in the world to legalize the cultivation and sale of cannabis in 2013. This law covers “Cannabis and its derivatives” for the “Control and regulation of the state of import, production, acquisition, storage, marketing and distribution.”
Federal law prohibits the use of cannabis as a narcotic, under the same category of use as drugs such as cocaine and heroin. Individual states have autonomy for determining if cannabis is legal. Thirty-four states in the USA have voted to authorize or implement medicinal cannabis programs. Among these, twelve states and the District of Columbia have legalized the recreational use of Cannabis.
A federal law was passed in 2018 permitting the cultivation and sale of CBD and its derivatives. However, states still determine whether to authorize these products, and currently eight states have no tolerance for such products.
Cannabis in the Netherlands is decriminalized for personal use, and is openly sold in so-called ‘coffeeshops.’ While the sale of cannabis at coffeeshops is tolerated by the law, the supply to the coffeeshops is illegal. Nationwide, this is largely ignored, and has been a topic of concern for the right-wing government party. CBD is legal for consumption and is sold as a component of products such as oil. Medical cannabis is available by prescription in pharmacies.
Cannabis became legal for medicinal use in the UK in 2018. However, there have only been a handful of patients treated with cannabis. Regarding recreational use, cannabis still remains illegal and is considered a narcotic. For personal amounts, the punishment is typically a fine or a ticket. However, police do not typically target those using cannabis. CBD is legal in the UK, and is considered a food supplement.
Cannabis is legal for medical use in Spain. Regarding recreational use of cannabis, federal law deems it illegal, but decriminalized. There are regional exceptions to the federal mandate. There is a cannabis club system which exists throughout cities in Spain. These are beyond the law due to a decision made by a drug prosecutor in Barcelona. The fact that these clubs are not subject to the law has led to uncertain terms of what is allowed and what is not, which has caused recent dissent between authorities and club owners. CBD oil and cream are legal in Spain.
Cannabis use is illegal in Switzerland and is considered a narcotic. However, it is distinguished from CBD, which is sold in specialty stores in cities. CBD flowers are marketed as an alternative to tobacco products. Only one medical cannabis product is available, and it is a cannabis spray called Sativex, used predominantly for multiple sclerosis.
Thailand has just legalized cannabis for medical use. A part of the new law states that citizens with a medical cannabis license or prescription can grow up to 6 plants in their household. The Thai government began permitting CBD for use in medical studies in 2018. Those who use cannabis recreationally still face strict punishment, including up to 10 years in prison.
Despite the fact that the earliest documented use of cannabis occurred in China, cannabis remains illegal for all uses in China. Although not officially permitted, cannabis is cultivated and sold widely, and can often be found growing in the wild. The Chinese government is a large player in the medical cannabis market; it owns 309 of the 606 existing patents for medical cannabis, and is one of the world’s largest medical cannabis producers. China has a large domestic industry for CBD, and also exports it throughout the world.