In Italy, in reference to the use of medical cannabis, the legislation says that physicians, including general practitioners, are allowed to prescribe, and patients to receive, cannabis for certain types of pathologies. Cannabis is imported in the form of cannabis-based medicines, purchased in the form of galenic preparations, and since 2016 produced in an ad-hoc facility operated by the Italian Army. Cannabis produced for pharmaceutical use, in accordance with the European directives on medicinal products (EU – GMP), differs from the illegal one for the different composition of CBD and THC and is to be taken in the form of decoction or by inhalation with a special vaporizer. https://www.salute.gov.it/portale/temi/p2_6.jsp?id=4587&area=sostanzeStupefacenti&menu=vuoto
The law is certainly perfectible, and the major criticality is currently constituted by the insufficient quantity of supplies. For this reason, the Ministry of Health has recently announced the issuance of a call to entrust the production to authorized private companies, in order to ensure the quality requirements and percentages of active ingredients required, and the quantities needed by patients to whom it is prescribed. At present, studies, even at a global level, on therapeutic efficacy are contradictory and inconclusive, and most of them are based on patients’ self-evaluation. For this reason, and also to understand any extension of its application to other pathologies, which someone requests, we are in favor of in-depth studies on the subject, which can shed light on the real benefits and any adverse effects, evaluating the relationship between them.
As for the non-medical use and possession for personal use of cannabis – as well as any other psychoactive substance – according to the Italian law 309/90 and subsequent amendments – they are not considered criminal offenses, however in some cases administrative santions may be imposed. However, there have been and there are numerous legislative proposals to legalize not only the use of cannabis but also its domestic cultivation, partly to overcome the lack of cannabis for medical use, but also in an attempt to broaden the range of those who can access it. This proposal leaves many question marks, particularly in relation to control over the quality of the product and its active ingredient content as well as its destination and possible diversion. Also in this case, before proceeding towards legislation that would expand the availability and use of cannabis, we believe that many studies and further investigations are needed, that can offer conclusive indications on the effects of cannabis, particularly in the case of adolescents and young adults whose brain is still developing: it has in fact been ascertained that in this case cannabis can have very serious and long-lasting consequences. The drafting of a law regulating the use of cannabis, even more so if it is used for non-medical purposes, should in fact be guided by such scientific studies which can help establish the limits in terms of age, quantity and percentage of active ingredients. On the contrary, in many countries where this has happened, regulation and distribution has followed purely commercial and profit-oriented logics, with negative consequences especially for the most vulnerable groups, whom this initiative was intended to protect. Drug policies must be dictated by respect for human rights and protection of the most vulnerable groups, adolescents, the most fragile, people in economic and social difficulties, who are more likely to suffer from the negative aspects of substance use and, because of their life experiences, may more easily develop problematic use trajectories. All of us should direct our greatest efforts to these vulnerable groups, in terms of prevention and advocacy, and also to stimulate the creation of more affordable and accessible services able to support, offer treatment and facilitate social reintegration.