Last year, I wrote that 2024 felt like a defining year for medical cannabis internationally.
If 2024 was about putting new frameworks on the map, 2025 has been about testing them in the real world. Stress-testing them. Tightening them. And in some cases, recalibrating how access actually works for patients once the headlines fade.
Across Europe, medical cannabis continued to grow, not always smoothly, and not always evenly, but with clearer expectations around quality, compliance and clinical oversight. At Curaleaf International, we’ve tried to stay grounded in a simple belief: long-term progress in this category is built on responsibility, evidence-based medicine, and a focus on patients, not momentum for its own sake.
Regulatory progress, with higher expectations
In Europe’s largest medical cannabis market, Germany, 2025 saw continued patient and prescription growth following the removal of cannabis from the narcotics list and the creation of a dedicated Medical Cannabis Act. At the same time, political efforts have emerged to revisit aspects of the existing program, particularly around telemedicine and mail-order supply. Importantly, the SPD has been clear that video consultations and mail-order pharmacies should continue, precisely, to avoid unnecessary disruption to patient access. The direction of travel remains consistent: access can expand, but it must do so within a clearly medical, well-governed framework.
One reality is hard to ignore: regulatory change does not eliminate underlying patient need and demand does not disappear by decree. Adjustments to access models can create short-term friction, but experience in markets such as Poland suggests that legitimate demand has a way of resurfacing, even under far more restrictive conditions. Patients find alternative pathways, and over time systems tend to settle into new equilibria that reflect genuine medical use rather than policy intent alone.
France also moved closer to a permanent system, notifying three key medical cannabis texts to the European Commission and laying the groundwork to integrate cannabis-based medicines into its Public Health Code and reimbursement structures. What began as a tightly controlled pilot is now moving toward a structured, monitored national programme, despite broader political instability.
Spain, after many years of debate, approved its first national medical cannabis framework, centred on standardised preparations prescribed by specialists and dispensed through hospital pharmacies. It is a cautious beginning, but a meaningful shift from discussion to implementation in one of Europe’s largest healthcare systems.
Across the region, regulators have continued to refine their expectations around access models. Poland’s experience with telemedicine, alongside ongoing debate in Germany, reinforced a clear message in 2025: digital access has a role, but only when anchored to the same clinical, compliance and governance standards as in-person care.
Behind these regulatory developments, the European supply chain continued to evolve and, at times, strain. Germany’s imports again approached quota limits, highlighting both the strength of demand and the pressure points of a system built on international sourcing. Export hubs such as Portugal and Canada remained central to European supply, reinforcing the importance of resilience, traceability and consistent quality.
At the same time, we saw something equally important: broader acceptance, growing clinical data, and patient stories that quietly but powerfully demonstrate the impact medical cannabis can have on quality of life.
Curaleaf International’s contribution in 2025
Against this backdrop, our focus at Curaleaf International remained consistent: expanding access responsibly, supported by evidence and high manufacturing standards.
A major milestone this year was the UK launch of the Curaleaf Que Medical Inhalation Device (QMID). Developed through Curaleaf Laboratories in partnership with Jupiter Research, QMID is the first CE-certified, EU Class IIa liquid medical cannabis inhaler available on prescription in the UK. It was designed from the outset as a medical device, offering controlled, repeatable dosing to support prescribers with an evidence-based, clinically compliant inhalation option for eligible patients.
We also extended that work beyond Europe. In Australia, we launched four Curaleaf-branded cannabis flower strains, bringing our evidence-led approach to one of the fastest-growing regulated medical markets globally.
These advancements reflect continued investment in EU-GMP manufacturing, liquid extract capabilities and device-ready formulations. Medical cannabis is no longer just about availability; it is about delivering consistent, pharmaceutical-grade medicines that can sit credibly alongside other prescribed treatments within established healthcare systems.
Across Europe, we also deepened partnerships with pharmacies and clinicians, focusing on practical collaboration and structured patient pathways. Regulation only works when it translates into day-to-day clinical reality.
Evidence, economics and public dialogue
2025 was also an important year for research and public discussion.
In the UK, Curaleaf Clinic worked with the Centre for Economics and Business Research on an independent analysis of the broader economic impact of medical cannabis. The study suggested that expanding NHS access could unlock up to £13.3 billion in economic value over the next decade, driven by reduced hospital utilization and improved workforce participation among people living with chronic conditions.
The significance of this work is not the headline figure, but the framing. Medical cannabis is a health policy issue as much as it is a clinical one. When evidence-based treatments remain largely confined to private access, the cost is borne more broadly, and patients are left with fewer choices than they should have.
Across International Markets, our teams continued to contribute to national conversations on quality, compliance and clinical education. Through advisory roles, industry participation and direct engagement with regulators, our goal has been to share data and experience, not to advocate for shortcuts. As expectations increase around dosing precision, device standards and pharmacovigilance, that dialogue becomes increasingly important.
A global signal from the United States
After nearly two years of speculation, political noise and market volatility, the US took a decisive step in 2025. President Donald Trump signed an executive order advancing the rescheduling of cannabis at the federal level, formally acknowledging accepted medical use under U.S. law.
Regardless of the underlying motivations (whether electoral considerations or a genuine evolution in policy thinking) the decision will stand as one of the most consequential drug-policy reforms in modern U.S. history. Its implications extend well beyond domestic markets.
A federal acknowledgement of medical use matters. The US remains a central reference point for global drug policy, including international institutions and national regulators. When that reference point shifts, alignment elsewhere often accelerates.
This change may also catalyze regulatory discussions in countries that have hesitated to move from debate to implementation. As American institutional capital and pharmaceutical expertise increasingly look toward international markets, jurisdictions with regulatory clarity and credible medical frameworks are likely to attract greater attention. Policy shifts of this scale rarely occur in isolation; they create momentum.
Progress, but still uneven
Despite the progress of 2025, access remains uneven.
In the UK, medical cannabis continues to sit largely outside NICE guidance. Specialist-only prescribing and limited NHS pathways remain significant barriers for many patients. While cannabis has been legal for medical use since 2018, uptake within public healthcare remains minimal. As we await the findings of the Advisory Council on the Misuse of Drugs review, increased engagement from regulators such as the Care Quality Commission and the General Pharmaceutical Council is likely. With rising patient numbers comes greater scrutiny, and that scrutiny is a natural part of the sector’s maturation.
Elsewhere in Europe, Spain’s new framework is restricted to hospital-based specialist care, and many practical questions around patient identification, training and funding remain unresolved. Italy, despite a long-standing legal regime, continues to experience regional disparities that affect consistency of access.
Even in more established markets, tighter oversight of telemedicine has highlighted where access models expanded faster than governance structures. The task now is to preserve the legitimate benefits of digital care while ensuring every prescription meets the same clinical and regulatory standards.
These challenges are not theoretical. They determine whether someone living with a qualifying condition can access a legal, clinically appropriate and affordable treatment, prescribed within a system that understands its role in a broader care plan.
Looking ahead to 2026
If 2025 reinforced anything, it is this: sustainable progress in medical cannabis does not come from cycles of hype. It comes from careful, sustained work: on regulation, evidence, manufacturing quality and clinical practice.
In some markets, early signs of commoditization and aggressive price competition are emerging. History suggests that this approach risks undermining quality, encouraging shortcuts and eroding trust. That is not how medical categories endure.
Looking ahead to 2026, our priorities at Curaleaf International remain clear:
- continuing to innovate in medically compliant delivery formats
- maintaining and strengthening EU-GMP and device quality standards
- supporting regulators and clinicians as access frameworks evolve
- expanding safe, compliant pathways that protect patients
There is still a long way to go before medical cannabis is fully integrated into healthcare systems worldwide. Our commitment is to remain on the side of responsibility, credibility and long-term value for patients, partners and policymakers alike.
Thank you to our teams, our clinical partners, and above all the patients and families who place their trust in us.
Juan
