Which countries legalized medical cannabis before France?

Saying that a country has «legalized medical cannabis» can mean many different things. It could mean authorizing a medication like Sativex or Epidyolex, allowing the cultivation of cannabis for export… or actually allowing a patient to obtain cannabis with a prescription.

It was this last criterion that we chose: access to cannabis flowers, oils, extracts, or preparations, and not just a pharmaceutical product containing a cannabinoid. And with this definition, France is falling spectacularly behind.

The pioneers were nearly twenty years ahead of their time

As soon as 1996, California became the first U.S. state to authorize the medical use of cannabis. Alaska, Oregon, and Washington State followed suit in 1998.

The American paradox is that these programs are expanding even though cannabis remains illegal under federal law. That hasn’t stopped dozens of states from gradually establishing fully-fledged systems that allow patients to access cannabis: in 2024, 38 states, as well as Washington, D.C., and several U.S. territories, had a comprehensive medical program.

The Canada opens, for its part, starting at 1999 legal access to medical cannabis through individual exemptions, before establishing in 2001 a genuine program that allows certain patients to obtain or even produce dried cannabis.

The Netherlands followed by 2003. This time, the program provides standardized medical cannabis, prescribed by a doctor and dispensed directly at a pharmacy.

Visit Italy, doctors have been able to prescribe since 2006 compounded preparations made in pharmacies from cannabis, including flower buds intended for oral or vaporized use.

Israel is also among the pioneers, with a program that allows authorized patients to use medical cannabis under the supervision of the Ministry of Health, a program that will continue in 2015.

In other words, by the time France finally begins its pilot program in 2021, some countries will have already been allowing access to cannabis itself for a quarter of a century.

Then medical cannabis began to spread around the world

Starting in the mid-2010s, the movement gained momentum.

L’Australia has been expanding its national program since 2016, thereby allowing, in particular, the prescription of products that do not have a traditional marketing authorization. That same year, Colombia is establishing its framework for cannabis derivatives intended primarily for the domestic market.

Visit 2017, theGermany Allows Prescriptions to Be Filled at Pharmacies dried flowers and cannabis extracts for certain patients. Argentina and Peru are also enacting laws regulating the medical use of cannabis and its derivatives.

The year 2018 marks a further acceleration. The Portugal Legalizes the Prescription and Dispensing of Medications pharmacies sell not only medications but also preparations and substances derived directly from plants. The The United Kingdom authorizes certain medical specialists to prescribe cannabis-based products. The Luxembourg also adopts its measures.

And the movement extends far beyond Europe: the Thailand Amends Its Legislation in Late 2018 and then establishes clinics that offer cannabis products for medical use.

Uruguay, already known for regulating cannabis for adults in 2013, established in 2019 a national program specifically for medical and therapeutic cannabis.

Finally, the Medicinal Cannabis Scheme from New Zealand: Effective April 1, 2020. Oils, extracts, and even certain dried flowers may be prescribed.

All of that before the first patient in the French trial, in March 2021. And we’ll set aside the Czech Republic, Germany, Italy, the Netherlands, Croatia, Denmark, Finland, Norway, Poland, and Sweden, which already had established European programs or special initiatives in place at that time.

Africa: Beware of Deceptive «Legalizations»

In Africa, the situation is more complicated. Medical cannabis production is a source of growth for these countries, but it is often limited to export, with no authorized access for patients.

Lesotho was one of the first African countries to legally authorize the commercial cultivation of medical cannabis. Zimbabwe He, too, has developed a legal distribution network.

And in 2021, Morocco Enacts Law 13-21, which authorizes a regulated system for the cultivation, processing, and sale of cannabis, particularly for medical and pharmaceutical purposes.

But the legal production of medical cannabis does not necessarily mean that patients have legal access to medical cannabis.

And what about France in all this?

Although France authorized, by decree, the marketing of pharmaceutical products containing cannabis or its derivatives in 2013, it did not establish a program allowing doctors to prescribe cannabis flowers or oils to their patients.

To do this, We'll have to wait until March 2021 and the launch of a pilot study limited to 3,000 patients.

That door has since closed: No new patients have been able to enroll in the program since March 27, 2024. Patients already enrolled in the program benefited from a transitional arrangement, while the long-term framework prepared by the government has still not led to anything on widespread access for new patients.

So, how many countries have actually surpassed France?

Many. Canada, the Netherlands, Italy, Israel, Australia, Colombia, Germany, Argentina, Peru, Portugal, the United Kingdom, Luxembourg, Thailand, Uruguay, New Zealand… not to mention all the more restrictive or exceptional measures implemented elsewhere.

While patients were able to legally obtain medical cannabis in Canada around the turn of the 2000s and in Dutch pharmacies as early as 2003, in France, as of 2026, general access for new patients is still not a reality.