Spain is finally moving toward the regulation of medical cannabis, with the government expected to approve a Royal Decree before the summer of 2025. This long-awaited development has been welcomed by patients, but it has also drawn criticism for its limited scope.
While the regulation represents a historic step, its conservative framework leaves much to be desired for those advocating for broader access.
What the proposal includes
The Spanish Ministry of Health has submitted the draft Royal Decree regulating medical cannabis to the European Commission. In line with European regulations, Brussels has three months to review and respond. Once approval is granted, the Council of State will issue its advice, paving the way for the government to finalise the decree.
The proposal focuses on the “dispensation of standardised magistral preparations of cannabis for therapeutic purposes.” This includes cannabis-based oils and two existing medications but excludes cannabis flowers and home cultivation. The entire process is expected to conclude within five months.
Can patients grow cannabis at home?
In Spain, growing cannabis for personal use is allowed within strict limits: cultivation must occur on private property, out of public view, and only for personal consumption. However, this exists in a legal grey area, with commercial production and sale remaining illegal.
The current proposal explicitly prohibits home cultivation for medical purposes. As a result, patients will need to rely on pharmacies to access cannabis products, limiting availability and convenience.
Approved conditions for medical cannabis
Medical cannabis will only be available as a last resort treatment when conventional therapies fail. Approved conditions include:
- Spasticity in multiple sclerosis
- Severe therapy-resistant epilepsy
- Nausea and vomiting caused by chemotherapy
- Chronic therapy-resistant pain
- Other conditions supported by scientific evidence
The Ministry of Health has indicated that this list could be expanded as new research emerges.
Criticism of the proposed regulation
While the regulation is seen as progress, it has faced criticism from patient groups and experts. Only medical specialists will be authorised to prescribe cannabis, and it will only be dispensed through hospital pharmacies. Critics argue this creates unnecessary barriers for patients.
Additionally, the exclusion of cannabis flowers—a format permitted in other countries—has been a significant point of contention.
“The program is too limited and lacks ambition,” said representatives of the Spanish Observatory of Medicinal Cannabis. They argue that cannabis offers therapeutic benefits for conditions such as fibromyalgia, Parkinson’s disease, and Alzheimer’s, which are not included in the current proposal.
The long journey to recognition
The regulation of medical cannabis in Spain has been a slow process. Advocacy by patient organisations and grassroots campaigns played a key role in pushing the issue into the spotlight. Although political parties like Podemos and Ciudadanos introduced proposals in the past, resistance—particularly from the Socialist Party (PSOE)—delayed progress.
A breakthrough came in 2021 when Parliament approved exploratory research into international medical cannabis programs, setting the stage for the current legislation.
Implications for Spain
If the decree is approved, Spain will join a growing list of countries that have legalised medical cannabis. For thousands of patients, it represents a long-overdue acknowledgment of cannabis as a legitimate treatment option.
However, patient groups continue to push for broader regulations, including expanded access and more inclusive conditions. While the upcoming regulation is a step forward, it highlights the need for further progress in ensuring comprehensive and equitable access to medical cannabis.
The expected approval of medical cannabis in Spain marks a significant milestone, but the program’s restrictive nature leaves room for improvement. For patients, this represents a glimmer of hope after years of waiting. However, continued advocacy will be essential to expand access and refine the program to better meet the needs of those who rely on this treatment.