What does the future of medicinal cannabis look like for different countries?

Regulations surrounding medicinal cannabis are changing all around the world. Most countries are shifting from the prohibition of medicinal cannabis to its control and taxation.

Here’s a look at what the future of medicinal cannabis is likely to hold for a number of specific countries.

The future of medicinal cannabis in Germany

The cannabis sector in Germany is forecast to become the biggest in Western Europe by 2025, according to Euromonitor International’s Passport Cannabis database. This estimate includes both legal and illicit use of cannabis, so is not solely representative of medicinal cannabis. As a whole, the cannabis market in Germany is expected to reach 5.8 billion Euros over the next four years.

Medicinal cannabis in Germany was legalised in 2017, and since then the market has grown to be worth 190 million Euros. The pandemic, however, has slowed it down with the three major companies involved forced to postpone their growing and production until this year. They’re planning to restart the production process now that the vaccinations are being rolled out, but it’s also possible that further delays will occur due to the ongoing impact of COVID-19.

Use of cannabis for recreational use in Germany is forecast to become legal for adults by 2025. This will have a knock-on impact on the production and growth of medicinal cannabis in that it will slow the focus on this specific sector. The predictions surrounding the legalisation of recreational cannabis is linked to the parliamentary election that is happening in 2021. It’s likely that the new Government will include at least one or two parties in favour of legalising recreational cannabis use.

Medicinal cannabis use and regulation in Canada and the US

In Canada we’ve seen the impact that legalising recreational cannabis has on medicinal cannabis availability. Due to the legislative changes and the impact of COVID-19, cannabis producers shifted their focus from medicinal to the adult-use recreational market.

This meant that registered patients dropped as they simply turned to the adult-use market and bought it themselves. The result of this on the Canadian medicinal cannabis market is that it will decline by -8% CAGR between 2020 and 2025, down to CA$153 million sales.

However, many patients will stay under the medical care of doctors as they receive instructions and guidance as well as the product. This is essential for many people who need medicinal cannabis, and something that the recreational sector can’t supply.

In America, states are constantly updating their legislation regarding cannabis use, but the biggest impacting factor over the next five years is federal legislative changes. By 2025, it’s expected that the sector will see growth of around 364%. This equates to US$53 billion in sales.

Another driver for growth of the cannabis market is state legislation. As more states shift stance on this, the medicinal market will also grow. However, there will be a certain crossover, as some of the legal adult use market absorbs some of the medicinal market.

What about the future of medicinal cannabis in the highly regulated UK?

Medicinal cannabis in the UK is attracting more interest due to increased media coverage. And there is huge potential for the cannabis market in the UK, which is currently worth around £2.8 billion. Public opinion is slowly shifting towards acceptance of the use of cannabis for medicinal and recreational reasons.

Some speculate that the negative impacts of COVID-19 and Brexit on the economy may open the door to more political support for legal recreational sales of cannabis. However, there is still a long way to go in the UK to make medicinal cannabis truly available to people who need it.

Despite it becoming legal in 2018, accessing a prescription for medicinal cannabis in the UK is still difficult. Prescriptions are only available privately from very few doctors, and even then, it’s not guaranteed that people can obtain them. The private sector will in turn eventually influence policy within the National Health Service (NHS), but the rate of legislative change is very slow.

What are the barriers to easy access of medicinal cannabis in the UK?

When the laws changed in November 2018, the UK Government made it possible for what they call ‘cannabis-based products for medicinal use in humans’ (CBPMs) to be prescribed by ‘specialist practitioners’. However, these reforms came with restrictions that mean only very few patients have been able to access it.

One of the biggest barriers has been that many doctors are still either unable or unwilling to prescribe medicinal cannabis to their patients. This is because of a combination of a lack of education and also the burden of responsibility placed on the doctor if they prescribe this treatment.

There are just three cannabis drugs abled to prescribed, as outlined by the National Institute for Health and Care Excellence (NICE) guidelines:

  1. Epidyolex
  2. Nabilone
  3. Sativex

Furthermore, these three drugs can only be prescribed to treat four conditions:

  1. Nausea and vomiting caused by chemotherapy.
  2. Spasticity of muscles in adults with MS (multiple sclerosis).
  3. Two severe forms of epilepsy that are resistant to other treatments.

Obviously, many patients, medicinal cannabis campaigners, doctors and experts have been protesting that these limitations are too strict. Reform is being pushed throughout the country, with many experts saying that physicians need more education and awareness in this area before progress can be made.

However, COVID-19 has emphasised just how important it is to move faster in order to improve wellbeing and health. There has been an upsurge in consumer interest in holistic health solutions that will continue to push the medicinal cannabis sector forward in the UK.

As more evidence about the efficacy and usefulness of medicinal cannabis arises, it’s very likely that the very restrictive regulations in the UK will start to ease. This in turn will help to lower the stigma of medicinal cannabis prescriptions. And as more companies enter the space with viable and logical product offerings, the cost of drugs will be driven down.

Given enough time, I think that cannabis will play a major role in UK healthcare. This is backed up by predictions for medicinal cannabis in the UK to register a CAGR of 180% between 2020 and 2025, which represents a rise of £123 million. These figures are according to the Passport Cannabis database.