What is Medical Marijuana? The Complete Guide 2026 (Poland)

Medical marijuana is a standardized dry herb or extract of cannabis (Cannabis sativa L.) with a known cannabinoid profile, dispensed in pharmacies only with a Rpw prescription. It has been legal in Poland since November 1, 2017, based on Article 33a of the Act on Counteracting Drug Addiction (Journal of Laws 2005 No. 179 item 1485).

The cannabinoid therapy market is growing rapidly. According to data from pacjent.gov.pl, over 300,000 Rpw prescriptions were issued in Poland in 2024, compared to about 60,000 in 2020. This represents an increase of nearly 400% in four years. The number of doctors authorized to issue Rpw prescriptions exceeded 8,000 in the first quarter of 2026.

This guide explains what medical marijuana is in the legal reality of Poland in 2026. We discuss clinical indications, the prescription acquisition process, pharmaceutical forms, dosing, cannabinoids, therapy costs, and the difference between medical marijuana and CBD hemp flower. Sources include Polish legal acts, the Ministry of Health, PMC/PubMed, BMJ, Lancet, EMA, and Cochrane.

KEY INFORMATION
– Medical marijuana has been legal in Poland since November 1, 2017, on prescription (Article 33a of the Act on Counteracting Drug Addiction).
– In 2024, over 300,000 Rpw prescriptions were issued, compared to 60,000 in 2020. (patient.gov.pl, 2024). An increase of nearly 400% in four years.
– The main indications are chronic pain, spasticity in MS, chemotherapy nausea, refractory epilepsy, PTSD and oncological cachexia.
– Cost of therapy: PLN 1,050-3,900 per month, not reimbursed by the National Health Fund. Price of dried herb: PLN 35-65 per gram.
– From 2023, the cultivation of medical cannabis in Poland will be possible after obtaining a permit from the Chief Pharmaceutical Inspector.

What exactly is medical marijuana?

Medical marijuana is a standardized herbal extract or herb from the female inflorescences of Cannabis sativa L., with a declared cannabinoid content, produced under Good Manufacturing Practice (GMP) conditions. It is distinguished from other forms of cannabis by quality control, pharmaceutical status, and the requirement to obtain it only with a prescription. In Poland, it is available under the trade name "Cannabis Flos" and as imported products under the brands Aurora, Tilray, Bedrocan, and Spectrum (EMA, 2023).

Cannabis plants contain over 500 chemical compounds, of which more than 100 are cannabinoids. The medical effects of marijuana are based on the pharmacological activity of the main cannabinoids: THC (tetrahydrocannabinol) and CBD (cannabidiol). Both interact with the human endocannabinoid system (ECS), which was discovered only in the 1990s.

A medical product fundamentally differs from marijuana from the black market. Pharmaceutical dry herb has a label with precise THC and CBD concentrations, batch number, production date, expiration date, and laboratory analysis results. It is free from pesticides, heavy metals, mycotoxins, and microbiological contaminants. This is a pharmaceutical standard, not an agricultural product.

The history of therapeutic use of cannabis dates back at least 5,000 years. Records have been found in traditional Chinese medicine (2737 BC), India (Ayurveda), ancient Egypt, and Greece. In 19th-century Europe, cannabis was a standard medicine in pharmacopoeias, used against pain, insomnia, epilepsy, and migraines. A ban was introduced in the 20th century as part of a global drug prohibition policy.

What is Cannabis Flos in Poland?

Cannabis Flos is the Polish term for the medical cannabis dry herb allowed for trade. It is a medicinal product in the form of dried female flower clusters, either ground or whole, packaged in glass bottles or single-use packages. It contains standard concentrations of THC and CBD, with an allowable tolerance of plus/minus 10% relative to the declaration (Ministry of Health, 2023).

Typical strains available in Polish pharmacies include Bedrocan (22% THC, below 1% CBD), Bediol (6.3% THC, 8% CBD), Bedrolite (below 0.4% THC, 9% CBD), Pedanios 22/1 (22% THC, 1% CBD), Cannaxan (18% THC, 1% CBD), and Aurora 20/1 (20% THC, below 1% CBD). Each strain has a unique terpene and cannabinoid profile.

What pharmaceutical forms are available?

Medical marijuana in Poland comes in three main forms. Dry herb (Cannabis Flos) for vaporization is the most popular form, used by about 75% of patients. Cannabinoid oil (in a lipid carrier, such as MCT or sesame oil) taken sublingually covers about 20% of the market. Concentrated extracts (rarer) make up the remaining 5%.

Each form has a different pharmacokinetic profile. Vaporization provides a quick effect (5-15 minutes), with a bioavailability of 30-35%, and a short duration of action (1-3 hours). Sublingual oil has a delayed onset (30-60 minutes), a bioavailability of 13-19%, and a longer duration of action (4-8 hours). The choice depends on the therapeutic goal and clinical indication.

Medical marijuana is a standardized pharmaceutical product with known concentrations of THC and CBD, produced under GMP conditions, dispensed only with a Rpw prescription. It has been legal in Poland since November 1, 2017, based on Article 33a of the Act on Counteracting Drug Addiction (Journal of Laws 2005 No. 179 item 1485).

What is the legal status of medical marijuana in Poland in 2026?

Medical marijuana has been legal in Poland since November 1, 2017. The legal basis is Article 33a of the Act of July 29, 2005, on Counteracting Drug Addiction, added by the amendment of July 2017. It allows the trade of cannabis raw materials other than fiber for pharmaceutical purposes, including as an active substance for pharmacy formulations (Dz.U. 2017 poz. 1458).

Since 2023, the cultivation of cannabis other than fiber for medical purposes is also possible in Poland. Permits are issued by the Chief Pharmaceutical Inspector (GIF). By the end of 2025, such permits were granted to 11 domestic entities, including Pharmacann Polska, Aurora Polska, and Canopy Growth Polska. The first Polish medical dry herb reached pharmacies in the third quarter of 2024.

Legal distinction: medical marijuana (medical dry herb, extracts) requires a Rpw prescription. Recreational marijuana remains illegal in Poland, with a penalty of up to 3 years in prison for possession. CBD products from hemp (with THC below 0.3%) are available without a prescription as hemp dry herb, oils, cosmetics, and dietary supplements. These are three separate legal categories.

The international UN classification changed in December 2020. At the request of the World Health Organization (WHO), the UN Commission on Narcotic Drugs voted to remove cannabis from Schedule IV of the 1961 Convention. It remains in Schedule I (controlled substances) but without the strictest regulations, facilitating global pharmaceutical research (UNODC, 2020).

What does the Rpw prescription mean?

The Rpw prescription (Rp. list of narcotic substances) is issued for narcotic substances of group I-N and II-N, including medical marijuana. It takes the form of a pink copy and requires detailed annotations of dosage, quantity, and indication. It is valid for 30 days from the date of issuance. It can only be filled by a pharmacy with a GIF permit for the trade of narcotic substances, which in Poland includes about 40% of facilities (GIF, 2025).

The doctor issuing the Rpw does not need a special certificate but must be registered in the e-Prescription system and aware of professional responsibility for prescribing controlled substances. In practice, these are specialists: neurologists, oncologists, pain management anesthesiologists, psychiatrists, and palliative care physicians. Some family doctors also prescribe Rpw after supplementing their knowledge.

Cultivation of medical cannabis in Poland since 2023.

The amendment to the Act on Counteracting Drug Addiction from October 2022 allowed the cultivation of cannabis other than fiber for medical purposes starting January 1, 2023. Conditions: GIF permit, GMP certificate, electronic monitoring of cultivation, physical security, and insurance. The goal is to reduce imports and lower therapy costs (Ministry of Health, 2023).

The first cultivations started in 2024. Polish medical dry herb reached pharmacies in the third quarter of 2024 under the ThC-Med and Polcann brands. The price per gram is 38-52 PLN, which is about 20-30% cheaper than imported equivalents. In the first half of 2025, Polish production covered 18% of domestic demand, with a forecast of 35-45% by the end of 2026.

Unique observation: The difference between the Polish and German or Czech medical marijuana markets does not lie in regulations but in reimbursement. In Germany, a patient with public insurance receives reimbursement of up to 90% of therapy costs after application approval. In Poland, there is no reimbursement at all. This means that Polish medical marijuana remains a therapy mainly available to the middle class, despite its formal legality since 2017.

In Poland, medical marijuana has been available since November 1, 2017, based on Article 33a of the Act on Counteracting Drug Addiction. Since 2023, domestic cultivation has been allowed, and in 2024, over 300,000 Rpw prescriptions were issued, compared to 60,000 in 2020 (patient.gov.pl, 2024).

What are the indications for therapy with medical marijuana?

Polish law does not set a closed list of indications for medical marijuana. The decision about therapy lies with the doctor, after assessing the patient's clinical condition and exhausting standard treatment methods. In practice, the most common indications are chronic pain (about 45% of prescriptions), spasticity in multiple sclerosis, chemotherapy-induced nausea, refractory epilepsy, PTSD, migraines, insomnia, and oncological cachexia. The effectiveness in these indications is confirmed by systematic reviews (BMJ, 2021).

Unlike Germany or Israel, where strict lists of reimbursed indications exist, Poland uses an open model. This gives doctors flexibility but also requires professional responsibility. Medical marijuana in Poland is usually a second or third-line therapy, not a first choice. The patient should have documented ineffectiveness of standard methods.

Chronic and neuropathic pain

Neuropathic pain, caused by nerve damage, is the most common indication for medical marijuana in Poland. It includes diabetic neuropathies, post-herpetic neuralgia, phantom pain, postoperative pain syndrome, and pain in the course of MS. A Cochrane meta-analysis from 2018 included 16 studies with 1,750 patients. It showed moderate effectiveness of cannabinoids in reducing neuropathic pain by about 30% compared to placebo (Cochrane, 2018).

The mechanism of action involves the activation of CB1 receptors in the spinal cord and brain (THC) and modulation of TRPV1 and inhibition of COX-2 (CBD). The synergistic effect of both cannabinoids explains why balanced strains (1:1 THC:CBD) are more often recommended than pure high-THC strains. Typical dosage: 0.3-1 g of dry herb daily divided into 2-3 inhalations.

Multiple sclerosis and spasticity

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system. Spasticity (excessive muscle tension) affects 80% of patients in advanced stages. Nabiximols (Sativex), a standardized cannabis extract in a THC:CBD ratio of 1:1, has been registered in the EU for the treatment of MS spasticity since 2010 and is available in Poland as an imported drug (EMA, 2010).

Studies show that 40-50% of MS patients experience significant relief from spasticity after using Sativex or balanced medical dry herb. Other benefits include improved sleep quality, reduced chronic pain, and decreased frequency of spasms. Sativex is not reimbursed by the NHF in Poland, and the patient bears the cost themselves (300-600 PLN per month).

Oncology: nausea, vomiting, and cachexia

Dronabinol and nabilone (synthetic analogs of THC) have been registered in the USA as antiemetics in chemotherapy since the 1980s. In Poland, Rpw medical dry herb is used in oncology patients with nausea and vomiting resistant to classical antiemetics after cisplatin or doxorubicin. The antiemetic effectiveness of THC can be comparable to ondansetron in highly emetogenic regimens (PubMed, 2019).

Cachexia, or wasting in patients with advanced cancer, threatens life and worsens prognosis. THC stimulates appetite by activating CB1 in the hypothalamus. In clinical studies in 2018, dronabinol increased calorie intake by 23% in oncology patients, improving body weight by an average of 2.1 kg over 12 weeks of therapy (PMC, 2020).

Treatment-resistant epilepsy

Epidiolex (pure CBD) is approved by the FDA (2018) and EMA (2019) for the treatment of three refractory epilepsy syndromes in children: Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex. In randomized studies, CBD reduced the number of seizures by 36-44% compared to placebo (New England Journal of Medicine, 2018).

In Poland, Epidiolex is available as an imported drug for targeted import. The cost of monthly therapy is 3000-8000 PLN, rarely reimbursed by the NHF under the drug program. For pediatric patients with severe refractory epilepsy, it is often the only effective option after exhausting classical antiepileptic drugs (valproate, clobazam, topiramate).

PTSD, depression, and anxiety disorders

Post-traumatic stress disorder (PTSD) has increasingly appeared as an indication for medical marijuana in Europe since 2021-2022. In Poland, it is not separately specified, but psychiatrists issue Rpw in resistant cases of PTSD after exhausting sertraline, paroxetine, and prazosin. Cannabinoids modulate anxiety responses in the amygdala and hippocampus, reducing reactivity to traumatic stimuli (PMC, 2019).

In Canada and Israel, PTSD has been an official indication since 2014. Observational studies in military veterans show a 32% reduction in the intensity of flashbacks and improved sleep quality in 52% of patients after 8 weeks of therapy with balanced dry herb. CBD at higher doses (100-600 mg) has anxiolytic effects without psychoactivity.

Migraines and headaches

Migraine is a recurrent headache affecting about 12% of the population, more often women. Classical treatment (triptans, CGRP antagonists, beta-blockers) fails in some patients. Medical marijuana, especially vaporized dry herb with high THC, shows effectiveness in interrupting attacks and reducing frequency. In a study by Skrabek et al. from 2011, patients reported a 40% reduction in pain intensity and a shortening of attack duration (PubMed, 2011).

The mechanism likely involves modulation of trigeminal discharges and the vascular regulatory action of cannabinoids. Note: individuals prone to anxiety attacks or with a family history of psychosis should exercise caution, as high-THC strains may exacerbate migraines with aura. Balanced strains are preferred.

Insomnia and sleep disorders

Medical marijuana containing CBN (cannabinol) or myrcene is used in insomnia resistant to traditional medications. In clinical studies, 64% of patients with chronic insomnia reported improved sleep quality after 2 weeks of therapy with balanced dry herb (PMC, 2020). The effect mainly concerns shortening the time to fall asleep and prolonging deep sleep phases.

The most common indications for medical marijuana in Poland are chronic pain (45% of prescriptions), spasticity in MS, chemotherapy-induced nausea, refractory epilepsy (Dravet syndrome, Lennox-Gastaut), PTSD, migraines, and oncological cachexia. Effectiveness in neuropathic pain is about 30% compared to placebo (Cochrane, 2018).

How to obtain an Rpw prescription for medical marijuana?

The process of obtaining an Rpw prescription in Poland usually takes 1-3 weeks from the first contact with a doctor to fulfillment at the pharmacy. According to data from the medical services sector, over 80% of patients in 2025 used online e-visits, significantly shortening waiting times and logistical costs. In the first quarter of 2026, there were over 200 facilities in Poland specializing in cannabinoid therapy (patient.gov.pl, 2025).

Step-by-step process: choosing an authorized doctor, registering for an appointment, medical interview with indication analysis, providing documentation of previous treatment, assessing contraindications, issuing an e-Rpw prescription, fulfilling it at the pharmacy with a permit for the trade of narcotic substances. A follow-up visit usually occurs after 4-12 weeks, depending on the diagnosis.

Who can issue an Rpw prescription?

An Rpw prescription can be issued by any doctor with the right to practice and an account in the e-Prescription system that allows for the issuance of narcotic substances. In practice, these are mainly specialists: neurologists, oncologists, anesthesiologists (pain management specialists), psychiatrists, palliative care physicians, and rehabilitation doctors. Some family doctors also prescribe Rpw after supplementing their competencies in cannabinoid therapy.

The number of doctors issuing Rpw in Poland exceeded 8,000 in the first quarter of 2026, compared to about 2,500 in 2022. This is more than a threefold increase in four years. The increase is due to the development of cannabinoid teleconsultations, of which there are currently over 60 in Poland, and the liberalization of the Supreme Medical Chamber's approach to medical marijuana therapy.

What documents are needed for the visit?

At the visit with a doctor authorized to issue Rpw, it is advisable to have: complete medical documentation (hospital records, imaging test results, specialist consultations), a list of currently taken medications, a symptom diary from the last 4-8 weeks, referrals from other specialists, and a discharge summary indicating the ineffectiveness of standard therapy. A well-documented interview shortens the time for clinical decision-making.

Some teleconsultation facilities offer preliminary online qualification through a form. After filling out the questionnaire, the doctor assesses whether the patient qualifies for therapy and proposes an appointment date. If there are no grounds for Rpw, the patient receives recommendations for alternative methods, e.g., over-the-counter CBD products, consultation with another specialist, or further diagnostics.

What does an e-visit with a Rpw doctor look like?

An e-visit usually lasts 30-45 minutes. It includes a detailed interview, documentation analysis, safety assessment (contraindications, drug interactions, psychiatric history), discussion of therapy goals and patient expectations, selection of strain and form (dry herb or oil), establishing a dosing schedule, and discussing side effects and driving rules.

After the visit, the doctor issues an e-Rpw prescription. The patient receives an SMS code and email confirmation. Fulfillment occurs at a pharmacy with a GIF permit for the trade of narcotic substances. The pharmacy verifies the patient's identity (ID card or PESEL) and dispenses the product in a glass or plastic container with a complete pharmaceutical label.

From the Bucha editorial office: In conversations with patients after the first Rpw visit, three topics often arise that are insufficiently discussed during the consultation: how to set the vaporizer temperature, how long to hold the vapor in the lungs, and how to recognize the first signs of overdose (tachycardia, anxiety, nausea). We recommend that patients ask about these details directly, as they affect the comfort of the first days of therapy.

How long does verification at the pharmacy take?

Fulfilling the e-Rpw prescription at the pharmacy takes from 10 minutes (if the product is in stock) to 3 days (if it needs to be ordered). Rare strains, especially high-CBD or hybrid ones, may be ordered from wholesalers. Pharmacies cooperate with Farmacol, Neuk, Salus, or PGF. The patient can inquire about availability before the doctor's visit to avoid delays.

In 2025, about 4,200 pharmacies with a permit for the trade of narcotic substances operated in Poland, which is about 40% of all facilities. The list is available in the GIF search engine. It is advisable to choose a chain pharmacy or one specializing in cannabinoid products that regularly fulfills Rpw prescriptions and has a constant contact with wholesalers.

What cannabinoids are found in medical marijuana?

Medical marijuana contains over 100 different cannabinoids, about 150-200 terpenes, and 20 flavonoids. The most important cannabinoids are THC (tetrahydrocannabinol) and CBD (cannabidiol), which usually constitute 90-99% of the total active ingredient content. The rest are so-called minor cannabinoids: CBG, CBN, CBC, THCV, and CBDV, occurring in amounts of 0.1-5% of the dry herb mass (PMC, Frontiers in Pharmacology, 2020).

Typical concentrations in medical dry herb: THC 5-22%, CBD 0.5-15%. The THC:CBD ratio shapes the therapeutic profile of the strain. THC-dominant strains are used for pain and appetite stimulation, CBD-dominant for epilepsy, anxiety, and in children, and balanced (1:1) for MS and neuropathic pain. Terpenes add the entourage effect and modulate the action of the main cannabinoids.

THC, the psychoactive main component

Delta-9-tetrahydrocannabinol (THC) is the only strongly psychoactive natural cannabinoid. It binds to the CB1 receptor, which is densely present in the hippocampus, cerebral cortex, cerebellum, and striatum. Activation of CB1 by THC induces euphoria, altered perception of time, increased appetite, antiemetic effects, muscle relaxation, and analgesia (PMC, Journal of Neuroscience, 2012).

THC has a biphasic action profile. Doses below 5 mg produce mild therapeutic effects. Doses of 5-10 mg produce a classic "high" with euphoria and impaired concentration. Doses above 15-20 mg, especially in new users, can cause anxiety, paranoia, tachycardia, and psychotic symptoms. Hence the key role of gradual dosing ("start low, go slow") in Rpw therapy (Lancet Psychiatry, 2019).

CBD, a non-psychoactive modulator

Cannabidiol (CBD) does not induce psychoactivity or a high. It binds weakly to CB1 and CB2 receptors, mainly acting through allosteric modulation of CB1, activation of the serotonin receptor 5-HT1A, inhibition of anandamide breakdown, and influence on TRPV1 channels. It has documented anxiolytic, anti-inflammatory, and anticonvulsant effects. WHO considers CBD safe at doses up to 1500 mg daily (WHO, 2018).

CBD mitigates the psychoactivity of THC. Adding CBD to a high-THC strain reduces anxiety, paranoia, and tachycardia while maintaining analgesic effects. This explains why balanced strains are better tolerated than pure THC. In 2018, the FDA approved Epidiolex, a pure CBD drug, as the first cannabinoid with registered drug status.

CBG, CBN, CBC, and other minor cannabinoids

CBG (cannabigerol) is a chemical precursor to THC and CBD. It occurs in higher concentrations in the fresh plant but transforms into other cannabinoids as it matures. Mature dry herb usually contains 0.1-2% CBG. It has neuroprotective, anti-inflammatory, and antibacterial effects. It activates alpha-2-adrenergic receptors and TRPV1, explaining its role in appetite regulation and intraocular pressure.

CBN (cannabinol) is formed from the oxidation of THC under the influence of light and oxygen. Old dry herb has more CBN than fresh. It has mild sedative effects, enhancing the sleep-inducing effect of THC. CBC (cannabichromen) has anti-inflammatory and analgesic effects through TRPV1 and TRPA1 receptors, without activating CB1. THCV (tetrahydrocannabiwarin) is structurally similar to THC but acts oppositely at low doses, suppressing appetite.

Terpenes and the Entourage Effect

Terpenes are aromatic organic compounds responsible for the smell and part of the action of medical marijuana. The most important are myrcene (earthy, sedative), limonene (citrusy, mood-enhancing), linalool (lavender, calming), beta-caryophyllene (peppery, anti-inflammatory, activates CB2), pinene (pine, enhances concentration), and humulene (hoppy, appetite-suppressing).

The entourage effect is the synergistic action of the entire profile of cannabinoids and terpenes. Comparative studies show that full-spectrum extracts provide stronger and more complex therapeutic effects than isolated cannabinoids at the same dose (PMC, British Journal of Pharmacology, 2011). Therefore, medical dry herb is usually more effective than pure THC (dronabinol) at the same dose.

Medical marijuana contains over 100 cannabinoids (THC, CBD, CBG, CBN, CBC, THCV), 150-200 terpenes, and 20 flavonoids. Typical concentrations: THC 5-22%, CBD 0.5-15%. The entourage effect enhances the action of full-spectrum dry herb compared to isolated ingredients (PMC, British Journal of Pharmacology, 2011).

What are the forms and dosing methods for medical marijuana?

Medical marijuana in Poland comes in three main pharmaceutical forms: dry herb for vaporization (about 75% of the market), sublingual oil (about 20%), and concentrated extracts (about 5%). Each form has a different pharmacokinetic profile and duration of action. The bioavailability of vaporization is 30-35%, oral 6-20%, which directly affects the effective therapeutic dose (Frontiers in Pharmacology, 2020).

The "start low, go slow" dosing principle is the foundation of cannabinoid therapy. Patients begin with a minimal dose, for example, 0.1 g of vaporized herb once daily, and increase the dose every 3-7 days, monitoring their response. The goal: finding the minimum effective dose without excessive side effects. A full therapeutic response usually develops after 2-4 weeks of regular therapy.

Vaporization of herbs

The vaporizer heats the dry herb to 180-210 degrees Celsius, releasing cannabinoids and terpenes as water vapor, without burning plant material. This is a significantly safer form than smoking, free from benzo[a]pyrenes, carbon monoxide, and tar substances. The effect appears in 5-15 minutes, peaks in 30 minutes, with a total duration of action of 1-3 hours. The bioavailability of THC is 30-35%.

In Poland, recommended medical devices include the Volcano Medic 2, Mighty Medic, Storz & Bickel Venty, and DaVinci IQ2. Medical certification includes a Class IIa or IIb CE certificate. Costs range from 500 to 2500 PLN. Doctors typically recommend specific models. A temperature of 180-185°C releases primarily terpenes and CBD, 190-200°C releases THC and minor cannabinoids, and 205-210°C releases full spectrum.

Sublingual oil

Cannabinoid oils on Rpw prescription come in lipid carriers (sesame oil, MCT, coconut oil) with dissolved cannabinoid fractions. Dosing: drops under the tongue, held for 60-90 seconds for submucosal absorption, then swallowed. The effect appears in 15-45 minutes, peaks at 60-120 minutes, with a duration of action of 4-8 hours. Bioavailability is 13-19%.

Oils are preferred for patients who do not tolerate inhalation (asthma, COPD, children, elderly). They provide a more stable effect throughout the day, without the peaks and troughs characteristic of vaporization. A drawback is the delayed onset of action, which complicates dose control during initial attempts. They are mainly used in chronic therapy (pain, insomnia, spasticity).

Concentrated extracts

Extracts (CO2 oil, RSO, distillates) are concentrated forms with cannabinoid content of 40-90%. They are less commonly used in Poland, mainly in palliative care and oncology. Dosing is very precise (milligrams of cannabinoids) but requires a dosing syringe and an experienced patient. The price per gram ranges from 200 to 500 PLN, several times more expensive than dry herb when converted to mg of THC.

Typical dosing schemes

Therapy initiation: 0.05-0.1 g of vaporized dry herb daily (about 5-10 mg THC), increased every 3-7 days. Maintenance dose for most patients: 0.3-1 g of dry herb daily (30-100 mg THC) divided into 2-3 vaporization sessions. Monthly consumption: 10-30 g for chronic pain, 15-45 g for MS, 30-60 g for oncological cachexia.

For oils: start with 1-2 drops of 5% CBD twice daily, increasing every 3-7 days to 4-8 drops. For balanced strains or those with THC: start with 0.5-1 mg of THC, increasing to 5-10 mg in the evening dose. All schemes are individualized by the attending physician. Self-increasing the dose is not recommended, especially in the first 8 weeks.

The bioavailability of cannabinoids depends on the route of administration: vaporization 30-35%, sublingual oil 13-19%, edible products 6-20%. The dosing principle is "start low, go slow", usually 0.1 g of dried herb per day as a starting dose, increased every 3-7 days to a maintenance dose of 0.3-1 g (Frontiers in Pharmacology, 2020).

What is the difference between medical marijuana and CBD dry herb from hemp?

Medical marijuana and CBD dry herb are two distinct legal and pharmacological categories. Medical marijuana contains 5-22% THC, requires a Rpw prescription, and induces psychoactive effects. CBD dry herb from hemp contains up to 0.3% THC, is available without a prescription, does not induce a high, and mainly acts anxiolytically, anti-inflammatory, and anticonvulsively. This is a fundamental difference at the pharmacological and legal level (Journal of Laws 2005 No. 179 item 1485).

Both forms come from the same plant, Cannabis sativa L. The difference lies in the strain (chemotype) and cannabinoid profile. Hemp strains are selected for low THC and high CBD content and fiber. Marijuana strains are selected for high THC, mainly for medical purposes (after 1996) or earlier recreational.

Cannabinoid Profile

Medical marijuana: THC 5-22%, CBD 0.5-15%. Available strains include THC-dominant (Bedrocan, Pedanios 22/1), balanced (Bediol 6.3/8), and CBD-dominant (Bedrolite 0.4/9). CBD dry herb from hemp: CBD 4-15%, THC below 0.3% (often below 0.2%). No psychoactivity, no risk of a positive drug test with moderate consumption, no prescription requirement.

In Poland, CBD dry herb is a legal alternative for those who do not qualify for Rpw. Popular strains include White Widow CBD, Orange Bud CBD, Northern Lights CBD, Amnesia CBD, and Strawberry CBD. CBD content is 5-12%. Anxiolytic, relaxing, supportive of sleep and recovery, without psychoactive effects.

Therapeutic effect

Medical marijuana: strong analgesic, antiemetic, appetite-stimulating, muscle-relaxing, psychoactive effects. Used in chronic pain, spasticity in MS, chemotherapy, cachexia, epilepsy, PTSD. The action mainly results from the activation of CB1 by THC. The risk of addiction is 9% among regular users (NIDA, 2020).

CBD dry herb: anxiolytic, anti-inflammatory, anticonvulsant effects, supportive of sleep. No psychoactivity. WHO considers CBD safe and does not increase the risk of addiction (WHO, 2018). Used as a supplement for daily well-being, sleep support, and stress reduction. It does not replace Rpw therapy in advanced clinical indications.

Legal status and availability

Medical marijuana: legal only with a Rpw prescription, fulfilled at a pharmacy with a GIF permit, prescription validity of 30 days, the patient covers the full cost. CBD dry herb from hemp: available in specialty stores, pharmacies, and online without a prescription, according to EU Regulation 2021/2115 and Polish food law (when sold as a herbal raw material or for vaporization).

Medical marijuana (THC 5-22%, Rpw prescription) and CBD dry herb from hemp (CBD 4-15%, THC below 0.3%, without prescription) are two distinct categories. Medical marijuana has psychoactive and therapeutic effects in advanced indications. CBD acts anxiolytically and anti-inflammatorily without a high (WHO, 2018).

How much does therapy with medical marijuana cost in Poland in 2026?

Therapy with medical marijuana in Poland is not reimbursed by the NHF. The patient covers the full cost. The price of medical dry herb in pharmacies ranges from 35-65 PLN per gram, depending on the strain, manufacturer, and current availability. Typical monthly consumption of 30-60 g means a cost of 1050-3900 PLN. Additional costs include doctor visits, vaporizer, and accessories, raising the total cost of the first month of therapy to 2000-5000 PLN (patient.gov.pl, 2025).

This is one of the main barriers to access. In survey studies in 2024, 62% of patients indicated cost as the main reason for not completing Rpw therapy or limiting the dose below optimal. Other barriers: limited reimbursement, difficulties in finding a doctor, social stigma, doubts about effectiveness, fear of psychoactivity.

Prices of dry herb per gram by strain

Typical prices in Polish pharmacies (Q1 2026): Bedrocan (22% THC) 45-55 PLN/g, Bediol (6.3/8) 42-52 PLN/g, Bedrolite (0.4/9) 40-50 PLN/g, Pedanios 22/1 38-48 PLN/g, Cannaxan 40-55 PLN/g, Aurora 20/1 35-45 PLN/g. Polish dry herbs ThC-Med and Polcann (introduced in 2024) cost 38-52 PLN/g, which is about 20-30% cheaper than imported.

Prices of medical oils: THC 10% oil (extract) 350-500 PLN for 10 ml, medical CBD 10% oil 250-400 PLN for 10 ml, concentrated extracts like RSO 600-1200 PLN for 10 ml. Sativex (nabiximols) sublingual spray: 500-700 PLN for a 10 ml package, usually sufficient for 3-4 weeks of MS therapy.

Additional costs

Visit to a doctor authorized to issue Rpw: 200-500 PLN (first), 150-300 PLN (check-up every 3-6 months). Teleconsultation: 180-350 PLN for the first visit, 120-250 PLN for follow-up. Vaporizer: 500-2500 PLN (one-time). Accessories (grinder, cleaners, filters, cotton pads): 100-300 PLN annually. Annual therapy cost: 15,000-45,000 PLN, depending on dosage and strain.

Does the NHF reimburse costs?

In 2026, the NHF does not standardly reimburse medical marijuana or Cannabis Flos dry herb. An exception is Epidiolex (pure CBD) in the drug program for children with refractory epilepsy, available in about 15 reference centers. Sativex is formally registered in the EU but is not on the list of reimbursed drugs in Poland. The patient pays the full catalog price, about 500-700 PLN per month.

In 2024-2025, there was a discussion about reimbursing medical marijuana within the RIL (Health Innovation Council). Proposals included limited reimbursement for patients with MS, refractory epilepsy, and late-stage cancer. As of April 2026, none of the proposals have been implemented. Poland remains an EU country without reimbursement for medical marijuana (Ministry of Health, 2025).

What are the side effects and risks of medical marijuana?

Medical marijuana has a safety profile comparable to many psychotropic drugs and better than opioids. The most common side effects are dry mouth, drowsiness, dizziness, increased appetite, and tachycardia. According to a BMJ review, 30-40% of patients report mild side effects in the first weeks of therapy, usually subsiding after acclimatization (BMJ, 2021).

Risks mainly concern the THC fraction, not CBD. CBD is considered very safe, with the WHO assessing no significant risk of abuse, psychoactivity, or serious side effects at doses up to 1500 mg daily. THC, on the other hand, can induce anxiety, paranoia, tachycardia, psychosis, and addiction, especially in mentally sensitive individuals and at high doses.

Addiction to medical marijuana

Marijuana is addictive, though to a lesser extent than nicotine or alcohol. The risk of addiction for regular users is 9% in the general population and 17% in those starting in their teenage years (NIDA, 2020). For comparison: nicotine 32%, alcohol 15%, cocaine 17%. The risk is lower but real, especially with high-THC strains and prolonged use.

Withdrawal syndrome from medical marijuana includes irritability, insomnia, decreased appetite, anxiety, and low mood. It lasts 1-2 weeks after cessation. It is less severe than with alcohol or opioids, but for patients with a history of addiction, supervision is required. When ending therapy, doctors recommend gradually reducing the dose over 4-8 weeks.

Drug interactions

Cannabinoids inhibit cytochrome P450 enzymes (CYP3A4, CYP2C9, CYP2C19). This affects the metabolism of many drugs. Special caution: warfarin (risk of bleeding), statins, anticonvulsants (clobazam, valproate, phenytoin), some antidepressants (SSRIs, tricyclics), immunosuppressants, clarithromycin, ketoconazole (PMC, 2019).

Before starting therapy, it is necessary to verify the current pharmacotherapy. The attending physician should assess the risk of interactions and adjust doses. Sometimes a temporary deviation between taking the cannabinoid and another drug (2-4 hours) is sufficient, sometimes a dose change is necessary, and sometimes it is necessary to forgo marijuana in favor of a therapeutic alternative.

Contraindications

Absolute contraindications: pregnancy and breastfeeding (THC passes through the placenta and into breast milk), age under 18 (with pediatric exceptions in refractory epilepsy), active psychosis, schizophrenia or family history of psychosis in young individuals, severe liver and kidney failure, allergy to cannabinoids or oil carrier.

Relative contraindications: depression with suicidal thoughts, bipolar disorder in an acute phase, addiction to other substances, unstable cardiovascular disease (myocardial infarction within the last 6 months, uncontrolled arrhythmia), respiratory failure (advanced COPD), early pregnancy or reproductive plans.

Driving vehicles and operating machinery

Driving under the influence of THC is punished in Poland under rules analogous to alcohol, according to the Code of Offenses (Article 87) and the Penal Code (Article 178a). The detection threshold for THC in the blood is 1 ng/ml. THC metabolites (THC-COOH) are detectable in the blood for up to 48 hours and in urine for up to 30 days after the last dose in regular users. Patients with an Rpw prescription are not exempt from these regulations.

Most doctors recommend completely refraining from driving during therapy with medical marijuana containing THC. Alternatively, a safe interval of at least 8-12 hours after the last dose for vaporization and 24 hours for oral forms. For patients on CBD oils without THC (Bedrolite, Epidiolex), driving restrictions are milder.

Medical marijuana has mild side effects in 30-40% of patients (dry mouth, drowsiness, dizziness). The risk of addiction is 9% among regular users. Absolute contraindications: pregnancy, age under 18, active psychosis, severe liver failure (BMJ, 2021).

What does the medical marijuana market look like in Poland in 2026?

The Polish medical marijuana market is growing dynamically. The market value in 2024 was estimated at 330-380 million PLN, with a forecast of 550-650 million PLN in 2026. The number of patients exceeded 160,000 in the first quarter of 2026, compared to 40,000 in 2022. This is a fourfold increase in four years. Poland is currently the second-largest medical marijuana market in Central and Eastern Europe after the Czech Republic (EMA, 2025).

This growth results from several factors: generational change (younger doctors are more open), the development of cannabinoid teleconsultations, the liberalization of the Supreme Medical Chamber's position, broader availability of domestic dry herbs after 2024, and social acceptance of cannabinoid therapy. According to CBOS surveys in 2024, 76% of Poles support legal access to medical marijuana by prescription (CBOS, 2024).

The Polish patient and strain registry

In 2023, the Ministry of Health launched a pilot registry of cannabinoid therapy patients, collecting clinical data on effectiveness, side effects, and dosing profiles. In 2024-2025, the registry covered over 50,000 patients. The data serve to assess the pharmacoeconomic aspects of therapy and potential reimbursement in the future (Ministry of Health, 2025).

The Office for Registration of Medicinal Products publishes a list of strains approved for trade. As of April 2026, it includes 27 strains of Cannabis Flos dry herb, 8 types of THC/CBD oils, and 3 concentrated extracts. The list is updated quarterly as applications from producers come in. Polish dry herbs ThC-Med (4 strains) and Polcann (3 strains) are actively available.

Cannabinoid teleconsultations

Cannabinoid teleconsultation facilities are a new segment of the Polish medical services market. In the first quarter of 2026, over 60 were operating. Popular players include Konopna Klinika, Medyczna.com, HelloCanna, CannabisMed, Kanabis24, and Canna Clinic. Each offers the first consultation for 180-350 PLN, an e-visit without leaving home, and coordinator support after the visit.

Market observation at u Bucha Q1 2026: In conversations with store customers, we see three trends. First, more and more patients combine Rpw therapy with over-the-counter CBD products (mainly 5-10% oils) for continuity of support between THC doses. Second, about 40% of those inquiring about CBD dry herb are individuals awaiting their first Rpw visit, looking for a legal alternative during the transition period. Third, awareness of minor cannabinoids, particularly CBG and CBN, previously little known to the general public, is increasing.

Competitive markets in Europe

Poland lags behind Germany (over 500,000 patients, reimbursement up to 90%), Italy (250,000, partial reimbursement), the Czech Republic (180,000, reimbursement up to 90% since 2022), and Israel (150,000, the longest tradition of therapy since 1992). The Netherlands, Austria, and Finland have smaller markets but with a longer history. Germany's liberal law from April 2024 further opened the market.

In the Czech Republic, since 2022, medical marijuana is reimbursed by the public health insurance VZP at 90% for registered indications. The cost for patients has dropped from 300-700 CZK/gram to 30-70 CZK/gram. This has drastically increased access. In Poland, such a solution would be possible but requires political will and budgetary agreements with the NHF.

What are the prospects for medical marijuana in Poland for 2026-2028?

The prospects for medical marijuana in Poland for 2026-2028 are optimistic, although with clear barriers to overcome. Healthcare sector analysts predict that the number of Rpw patients will reach 300-400 thousand by the end of 2028, with a market value of 900-1200 million PLN. The main discussion topics include NHF reimbursement, the development of domestic cultivation, standardization of physician training programs, and regulation of teleconsultations (EMA, 2025).

Potential NHF reimbursement

Reimbursement for medical marijuana in Poland has been a recurring topic in discussions since 2019. In 2025, the Ministry of Health commissioned a pharmacoeconomic analysis of Cannabis Flos therapy in three pilot indications: severe spasticity in MS, cancer pain resistant to opioids, and refractory epilepsy in children. Results are expected in Q4 2026.

A positive outcome of the analysis could result in partial reimbursement in 2027-2028 for selected indications, reducing the patient's cost from 1050-3900 PLN to 150-600 PLN per month. This solution is analogous to the Czech model from 2022. In the case of a negative assessment, reimbursement will remain out of reach, and patients will continue to bear the full costs.

Development of domestic cultivation

Since 2023, the cultivation of medical cannabis has been possible in Poland after obtaining a GIF permit. By the end of 2025, such permits were granted to 11 entities. The first Polish production of Cannabis Flos started in 2024. In the first half of 2025, it covered 18% of domestic demand, with a forecast of 35-45% by the end of 2026 and 60-70% in 2028.

The development of domestic cultivation means lower prices, shorter supply chains, and fewer availability issues. Currently, the waiting time for rare imported strains is 5-15 days. Polish dry herbs are available within 24-72 hours. This is a significant change in patient comfort. Prices of Polish dry herbs are 20-30% lower than imported.

New indications and clinical trials

In 2025-2026, clinical trials evaluating new indications for medical marijuana are being conducted in Poland and Europe: Crohn's disease, ulcerative colitis, irritable bowel syndrome, fibromyalgia, endometriosis, Parkinson's disease, Tourette's syndrome, chronic migraine. Results of some studies are expected by 2027. Positive data may expand the list of standard indications (EMA, 2025).

Frequently Asked Questions

What exactly is medical marijuana?

Medical marijuana is a standardized dry herb or extract from the female flower clusters of Cannabis sativa L., with a known cannabinoid content (THC, CBD, CBG, CBN), dispensed in pharmacies only with a Rpw prescription. It is produced under GMP conditions under the supervision of the countries of origin and has been allowed for trade in Poland since November 1, 2017, based on Article 33a of the Act on Counteracting Drug Addiction (Journal of Laws 2005 No. 179 item 1485).

What are the indications for medical marijuana in Poland in 2026?

The most common clinical indications are chronic and neuropathic pain (about 45% of prescriptions), spasticity in multiple sclerosis, nausea and vomiting in chemotherapy, refractory epilepsy (Dravet syndrome, Lennox-Gastaut syndrome), PTSD, chronic migraine pain, and oncological cachexia. In Poland, there is no closed list of indications; the decision is made by the doctor after an interview and exhausting standard therapy (BMJ, 2021).

How to obtain an Rpw prescription for medical marijuana?

The Rpw prescription is issued by an authorized doctor (specialist or with a pain management certificate) after a medical interview and verification of the indication. The process: registration for an appointment (in-person or e-visit), documentation of previous treatment, assessment of contraindications, issuance of a Rpw prescription valid for 30 days. Fulfillment is only at a pharmacy with a permit for the trade of narcotic substances. The patient covers the full cost; therapy is not reimbursed by the NHF.

How much does therapy with medical marijuana cost in Poland?

The price of medical dry herb in Polish pharmacies ranges from 35-65 PLN per gram, depending on the strain and manufacturer (Aurora, Tilray, Bedrocan, Cannabis Flos). A typical monthly dose of 30-60 g means a cost of 1050-3900 PLN. Additional expenses include a doctor's visit (250-500 PLN), follow-up visits every 3-6 months (150-300 PLN), and a medical vaporizer (500-2500 PLN). Therapy is not reimbursed by the NHF in 2026.

What is the difference between medical marijuana and CBD dry herb?

Medical marijuana contains 5-22% THC and 0.5-15% CBD, requires a Rpw prescription, and induces psychoactive effects. CBD dry herb from hemp contains up to 0.3% THC and a significant amount of CBD (usually 4-15%), is available without a prescription, does not induce a high, and mainly acts anxiolytically and anti-inflammatorily. These are two distinct legal and pharmacological categories (Journal of Laws 2005 No. 179 item 1485, Article 33a).

What cannabinoids are found in medical marijuana?

Medical marijuana contains over 100 cannabinoids, including THC (tetrahydrocannabinol, psychoactive), CBD (cannabidiol, anxiolytic), CBG (cannabigerol, precursor), CBN (cannabinol, sedative), CBC (cannabichromen), and THCV. The content and proportions depend on the strain. Additionally, the dry herb contains 150-200 terpenes and 20 flavonoids, collectively creating the entourage effect (PMC, Frontiers in Pharmacology, 2020).

Is medical marijuana safe?

Medical marijuana has a safety profile comparable to many psychotropic drugs, better than opioids. The most common side effects are dry mouth, drowsiness, dizziness, and increased appetite (30-40% of patients in the first weeks). Addiction affects 9% of regular users (NIDA, 2020). Absolute contraindications: pregnancy, age under 18, active psychosis, severe liver failure.

Can a patient on medical marijuana drive a car?

No. Driving under the influence of THC is punished in Poland under rules analogous to alcohol. The detection threshold for THC in the blood is 1 ng/ml, and metabolites are detectable in the blood for up to 48 hours and in urine for up to 30 days after the last dose. Patients with an Rpw prescription are not exempt from these regulations. Most doctors recommend completely refraining from driving during therapy (Code of Offenses, Article 87).

Summary: what is worth remembering about medical marijuana

Medical marijuana is a standardized pharmaceutical product with a known cannabinoid profile, available in Poland by Rpw prescription since November 1, 2017. In 2024, over 300,000 prescriptions were issued, and the number of patients exceeded 160,000 in the first quarter of 2026. This is a dynamically growing segment of healthcare, with real clinical applications confirmed by research.

The main indications are chronic pain, spasticity in MS, chemotherapy-induced nausea, refractory epilepsy, PTSD, and oncological cachexia. Therapy is based on the appropriate selection of strain (THC-dominant, balanced, CBD-dominant), form (vaporized herb, sublingual oil), and dosage. The "start low, go slow" principle is the foundation for a safe initiation of treatment under medical supervision.

Therapy costs remain a barrier: 1050-3900 PLN per month for dry herb without NHF reimbursement. Poland remains an EU country without reimbursement, despite Germany and the Czech Republic taking this step between 2017-2022. The development of domestic cultivation since 2024 lowers prices by 20-30%, and potential reimbursement in 2027-2028 could democratize access.

For those who do not qualify for Rpw (lack of indications, too early stage of the disease, waiting for an appointment), a legal alternative is CBD products from hemp: CBD dry herb, CBD oils 5-10%, CBG oils. They do not replace Rpw therapy in severe indications but can support sleep, stress reduction, and recovery. The choice is up to the patient after consultation with the doctor.

This article is for informational and educational purposes and does not constitute medical advice. Before starting the use of medical marijuana, CBD, or other cannabinoids for therapeutic purposes, consult a doctor, especially if you are taking other medications, are pregnant, or breastfeeding. Self-treatment of serious conditions is dangerous. Medical marijuana in Poland is available only with a Rpw prescription issued by an authorized doctor. Recreational marijuana remains illegal in Poland, and possession is subject to criminal liability under the Act of July 29, 2005, on Counteracting Drug Addiction.

Author: Michał Waluk, Editor of the Bucha blog
Publication date: September 27, 2025
Last update: April 23, 2026
Next review: April 23, 2027