Medical cannabis: the history of a millennia-old use

Chinese pharmacopoeia texts mention hemp as a remedy for pain and digestive disorders as far back as antiquity. The plant then travelled along trade routes to India, where it became part of Ayurvedic medicine, and on to the Middle East and Europe. In the 19th century, Western doctors such as William O'Shaughnessy documented its use against spasms and convulsions. This medical recognition came to an abrupt halt in the 20th century: the 1961 Single Convention on Narcotic Drugs placed cannabis among the most tightly controlled substances, holding back research for decades.

In March 2021 the ANSM (the French national medicines safety agency) launched a trial of cannabis for medical use, tightly supervised and limited to a small number of patients monitored in hospital. It covers specific clinical situations: neuropathic pain resistant to available treatments, certain forms of severe epilepsy, supportive care in oncology, palliative situations and spasticity linked to multiple sclerosis. This trial, extended several times, remains distinct from the well-being CBD market: it rests on a medical prescription and hospital monitoring, not on a purchase in a shop.

Two medicines illustrate this regulated pharmaceutical route. Sativex (nabiximols), an oromucosal spray combining THC and CBD, is authorised in several European countries for spasticity linked to multiple sclerosis. Epidyolex (purified cannabidiol), developed by GW Pharmaceuticals, has obtained a marketing authorisation in Europe for certain rare and severe forms of childhood epilepsy, such as Dravet and Lennox-Gastaut syndromes. These products are medicines in the strict sense: they follow the classic pharmaceutical route, with clinical trials, marketing authorisation and mandatory prescription.

The CBD sold in French shops has an entirely different status: food supplement, cosmetic or everyday consumer product, never a medicine. No French authority, neither the ANSM nor the HAS, has validated any therapeutic claim for these products. This distinction is not merely administrative: it determines what a brand is entitled to say. A medicine such as Epidyolex can claim an anticonvulsant effect documented by clinical trials; a CBD oil sold in a shop cannot, however good its quality. To understand what the French framework allows one to say about well-being CBD, see our overview of reported uses.

Can you obtain medical cannabis from a pharmacy in France?

Only patients included in the ANSM trial, monitored in hospital and under prescription, have access to it. It is not a product freely available in pharmacies or in CBD shops.

Is the CBD sold in shops a medicine?

No. It has the status of a food supplement or a cosmetic depending on the form, never that of a medicine within the meaning of the Public Health Code.

What is the difference between Sativex and a classic CBD oil?

Sativex combines THC and CBD at precise pharmaceutical doses, authorised after clinical trials for a defined medical indication. A well-being CBD oil contains at most 0.30% THC and has no recognised therapeutic indication.

Has the French medical cannabis trial come to an end?

It has been extended several times since 2021. Its evolution towards a permanent framework depends on regulatory decisions still under discussion at national level.