Medical Cannabis in Italy: Prescriptions, Qualifying Conditions & Access

Considering medical cannabis treatment in Italy?

Medical cannabis in Italy has been legal since 2007, making the country one of Europe’s earliest adopters of therapeutic cannabinoid programs. With a unique system where the military produces cannabis at a pharmaceutical institute in Florence and the majority of supply arrives from the Netherlands and Canada, Italy’s medical cannabis landscape is unlike any other. Yet patients still face supply shortages, inconsistent regional coverage, and bureaucratic barriers that limit access across the country.

This guide covers everything you need to know about qualifying conditions, the prescription process, available products and their cannabinoid profiles, pharmacy access, costs, and regional insurance coverage for medical cannabis in Italy in 2026. For a broader overview of recreational, CBD, and hemp regulations, see our complete guide to cannabis laws in Italy.

History of Medical Cannabis Legalization in Italy

Italy’s journey toward medical cannabis access has unfolded in stages over nearly two decades. In 2007, the government issued the first ministerial decree acknowledging the therapeutic benefits of THC. This initial step allowed cannabis-based medicines to be used for a narrow set of conditions, including multiple sclerosis, intractable pain, and certain forms of epilepsy.

The landmark change came on January 23, 2013, when a decree enabled any Italian doctor to prescribe cannabis-based medicine. Under this framework, any pharmacy with proper supplies could distribute cannabis products in the forms and doses specified by a doctor’s prescription. This decree opened the door to broader patient access across the country.

In 2014, parliament authorized domestic cannabis production, but with a critical restriction: only the Ministry of Defence was permitted to cultivate. The Stabilimento Chimico Farmaceutico Militare (SCFM), the military’s chemical-pharmaceutical institute in Florence, became Italy’s sole domestic producer. The SCFM began growing cannabis plants in September 2014, and by December 2016, the first domestically produced strain (FM2) became available to patients.

Key Milestones in Italian Medical Cannabis

Who Can Access Medical Cannabis in Italy

Qualifying Conditions

Medical cannabis in Italy can be prescribed for a range of conditions where conventional treatments have proven insufficient. The nationally recognized indications include:

• Chronic pain (neuropathic and oncological)
• Multiple sclerosis spasticity
• Chemotherapy-induced nausea and vomiting
• Appetite stimulation (HIV/AIDS, cancer cachexia, anorexia)
• Glaucoma
• Tourette syndrome
• Anxiety disorders
• Spinal cord injuries

Beyond these categories, prescribing is at the physician’s discretion. Some regions recognize additional conditions, creating variation in access across the country.

How to Get a Prescription

All physicians in Italy may prescribe medical cannabis regardless of their specialization. However, patients must meet specific requirements before receiving a prescription:

• Non-responder requirement: The patient must have tried conventional treatments first and demonstrated an inadequate response.
• Clinical documentation: The physician supplements the prescription with anonymous patient data, including age, sex, dosage by weight, and treatment requirements.
• Regional reporting: Data must be transmitted to the competent regional authority for statistical monitoring.
• No self-referral: A doctor must initiate the prescription based on clinical need.
• Foreign prescriptions are not accepted: Only Italian-licensed physicians can issue valid medical cannabis prescriptions.

Prescriptions are valid for a limited period, typically up to six months, after which the prescribing physician must evaluate the treatment’s effectiveness before renewal.

Types of Medical Cannabis Available in Italy

Domestic Production: FM1 and FM2

Italy’s domestically produced medical cannabis comes exclusively from the SCFM in Florence. The military manufactures two proprietary strains branded as “Farmaceutico Militare.”

FM2 consists of unfertilized, dried, and milled female inflorescences. It was the first domestically produced cannabis made available to Italian pharmacies. FM1, with its higher THC content, was introduced two years later to serve patients requiring stronger psychoactive effects.

Imported Products

Because domestic production falls far short of demand, approximately 80% of medical cannabis sold in Italy is imported. The Netherlands’ Bedrocan is the primary supplier, with additional products from Canada and Australia.

Five authorized pharmaceutical wholesalers (FL Group, ACEF, Galeno, Farmalabor, and Fagron) handle Bedrocan imports through the Dutch Office of Medicinal Cannabis. Since September 2023, standardized cannabis extracts from Tilray, Farmalabor, and Avextra have also been available at Italian pharmacies.

Administration Methods

Italian regulations specify the following approved routes of administration:

• Vaporization: Dried flower must be vaporized, not smoked. Smoking is not a permitted method under Italian medical cannabis regulations.
• Galenic oil preparations: Pharmacists prepare oil-based formulations from raw cannabis material.
• Oral decoctions: Cannabis-infused tea preparations.
• Standardized extracts: Pre-manufactured extract formulations (available since 2023).

Where to Buy Medical Cannabis in Italy

Pharmacy Access

Medical cannabis in Italy is dispensed only through licensed compounding pharmacies (farmacie galeniche). Not every pharmacy in the country carries cannabis products; patients need to locate one within the specialized network.

Pharmacists play a central role in the Italian system. They prepare galenic preparations from raw cannabis material according to the physician’s prescription. Each preparation is individually compounded, which ensures precise dosing but can also add waiting time. Pharmacies are required to sell extract formulations at cost price, with 0% retail margin.

Cost and Insurance Coverage

The standard price for medical cannabis flower in Italy is EUR 9 per gram plus VAT. Monthly treatment costs range from approximately EUR 150 to EUR 400 depending on the prescribed dosage.

Under Law No. 172/2017, medical cannabis is reimbursable through the Servizio Sanitario Nazionale (SSN, Italy’s national health service). However, the government delegated implementation to regional health authorities, creating a patchwork of coverage across the country.

Patients in regions without established programs may need to pay out of pocket, even when their condition qualifies nationally.

Challenges Facing Medical Cannabis in Italy

Italy’s medical cannabis program, despite its relatively early start, faces several persistent obstacles:

Supply shortages: The SCFM’s domestic production has plateaued at around 300 kilograms annually, far below national demand. Import procedures are bureaucratic and slow, leaving patients with frequent gaps in availability.

Military monopoly: Private sector participation in cannabis cultivation remains prohibited. This limits innovation, strain diversity, and production scale. Advocates have pushed to open production to private companies with specialized growing expertise, but no legislative change has materialized.

Regional inconsistency: Because the national government delegated implementation to regional authorities, patients in different parts of Italy face vastly different levels of access, cost coverage, and available infrastructure.

Healthcare stigma: Many Italian physicians remain reluctant to prescribe cannabis, either from lack of training or concerns about professional reputation. This limits the number of effective prescribing doctors in practice.

Limited product range: Compared to markets like Germany or the Netherlands, Italy offers relatively few strains and formulations, restricting physicians’ ability to tailor treatment to individual patients.

Medical Cannabis and International Patients

Tourists and visitors to Italy cannot access the Italian medical cannabis system. Prescriptions must be issued by Italian-licensed physicians, and foreign prescriptions are not accepted.

However, patients traveling to Italy from other Schengen countries may bring their own prescribed medical cannabis. This requires a Schengen Certificate under Article 75 of the Schengen Convention. The certificate must be completed and signed by the prescribing physician, approved by the Ministry of Health in the country of origin, and is valid for a maximum of 30 days.

Requirements for the Schengen Certificate include:

• Dosage, concentration, and international names of active substances
• A separate certificate for each medication
• Cannabis must be kept in original packaging at all times
• The application process should begin at least two to four weeks before departure

For more on travel-related cannabis rules, see our guide on what tourists need to know about cannabis in Italy.

Frequently Asked Questions

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