Legalization of medical cannabis in Ukraine has become a reality. Even yesterday it seemed impossible – the topic was toxic, politicians were afraid to even mention it, and society was torn between myths and facts. For some, this is a chance to relieve chronic pain and treat serious conditions, for others, it is a risk of abuse and weak control mechanisms. But now the law has been passed, and the country is facing a new reality: the legal use of cannabinoids in medicine. Ahead is a difficult path from the adoption of the law to its actual implementation. Ukraine is part of the world trend, but at the same time it is forced to overcome its own unique challenges.
The law that provides new opportunities for the medical system
Law on the legalization of medical cannabis entered into force on August 16, 2024. This decision was not easy for the deputies, but the war became almost the most decisive factor in accelerating its adoption. President Volodymyr Zelenskyi emphasized that Ukraine intends to create the strongest mental and physical rehabilitation industry in Europe. Well-known Ukrainian journalists, athletes, politicians, scientists and doctors also spoke out for the legalization of medical cannabis.
According to the Ministry of Health, 6 million patients need medicines based on medical cannabis. For more than 5 years, activists who care for the interests of patients have fought for the availability of such drugs in Ukraine. That is why in January 2025 the first medicines based on medical cannabis produced in Spain were officially registered by Curalif, as reported in its posts on Facebook, a member of the Parliamentary Committee on National Health, Medical Care and Medical Insurance, Olha Stefanyshina, referring to to the “Patients of Ukraine” charity fund.
This is a crucial moment for the Ukrainian medical system, as doctors have been given the opportunity to prescribe cannabis-based drugs to patients, and patients to receive the drug by electronic prescription. Pharmacies that will manufacture medicines will have to have three licenses:
- for retail trade;
- production of drugs;
- on the circulation of narcotic substances.
In addition to cannabis oral drops, pharmacies will soon be able to buy hard capsules, toothpastes and gels, approved by the Ministry of Health (MOH) in 2024. A list of diseases and conditions for which Ukrainian patients can receive prescriptions for medical cannabis was also determined. At the same time, such drugs will not be the primary treatment option – they will be used only in cases when other drugs do not give the desired therapeutic effect or cause significant side effects. The following are included in the list of diseases that require the use of the drug:
- patients with chronic pain,
- with Parkinson’s disease;
- with nausea and vomiting caused by chemotherapy,
- with Tourette syndrome;
- drug-resistant epilepsy;
- diseases that cause convulsive attacks in childhood;
- anorexia due to HIV.
It is worth noting that the patient community insists on including post-traumatic stress disorder (PTSD) in the above-mentioned list. The difficulty is that the effect of cannabis on PTSD has not yet been proven by scientific research, but is based only on testimony people who claim that taking such a drug alleviates their condition.
Medical cannabis is a plant raw material of hemp that has no narcotic properties and is used to reduce pain, spasms and muscle cramps, etc. Cannabidiol (CBD) and tetrahydrocannabinol (THS) stand out among the 200 active components included in the content of cannabis. It is tetrahydrocannabinol (THS) that is able to influence human consciousness. However, Ukrainian legislation regulates and limits the content of THS in medical cannabis (it has equal or exceed 0.3% – ed.). Unlike medical cannabis, recreational cannabis has no such restrictions. That is why recreational cannabis is banned in Ukraine.
Ukraine has taken a historic step – the legalization of medical cannabis, a topic that has caused fierce disputes for years, is now fixed at the legislative level. From prohibition to prescription – the country has gone through this path quickly, but the real challenges lie ahead. The medical system will change, new opportunities will open up for the pharmaceutical business, and thousands of patients will finally have access to the necessary treatment. However, with hopes come risks, from bureaucratic hurdles to a potential black market.
A new sector or a minefield
The legalization of medical cannabis opens the door for pharmaceutical companies, the agricultural sector and start-ups specializing in production and import. The global market for medical cannabis is estimated at tens of billions of dollars, and Ukraine, with its fertile soil and relatively cheap labor force, has every chance to take its place in this sector.
However, the rules of the game have not yet been formed. The legalization of medical cannabis is not only an opportunity, but also a huge responsibility. If the state does not provide transparent rules, control and training of medical workers, the new market can become another zone of corruption, manipulation and shady schemes.
Officially, the state promises strict control over the production and distribution of cannabis, but in practice this can turn into a corruption scheme. Licenses for the cultivation of raw materials, the import of drugs and their sale can become a “golden vein” for officials, who will issue permits only to companies that are profitable for them.
If the medical cannabis market is monopolized by a few big players, this will not only limit competition, but also lead to inflated prices. In this case, patients will be left without affordable medicines, and the market will develop not according to the rules of the economy, but according to the schemes of “contractors”.
When something becomes scarce or expensive, an illegal alternative emerges. If the prices of official medical cannabis prove to be prohibitive and access to it is too regulated, patients will begin to look for options in the shadows. This will open up space for smuggling, counterfeiting and sale of dubious products without laboratory control.
Added to this is another problem: the lack of a culture of responsible use of cannabis in medicine. Without proper information, patients may start to buy the drug themselves from illegal sellers, not understanding the difference between medical drugs and narcotic substances.
In developed countries, medical cannabis is prescribed by doctors who have the appropriate training and know to whom and how to prescribe it. In Ukraine, many doctors are not even familiar with the principles of cannabinoid therapy. If the state does not take care of training doctors and updating clinical protocols, the situation will be chaotic. Some doctors will be afraid to prescribe these drugs, others will prescribe them for everyone in a row.
In addition, it is important to avoid a situation where medical cannabis becomes a magic pill for everything. In the US, for example, there have been cases where people started using cannabis without a real medical need, and some doctors turned prescriptions into a commercial service. If this issue is not settled in Ukraine, medical cannabis may turn into a new business of selling legal prescriptions.
Politicians are also speculating on the legalization of cannabis. Some parties promote this topic as a huge achievement, while others scare the public with the legalization of drugs. The state should make an effort to explain the benefits of medical cannabis, otherwise this topic will continue to divide society. This can lead to populist decisions, new bans or, on the contrary, an overly liberal approach without proper controls.
In turn, the law on the legalization of cannabis cannot help but affect law enforcement agencies. For decades, the Ukrainian police and courts worked under a scheme where any connection with cannabis is a crime. Obviously, without clear control mechanisms, there is a risk that law enforcement officers will either continue to intimidate patients and doctors, or, on the contrary, will turn a blind eye to the illegal market.
The world experience of cannabis legalization
Legalizing cannabis is like surgery. If done correctly, the patient, in this case the entire country, will benefit. If you approach it without proper preparation, the consequences can be worse than the problem itself. Dozens of countries have already gone this way, and their experience proves that legalization is not just “allow or forbid”, but a complex balance between benefit, control and unpredictable risks.
In the USA, the legalization of medical cannabis began back in 1996 with California. At first, it all looked like a humane step for patients with chronic pain and serious illnesses. But over time, each state began to play by its own rules. Today in the USA the situation is paradoxical: in 38 states cannabis is legal in one form or another, but at the federal level it is still considered an illegal drug. This wreaks havoc on business financing, taxes and law enforcement. In some states, medical prescriptions have become a formality. It is enough to complain about insomnia or stress – and you already have a legal “sedative” in your hands.
But there are also advantages, because a multibillion-dollar market has appeared, new jobs, taxes that go to state budgets. For example, in Colorado, just in the first year of the legal market, taxes on the sale of cannabis brought in more than 130 million dollars.
The US example shows that legalization can be beneficial, but without strict control, the line between medical and recreational cannabis can lead to serious problems.
Canada legalized medical cannabis back in 2001, and in 2018 went further by allowing recreational use. But unlike the US, where the market is chaotic, the Canadian model is a government machine that keeps everything under control. Cannabis can only be bought from specialized licensed outlets, and quality and price are regulated by the government. Everything looked perfect at first, but problems started almost immediately. State stores did not have time to meet the demand, and the black market did not disappear. Due to high taxes, legal cannabis turned out to be much more expensive than illegal, which only stimulated shadow sales. Canadian companies, hoping for huge demand, overproduced tons of cannabis, and the market quickly became saturated.
In 2017, Germany legalized medical cannabis, and did it in a German-style way – through strict regulation. Only certified doctors can prescribe drugs, and only pharmacies can get them. Unlike in the US, where patients themselves decide whether they need cannabis, in Germany this process is strictly controlled. At the same time, the country faces a serious problem where most of the raw materials are imported, making treatment expensive and out of reach for many patients. In 2024, Germany went even further, allowing the limited use of recreational cannabis through “consumer clubs”, but under strict restrictions. This is a compromise model between prohibition and full legalization.
Thailand wanted to become the first country in Asia with a fully legal medical cannabis market. In 2018, the authorities announced reforms, and within a few years, shops selling cannabis allegedly for medical purposes began to appear across the country. This led to the emergence of so-called “coffee shops” and “pharmacies” where anyone could buy cannabis without a real medical justification. Due to the lack of proper control, the country has effectively turned into a new Amsterdam, and the government is already considering the possibility of returning to stricter restrictions. But returning restrictions after legalization turned out to be an extremely difficult matter.
The legalization of medical cannabis is definitely a step forward. But its effectiveness depends on how exactly it will be implemented. If the law remains just a text on paper without a well-thought-out system of implementation, deregulation and control, real changes can take years.
So, Ukraine is joining the global trend of legalizing medical cannabis, but it is doing so in conditions of war and economic instability. On the one hand, a new industry can boost the economy, create jobs and attract investment. On the other hand, the lack of clear control mechanisms can lead to abuse, corruption and the growth of illegal trafficking.
Information policy plays an important role. Despite the adoption of the law, a part of society still perceives cannabis exclusively as a drug. If the government does not make efforts to explain its medical benefits and safe use, public resistance, manipulation and political speculation on this topic can be expected. It is obvious that the country has a chance to change the approach to the treatment of thousands of patients and create a new economic sector. The only question is whether this chance will be used correctly or will turn into another story of missed opportunities.
