Portugal Expands Export and Use of Medical Cannabis in Public Hospitals

Six years after the regulation of cannabis for medical purposes in Portugal, the use of these substances in public hospitals continues to grow, as does the export of products derived from the plant.

Between January and November 2024, hospital consumption reached 950 units, a significant increase from 707 units in 2023 and 524 in 2022. Pharmacies also recorded an increase, with 1,549 packages of medical cannabis products, reinforcing the trend of continuous growth.

Growth in Hospital Use

Data from Infarmed released by the Jornal de Notícias shows that 515 of the units consumed in public hospitals contained cannabidiol (CBD) as the active substance, while 435 combined CBD and tetrahydrocannabinol (THC).

Medical cannabis is prescribed in the country only when conventional treatments do not produce the desired effects or cause adverse reactions. Conditions treated include nausea and vomiting caused by chemotherapy or radiotherapy, chronic pain associated with oncological or neurological diseases, and epilepsy.

Currently, Portugal has 37 entities authorized to cultivate medical cannabis. Tilray, a Canadian company, is one of the main producers, with three products approved in the country - two oral solutions and one dry flower for inhalation.

Export on the Rise

Portugal exported more than 18,000 kilograms of medical cannabis between January and November 2024. About 46% of this volume was destined for Germany, where recent changes in legislation have facilitated patient access to these products.

According to Nuno Mendonça, director of Curaleaf International, medical cannabis exports increased from 709 kilograms in 2019 to over 25 tons in 2024. He believes that countries like France and Ukraine may follow Germany's example and expand the therapeutic use of cannabis, further boosting the market. 

Access Difficulties

Although the sector has grown, the lack of participation in medical cannabis restrictions remains a significant obstacle. Carla Dias, president of the Portuguese Observatory of Medical Cannabis, warns that many people cannot continue treatment due to high costs.

For example, a dry flower to relieve spasticity associated with multiple sclerosis can cost up to 300 euros per month. Lara Silva, mother of Sofia, a six-year-old girl with epileptic encephalopathy, spends about 150 euros every 35 days and resorts to recycling caps, paper, and plastic to help cover the costs.

Alternatives and Expectations for the Future

The difficulty of access leads some patients to seek alternatives, such as purchasing foreign products online or practicing self-cultivation.

Portugal currently has two cannabis-based medications approved: Sativex, with a 37% market share, and Epidyolex, available only in hospital pharmacies. However, the privacy of medical cannabis has no state support.