Medical cannabis, the Trojan horse that is leading the way to marijuana legalisation in so many countries, and the treatment demanded by thousands of patients who have found unprecedented relief in cannabinoids. In Spain you often hear that growing medical cannabis is legal, or that when cannabis is used as medicine it refers to a type of marijuana that does not get you high, but nothing could be further from the truth. There is great confusion about medical cannabis and its legalisation. In this post we try to clear up doubts about what medical cannabis is and its legal status in Spain and Europe.
Uses of medical cannabis
The uses of medical cannabis are very numerous and depend on the cannabinoids patients take (CBD, THC or CBG, among others), how they are taken (tinctures, vaporisation, topical use or oils, among others) and the dose of these cannabinoids. Although people often wrongly say that medical cannabis is exclusively linked to CBD, this is incorrect, because cannabidiol is not the only cannabinoid with therapeutic properties. Broadly speaking, we will try to list the most common uses of medical cannabis based on the properties found in the two cannabinoids with the most clinical studies behind them, THC and CBD.
Medical uses of the cannabinoid CBD
CBD, whose scientific name is cannabidiol, is the cannabinoid that has revolutionised the perception of marijuana because it has no psychotropic effects (it does not get you high) and because of its proven applications against several types of epilepsy. In fact, CBD burst onto the scene with the successful treatment given to an American girl, Charlotte Figi, who suffered from a rare drug-resistant epilepsy whose seizures fell dramatically after her parents started her on CBD oil treatment. Since then, and since the scientist Raphael Mechoulam isolated the cannabinoid and explored the effects of cannabidiol in children with epileptic seizures, many children have successfully received treatments similar to Charlotte’s. But these anticonvulsant properties are not CBD’s only benefits. What other benefits are attributed to CBD? We list them below.
Medicinal properties of CBD:
- Anticonvulsant
- Neuroprotective
- Anti-inflammatory
- Anxiolytic
- Muscle relaxant
- Immunomodulator
- Antioxidant
- Antitumour
- Relaxant
Based on these medicinal properties, these are the diseases or conditions for which CBD-rich medical cannabis is used:
- Epilepsy
- Neurodegenerative diseases such as Parkinson’s or Alzheimer’s
- Inflammatory diseases such as arthritis, ulcerative colitis or Crohn’s disease
- Occasional pain
- Muscle problems or contractures
- Cancer, infections or other diseases linked to stimulation or depression of the immune system
- Cardiovascular diseases
- Anti-cancer treatments
- Anxiety
Medical uses of the cannabinoid THC
THC, whose scientific name is tetrahydrocannabinol, is the most controversial cannabinoid. It is controlled by the United Nations because of its psychoactive effects, but that does not mean it lacks therapeutic properties. Of course, its medical use becomes complicated if, to obtain its healing benefits, the patient has to deal with the substance’s psychoactivity, as well as other effects that may be unpleasant, such as tiredness, dry mouth or drowsiness. These side effects, it must be said, can be counteracted by taking cannabidiol at the same time, as it is an antagonist of THC and reduces its mental effects. Below we list the medicinal properties of THC:
- Anti-inflammatory
- Muscle relaxant
- Narcotic
- Anti-nausea and appetite stimulant
- Drowsiness
Based on these medicinal properties, these are the diseases or conditions for which THC-rich medical cannabis is used:
- Inflammatory diseases such as arthritis, ulcerative colitis or Crohn’s disease
- Muscle pain and contractures
- Acute and chronic pain
- Chemotherapy treatment
- Insomnia and sleep problems
European legislation on therapeutic cannabis
At European level there is no legislation on therapeutic cannabis. It has been debated several times in the European Parliament, but no legislation has followed. In fact, in February 2019, the European Parliament adopted a resolution urging the European Commission and member states to advance research into the therapeutic uses of cannabis. It also asked that, if the research results were favourable, its use to treat diseases and conditions should be allowed. But that resolution was not binding, so to date it is the member states themselves that regulate the use of medical cannabis within their borders.
The WHO’s position on medical cannabis
The World Health Organization has spoken out in favour of medical cannabis and has recommended on several occasions that the United Nations reduce controls on marijuana. The first time was in December 2017, when the WHO Expert Committee on Drug Dependence drew up a report stating that “CBD is not addictive”, “does not produce adverse psychoactive or cardiovascular effects”, “presents no individual or social risks” and has “promising therapeutic uses”. In the same report they described how several advanced studies had shown its effectiveness against epilepsy, and added a list of conditions for which CBD could be useful. Then, in February 2019, a WHO expert committee wrote a report on cannabis so that the UN Commission on Narcotic Drugs could assess whether cannabis needed to change control category, and recommended that the United Nations move the cannabis plant from Schedule IV of the Single Convention on Narcotic Drugs (1961), which covers the most dangerous substances, to Schedule I, which has lighter controls. The suggestion referred to cannabis and cannabis resin in general, but the experts specified one point: CBD preparations should be outside the international control applied to substances listed in the International Drug Control Conventions.
Medical cannabis in Spain
As of March 2021, medical cannabis in Spain was neither regulated nor legal. Cannabinoid therapies remained a reality used by hundreds of patients through patient associations or private clinics, but the health authorities did not provide for cannabis treatments. This meant that patients who had found relief in cannabis were supplied on the black market, where the product has no quality control, and did not always use cannabinoids under medical supervision. Although some political parties and the Spanish Medical Cannabis Observatory promoted bills to regulate medical cannabis in Spain, in the Spanish Congress of Deputies these initiatives were blocked. Update: in October 2025 Spain approved a royal decree regulating standardised cannabis preparations for medical use, prescribed by specialist doctors and dispensed by hospital pharmacies.
Do you need legal advice?
At S&F Abogados we specialise in cannabis law. Find out about our medical cannabis licence service, send us an online enquiry or call us on +34 919 532 802.
