The Rise of Medical Marijuana: Health Benefits and Changing Societal Attitudes
Medical marijuana in Poland: legality since 2017, Rpw prescription, costs, and clinical indications according to the NASEM report, as well as the difference compared to CBD from the store.
Just a decade ago, cannabis in the Polish public debate was associated solely with criminal law. Today, the same raw material, in the form of pharmaceutical herb or oil with standardized THC and CBD content, is available in pharmacies with an Rpw prescription. According to the report National Academies of Sciences, Engineering, and Medicine from 2017, there is conclusive or substantive evidence of the effectiveness of cannabinoids for three clinical indications: chronic pain, nausea after chemotherapy, and spasticity in multiple sclerosis. This article explains why medical marijuana is gaining popularity, what the patient pathway looks like in Poland in 2026, and what contemporary science says about it. Along the way, we also show where the greatest simplifications appear in the corpus of circulating information about cannabis.
KEY INFORMATION
• Medical marijuana has been available in Poland by prescription Rpw since November 1, 2017, following the amendment of the Act on Counteracting Drug Addiction (Journal of Laws 2017, item 1458).
• The strongest scientific evidence confirms effectiveness in three indications: chronic pain, nausea after chemotherapy, and spasticity in MS (NASEM, 2017).
• The number of filled Rpw prescriptions increased from several hundred per year in 2019 to over 600,000 in 2023.
• The THC threshold for legal hemp in Poland is 0.3% of the total delta-9-THC and THCA (Article 4, point 5 of the Act on Counteracting Drug Addiction, Journal of Laws 2022, item 763).
• CBD is not a controlled substance and is available over the counter as a dietary supplement or cosmetic.
What exactly is medical marijuana?
Medical marijuana is a pharmaceutical flower or extract from Cannabis sativa L. with controlled THC and CBD content, issued only by Rpw prescription. The category includes over 100 cannabinoids and synthetic preparations (NASEM, 2017). The key difference from cannabis in illegal trade is standardization, GMP control, and supervision by the attending physician.
The plant has identified over 100 cannabinoids, but two are clinically the most important. THC (delta-9-tetrahydrocannabinol) is responsible for psychoactive and analgesic effects. CBD (cannabidiol) does not produce a high but exhibits anticonvulsant, anxiolytic, and anti-inflammatory effects. Both molecules interact in what is known as the entourage effect.
| Form | Duration of action | Examples / feature |
|---|---|---|
| dried flower for vaporization | 5-15 minutes | Aurora, Bedrocan, Tilray |
| Olej z ekstraktu | 30-90 minutes, longer effect | standardized THC/CBD concentration |
| Gotowe leki rejestrowane | depending on the preparation | Sativex, Epidiolex |
Standardization of THC and CBD content is the foundation of medical marijuana pharmacy: each batch has laboratory-confirmed concentrations of both compounds, distinguishing it from material with unknown composition. Producers also provide a full profile of cannabinoids and terpenes on the packaging label, allowing doctors and pharmacists to select a preparation for a specific indication, rather than just the general strain name.
What has been the history of medical marijuana legalization?
The first breakthrough was California in 1996, when Proposition 215 legalized the use of cannabis for medical purposes. Other milestones include Germany in March 2017, Poland from November 1, 2017, and Canada, which additionally legalized recreational use in 2018. Over three decades, the law has changed in more than 50 jurisdictions worldwide.
| Year | Jurysdykcja | Event |
|---|---|---|
| 1996 | Kalifornia, USA | Proposition 215 referendum (55.6% in favor) legalizes medical cannabis for cancer patients and those with AIDS. |
| 2017 (marzec) | Germany | The "Cannabis als Medizin" law introduces reimbursement for selected indications. |
| 2017 (listopad) | Poland | The amendment to the Act on Counteracting Drug Addiction (Journal of Laws 2017, item 1458) comes into force; the first Rpw prescription was filled in January 2019. |
| 2018 (October) | Canada | Cannabis Act legalizuje konopie medycznie i rekreacyjnie |
By 2024, medical cannabis was legal in 38 states in the USA, although federal classification as Schedule I remains a subject of disputes. In Canada, the percentage of adults reporting cannabis use in the past year increased from about 14% in 2018 to over 25% in 2023, without the catastrophic health effects predicted before the reform.
How many patients in Poland use medical marijuana?
The Polish medical marijuana market is growing rapidly. The number of filled Rpw prescriptions for cannabis raw material increased from several hundred in 2019 to over 600,000 in 2023. According to industry data monitoring the P1 ZSMOPL system, over 8 tons of pharmaceutical herb arrived in Poland in 2024.
| Year | Zrealizowane recepty Rpw |
|---|---|
| 2019 | several hundred (the first full year of distribution) |
| 2020 | ponad 60 tys. |
| 2022 | ponad 280 tys. |
| 2023 | ponad 600 tys. |
| 2024 | import ponad 8 ton suszu farmaceutycznego (system P1 ZSMOPL) |
Analysis of inquiries directed to pharmacies specializing in filling Rpw prescriptions shows that there are two dominant groups of patients: individuals aged 35-55 with chronic pain (sciatica, fibromyalgia, neuropathies) and oncology patients aged 60 and older. A third, smaller group consists of parents of children with drug-resistant epilepsy seeking complementary therapy. The increase in the number of prescriptions is also driven by pharmacies specializing in filling Rpw prescriptions, which are increasing year by year in large cities, and the growing number of doctors willing to assess clinical indications. Nevertheless, access outside a few large centers can still be limited, and some patients travel dozens of kilometers to obtain a prescription and pick up their medication.
What are the main medical indications?
The strongest scientific evidence points to three therapeutic areas. According to the report NASEM (2017) there is conclusive evidence for the effectiveness of cannabinoids in treating chronic pain in adults, chemotherapy-induced nausea, and spasticity in multiple sclerosis. Other indications have weaker evidence bases, although a growing clinical foundation.
| Indication | Level of evidence | Key data |
|---|---|---|
| Chronic pain | high quality / moderate | pain reduction in 37% of patients compared to 31% in the placebo group (Whiting et al., 8 studies) |
| Nausea after chemotherapy | decisive (NASEM) | Nabilone and dronabinol registered by the FDA as early as 1985. |
| Spasticity in MS | decisive (NASEM) | About 40% of patients achieve clinically significant reduction in spasticity (Sativex) |
| Drug-resistant epilepsy (Dravet syndrome) | badanie III fazy | The median number of seizures decreased from 12.4 to 5.9 per month, p=0.01 (Devinsky et al., NEJM 2017) |
| PTSD and anxiety | ograniczone (NASEM) | An increasing number of clinical observations, but still lacking strong RCT studies |
Kevin Hill in a review published in JAMA (Hill, 2015) assesses that the use of cannabis in neuropathic pain is supported by high-quality evidence: six studies involving 396 patients. The meta-analysis Whiting i wsp. (2015) included a total of 79 studies and 6462 patients across various indications; in eight studies on pain, cannabinoids were associated with a reduction in pain intensity of at least 30% in 37% of patients compared to 31% in the placebo group. Low-quality evidence also suggests improvement in weight loss in patients with HIV/AIDS.
What is the endocannabinoid system?
The endocannabinoid system (ECS) is an internal network of receptors and lipid mediators, discovered in the 1990s by Raphael Mechoulam's team. It consists of CB1 and CB2 receptors, endogenous cannabinoids (anandamide, 2-AG), and enzymes. The ECS regulates pain, sleep, appetite, mood, and immune response, which is why cannabis exhibits such a wide range of effects.
| Element ECS | Rola |
|---|---|
| CB1 receptors | mainly in the brain (cortex, hippocampus, cerebellum); responsible for the psychoactivity of THC, memory, and coordination |
| CB2 receptors | mainly in immune system cells (B lymphocytes, macrophages); through them, CBD acts anti-inflammatory |
| Anandamid | endogenous ECS ligand, produced in response to pain, stress, and physical exertion |
| 2-AG (2-arachidonoyloglicerol) | the second main endogenous cannabinoid, modulates pain signaling and mood |
Endocannabinoid tone deficiency (CECD) is a hypothesis explaining, among other things, fibromyalgia and migraines. The fact that this system was discovered only while studying the mechanism of action of THC, and not the other way around, illustrates the paradox of cannabis pharmacology: thousands of years of traditional use preceded scientific understanding, and the plant helped uncover a fundamental regulatory system in mammals.
What cannabis-based medications are registered?
Four cannabinoid molecules have drug status registered by the FDA, EMA, or in national jurisdictions. Each has undergone a full registration pathway with phase III clinical trials, not just observations.
| Lek | Substance | Registration | Indication |
|---|---|---|---|
| Cesamet | nabilon (syntetyczny analog THC) | 1985, FDA | nausea after chemotherapy resistant to standard antiemetic drugs |
| Marinol | dronabinol (syntetyczny THC) | 1985, FDA | nausea after chemotherapy; anorexia in AIDS |
| Sativex | nabiksimols (THC i CBD 1:1) | 2010, UE | spasticity in adult patients with multiple sclerosis |
| Epidiolex / Epidyolex | kannabidiol farmaceutyczny | 2018 FDA, 2019 EMA | padaczka w zespole Draveta i Lennoxa-Gastauta |
Sativex, a sublingual spray containing standardized cannabis extract, is indicated when other antispastic medications fail. Epidiolex shows how an isolated cannabinoid follows the same registration pathway as other modern therapies: phase III clinical trials, safety and efficacy assessment, and only then registration. This distinguishes these four drugs from pharmaceutical cannabis, which patients receive on a prescription without separate registration of the product as a drug, although it is subject to the same GMP requirements as pharmaceutical raw material.
What does the NASEM 2017 report say about health benefits?
The report „The Health Effects of Cannabis and Cannabinoids” (NASEM, 2017) This is one of the most comprehensive reviews of the scientific literature on cannabis, based on over 10,000 publications. The committee classified the evidence into five categories, from decisive to insufficient. Only three indications received the highest category.
| Evidence category | Indications |
|---|---|
| Decisive / substantive | chronic pain in adults, nausea after chemotherapy, spasticity in MS |
| Moderate | sleep disorders with chronic pain, fibromyalgia, and MS; short-term improvement of MS symptoms |
| Limited / insufficient | anxiety, PTSD, glaucoma, Tourette's syndrome |
The report also indicates risks: an increased risk of road accidents after using THC, the risk of psychotic disorders in genetically predisposed individuals, and the impact on fetal development. However, the committee did not find conclusive evidence linking cannabis use to lung cancer, despite long-standing concerns. The authors also emphasize that most of the analyzed studies concerned short treatment periods, so data on the long-term safety of cannabis use remains incomplete. This is one of the reasons why the committee recommended further funding for clinical research instead of basing regulatory decisions solely on historical observations.
How are social attitudes changing in Poland?
Polish society is increasingly favorable towards medical marijuana. Support for the legalization of medical use has grown over the last decade, while recreational legalization remains contentious, although the percentage of supporters is also increasing, especially among those under 40.
| Source | Outcome |
|---|---|
| CBOS Surveys (2018-2023) | over 70% of Poles support the legalization of cannabis for medical purposes |
| ESPAD (2019, youth aged 15-16) | about 21% of students have had contact with cannabis at least once in their lives |
| Eurobarometr (Komisja Europejska) | Polish opinion is close to the EU average in accepting medical cannabis, but more conservative regarding recreational use |
The increase in acceptance is greatest among those aged 25-44 and among residents of large cities. The percentage of students having contact with cannabis has remained stable for a decade, despite regulatory changes regarding medical cannabis. Separating the debate on medical use from the debate on recreational use is, according to analyses by the European Commission, important for future regulatory reforms. A similar pattern is observed in other countries in the region: acceptance grows faster for clinical indications than for decriminalization of possession, suggesting that public opinion treats both issues as separate rather than a single package of decisions.
What does the patient pathway look like in Poland?
To legally access medical marijuana in Poland, a patient goes through five steps: a medical consultation, an assessment of indications, the issuance of an electronic prescription Rpw in the P1 system, fulfillment at a specialized pharmacy, and continuation of treatment with follow-up visits. The Rpw prescription is valid for 30 days from the date of issuance.
| Etap / aspekt | Information |
|---|---|
| Who issues the prescription | any doctor with the right to practice; in practice, mainly pain management anesthesiologists, neurologists, psychiatrists, and oncologists |
| Validity of the prescription | 30 dni od daty wystawienia, elektronicznie w systemie P1 |
| Koszt suszu | 50-90 PLN per gram; with a dose of 1 g per day, monthly therapy costs 1500-2700 PLN |
| Refundacja NFZ | point-based, limited to a few cases |
| Dostawcy surowca | Aurora, Tilray, Spectrum, Bedrocan, Cantourage, Cellen (po rozszerzeniu listy w 2023-2024 r.) |
Our observation of the cannabis market in Poland indicates that the biggest barrier for patients is not the price, but the unpredictability of supply: a patient who responds consistently to a specific strain often has to change the product after a few months, which requires a new dose adjustment. Step by step, we described this path in the guide how to become a medical marijuana patient in Poland, and we compiled the current list of available strains separately in the text about how to choose the right strain of medical marijuana how to choose the right strain of medical marijuana.
What is the difference between CBD available in stores and medical marijuana?
CBD from industrial hemp is legal for sale outside pharmacies in Poland if the raw material meets the threshold of 0.3% total delta-9-THC and THCA according to Article 4 point 5 of the Act on Counteracting Drug Addiction (Journal of Laws 2023, item 1939, as amended by the Act of March 24, 2022, Journal of Laws 2022, item 763). The national threshold corresponds to the EU threshold but arises from a separate legal basis. CBD does not require a prescription and is not medical marijuana.
| Feature | CBD ze sklepu | Medyczna marihuana (recepta) |
|---|---|---|
| THC content | trace amounts, below the threshold of 0.3% total THC and THCA | kontrolowana, standaryzowana (np. 5-22%) |
| Legal status | suplement diety lub kosmetyk | medication issued on prescription Rpw |
| Availability | sklep stacjonarny lub online, bez recepty | only pharmacies, after a medical consultation |
| Application | codzienne wsparcie dobrostanu | treatment of specific clinical indications under the supervision of a doctor |
According to a critical review WHO ECDD (2018), CBD does not show addictive potential or harmful effects at typical doses and should not be subject to international control. We discussed the conclusions of this report more broadly in the text raport WHO z 2018 o CBD. In Poland, cannabidiol is not listed in the register of controlled substances (Regulation of the Minister of Health of August 17, 2018, Journal of Laws 2024, item 1139).
What are the myths and facts about medical marijuana?
There are many misunderstandings surrounding medical marijuana. Below are five of the most common myths and what science says about them. Some popular beliefs have no basis in clinical data, while other warnings are fully justified (NASEM, 2017).
| Mit | Fakt |
|---|---|
| Medical marijuana is the same as illegal marijuana. | has standardized levels of THC and CBD, is produced according to GMP, and is subject to quality control, which cannot be said about material from illegal trade |
| Cannabis causes lung cancer | NASEM (2017) found no conclusive evidence of such a link; however, burning dried cannabis is harmful to the respiratory system, which is why vaporization is recommended |
| Anyone can get an Rpw prescription | A prescription is issued by a doctor after assessing the clinical indication, and access can vary depending on the region. |
| CBD is pseudoscience. | Cannabidiol is the active substance of the registered drug Epidiolex; Devinsky et al. (NEJM, 2017) demonstrated a statistically significant reduction in seizures in Dravet syndrome. |
| THC always causes addiction. | Cannabis use disorder affects an estimated 9% of regular recreational users (Anthony et al., 1994); in doctor-supervised therapy, the risk is lower. |
Paradoxically, one of the stronger arguments for broader use of medical marijuana in pain treatment is its safety profile: cannabis has a significantly lower potential for fatal overdose than opioids. In U.S. states that have legalized medical cannabis, some observational studies have reported a smaller increase in opioid-related deaths than in states without such regulations.
What does the future hold for medical marijuana in Poland?
Polish medical marijuana faces three main challenges from 2026 to 2030: stabilizing supply, educating doctors and patients, and the potential introduction of domestic cultivation. The regulator still does not allow the cultivation of cannabis for medical purposes, despite pressure from patient organizations and the agricultural sector.
| Wyzwanie | Stan obecny i perspektywa |
|---|---|
| Krajowa uprawa | The GIF still does not allow cultivation for medical purposes; Germany and the Czech Republic show that controlled domestic cultivation is possible. |
| Refundacja NFZ | Currently, only Sativex in selected MS centers and Epidiolex/Epidyolex for pediatric epilepsy; pharmaceutical cannabis remains fully paid. |
| Edukacja lekarzy | There is a lack of systematic teaching of cannabis pharmacology in universities; postgraduate courses are being developed, and the number of doctors actively issuing Rpw is estimated at several thousand. |
Arguments for domestic cultivation are economic (lower costs, greater supply stability) and strategic (independence from imports). Opponents point to quality control risks and possible leaks into illegal trade. Experiences from Germany and the Czech Republic, which allowed controlled domestic cultivation under regulatory supervision, show that it can be done without losing control over the supply chain. We discuss these challenges in more detail in the report. The development of the medical marijuana industry in Poland..
Summary
Medical marijuana has transitioned over three decades from a banned substance to a pharmaceutical available in pharmacies in 38 U.S. states, most EU countries, and over 50 jurisdictions worldwide. In Poland, it has been available by prescription Rpw since November 2017, and the number of patients is increasing dramatically year by year. The strongest scientific evidence points to three indications: chronic pain, nausea after chemotherapy, and spasticity in MS, according to. the NASEM report (2017).
However, the Polish patient pathway requires patience: supply shortages, high costs, and limited reimbursement are barriers that most patients still face. CBD from hemp remains a legal, widely available alternative for those seeking cannabinoid support without a prescription, but as a supplement, not a substitute for medication. If you are considering therapy, the first step should be a consultation with a doctor knowledgeable about cannabinoid pharmacology, rather than self-selecting a strain or concentration based on online forums. The coming years will show whether domestic cultivation and broader reimbursement will reduce the currently high barriers to entry for new patients.
Frequently Asked Questions
Is medical marijuana legal in Poland in 2026?
Yes. Medical marijuana has been legal in Poland since November 1, 2017, following the amendment to the Act on Counteracting Drug Addiction (Dz.U. 2017 poz. 1458). The raw material is dispensed by pharmacies on an Rpw prescription. The first prescriptions were filled in January 2019, and in 2023, the number of filled prescriptions exceeded 600,000 annually.
How to obtain an Rpw prescription for medical marijuana?
An Rpw prescription can be issued by any doctor with the right to practice if they assess the clinical indication as justified. In practice, it is most often issued by anesthesiologists dealing with pain, neurologists, psychiatrists, and family doctors. The prescription is electronic, valid for 30 days, and can be filled at a pharmacy with the available raw material.
How much does a monthly medical marijuana therapy cost?
The cost of flower in Polish pharmacies ranges from 50 to 90 PLN per gram. A patient with a typical dose of 1 g per day spends 1500-2700 PLN monthly. The NFZ reimburses selected preparations (Sativex, Epidiolex) for specific indications, but pharmaceutical flower remains fully paid.
What is the difference between CBD and medical marijuana?
CBD from hemp stores comes from hemp fiber, in which the total delta-9-THC and THCA does not exceed the threshold of 0.3%, and does not require a prescription. Medical marijuana contains controlled, higher amounts of THC and CBD, is produced according to GMP, and is dispensed exclusively on an Rpw prescription by a pharmacy.
Is medical marijuana addictive?
The risk of addiction exists but is lower than with opioids or benzodiazepines. Classic American studies (Anthony et al., 1994) estimate that about 9% of regular cannabis users develop a cannabis use disorder (CUD). In medical therapy, controlled by dosage and indication, the risk is lower than in recreational use.
Can I drive after using medical marijuana?
No. THC in the body is detected by drug tests and leads to the loss of driving rights and criminal liability, regardless of the Rpw prescription. Polish regulations do not provide a medical exception for THC. Patients treated with medical marijuana must refrain from driving or use products without THC.
What are the side effects of medical marijuana?
The most common side effects include dizziness, dry mouth, drowsiness, concentration disorders, tachycardia, and changes in appetite. At higher doses of THC, anxiety states and paranoid thoughts may occur. Whiting et al. (2015) noted an increased risk of short-term side effects, including serious ones, although most are mild.
How does vaporization differ from smoking medical flower?
Vaporization heats the herb to a temperature of 180-220 degrees Celsius, releasing cannabinoids without combustion. This produces vapor, not smoke, which eliminates most harmful combustion products. Polish doctors recommend only vaporizing medical herb. Medical vaporizers are certified as medical devices.
If you are interested in the legal category of CBD for daily support without a prescription, check out the offer of hemp flower in the category. drought in the u Bucha store.
The article is for informational and educational purposes and does not constitute legal advice. The legal status described in the article is valid as of the publication date: regulations regarding hemp may change. Before making a decision, consult a lawyer or current legal acts.
Author: Michał Waluk · Opublikowano: 2026-05-10 · Aktualizacja: 2026-08-10
