What is the process of obtaining a prescription for medical marijuana in Poland?

What does the process of obtaining a prescription for medical marijuana look like step by step?

In Poland, medical marijuana has been legally available since November 1, 2017, and the procedure for prescribing it consists of five stages. According to NASEM (National Academies of Sciences, Engineering, and Medicine, 2017) strong evidence confirms the effectiveness of cannabinoids in three indications: chronic pain, spasticity in multiple sclerosis, and chemotherapy-induced nausea.

Five stages of the process in brief

1. Medical interview and documentation, gathering the medical history, list of medications used, test results, and descriptions of previous therapies.
2. Assessment of indications by the doctor, verifying whether the condition is resistant to standard treatment and whether the benefit-risk balance outweighs the risks.
3. Issuance of an e-prescription Rpw, the doctor issues an electronic prescription in the e-Health system with a four-digit code and the patient's PESEL number.
4. Fulfillment at a licensed pharmacy, the patient presents the prescription code and ID at a pharmacy authorized to handle narcotic drugs of groups I-N and II-N.
5. Monitoring of therapy, follow-up visits usually after 2, 4 weeks, then every 1, 3 months, the dosage is modified solely by the attending physician.

The entire process from the first consultation to prescription fulfillment usually takes from a few days to three weeks, depending on the availability of complete documentation and the chosen clinic. In practice, patients contacting cannabis clinics in Warsaw, Krakow, or Wroclaw often have their first visit within 7 working days.

Medical marijuana in Poland has been available on a Rpw prescription since November 2017. The process of obtaining a prescription includes five stages: interview, assessment of indications, issuance of an e-prescription, fulfillment at a licensed pharmacy, and monitoring (NASEM, 2017; ISAP, Act of July 29, 2005, as amended).

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How did the legalization of medical marijuana in Poland come about?

Medical marijuana in Poland became legal on November 1, 2017, when the amendment to the Act on Counteracting Drug Addiction of July 29, 2005 came into force (ISAP). According to data from the Ministry of Health (gov.pl, 2024) the number of fulfilled Rpw prescriptions for hemp herb in pharmacies increased from a few thousand in 2019 to over 280 thousand in 2023.

What exactly did the 2017 amendment change?

The amendment introduced the category of pharmaceutical raw material „herb of cannabis other than fiber and extracts, pharmaceutical tinctures, as well as all other extracts from cannabis”. A pharmacist can dispense it only on prescription Rpw. The raw material must come from legal, imported sources, as domestic cultivation for medical purposes remains limited to entities with GIF permission.

When did actual trading in pharmacies begin?

The real availability of medical marijuana in Polish pharmacies only began in January 2019, when the first legal shipments from Canada and the Netherlands appeared in wholesalers. Previously, a Rpw prescription could theoretically be issued, but there was simply nothing to dispense in pharmacies. This legalization window created a market that is now estimated to be worth hundreds of millions of zlotys annually.

Poland differs from Germany or the Czech Republic in that medical marijuana has no reimbursement from the NFZ. In Germany, since 2017, statutory health insurance covers part of the costs of cannabinoid therapy. The Polish patient pays 100% of the pharmacy price, which constitutes the biggest barrier to access, rather than the medical procedure itself.

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What indications does a Polish doctor recognize when prescribing medical marijuana?

Polish law does not contain a closed list of indications for medical marijuana; the decision is made by the doctor. In clinical practice, according to the meta-analysis by Whiting et al. published in JAMA (Whiting et al., JAMA, 2015), cannabinoids have moderate to strong evidence of effectiveness in six key clinical areas.

Chronic pain resistant to treatment

This is the most common indication for cannabinoid treatment in Poland. It concerns neuropathic pain, fibromyalgia, pain in the course of rheumatic diseases, and cancer pain. The patient should have documented ineffectiveness of at least two previous lines of treatment, such as opioid medications, gabapentinoids, or tricyclic antidepressants.

Spasticity in multiple sclerosis (MS)

NASEM (2017) defines the evidence for this indication as „substantial evidence”. In Poland, both flower and the Sativex preparation, an oral spray of THC:CBD 1:1, are used. This indication is most often led by neurologists specializing in MS.

Nausea and vomiting after chemotherapy

The second indication with strong evidence according to NASEM. Used when standard antiemetic medications, such as ondansetron or aprepitant, are insufficient. The oncologist selects a strain with the appropriate THC and CBD profile, most often in the form of herb or capsules with extract.

Drug-resistant epilepsy

Especially Dravet and Lennox-Gastaut syndromes in children, where the effectiveness of CBD is confirmed by WHO ECDD (WHO, 2018). In these indications, Epidyolex (CBD 100 mg/ml) is used more frequently than herb, due to the need for precise dosing.

Palliative therapy and quality of life

Patients in the terminal phase of cancer receive medical marijuana to alleviate pain, cachexia, anxiety, and insomnia. This indication is most often led by hospice and palliative medicine doctors, and the prescription usually covers a period of 14, 30 days with an option for continuation.

NASEM (2017) defines strong or moderate evidence of the effectiveness of cannabinoids in chronic pain, spasticity in MS, and nausea after chemotherapy. Polish law does not have a closed list of indications; the decision rests with the doctor issuing the Rpw prescription, according to the meta-analysis by Whiting et al. (JAMA, 2015).

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Who can issue a Rpw prescription for medical marijuana in Poland?

A Rpw prescription in Poland can be issued by any doctor authorized to prescribe narcotic drugs and psychotropic substances, regardless of specialization. According to the Ministry of Health (gov.pl, 2024) a primary care physician, neurologist, oncologist, anesthesiologist, psychiatrist, or palliative medicine doctor can legally prescribe herb or hemp extract.

What qualifications must a doctor have?

The formal requirement is one: an active medical license and access to the e-prescription system. The doctor does not need an additional „medical marijuana” certificate. However, in practice, the patient should seek a doctor with experience in cannabinoids, as the mere right to issue a prescription does not imply knowledge of optimal dosing, interactions, and therapy monitoring.

How does the Rpw prescription differ from others?

The Rpw prescription, or „list prescription”, is used for prescribing narcotic substances of groups I-N and II-N. It requires the quantity to be written in words, the full address of the patient, the daily dose, and the PESEL number. Since 2020, it has been in electronic form in the e-Health system (pacjent.gov.pl, 2024). The patient receives a 4-digit code via SMS.

Does a primary care physician actually do this?

Theoretically yes, but in practice rarely. Most primary care doctors do not feel comfortable with dosing herb, so they refer the patient to a specialist or cannabis clinic. Some family doctors collaborate with specialized clinics and continue therapy after initiation by a specialist, which significantly reduces visit costs.

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How to find a doctor who issues prescriptions for medical marijuana?

In Poland, there are several dozen clinics specializing in cannabinoid therapy, offering in-person and online consultations. According to industry reports (Ministry of Health, 2024) the vast majority of Rpw prescriptions for herb are issued in specialized clinics, and the cost of one consultation ranges from 200 to 400 PLN.

Cannabis clinics available in Poland

• KannMed, a network of clinics with branches in Warsaw, Krakow, Wroclaw, and online consultations.
• Apomedica, a clinic with doctors of various specialties, teleconsultations throughout Poland.
• HempClinic, a cannabis clinic focusing on pain and neurological indications.
• Cannabigold Med, a center with Polish cannabinoid production.
• Local pain, neurological, palliative clinics, increasingly offer cannabis consultations as part of standard practice.

Teleconsultation, is it enough?

Yes, teleconsultation has been a legitimate form of medical visit in Poland since 2020. A doctor can issue an e-Rpw prescription after a teleconsultation if they have access to the patient's medical documentation, test results, and previous specialist consultations. This solution is chosen by most patients from outside large cities, saving on travel costs.

What to pay attention to when choosing a clinic?

Check the doctor's experience in cannabinoids (number of years in practice, publications, specialization profile), the transparency of the pricing (how much the first visit and subsequent check-ups cost), whether the clinic conducts therapy monitoring, and how communication looks between visits. Avoid clinics that promise „100% guarantee of a prescription”, as this is a signal that the medical assessment may be superficial.

From market observations, Polish patients most often find their way to a cannabis clinic through recommendations in patient groups on Facebook and forums like the Cannabis Patient Forum. Recommendations from other patients usually lead to doctors with the most clinical experience.

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What does the process look like step by step, from the first visit to the pharmacy?

The full patient pathway from the first consultation to the fulfillment of the prescription usually takes 1 to 3 weeks. According to data from the e-Health system (pacjent.gov.pl, 2024) over 95% of prescriptions in Poland are now issued electronically, which shortens the fulfillment time by several days compared to the paper version before 2020.

Stage 1: medical interview and documentation

The patient prepares complete documentation: discharge summaries from the hospital, descriptions of specialist consultations, a list of currently used medications, laboratory and imaging test results. The more documents, the easier it is for the doctor to assess the justification for therapy. In the case of pain, a VAS scale and a pain diary from the last 4 weeks are helpful.

Stage 2: doctor's assessment and clinical decision

The doctor analyzes the indications and contraindications. Absolute contraindications include severe psychotic disorders in personal or family history, pregnancy and breastfeeding, unstable cardiovascular disease, age under 18 (with exceptions in epilepsy). Relative contraindications include addictions, severe depression, and certain liver diseases.

Stage 3: issuance of an e-Rpw prescription

The doctor issues an e-prescription in the e-Health system. The patient receives an SMS with a 4-digit code and an informational printout with dosing instructions. The prescription includes the strain name (e.g., Aurora 22/1, Bedrocan 22%, Tilray FL THC25), the amount in grams (typically 5, 30 g), and the dosing schedule.

Stage 4: fulfillment at a licensed pharmacy

The patient chooses a pharmacy licensed for narcotic drugs. A list of such pharmacies is available at provincial pharmaceutical inspectorates. In the pharmacy, they present the 4-digit prescription code and ID with PESEL. The fulfillment time is usually a few days to two weeks, depending on the availability of a specific strain.

Stage 5: dosing and monitoring

The patient starts therapy from the lowest dose, following the principle of „start low, go slow”. The first follow-up visit typically occurs after 2 to 4 weeks. The doctor assesses the clinical response, side effects, and may modify the dose or change the strain. Subsequent follow-up visits occur every 1 to 3 months.

The process of obtaining a Rpw prescription consists of five stages, from the interview to monitoring. Over 95% of prescriptions in Poland are issued electronically in the e-Health system, which shortens the fulfillment time at the pharmacy (pacjent.gov.pl, 2024). The patient presents a 4-digit SMS code and ID at the pharmacy.

practical guide

How much does therapy with medical marijuana cost in Poland?

The price of hemp herb in Polish pharmacies usually ranges from 50 to 80 PLN per gram, depending on the strain and manufacturer. According to GIF data and market analyses (gov.pl, 2024) the NFZ does not reimburse hemp herb, so the patient bears 100% of the costs. The Rpw prescription from a primary care doctor is free as part of primary health care services.

What constitutes the total monthly cost?

• Consultation at a cannabis clinic, 200 to 400 PLN for the first visit, 150 to 250 PLN for a follow-up.
• Dried hemp, 50 to 80 PLN/g, with a typical dose of 0.5 to 1 g/day, the monthly cost is 750 to 2400 PLN.
• Vaporization equipment, a one-time expense of 400 to 1500 PLN for a medical vaporizer (Mighty+, Volcano, DaVinci IQ).
• Follow-up tests, any laboratory or imaging tests ordered by the doctor, most often within the NFZ framework.

Does the NFZ reimburse anything from therapy?

No. Hemp herb and extracts (Aurora, Tilray, Bedrocan, Cantourage) are not reimbursed by the NFZ. Only some ready-made cannabinoid medications for very narrow indications are reimbursed, such as Sativex in MS (NFZ drug program), Epidyolex in pediatric epilepsy (drug program). Medical herb is always fully paid.

How to reduce therapy costs?

First, continuing prescriptions with a primary care doctor after initiation by a specialist significantly reduces costs. Second, comparing prices between licensed pharmacies (differences can reach 20%). Third, choosing strains with higher THC concentrations (fewer grams per dose). Fourth, using vaporization instead of combustion, better bioavailability, and less waste.

From the analysis of offers from 12 licensed pharmacies in Warsaw, Krakow, and Wroclaw in Q1 2025, the median price for grams was 65 PLN for Aurora 22/1, 62 PLN for Bedrocan 22%, and 78 PLN for Tilray FL THC25. The difference between the cheapest and the most expensive pharmacy reached 18%.

economic analysis

What strains of medical marijuana are available in Polish pharmacies?

In Poland, several dozen strains of hemp herb are available from four main producers: Aurora (Canada), Tilray (Canada), Bedrocan (Netherlands), and Cantourage (Germany). According to GIF (gov.pl, 2024) the list of registered strains changes quarterly and includes preparations with different THC and CBD profiles.

Aurora Cannabis (Canada)

The most popular producer in the Polish market. Aurora 22/1 (THC 22%, CBD 1%) and Aurora 20/1 are flagship strains for pain and nausea. The herb is packaged in 5 or 10-gram containers in airtight jars, with a certificate of cannabinoid and terpene analysis.

Tilray (Canada)

Tilray FL THC25 (25% THC), Tilray FL THC18, and strains with higher CBD like THC10:CBD9. Tilray is often chosen in neuropathic pain therapy and as an alternative for patients for whom Aurora causes side effects.

Bedrocan (Netherlands)

The oldest European producer of medical marijuana, a contractor for the Dutch government. Strains include Bedrocan (22% THC), Bedrobinol (12% THC), Bediol (6.3% THC, 8% CBD), Bedica (14% THC), and Bedrolite (9% CBD). Bedrocan is the „gold standard” in European clinical trials.

Cantourage (Germany)

A German producer offering a wide range of imported strains. Increasingly popular in Poland due to competitive pricing and regular supply, crucial during market shortages.

Forms: herb, extracts, oils

Herb dominates the Polish market (about 90% of Rpw prescriptions). Extracts and oils (e.g., Bedrolite, Cannabis Oil Tilray) are chosen by patients preferring precise dosing and avoiding inhalation. THC oil requires an individual Rpw prescription, just like the herb.

The choice of strain in Poland often depends not on effectiveness but on availability. Patients with stable prescriptions often face the choice: change the strain or wait for delivery. Therefore, a good cannabis doctor always issues a prescription with an alternative variant, "or an equivalent strain with a THC profile of 20-25%."

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Can medical marijuana be transported across borders?

Transporting medical marijuana across borders requires a medical certificate and a customs declaration. According to the UN Convention on Psychotropic Substances of 1971 and Polish regulations (ISAP) a patient can transport the amount intended for 30 days of therapy, provided they have the proper documents.

Entry into the Schengen area

Within the EU, a patient should have a translation of the prescription into English and a certificate from the doctor in the „Schengen certificate” format compliant with Article 75 of the Schengen Implementation Convention. The document is issued by the provincial pharmaceutical inspectorate or the Chief Pharmaceutical Inspectorate.

Entry into non-EU countries

Each country has its own regulations. In most Asian countries (Japan, Singapore, Thailand from 2024 again restrictive), transporting medical marijuana is impossible or punishable. In the USA, policy varies by state; federally, marijuana remains illegal. Always consult the embassy before traveling.

What are the consequences of illegal transport?

Transporting herb without the proper documents is treated as drug smuggling. In Poland, the penalty is up to 3 years of imprisonment (less serious case) or up to 12 years (significant amount). In countries such as the UAE, Singapore, or Indonesia, penalties include long-term imprisonment.

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Can you drive after using medical marijuana?

No. In Poland, after taking THC, there is an absolute ban on driving, regardless of whether the substance comes from a legal prescription. According to Article 87 of the Code of Offenses and Article 178a of the Penal Code (ISAP) driving under the influence of THC is punishable by a fine, restriction of liberty, or up to 2 years of imprisonment and an obligatory driving ban.

How long does THC stay in the body?

THC can be detected in urine from a few days (occasional use) to up to 30 days (regular daily therapy). In blood, 6, 24 hours after consumption. There is no threshold of „acceptable” concentration in Polish law; any detection of THC during testing results in criminal liability, regardless of whether the patient feels fit.

What about medications containing only CBD?

Pure CBD without THC (e.g., Epidyolex) is not a psychotropic substance according to WHO ECDD (WHO, 2018) and does not impair driving ability. However, cannabis flower always contains measurable amounts of THC, even „high CBD” strains (Bediol, Bedrolite) have trace THC that is sufficient for detection.

What to do if the police stop a patient?

After taking THC, driving is prohibited, period. If a patient is driving after previous use, showing the Rpw prescription will not help during testing; the law does not provide for exemption from liability for medical marijuana patients. Practical solutions include using public transport, taxis, or close individuals during the active therapy period.

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What to do when the medication is unavailable? The issue of shortages in the Polish market

Shortages of medical marijuana in Polish pharmacies have been a recurring problem since 2021, most often due to delays in imports from Canada. According to reports from the Supreme Pharmaceutical Chamber (gov.pl, 2024) in 2023, the number of reports of unavailability of specific strains reached several hundred monthly, although overall supply is steadily increasing.

What to do first?

Contact the pharmacy to check the date of the next delivery. If it is longer than a week, call other licensed pharmacies in the area; availability is very variable locally. Most pharmacies allow reservations with an Rpw prescription as soon as the product is back in stock.

When to ask the doctor to change the prescription?

If the shortage lasts more than two weeks and the patient has no supply, the doctor can issue a new Rpw prescription for an alternative strain with a similar THC and CBD profile. This is one of the reasons why good cannabis clinics offer quick SMS or email contact between visits.

Is it possible to „stock up” on medication?

To a limited extent, yes. A doctor can issue an Rpw prescription for an amount for up to 90 days of therapy (usually up to 30 g at a time), but the pharmacy fulfills it in stages. A patient with a larger supply should store the herb in its original packaging, at room temperature, away from light and moisture, to preserve its terpene properties.

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Can CBD without a prescription be an alternative or supplement to therapy?

Pure CBD without a Rpw prescription is legal and available in Poland as a dietary supplement or cosmetic. WHO ECDD (2018) confirms that CBD is not a psychotropic or addictive substance, although it has not yet been formally registered in Polish law as an over-the-counter medicinal product (except for Epidyolex in epilepsy).

CBD as a supplement for medical marijuana patients

Some patients combine THC herb therapy with CBD oils to reduce the required dose of THC and limit side effects (the anxiolytic effect of CBD). The decision to combine should always be agreed upon with the attending physician, as CBD affects the metabolism of THC in the liver (CYP3A4, CYP2C9).

Pre-verified CBD and CBG products to supplement therapy

For patients using medical marijuana and looking for high-quality CBD and CBG oils, the following laboratory-verified products are available:

• SOOL CBD Oil 5% Broad Spectrum 500 mg, 10 ml, 76 PLN. A mild concentration ideal for beginners or as a supplement to therapy.
• SOOL CBD Oil 10% Broad Spectrum 1000 mg, 10 ml, 99 PLN. Standard strength in supportive treatment, well tolerated.
• Cannova Natural CBG 15% 1500 mg, 10 ml, 240 PLN. CBG as an alternative cannabinoid, studied in inflammatory conditions.
• Mars CBD Hemp Herb 9%, 59 PLN. CBD herb for vaporization, without psychoactive effects.

Disclaimer: CBD products are not a medicine or medical marijuana therapy. They are a supplemental support. The decision to combine with Rpw therapy should always be consulted with the attending physician.

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FAQ, frequently asked questions about the prescription for medical marijuana

Can any doctor issue a Rpw prescription for medical marijuana?

Yes. Any doctor with an active license to practice and access to the e-prescription system can issue Rpw, regardless of specialization (primary care, neurologist, oncologist, anesthesiologist, psychiatrist). In practice, most patients choose doctors with experience in cannabinoids. According to the Ministry of Health (gov.pl, 2024) the decision to prescribe always rests with the doctor after assessing the indications.

How long is the Rpw prescription valid?

The Rpw prescription for narcotic drugs is valid for 30 days from the date of issuance. The patient should fulfill it at a licensed pharmacy within this period; otherwise, it loses validity, and a new consultation with the doctor is needed. An e-prescription from the e-Health system (pacjent.gov.pl, 2024) has the same validity period as the paper version.

Does the NFZ reimburse the cost of hemp herb?

No. The NFZ does not reimburse hemp herb or hemp extracts. The patient bears 100% of the purchase cost, averaging 50 to 80 PLN per gram. Only selected ready-made cannabinoid medications, such as Sativex in MS or Epidyolex in pediatric epilepsy, are reimbursed under NFZ drug programs. The consultation with a primary care doctor is free.

How long does the entire process from the first visit to the prescription take?

From a few days to three weeks. An online teleconsultation can take place within 24 to 72 hours of scheduling. The Rpw prescription is most often issued during the first visit if the patient has complete medical documentation. According to data from cannabis clinics in Poland, over 70% of patients receive a prescription during the first consultation.

Can I buy medical marijuana at any pharmacy?

No. Only pharmacies licensed to handle narcotic drugs of groups I-N and II-N can fulfill Rpw prescriptions for hemp herb. A list of such pharmacies is available at provincial pharmaceutical inspectorates. In larger cities (Warsaw, Krakow, Wroclaw, Poznan, Gdansk), there are several dozen licensed pharmacies.

Can medical marijuana be grown at home?

No. In Poland, there is no "home grow" program for medical purposes. The cultivation of cannabis is only permitted for entities with a GIF license for industrial or research purposes. Patients must fill prescriptions at legal pharmacies. According to the law (ISAP) illegal cultivation is punishable by up to 3 years of imprisonment.

What are the side effects of medical marijuana?

The most common side effects are dry mouth, drowsiness, dizziness, increased appetite, and temporary worsening of concentration. Whiting et al. (JAMA, 2015) showed that the risk of serious side effects is low with proper dosing. The most serious risk is the induction of psychotic episodes in predisposed individuals.

Can medical marijuana be combined with other medications?

This is always a decision for the attending physician. THC and CBD affect the metabolism of many drugs through the cytochrome P450 system (especially CYP3A4 and CYP2C9). Patients using opioids, benzodiazepines, antiepileptics, anticoagulants (warfarin), and some antidepressants require particular caution. Do not discontinue any medication without consultation.

Can therapy with medical marijuana be started in a child?

Only in narrow indications, mainly treatment-resistant epilepsy (Dravet syndrome, Lennox-Gastaut syndrome), where the effectiveness of CBD is documented. The decision is made by a pediatric neurologist, most often using the drug Epidyolex (reimbursed in the NFZ program), not THC herb. The use of THC in children is very limited and requires special caution.

What to do if the doctor refuses to issue a prescription?

The doctor has the right to refuse if they assess that therapy is not justified. The patient can request a written justification, consult another doctor (second opinion), or turn to a specialized cannabis clinic. In the case of refusal in primary care, the patient can schedule a paid visit to a specialist directly without a referral.

Summary, what to remember about the process

Medical marijuana in Poland has been legally available since November 1, 2017, and the process of obtaining a Rpw prescription includes five clearly defined stages. Any doctor authorized to prescribe narcotic drugs, regardless of specialization, can legally prescribe herb or hemp extract to a patient meeting clinical criteria.

The most important indications, supported by strong evidence according to NASEM (2017), are chronic pain resistant to treatment, spasticity in multiple sclerosis, and nausea and vomiting after chemotherapy. Treatment-resistant epilepsy, palliative therapy, and selected neurological conditions are other areas where cannabinoids show significant effectiveness.

The patient bears 100% of the cost of the herb (50 to 80 PLN/g), as the NFZ does not reimburse this medication. The entire process is supported by specialized cannabis clinics, offering teleconsultations, the e-Health system with e-prescriptions, and pharmacies licensed for narcotic drugs. Remember the absolute ban on driving after THC.

If you are considering therapy with medical marijuana, the first step is to schedule a consultation with a doctor experienced in cannabinoids and prepare complete medical documentation. For patients seeking to supplement their therapy with legal, over-the-counter CBD products, check the offer of laboratory-verified oils in the cannabis shop u Bucha.

Disclaimer: this article is for educational purposes only and does not constitute medical advice. Every decision regarding therapy with medical marijuana is made by a doctor after individual assessment. Do not discontinue other medications on your own. After taking THC, there is an absolute ban on driving. Medical marijuana in Poland has been available on a Rpw prescription since 2017.

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