A guest article by Franziska Katterbach
Originally published in
Medizinisches Cannabis in Europa: Anerkannt – und dennoch ausgebremst?
The reclassification of cannabis at the UN level is now six years in the past. With its removal from Schedule IV of the 1961 Single Convention on Narcotic Drugs, the international community—based on scientific assessments by the World Health Organization (WHO)—clarified that cannabis is no longer classified as a substance without medical benefit. This decision was not a political signal or a medical guideline, but a legally significant step in international law: It makes clear that the therapeutic benefit of cannabis is no longer denied at the international level.
Thus, the question is no longer whether cannabis has medical benefits, but rather how and to what extent this recognition under international and EU law is actually implemented in national healthcare systems.
The European Union is also bound by this classification. Nevertheless, a considerable discrepancy remains to this day between the legal recognition at the international level and its actual implementation in the member states.
Uniformity as a Fundamental Principle of EU Law
Especially in pharmaceutical and health law, uniformity is not merely a political aspiration, but a fundamental structural principle of the European Union. Where the EU establishes a common line, member states may not selectively evade EU legal requirements – neither openly nor de facto through regulatory restraint.
The obligation of coherence is not merely a formality, but a prerequisite for legal certainty and equivalent patient care.
That this obligation of coherence is not merely theoretical was recently underscored by the European Court of Justice in a case against Hungary. The case did not concern the national implementation of cannabis law, but rather Hungary’s conduct during an international vote: The ECJ clarified that member states are bound by jointly established EU positions in UN votes and may not deviate from them unilaterally. The ruling thus does not affect the medical effects of cannabis, but it underscores that EU-wide uniformity is also binding externally.
With this ruling, the European Court of Justice (ECJ) draws clear lines regarding permissible national deviations and signals that fragmented implementations can undermine the credibility of the EU position.
Hungary: A Reason for a Further Question
Against this backdrop, the case of Hungary raises a further question. If the EU already deviates from its agreed-upon position during the joint vote on the international legal classification of cannabis, how robust is the uniform implementation of this classification at the national level?
Regardless of the specific details of individual national regulations, several member states demonstrate that the international and EU legal recognition of the medical benefits does not automatically translate into reliable patient access. A noticeable gap persists between formal recognition and practical provision. This is less an isolated national phenomenon than an expression of a European tension between a common legal basis and diverging implementation.
Germany: Progressive – Yet Contradictory
It is noteworthy that even in Germany, one of the largest markets for medical cannabis in Europe, the medical benefits have recently been publicly questioned again. This was evident, among other things, in the public hearing of the Health Committee of the German Bundestag on January 14, 2026, regarding the planned amendment to the Medical Cannabis Act. While the international and EU legal recognition of the therapeutic benefits has been considered settled for years, this foundation was relativized in the national legislative process.
Several experts also pointed out that tightening medical regulations while simultaneously liberalizing recreational cannabis use could effectively weaken the medically supervised supply pathway. The hearing thus made it clear that the internationally recognized classification of cannabis as a medicinal product is not consistently reflected in the national regulatory framework.
The recent debate in the Bundestag thus contrasts sharply with the developments since 2017, the reclassification of cannabis as a prescription drug, and the continuous expansion of patient access. At the same time, it increases uncertainty among physicians, for example, regarding potential claims for reimbursement from health insurance companies, and thus effectively hinders the provision of care.
Recognition without implementation?
Six years after the UN reclassification, it can therefore be stated:
The medical benefits of cannabis are recognized under international and EU law – however, implementation remains fragmented.
