Medical Cannabis & Cannabinoid Regulation 2025

Global Cannabis Reform Reaches Critical Juncture in 2025

Cannabis, once a niche and contentious field, has evolved into a multi-billion-dollar industry, influencing sectors such as textiles, biofuels and critical medical treatments. Historically, cannabis markets thrived in regions such as Amsterdam and China, but the liberalisation of laws in the USA and Canada has ignited global legislative revitalisation.

The cannabis industry is set for substantial growth, driven by the legalisation of recreational cannabis and the expansion of medical use. More recent independent forecasts have notably revised Europe’s cannabis-market outlook well beyond the USD7.25 billion by 2029 cited in last year’s guide. For the medical segment alone, estimates are that the market will grow from USD2.59 billion in 2024 to USD12.65 billion by 2033, at a compound annual growth rate (CAGR) of 18.33% over 2025–2033. Broader market analyses – including medical, adult-use and cannabidiol (CBD) – project expansion from USD4.48 billion in 2022 to USD18.84 billion by 2032, implying a 14.37% CAGR from 2024 to 2032. In the nearer term, Prohibition Partners forecasts that adult-use sales alone could reach EUR1.5 billion by 2026, contingent on the roll-out of recreational programmes in key markets.

Germany

Since the Bundestag passed the Cannabis Act on 23 February 2024, Germany has established a pioneering framework for both medical and recreational cannabis. Adults may cultivate up to three flowering plants per household, possess up to 50 g at home or 25 g in public, and join non-profit cannabis social clubs (maximum 500 members) that can distribute up to 50 g per member per month.

On the medical side, annual sales are increasing rapidly, driven by patient growth and streamlined regulations, including the removal of the tender requirement for domestic cultivation. Imports jumped from 32 tons in 2023 to over 70 tons in 2024, with Canada and Portugal as leading suppliers; current trends suggest imports could surpass 100 tons in 2025.

Digitalisation continues to reshape patient access: telemedicine platforms record over 150,000 visits per month across the leading providers, vastly expanding remote prescribing and reducing barriers for patients in all federal states.

On the recreational front, adults may legally grow three plants at home and acquire up to seven seeds or five clones each month. Non-profit social clubs began operations in mid-2024 and now operate under strict youth-protection and reporting rules.

Politically, on 9 April 2025 the incoming coalition confirmed that it will maintain the current cannabis framework and not seek repeal, committing instead to an open-ended evaluation of home-grow and club schemes in autumn 2025. This assessment will examine youth protection, market efficacy and supply security, and underpin any future legislative refinements.

Switzerland

Across the border in Switzerland, the pilot trials now encompass over 16,000 participants across seven adult-use projects. In February 2025, the National Council’s Health Committee communicated the main elements of a draft federal law by 14 votes to nine, which would permit adults to grow up to three plants, purchase and possess cannabis, and restrict sales to licensed non-profit outlets under a stringent electronic tracking system. Products will have to be neutrally packaged, non-branded and subject to an “incentive” tax, with all proceeds funding prevention and treatment programmes. Should this new legislation pass, Switzerland will lead the pack as the first jurisdiction in Europe to provide a fully commercialised supply chain for the non-medical adult-use cannabis market.

Portugal

Since the 2018 medical-legalisation framework, Portugal has surged ahead as Europe’s top medical cannabis exporter – shipping over 32 tons in 2024 – yet local patient access remains constrained by high, unsubsidised prices and limited domestic supply. Recreational use has been decriminalised since 2001, but no government-backed proposals for adult-use regulation, cultivation associations or social clubs have advanced amidst recent political upheaval and the growing influence of the far-right. With the current administration showing little appetite for change and the next elections still over a year away, the prospect of a fully regulated adult-use market in Portugal remains distant.

Spain

In Spain, medical cannabis regulation is on the verge of formalisation: the Ministry of Health’s draft Royal Decree – detailing prescription, preparation and dispensing of standardised cannabis-based magistral preparations via hospital pharmacies – was submitted to the European Commission in January 2025 and is expected to be approved before summer 2025, though stakeholders criticise its narrow scope and exclusion of cannabis flower and community pharmacies. Recreational cannabis remains illegal under national law, yet hundreds of non-profit cannabis social clubs continue to operate in a de facto tolerance framework (around 400 in Catalonia and over 600 nationwide); however, intensified enforcement has heightened legal uncertainty for operators and members, and no parliamentary bills to decriminalise or legalise adult use have progressed in 2025.

The Netherlands

In the Netherlands, the long-standing “backdoor” system – where coffee shops can legally sell cannabis, but suppliers must procure it illicitly – has entered a transformative experimental phase. Launched in December 2023 in Breda and Tilburg and expanded in June 2024 to ten municipalities, the “Closed Coffee Shop Chain Experiment” now requires, as of 7 April 2025, that all participating shops (around 75 in total) source exclusively from government-licensed cultivators. Initially limited to three licensed growers, the pool has been expanded to seven to meet demand. Under strict quality-control and traceability provisions overseen by an independent Monitoring and Evaluation Committee, this four-year trial will assess impacts on public health, crime, safety and nuisance, while providing data to inform nationwide policy. Early indicators point to more consistent product quality and reduced health risks compared to unregulated markets.

UK

In the UK, the medical cannabis sector has grown rapidly between 2023 and 2025, with both NHS and private prescriptions surging and patient numbers reaching the tens of thousands – making the UK one of Europe’s fastest-expanding medical markets. This expansion generated annual sales in excess of GBP200 million, driven by a growing network of private clinics, increasingly diverse product portfolios and streamlined telemedicine platforms that have lowered barriers to access and broadened treatment options. In early 2025, the Midlands-based manufacturer Dalgety shipped the UK’s first domestically produced medical-grade cannabis flower on prescription, a landmark moment for supply security and future market growth. Recreational cannabis remains illegal under the Misuse of Drugs Act 1971.

France

Medical cannabis in France remains in an extended pilot phase: originally launched in spring 2021, the national trial – serving around 1,800 patients – has been prolonged until 31 July 2025 while authorities finalise the regulatory framework and seek European Commission approval. On 21 March 2025, the government notified three draft regulatory texts to the European Commission:

• a decree integrating cannabis-based medicines into the Public Health Code and pharmacovigilance and distribution frameworks;
• a ministerial order defining product specifications and therapeutic indications; and
• a ministerial order setting technical conditions for cultivation, import-export, transport and storage of medicinal cannabis plants.

Member states and the Commission have a three-month stand-still period to comment, after which the decrees must be signed by the executive to take effect. Recreational cannabis remains fully illegal. The government has shown no appetite for decriminalisation beyond the existing fine-and-educate system, leaving France’s adult-use market in legal limbo.

Panama

Since President Laurentino Cortizo signed Panama’s medical cannabis law in October 2021 and two executive decrees in 2022 set out prescribing rules, patient registries and regulatory oversight, the country now operates one of Central America’s most comprehensive medical programmes. In January 2024, the National Directorate of Pharmacy and Drugs awarded the first seven manufacturing licences, paving the way for domestic production of oils, flower and extracts. Recreational use and cultivation remain illegal, though enforcement is generally lax, and personal possession is widely tolerated; no initiatives to decriminalise or regulate adult use have been proposed, so Panama’s recreational market remains closed.

Israel

Israel maintains one of the world’s largest medical-cannabis markets, with 135,213 registered patients as of November 2023 and over 140,000 active patients recorded in April 2024, making it the highest per capita globally and on track to exceed 240,000 by 2027. New regulations to expand prescribing criteria, originally slated for early 2024, have been delayed due to regional security concerns. Exports remain tightly controlled under existing frameworks. Recreational use has been decriminalised as an administrative infraction since April 2019, but no substantive Knesset bills to legalise or regulate adult-use markets have advanced in 2025.

Poland

Poland has emerged as one of Europe’s most dynamic medical-cannabis markets, with consumption up 224% in 2023; in response, the government doubled import quotas and tightened prescribing rules – shifting focus to oils and extracts and restricting inhalable products. A November 2024 ban on private telemedicine prescriptions limited remote prescribing to national health physicians and saw monthly prescriptions plunge from 68,000 in October to 28,000 by December 2024. Recreational use remains illegal in Poland. CBD products are legal under EU novel-food rules, and industrial hemp cultivation is licensed, while “non-industrial” cannabis remains prohibited outside medical channels.

USA

In the United States, the promise of federal reform has stalled. A hearing on the DEA’s proposed rescheduling of marijuana – initially set for 21 January 2025 – was postponed pending appeal, and as of April 2025 the process remains on hold with no further actions scheduled, underscoring ongoing federal uncertainty.

These mostly positive trends in the global cannabis industry present challenges for lawmakers, industry participants and consumers with navigating the fragmented legislation that sometimes supports, but at other times undermines, these fast-paced developments.

Legislative Frameworks Struggling to Keep Up With International Developments in the Cannabis Industry

Many legislative frameworks are inadequate for handling the complexities and opportunities presented by the burgeoning global cannabis market. Outdated laws, restrictive policies, uninformed authorities and inconsistent enforcement are widespread challenges.

Legal uncertainty in the cannabis industry stems from outdated laws that are designed to control criminal trade and license hemp for agriculture, not to regulate a sophisticated medical and wellness sector. Rapidly changing rules create further legal uncertainty as authorities interpret and implement new regulations. Most cannabis laws are unfit for the modern industry’s objectives, and consequently the proper application of many legal concepts remains unclear and untested in courts. The fluid regulatory environment complicates product development and business planning.

International developments have positively influenced the cannabis industry and associated legislative efforts, but progress has been slow. In January 2019, the World Health Organization (WHO) recommended several relaxations on cannabis controls to the UN Commission on Narcotic Drugs (CND). However, most recommendations were rejected. The CND removed cannabis and cannabis resin from Schedule IV of the main international drug control convention, potentially easing medical and scientific access. The CND also declined to clarify CBD regulations, maintaining legal ambiguity around CBD products. This decision reflects recognition of cannabis’s medical benefits but also a reluctance to fully relinquish control over recreational and wellness uses.

The European Union (EU) is moving towards more consistent regulations, demonstrated by the 2020 Kanavape case. The Court of Justice of the European Union ruled that EU law supersedes national laws regarding CBD, which cannot be classified as a narcotic based on available evidence. Despite this, the European Commission has paused CBD novel food applications pending further safety evaluations by the European Food Safety Authority. Inconsistent legislation and enforcement regularly subject permissible tetrahydrocannabinol (THC) thresholds to variation, hindering harmonisation and free movement of goods. Most European countries permit 0.3% THC in finished cannabis products; however, the Czech Republic and Switzerland allow 1% THC. The UK allows up to 1 mg of THC in the final product, applying a different metric altogether. These varying thresholds and metrics create significant issues for producers, whose products are often seized at customs, creating barriers to market entry and distribution.

This guide will highlight these pervasive challenges and structure its review of legislative frameworks in four primary sectors of the global cannabis industry:

• medical;
• wellness;
• recreational (or “adult use”); and
• industrial hemp.

Summary and Outlook

The legalisation of cannabis for medical and recreational purposes is gaining momentum. Nonetheless, while over 20 European countries have introduced medical cannabis legislation, recreational legalisation remains mixed. Germany is leading with its partial legalisation, and other countries are exploring non-profit models and pilot programmes for navigating EU and UN regulations.

Political challenges and regulatory clarity remain significant hurdles. Effective regulation that balances safety and commercial interests is crucial. Despite these challenges, the trend towards legalisation in Europe is expected to continue, driven by potential economic benefits and evolving social attitudes.

Legislative momentum in 2025 has already reshaped the cannabis landscape, setting the stage for substantial industry growth in the years ahead.

The Medical Cannabis & Cannabinoid Regulation 2025 Guide offers a comprehensive overview of cannabis laws across various jurisdictions, featuring articles on trends and developments. Each jurisdiction is reviewed through a question-and-answer format, facilitating easy comparison of specific issues and concerns, and providing a clear, jurisdiction-specific yet globally relevant guide to untangling the complexities of international cannabis laws.