Legal and medical status of cannabis
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Cannabis is in Schedule IV of the 1961 international treaty the Single Convention on Narcotic Drugs, making it subject to special restrictions. Article 2 provides for the following, in reference to Schedule IV drugs:
A Party shall, if in its opinion the prevailing conditions in its country render it the most appropriate means of protecting the public health and welfare, prohibit the production, manufacture, export and import of, trade in, possession or use of any such drug except for amounts which may be necessary for medical and scientific research only, including clinical trials therewith to be conducted under or subject to the direct supervision and control of the Party.
This provision, while apparently providing for the limitation of cannabis to research purposes only, also seems to allow some latitude for nations to make their own judgments. The official Commentary on the Single Convention indicates that Parties are expected to make that judgment in good faith.
- 1 African countries
- 2 Albania
- 3 Australia
- 4 Austria
- 5 Belgium
- 6 Canada
- 7 Croatia
- 8 Czech Republic
- 9 France
- 10 Germany
- 11 Ecuador
- 12 Honduras
- 13 Ireland
- 14 Israel
- 15 Jamaica
- 16 Japan
- 17 Luxembourg
- 18 Netherlands
- 19 New Zealand
- 20 North Korea
- 21 Norway
- 22 Philippines
- 23 Poland
- 24 Portugal
- 25 Romania
- 26 Russia
- 27 Singapore
- 28 Spain
- 29 South Africa
- 30 Sweden
- 31 Switzerland
- 32 Thailand
- 33 United Kingdom
- 34 United States
- 35 Uruguay
- 36 See also
- 37 References
- 38 External links
Cannabis has been used in African countries since at least the 15th century. Its use was introduced by Arab traders, somehow connected to India. "In Africa, the plant was used for snake bite, to facilitate childbirth, malaria, fever, blood poisoning, anthrax, asthma, and dysentery." (Zuardi, 2006, 4) Though African governments have tried to limit and stop its use, it still seems to be deeply ingrained, mostly through religious rituals.
Growing cannabis for any reason is illegal, though AIDS and cancer patients are allowed to use the drug to treat their symptoms.
Cannabis is widely grown and tolerated. Possession is technically illegal but possession of small amounts can lead to a small fine in the worst case when a user is smoking in public, but most often the user is warned to use cannabis in a private area.
The village Lazarat in Albania is one of Europe's greatest producers of the finest cannabis. Possession or use of even small amounts is illegal in Albania. Individuals are arrested, although rarely convicted by court. Possession of large quantities may lead to several years in prison. However this is often overlooked and cannabis is sold and consumed openly.
After politicians in the Australian Capital Territory voted to allow doctors to determine when cannabis was appropriate for their patients, intense lobbying by the federal government resulted in the legislation being overturned. In May 2003 the then Premier of New South Wales, Mr Bob Carr, promised patients a four-year trial into the medical uses of cannabis – but little to no action was taken.
Low-potency cannabis grown agriculturally for use as industrial hemp is legal to grow, transport and process in all states and territories of Australia, provided one has the correct government licenses. Hemp products such as clothes and paper are legal to sell at a retail level without specific licenses. Using agricultural cannabis for drug purposes is illegal.
In Victoria, Tasmania, Queensland, New South Wales and Western Australia; non-industrial cannabis is criminalized, although prison sentences for small amounts are rare. More commonly in these regions, first or second-time offenders caught with small amounts will be offered treatment and can avoid any criminal sentence or a criminal record. Repeat offenders caught with small amounts are likely to be fined and forced into treatment rather than sent to jail, though they may still obtain a criminal record. South Australia has officially decriminalized personal use of non-industrial cannabis, although this is a poorly defined law. Northern Territory and the Australian Capital Territory have also decriminalized small amounts of non-industrial cannabis, and small amounts of non-hydroponically grown plants. In all regions, offenders caught with large amounts are considered to be trafficking and are much more likely to have a jail sentence handed down.
There is no current law allowing the medical use of cannabis in Australia, and the federal law regarding drug use places marijuana in Schedule 9 (the most restrictive category, which also includes heroin), meaning it has no legal medical use and cannot be prescribed by a doctor. Drugs in the other schedules are considered to have medical uses (for instance cocaine, morphine and amphetamine) and can be prescribed. Cannabis users who claim to use the plant for medical purposes are treated the same as anyone else using non-industrial cannabis. Nevertheless, questions remain about the scope for defences argued on the basis of necessitous medical use.
A media report on 16 May 2013 stated that a New South Wales parliamentary committee has recommended the use of medically-prescribed cannabis for terminally ill patients and has supported the legalisation of cannabis-based pharmaceuticals on such grounds. As part of the recommendation, the committee has called upon the cooperation of the federal Australian government for a scheme that would allow patients to possess up to 15 grams of cannabis. Also, both the patients and their carers would be required to obtain a certificate from a specialist, registration with the Department of Health and a photo Identification card.
Both Δ9-THC and pharmaceutical preparations containing Δ9-THC are listed in annex IV of the Austrian Narcotics Decree (Suchtgiftverordnung). Compendial formulations are manufactured upon prescription according to the German Neues Rezeptur-Formularium.
On 9 July 2008, the Austrian Parliament approved cannabis cultivation for scientific and medical uses. Cannabis cultivation is controlled by the Austrian Agency for Health and Food Safety (Österreichische Agentur für Gesundheit und Ernährungssicherheit, AGES).
In the main cities of the country (such as Innsbruck, Graz) and especially Vienna it is possible to find hemp-shops which are allowed to sell cannabis-seeds, plants and tools for cultivation. Cannabis consumption is widely tolerated through most Austrians.
Though the drug is still illegal, the Belgian government has recently initiated trials to determine the effectiveness of medical cannabis. There have been changes in laws in the past 10–15 years that create a stage of 'tolerance' toward the possession of small amounts of cannabis. This means police officers are not doing something unlawful when not punishing cannabis users for possession of a small amount of cannabis (up to 3 grams) or one female plant. It still being illegal, it is then ultimately the police-officer in question who may decide to give the cannabis back to the user and let him go (probably with a verbal warning).
In Hitzig v. Canada (2003), a court again declared Canada's Marijuana Medical Access Regulations unconstitutional "in not allowing seriously ill Canadians to use marijuana because there is no legal source of supply of the drug." In effect, this means that Canadians cannot be prosecuted for using marijuana medically because the Marijuana Medical Access Regulations gives patients the right to do so, but does not set up any legal apparatus for obtaining cannabis.
Back in July 2000, in the "Parker" (epileptic Terry Parker) decision, another judge had made a declaration of invalidity of Canada's drug laws as they relate to the "simple possession" of marijuana due to the lack of a reasonable exemption from the law for medicinal use. The Canadian government was given one year (a suspension of the declaration of invalidity) to remedy the situation, and created the Marijuana Medical Access Regulations. These regulations have been repeatedly deemed unconstitutional in a series of court decisions including "Hitzig."
In a similar case based upon these decisions, lawyer Brian McAllister argued on behalf of a sixteen-year-old that because the Canadian government, after setting up the MMAR, never reenacted the relevant section of the Controlled Drugs and Substances Act, Canada effectively has no prosecutable laws prohibiting the "simple possession" of any amount of cannabis.
Representatives of the United States federal government have claimed that decriminalizing cannabis in Canada may disrupt border trade and relations between the two countries; many Canadians believe that this remains the primary obstacle to decriminalization in Canada.
Canada produces about 400 kg of medical cannabis annually. From 2002 until 2009 the marijuana was produced in an abandoned mine in Flin Flon, Manitoba. On 19 April 2005, the Canadian government additionally licensed the prescription sale of a natural marijuana extract – effectively liquid marijuana – called Sativex.
The federal department Health Canada now provides detailed advice (for its own citizens), including not only the medical information needed to make an informed choice, but the law enforcement aspects, and how to apply for authorization to possess marijuana for medical purposes. There is also information that may be of help to the patient's health professional.
In Canada, the regulation on access to cannabis for medical purposes, established by Health Canada in February 2000, defines two categories of patients eligible for access to medical cannabis. BC College of Physicians and Surgeons’ recommendation, as well as the CMPA position, is that physicians may prescribe cannabis if they feel comfortable with it. The MMAR forms are a confidential document between Health Canada, the physician and the patient. The information is not shared with the College or with the RCMP. No doctor has ever gone to court or faced prosecution for filling out a form or for prescribing medical cannabis. Category 1 covers any symptoms treated within the context of providing compassionate end-of-life care or the symptoms associated with different medical conditions. Category 2 is for applicants who have debilitating symptom(s) of medical condition(s), other than those described in Category 1. The application of eligible patients must be supported by a medical practitioner.
The cannabis distributed by Health Canada is provided under the brand CannaMed by the company Prairie Plant Systems Inc. In 2006, 420 kg of CannaMed cannabis was sold, representing an increase of 80% over the previous year. However, patients complain of the single strain selection as well as low potency, providing a pre-ground product put through a wood chipper (which deteriorates rapidly) as well as gamma irradation and foul taste and smell.
It is also legal for patients approved by Health Canada to grow their own cannabis for personal consumption, and it's possible to obtain a production license as a person designated by a patient. Designated producers were permitted to grow a cannabis supply for only a single patient. However, that regulation and related restrictions on supply were found unconstitutional by the Federal Court of Canada in January 2008. The court found that these regulations did not allow a sufficient legal supply of medical cannabis, and thus forced many patients to purchase their medicine from unauthorized, black market sources. This was the eighth time in the previous ten years that the courts ruled against Health Canada's regulations restricting the supply of the medicine. On 14 Dec 2012 the Canadian government announced plans to overhaul its rules regarding medical cannabis.
In Canada, there are four forms of medical cannabis. The first one is a cannabis extract called Sativex that contains THC and cannabidiol in a spray form. The second is a synthetic or manmade THC called dronabinol marketed as Marinol. The third also a synthetic version of THC called nabilone that is called Cesamet on the markets. The fourth product is the herbal form of cannabis often referred to as marijuana.
Illegal to possess, buy or sell any amount of cannabis. Criminal punishment, and if a person is found guilty, can be jailed up to three years. Also, a person will parallelly be charged for infraction with fines up to €700. In practice, a person won't be charged for criminal activity if the amount is less than 1 g, but the infraction charge will occur.
A bill allowing cannabis to be legally available on prescription in pharmacies as a medicine was passed by the Czech Chamber of Deputies on 7 December 2012. From the total of 200 deputies 126 voted for and only 7 against the legalisation (27 abstained and 46 were absent from the vote). The Czech Senate passed the bill 30 January 2013. From the total of 81 senators 67 voted for legalisation and only 2 voted against (5 senators abstained and 7 were absent from the vote). The bill passed to the President of the Czech Republic who can either sign it (than bill comes into force), veto it (than Chamber of Deputies may override the veto and bill may still come into force) or not look at the bill at all in the given period (in this case the bill also comes into force). The bill also states that only imported cannabis will be allowed for sale in the first year "to ensure standards." After that, sales may expand to include registered, domestic production that is strictly monitored.
The law came into effect on 1 April 2013 and since then medical use of cannabis has been legal and regulated in the Czech Republic.
As of 8 June 2013, cannabis derivatives can be used in France for the manufacture of medicinal products. The products can only be obtained with a prescription and will only be prescribed when all other medications have failed to effectively relieve suffering. The amended legislation decriminalizes "the production, transport, export, possession, offering, acquisition or use of speciality pharmaceutials that contains one of these (cannabis-derivative) substances", while all cannabis products must be approved by the National Medical Safety Agency (Agence nationale de sécurité du médicament – ANSM). A Pharmacists' Union spokesperson explained to the media that the change will make it more straightforward to conduct research into cannabinoids.
In February 2008, seven German patients could legally be treated with medicinal cannabis, distributed by prescription in pharmacies. To regulate therapeutic use, Germany modeled on Dutch neighbor who distributes this way since in 2003 (120 kg in 2008).
In Germany, dronabinol was rescheduled in 1994 from annex I to annex II of the Narcotics Law (Betäubungsmittelgesetz) in order to ease research; in 1998 dronabinol was rescheduled from annex II to annex III and since then has been available by prescription, whereas Δ9-THC is still listed in annex I. Manufacturing instructions for dronabinol containing compendial formulations are described in the Neues Rezeptur-Formularium.
The German narcotics law (Betäubungsmittelgesetz) states that authorities aren't required to prosecute for the possession of a "minor amount" of any narcotic drug meant for personal consumption, except in cases "of public interest", i.e. consumption in public, in front of minors or within a public school or a state prison. The law is deliberately vague and allows state governments to implement their own policy. As such the definition of a "minor amount" varies in the case of Cannabis from 2-3g in Bavaria to 15g in Berlin. Also, some states exclude repeat offenders while others don't.
Dronabinol was rescheduled 1994 from annex I to annex II of the German Narcotics Law (Betäubungsmittelgesetz) in order to ease research; in 1998 dronabinol was rescheduled from annex II to annex III and since then has been available by prescription.
Although Δ9-THC is still listed in annex I, in a few cases, patients have been able to obtain from the federal drug authority a special permit to import natural Cannabis through a pharmacy. Manufacturing instructions for dronabinol containing compendial formulations are described in the Neues Rezeptur-Formularium.
According to the 2008 Constitution of Ecuador in its Article 364 the Ecuadorian state does not see drug consumption as a crime but only as a health concern. Since June 2013 the State drugs regulatory office CONSEP has published a table which establishes maximum quantities carried by persons so as to be considered in legal possession and that person as not a seller of drugs. The amount of marihuana which is allowed as personal consumption quantity is 10 grams of marijuana or hash.
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Use is illegal for both medical and recreational use and severe punishments are predicted in the law. Despite this however, enforcement for consumption is lax.
Under Irish law cannabis is not recognized as having any medical benefits. The most recent Misuse of Drugs (Designation) Order (S.I. No. 69/1998) lists cannabis, cannabis resin, cannabinol and its derivatives as schedule 1 drugs under the Misuse of Drugs Acts of 1977 and 1984. As a consequence manufacture, production, preparation, sale, supply, distribution and possession of cannabis is unlawful for any purpose, except under license from the Minister for Health. A license can be granted under section 13 of the 1977 act for the purpose of research, forensic analysis, or in respect of the use of the drug as an essential intermediate or starting material in an industrial manufacturing process. As recently as 2003 the Irish Medicines Board (under the Control of Clinical Trials Acts 1987 and 1990) granted permission to GW Pharmaceuticals for trials in Irish medical institutions for the use of a cannabis-based medicinal extract in controlling cancer and multiple sclerosis related pain. The licenses were granted by the Department of Health to allow trials in a county Cork hospice and Waterford Regional Hospital.
The gardaí (Irish police) have a level of discretion when dealing with recreational cannabis users. To procure a conviction any cannabis seized has to be sent for analysis to the Garda Forensic Science Laboratory. This, along with the time needed to process the arrest, means that individual gardaí may decide not to arrest for small amounts, but the drug will be seized and the name of the individual will be taken. Possession of cannabis is an arrestable offense and in 2003, 53 per cent of all drug seizures and 70 per cent of all drug-related prosecutions were for cannabis. Trafficking or possession with intent to supply are serious offenses under Irish law.
On being brought to court, the penalties for possession are outlined as follows: First offence: On summary conviction, to a fine not exceeding €381, or on conviction on indictment, to a fine not exceeding €635. Second offence: On summary conviction, to a fine not exceeding €508, or on conviction on indictment, to a fine not exceeding €1,269. Third or subsequent offence: On summary conviction, to a fine not exceeding €1,269 or, at the discretion of the court, to imprisonment for a term not exceeding twelve months, or to both the fine and the imprisonment, or on conviction on indictment, to a fine of such amount as the court considers appropriate or, at the discretion of the court, to imprisonment for a term not exceeding three years, or to both the fine and the imprisonment. There is no law against possession or sale of cannabis seeds.
Marijuana for medical use has been permitted in Israel since the early 1990s for cancer patients and those with pain-related illnesses such as Parkinson's, multiple sclerosis, Crohn's Disease, other chronic pain and post-traumatic stress disorder. Patients can smoke the drug, ingest it in liquid form, or apply it to the skin as a balm. The numbers of patients authorized to use marijuana in Israel in 2012 is about 10,000.
There are eight government-sanctioned cannabis growing operations in Israel, which distribute it for medical purposes to patients who have a prescription from a doctor, via either a company's store, or in a medical center.
THC, the psychoactive chemical component in marijuana that causes a high, was first isolated by Israeli scientists Raphael Mechoulam of the Hebrew University in Jerusalem's Center for Research on Pain and Yechiel Gaoni of the Weizmann Institute in 1964.
The Tikkun Olam company has developed a variety of marijuana that is reported to provide the medical benefits of cannabis, but without THC. The cannabis instead contains high quantities of CBD, a substance that is believed to be an anti-inflammatory ingredient, which helps alleviate pain.
Cannabis for recreational purposes is illegal, and even the smallest amounts may lead to an arrest. up to 15g of marijuana or hash will end up with an interrogation in the police station, but no major acts against the user. above 15g will lead to having a police record and is treated as non-personal use.
A small number of people have been granted special permission to use cannabis for medical uses by the Health Ministry.
Cannabis has been illegal in Jamaica for many decades despite its association with the island's culture. In October 2013, a bill to decriminalize cannabis was passed by the country's House of Representatives.
In Luxembourg the law passed in April 2001 decriminalizes cannabis consumption, as well as its possession for personal use. The law classifies substances into two categories: A (other substances under control) and B (cannabis).
The use of cannabis is illicit but the punishment will not include prison sentences. Thus, a cannabis user may be sentenced to pay a fine (€250 – €2,500). However, prison sentences from eight days to six months can still be applied, if cannabis use happens in front of minors, in schools, or at the workplace. Penalties increase up to two years of imprisonment in case of adults using cannabis with minors, and up to five years in case of medical doctors or pharmacists using cannabis in specific settings (e.g. prison, school, social services). Additionally, use or possession, acquisition, and transport for personal use of illicit substance(s) other than cannabis incurs between eight days to six months imprisonment and/or a fine of €250–2500; Nevertheless, between one and five years imprisonment and/or a fine of €500 – €1,250,000 are foreseen in case of illicit cultivation, production, fabrication, extract, import, export, sale, and offer of type A and B drugs.
Since 2003, the country's pharmacies distribute medicinal cannabis (pharmaceutical form of the natural plant) by prescription, in addition to other drugs containing cannabinoids (dronabinol, Sativex).
Cannabis has been available for recreational use in coffee shops since 1976. Thus it has also been available without a prescription for medical uses. In addition, since 2003 it is a legal prescription drug known as "Mediwiet", available at the pharmacy. There are 3 different kinds of medical cannabis in the Netherlands a fourth is in the make more about this you can find on http://www.cannabisbureau.nl/en/ It is important to note that laws remain on the books classifying possession and sale as illegal, but due to a non-enforcement policy, it has been de facto legalized.
Former Health Minister Annette King has stated that she is not "unsympathetic to using cannabis in a medicinal form, but that's different to saying we should let everybody smoke it." Her official position is that more conclusive studies are needed, and a method of regulating dosage is necessary before she support medical access to cannabis.
Scott David Findlay, a paraplegic, was convicted of cannabis charges. The judge, Robert Spear (Dunedin District Court) offered to allow community service instead of imprisonment, but Findlay does not recognize the validity of New Zealand's cannabis laws and would not perform community service. Judge Spear claimed this was a "hollow protest" that he was nonetheless allowed to make, and sentenced him to three months imprisonment.
Possession and cultivation of any THC substance is illegal and even small amounts can lead to heavy fines or jail. There is, of course, a black market, and even some semi-organized pot rings for medicinal purposes.
Possession of cannabis is illegal in the Philippines under Republic Act 9165 or The Comprehensive Dangerous Drugs Act of 2002, which prohibits anyone from cultivating or using it. A pro-medical marijuana NGO group called Philippine Organization for the Reform of Marijuana Laws or PORMAL seeks to challenge the law in order to legalize its use, there is stiff opposition from the Philippine Drug Enforcement Agency and from Senator Sotto III, who was the ex-head of the Dangerous Drug Boards on the grounds that prescribed drugs can be easily abused by patients and that the groups have not submitted the proper research material to prove its beneficial use.
Possession of most drugs, including cannabis, is illegal in Poland. Since 2011 prosecutors can arbitrarily drop the charges if certain conditions are met: the amount of drugs seized is of a limited quantity (although no such limit is explicitly stated) and the drugs seized are believed to be for personal consumption only
Since 2001, possession of any drug for personal use has been decriminalized, though sale and trafficking are still criminal offenses. One can still be arrested and fined for using cannabis in public, or be accused of drug trafficking if in possession of more than 25 grams.
Possession of marijuana is illegal in Romania. In 2013, Bulgarian news agency Novinite published an article claiming that Romania had become the tenth EU country to legalize medical marijuana. There is, however, no source for this claim, and there have been no law projects or enacted laws to this end anytime in 2013.
Since the initial report, this information has spread to other major news sites.
These claims came after the President of the National Drug Authority said that medical marijuana could legally be commercialised in Romania, if such a drug producer would put forward a request to the National Drug Authority. The President of the NDA also said that medical marijuana could have been commercialised (under license) in Romania since 2005, when law no. 339 classified cannabis as a substance of medical interest.
Possession of up to 6 grams (dry weight) of cannabis or 2 grams of hashish is punishable by fine. Possession of more than this amount is punishable by prison term.
Several cannabis consumption clubs and user associations have been established throughout Spain. These clubs, the first of which was created in 1991, are non-profit associations who grow cannabis and sell it at cost to its members. The legal status of these clubs is uncertain: in 1997, four members of the first club, the Barcelona Ramón Santos Association of Cannabis Studies, were sentenced to 4 months in prison and a 3000 euro fine, while at about the same time, the court of Bilbao ruled that another club was not in violation of the law. The Andalusian regional government also commissioned a study by criminal law professors on the "Therapeutic use of cannabis and the creation of establishments of acquisition and consumption. The study concluded that such clubs are legal as long as they distribute only to a restricted list of legal adults, provide only the amount of drugs necessary for immediate consumption, and not earn a profit. The Andalusian government never formally accepted these guidelines and the legal situation of the clubs remains insecure. In 2006 and 2007, members of these clubs were acquitted in trial for possession and sale of cannabis and the police were ordered to return seized crops."
In October 2005, the autonomous government in the region of Catalonia launched a program of therapeutical use of Sativex for 600 patients of a wide set of illnesses, from multiple sclerosis to cancer, in order to avoid nauseas or to relax tense muscles. The project involves six hospitals, forty researchers and sixty drugstores. The product is presented as an atomizer to be taken orally, and it will be delivered at drugstores inside some hospitals. The full text of the research initiative can be seen here, in Catalan, from the Universitat Autònoma de Barcelona.
In February 2014, a Member of Parliament from KwaZulu Natal, Dr Mario Oriani-Ambrosini, introduced the Medical Innovations Bill, calling for legalization of 'medical and industrial' cannabis. Dr Oriani-Ombrosini was diagnosed with lung cancer and has been on cannabinoid treatment for the last 6 months. The bill is set to be tabled for parliament in Jan 2015.
Cannabis has no officially recognized medical usage and medical use is not seen as an extenuating circumstance. Rather the opposite, in a case that drew some attention in the national press involving a multiple sclerosis patient, the disease, and the fact that she stated that cannabis helped her, were seen as an aggravated circumstance by the court. The court argued in the verdict that she lacked motivation to stop using the drug and therefore gave her an unconditioned jail sentence, although she was a first-time offender, she would have otherwise regularly been given a suspended sentence or a fine.
The Medical Products Agency reported in 2008 that no drugs containing cannabinoids are available, although they can have beneficial effects on symptoms like neuralgia. Cannabinoid mouth spray Sativex that is derived from cannabis plants was approved in Sweden for the treatment of spasticity due to Multiple Sclerosis on 22 December 2011.
Though all possession and cultivation remains illegal in all parts of the country, coffee shops can still be found in Bienne and Interlaken. On the whole, people possessing small doses are very rarely prosecuted (see Legality of cannabis in Switzerland).
Cannabis is illegal in Thailand and penalties for possession can be harsh. Large numbers of cannabis consumers continue to be reported, probably due to the ease of growing marijuana.
In 1999, a House of Lords inquiry recommended that cannabis be made available with a doctor's prescription. Though the government of the U.K. has not accepted the recommendations, new long-term clinical trials have been authorized. Sometimes juries have returned verdicts of "not guilty" for people charged with marijuana possession for medical use though there are many people in jail for the offence of possession, cultivation or supplying medical marijuana.
In 2003, the U.K. company GW Pharmaceuticals, which has been granted the exclusive licence to cultivate cannabis for medicinal trials, had hopes of obtaining regulatory approval for the manufacture and sale of a cannabis-based medicine in the United Kingdom starting in 2004. Although licensed for prescription and sale in Canada in 2005, it was not until April 2013 that Sativex was moved to Schedule IV of the UK Drugs Act. This allows it to be prescribed by a GP, in the same way as drugs such as Diazepam or Codeine. However, a pack of 3 90-dose bottles of the drug costs £375, with an annual supply for a typical patient expected to cost £4250. This puts it beyond the reach of most individual patients and NHS trusts for all but the most serious cases. It is also far more expensive than similar medicines produced under the US medical marijuana scheme, which cost approximately $21US per bottle.
As a Schedule I drug under the federal Controlled Substances Act of 1970, marijuana (cannabis) is considered to have "no accepted medical use" and have a high potential for abuse and physical and/or emotional dependence. Cannabis use is illegal for any reason, with the exception of FDA-approved research programs. These programs, though, are hard to get approved. Those wishing to conduct research must get permission granted by the DEA and acquire the supply of cannabis from the NIDA. The Controlled Substances Act allows mis-controlled substances to be reclassified by petition by any member of the public, but federal agencies have so far delayed for many years each such petition on behalf of cannabis, and then denied it. (See removal of cannabis from Schedule I of the Controlled Substances Act.)
A successful "medical necessity" defense by patient Robert Randall led the FDA to create a "Compassionate Investigational New Drug program", which provides medical cannabis grown under a NIDA contract at the Research Institute for Pharmaceutical Science at the University of Mississippi to a small number of patients since 1978. The program was closed to new patients in 1992 when many AIDS patients applied., public health authorities concluded there was no scientific value to it, and due to President George H.W. Bush administration's desire to "get tough on crime and drugs." Four living patients continue to receive federal marijuana, including, since 1983, Irvin Rosenfeld (for bone spurs), a 52-year-old stockbroker who has been featured in numerous print articles and on the Penn & Teller: Bullshit! cable television series; Elvy Musikka (for glaucoma); and George McMahon (who authored Prescription Pot, a book detailing the federal program). The marijuana is grown on a farm at the University of Mississippi in Oxford and each person receives 300 doses a month. These patients are required by the U.S. Government to smoke the marijuana through a "rolled paper tube" (not ingesting or using pipes or vaporizers). Patients and their doctors report significant medical benefits from their use of marijuana. Many have reduced the amount of pharmaceuticals in their medicine regimen. However, these patients have also experienced hardships due to legal confusions. One was detained in prison for a short time after he was found with his allowed dosages.
There is a split between the U.S. federal and many state governments over medical marijuana policy. On 6 June 2005, the Supreme Court, in Gonzales v. Raich, ruled in a 6–3 decision that Congress has the right to outlaw medicinal cannabis, thus subjecting all patients to federal prosecution even in states where the treatment is legalized. Currently, there are at least sixteen states with medical marijuana laws in effect on the books: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, New Jersey and Washington, plus the District of Columbia. Maryland's law does not legalize possession of medical cannabis, but rather makes it a non-incarcerable offense with a maximum penalty of a $100 fine. The case brought into tension two themes of the Rehnquist court: the limits it has imposed on the federal government and the latitude it has afforded law enforcement officers. Joining Justice John Paul Stevens's majority decision were Justices Anthony Kennedy, David Souter, Ruth Bader Ginsburg, and Stephen Breyer. Justice Antonin Scalia wrote separately to say he agreed with the result, though not the majority's reasoning. Chief Justice William Rehnquist and Justices Sandra Day O'Connor and Clarence Thomas dissented.
DEA and NIDA opposition prevented any scientific studies of medical marijuana for more than a decade, but in the 1990s, activists and doctors were energized by seeing marijuana help dying AIDS patients. A study of smoked marijuana at the University of California, San Francisco, under Dr. Donald Abrams was approved after five years. Further research followed, particularly due to a ten million dollar research appropriation by the California legislature. The University of California coordinates this research. However, there are still significant barriers, unique among Schedule I substances, to conducting medical marijuana research in the US. Many years of work would remain before sufficient research could be approved and conducted to meet the FDA's standards for approving marijuana as a new prescription medicine.
A recent Gallup poll shows that in the past year (2012-2013), support for legalization of cannabis has shot up, with 58% of the US population now supporting the idea. While Congress has consistently rejected legislation to allow medical use of marijuana, 33 states and the District of Columbia have authorized it in some form. Most require that it be "prescribed", which is problematic when federal agencies control doctors' power to prescribe. Many states (listed above) have made laws which permit doctors to instead "recommend" marijuana, starting with California Proposition 215 (1996). In 2004, Montana legalized medical marijuana by a statewide referendum. Hawaii, Maine and Maryland have legalized medical marijuana by legislative action, and the California legislature expanded patient protections in 2003. District of Columbia voters also passed several medical marijuana initiatives, but Congress first denied the funds to count the vote, then when that was declared unconstitutional, voted to overturn the initiative, led by Rep. Bob Barr. Only years after Barr lost his election was the federal prohibition on DC medical marijuana allowed to lapse. Even where medical marijuana is legal, some law enforcement agencies and individual officers continue to harass or arrest patients, or confiscate the drug. For example, the official position of the California Narcotics Officers Association is that medical marijuana activists "misled" the public which voted to change the law. Legal and social support groups such as Americans for Safe Access  have sprung up in defense.
Sale of medical marijuana is illegal or barely legal, even in states where patients have the right to grow or use it, due to public confusion between dispensaries and "drug dealers". However, medical marijuana dispensaries have been established in many locations, particularly in California, where they work openly with local government officials to resolve difficulties. Many offer social services, medical consultations, and support groups as well as medicine. The first such dispensary, known as the Cannabis Buyer's Club (CBC), was opened by Dennis Peron in February 1994. The club operated openly in San Francisco for years, even before medical marijuana was legalized. Local police and politicians did not want to be seen arresting suffering AIDS patients, or denying them any medicine that could help them. This gay community activism led directly to the "Compassionate Use Act" medical marijuana initiative, California Proposition 215 (1996), which voters approved.
Washington state Initiative 692, passed by the voters in 1998, also authorizes the medical use of marijuana. On 2 November 2004, the voters of Ann Arbor, Michigan passed a similar resolution with 74% approval. In early 2005, Rhode Island was the first state to effectively legalize medical marijuana by a vote of the legislature rather than of the citizens.
In NYC, in 2001, local activist Kenny Toglia, known by some as "The Dog," achieved a significant victory for medical cannabis when charges against him were dropped in the "marijuana cookie case". He was arrested at "University of the Streets", a locally owned black community center on the corner of Tompkins Square at East 7th Street, with more than a pound of marijuana. Ultimately, all charges against him were dismissed following his complaint that the arresting officers had consumed a number of oatmeal cookies laced with marijuana which had been intended for use by patients with AIDS suffering from wasting syndrome. The events following his arrest led to the issue becoming important in the New York state gubernatorial campaign, and subsequently turned the statewide political tide in favor of the issue.
Although the DEA states that they "don't target sick and dying people", federal arrests of medical marijuana users and suppliers continue. Close to thirty federal criminal cases about medical marijuana are pending. Several jurisdictions, including Oakland, California and San Mateo County, California have announced plans to distribute medical marijuana to patients. Ed Rosenthal, author of dozens of books on marijuana cultivation, grew small "starter" plants for patients on behalf of the city government of Oakland. He was convicted in federal court of manufacturing marijuana, by a jury which was never told that his marijuana was for medical patients. Shortly after the trial, eight of the fourteen jurors (and alternates) who convicted him called a press conference and denounced their verdict, arguing that the trial was not fair because the evidence that Rosenthal was growing marijuana for medical use, working on behalf of the city, and was told by DEA agents and city officials that he was immune to prosecution, was all suppressed by the judge as "irrelevant under federal law". The jury discovered the real facts by reading newspapers, within hours after delivering their verdict. As a result of the intense public scrutiny, Rosenthal was given the most lenient possible sentence – a few days of time already served – since they had already found him guilty and could not change their verdict. He is appealing his felony conviction, and the federal government is appealing the short sentence.
The late Peter McWilliams, a vocal supporter of medical cannabis who was terminally ill with AIDS and cancer, was arrested by the DEA and convicted for violating federal marijuana laws. Even as he vomited repeatedly during court proceedings, McWilliams was not allowed by the federal judge to explain his condition or its connection to the charges against him. His mother's house had been used to collateralize the bond on which he was allowed to remain free pending sentencing, a condition of which was that he refrain from using cannabis. Prior to his death, McWilliams stated
The federal prosecutor personally called my mother to tell her that if I was found with even a trace of medical marijuana, her house would be taken away.
Richard Cowan and many other critics of U.S. drug policies have described his death as murder by the federal government, insofar as they denied him the use of the medical cannabis which might have prevented his death.
The federal government of the United States continues to argue that smoked cannabis has no recognized medical purpose (pointing to a definition of "medical purpose" published by the DEA, not the Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control, or the office of the U.S. Surgeon General and the U.S. Public Health Service) – many officials point to the difficulty of regulating dosage (a problem for treatment as well as research) despite the availability (in Canada and the U.K.) of dosage-controlled Sativex. The United States has also pressured other governments (especially Canada and Mexico, with which it shares long borders) to retain restrictions on marijuana.
The Health and Human Services Division of the federal government holds the patent US 6630507 for medical marijuana. The patent, "Cannabinoids as antioxidants and neuroprotectants", issued October 2003
On 4 November 2008, Massachusetts Ballot question No. 2 decriminalized possession of an ounce or less for personal use. It passed at almost a 2:1 ratio.
As of 2013, the recreational use of cannabis has been legalized in the states of Washington and Colorado, while Massachusetts voted "Yes" to question 3, thereby allowing the use of medical marijuana. On 6 November 2012, Colorado Amendment 64 (2012) was passed by initiative, thereby legalizing the recreational use of cannabis. In a historical event with global significance, Colorado Governor John Hickenlooper signed two bills on 28 May 2013 that made Colorado the world's first fully regulated recreational cannabis market for adults. Hickenlooper explained to the media: "Certainly, this industry will create jobs. Whether it’s good for the brand of our state is still up in the air. But the voters passed Amendment 64 by a clear majority. That’s why we’re going to implement it as effectively as we possibly can." In its independent analysis, the Colorado Center on Law & Policy found that the state could expect a to see "$60 million in total combined savings and additional revenue for Colorado’s budget with a potential for this number to double after 2017."
In 2013, the parents of a two-year-old with Dravet's syndrome confronted New Jersey governor Chris Christie, who signed a bill allowing access for sick children to medical marijuana in a controversy dubbed "pot for tots". In 2014, legislative proposals in New York, Washington state, Minnesota, and Florida are being considered, where "even some staunch opponents of medical marijuana now are willing to make an exception" to allow the marijuana extract for medical treatment. On 20 March 2014, the Florida House of Representatives Budget Committee passed the "so-called Charlotte’s Web measure (CS/HB 843)" designed to limit prosecutors' ability to prosecute those in possession of low THC/high CBD marijuana ("0.5 percent or less of tetrahydrocannabinol and more than 15 percent of cannabidiol") used for treating seizures. The bill takes effect 1 July 2014.
On 21 March 2014, Gary Herbert, the governor of Utah, signed a bill giving "families access to the marijuana extract for treating epilepsy." The bill, HB0105, allows import of Charlotte's Web extract across state lines from Colorado to Utah, and covers only use for intractable epilepsy with the consent of a neurologist. Also on 21 March 2014, an Arizona court found "that Arizona’s medical marijuana law allows consumption of the plant in extract form."
Because all possession and use of marijuana is a Federal offense, the U.S. Drug Enforcement Administration (DEA) has the power to arrest anyone in possession of any form of marijuana products. This has meant that those who follow what is legal in their particular state can still be arrested. In May 2014, in an amendment sponsored by Dana Rohrabacher, to bill H.R. 4660, the U.S. House of Representatives effectively "defunded DEA medical marijuana raids." The exact wording states: "None of the funds made available in this Act to the Department of Justice may be used, with respect to [states with medical marijuana laws in place], to prevent such States from implementing their own State laws that authorize the use, distribution, possession or cultivation of medical marijuana." Since other funds are available to the DEA, the amendment does not totally eliminate the possibility of DEA action against users and growers.
Uruguay has no legislation regarding personal usage of cannabis. While this technically allows its consumption, the lack of definition of "personal usage" is still a cause of discrepancies between courts of law, as allows the case law system. It is popular belief that possessing over an ounce (28 grams) is illegal and prosecutable, while lesser amounts are permitted to carry.
Recently, Uruguayan government officials President Jose Mujica and his administration announced, as part of a 16 proposals "package" to be introduced to Parliament, that the State would produce and commercialize cannabis to registered consumers for personal usage.
In 8 August 2012, on a bill presented to Parliament, Mujica's administration proposes that "the State assumes control and regulation of activities pertaining import, production, acquisition of any title, storage, commercialization, and distribution of marijuana and its derivatives, on terms and conditions of what the regularization states."
This broad bill is explained in detail on a letter Mujica's administration wrote to Parliament explaining their philosophy on the subject. The letter was signed by the Ministry of State and president Mujica. The letter mentions supposed facts on historical usage, failure in international regulation and a lost War on Drugs, among other subjects. The bill contains no mention to a list of registered consumers, as announced by the administration, nor is it mentioned on the letter to Parliament.
On an interview with CNN En Espanol, president Mujica announced a private company, under strict governmental control, would sell cannabis to users.
To control illegal cannabis trade from narcotics gangsters, Uruguay is the world's first that allowed to planting, distributing and using cannabis. A registered persons can plant up to 6 plants and in November 2014 there are 1,200 registered persons, while a registered users can buy up to 40 grams cannabis per month in drug stores. Since 1998, cannabis smoking is legal and now Uruguay has about 150,000 mild cannabis smokers.
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