Up in Smoke – Spain moves to regulate medicinal cannabis, but patients are frustrated with strict rules that limit access to a small group of eligible conditions.
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Up in Smoke – Spain moves to regulate medicinal cannabis, but patients are frustrated with strict rules that limit access to a small group of eligible conditions. Critics argue the new regulations risk pushing patients back to the black market. Find out who qualifies and why campaigners are fighting for broader access.
Spain moves to regulate medicinal cannabis: Here’s who will benefit from the therapy.
Spain has finally taken a step towards regulating medicinal cannabis, but the new rules have left many patients frustrated, claiming the legislation is too restrictive. On September 30, the Ministry of Health published a draft royal decree that outlines how cannabis-based medicines will be prescribed. However, critics argued that these regulations – which grant only a small group of patients access to cannabis treatments through custom prescriptions – fell short and risked driving patients back to the illegal market.
A Decade of Cannabis Legislation in the Making, Still Missing the Mark
The proposed regulations follow years of delays, compounded by a snap general election and government changes in 2023. Although recommendations were first made in June 2022, it wasn’t until Health Minister Monica Garcia took office in January 2024 that the framework finally began to take shape. Yet, supporters of the change said the limitations were a disappointment. Under the new rules, only specialist doctors can prescribe medicinal cannabis for a narrow list of conditions, including spasticity in multiple sclerosis (MS), refractory epilepsy, nausea and vomiting caused by chemotherapy, and chronic pain that hasn’t responded to standard treatments.
As reported by Cannabis Health, for patients like Carola Pérez, president of the Spanish Observatory of Medicinal Cannabis (OECM), who had spent years fighting for access, the draft decree felt like a step back. “They’ve made it so restrictive… it’s a mistake,” Pérez said. Patients who don’t meet the strict criteria will be left with no choice but to turn to the black market. “In tourist spots like Barcelona, there are social clubs, but what about the rest of Spain? People will be forced to grow at home or buy on the street, risking criminalisation,” she warned.
Strict Regulation and Monitoring
According to the draft, hospital pharmacy services will handle the preparation and dispensing of custom cannabis prescriptions, ensuring close monitoring of patients. But this adds another layer of difficulty for patients. Cannabis medicines will only be available through hospital chemists, meaning patients may need to travel long distances to access their treatment. This is very difficult for some living off-grid, if their nearest hospital is an hour’s drive away. If a patient has days when they struggle to get out of bed, they might not be able to access this medication.
Doctors prescribing medicinal cannabis must provide detailed reasoning in patient records, outlining the benefits and risks, and are required to continually evaluate the effects. Yet, critics argue that these checks and balances are too rigid, especially given the long waiting lists to see specialists. In some cases, it could take up to two years for patients to get an appointment, leaving them without effective treatment for extended periods.
More Research or Just Spanish ‘Red Tape’?
The government’s stance is that more research is needed before broader medicinal cannabis use can be approved. However, critics claim that there is already sufficient evidence from overseas studies that Spanish regulators refuse to acknowledge. At the same time, Spanish cannabis producers who have successfully built export businesses are unlikely to invest in local clinical trials.
The draft decree is still open for public consultation until October 21, giving campaigners a final opportunity to push for changes. The OECM is leading the charge, calling for wider access to medicinal cannabis, including GP prescribing and the availability of cannabis flowers. “We’ll fight for the right to access cannabis flowers, to get it from our local pharmacies, and for GPs – not just specialists – to prescribe it,” Pérez vowed.
A Step Towards Personalised Cannabis Medicine in Spain, But at What Cost?
While the new regulatory framework marks progress in Spain’s approach to medicinal cannabis, offering tailored treatment options for certain patients, many felt the restrictions undermined the potential benefits. The regulations aim to ensure the quality, safety, and efficacy of standardised cannabis preparations with strict supervision, but patients are questioning whether the framework has been overly politicised.
The battle for broader access to medicinal cannabis in Spain may be far from over, but patients and campaigners are determined to keep fighting for a system that works for everyone.
Who will be eligible for medicinal cannabis?
According to the draft decree, only certain patients – for whom there is scientific evidence showing that medicinal cannabis is beneficial – will be able to access these treatments. The conditions that will initially be eligible include:
- Spasticity from multiple sclerosis: This refers to the muscle stiffness and spasms experienced by people with multiple sclerosis. Medicinal cannabis has been shown to effectively relieve these symptoms.
- Refractory epilepsy: This refers to severe forms of epilepsy that don’t respond to conventional treatments, where medicinal cannabis could provide an alternative.
- Nausea and vomiting from chemotherapy: Some patients undergoing chemotherapy experience severe nausea and vomiting, and cannabis may help ease these symptoms.
- Chronic pain that doesn’t respond to regular painkillers: Cannabis could be an option for managing pain that doesn’t improve with traditional pain relief methods.
The list of conditions may expand over time as more scientific evidence becomes available and the regulations evolve. The official guidelines will be updated in the monograph published by the Spanish Agency of Medicines and Health Products (AEMPS) as part of the National Formulary.
Changes in legislation are expected all over Europe. Stay tuned.
