Yes, medical marijuana is legal in Italy. The country formally regulated cannabis prescriptions for therapeutic use through a ministerial decree in November 2015, and today more than 10,000 patients hold active prescriptions. However, access varies significantly depending on where in Italy you live, what condition you have, and whether your regional health system covers the cost.
How Italy Regulates Medical Cannabis
Italy’s framework for medical cannabis centers on the 2015 ministerial decree (DM 9 November 2015), which established rules for prescribing cannabis and for pharmacists to prepare cannabis-based medicines. The system treats cannabis not as a standard pharmaceutical product with a fixed list of approved conditions, but as a palliative treatment that doctors can prescribe when conventional therapies have failed or caused unacceptable side effects.
Because there is no single national list of qualifying diseases, prescribing decisions rest largely with the physician. In practice, medical cannabis is most commonly used for chronic pain, muscle spasticity in multiple sclerosis or spinal cord injuries, and nerve pain from various causes. Patients with terminal cancer or AIDS also receive prescriptions to manage nausea, vomiting, and appetite loss.
How Patients Get a Prescription
Any licensed physician in Italy can write a medical cannabis prescription, though the process involves more paperwork than a typical drug. Doctors must complete a specific form that includes the patient’s age and sex, the weight-based dosage of cannabis, the medical reason for the prescription, and the treatment outcomes over time. This data gets submitted to Italy’s national health institute (the Istituto Superiore di Sanità) through the patient’s local health unit or directly by the prescribing doctor via a dedicated web platform.
Once you have a prescription, you take it to a pharmacy that prepares galenic (custom-compounded) cannabis products. Most pharmacies follow a standardized protocol: cannabis is extracted into olive oil at a ratio of 1 gram per 10 milliliters, heated in a water bath, then filtered. Other available forms include decoction filter bags for tea and unit-dose formulations for inhalation. You won’t find pre-packaged cannabis products on pharmacy shelves the way you might in North America. Each preparation is made individually by the pharmacist.
Where the Cannabis Comes From
Italy is one of the few countries that grows its own medical cannabis through a military facility. The Military Chemical Pharmaceutical Institute in Florence cultivates a strain called FM2, developed in collaboration with Italy’s Council for Agricultural Research and Economics. FM2 contains roughly 59 mg/g of CBD and 42 mg/g of THC, making it a relatively balanced strain.
Domestic production has never been enough to meet patient demand, so Italy relies heavily on imports. The Dutch company Bedrocan is by far the dominant supplier, accounting for approximately 90% of cannabis products used in patient treatment by volume. Bedrocan supplies several strains: Bedrocan, Bedrolite, Bediol, and Bedica (a fifth, Bedrobinol, is authorized but not currently available). Smaller quantities have also been imported from Linneo Health in Spain, Little Green Pharma in Denmark, and Aurora in Canada. Among pharmacy preparations, Bedrocan’s products are the most widely used, appearing in over 60% of galenic cannabis oils.
Cost and Regional Differences
This is where Italy’s system gets complicated. The national health service can reimburse medical cannabis costs, but whether it actually does depends on your region. Currently, regions including Tuscany, Puglia, Liguria, Emilia Romagna, Veneto, Friuli Venezia Giulia, Piedmont, and Sicily subsidize medical cannabis purchases to varying degrees. Sicily fully reimburses eligible patients. In regions outside this group, patients pay the entire cost out of pocket.
There’s another important caveat: only prescriptions written through the public healthcare system qualify for reimbursement. If you get a private prescription, you won’t receive any coverage regardless of where you live. For patients in regions without reimbursement programs, or those using private doctors, the financial burden can be a real barrier to access.
Recreational Use Is Still Illegal
Italy draws a firm line between medical and recreational cannabis. Recreational marijuana remains illegal, and the government has recently moved to tighten restrictions even on industrial hemp. A new law that took effect on April 12, 2025 (Decree Law No. 48) classifies industrial hemp flowers as narcotics regardless of their THC content. This law criminalizes the cultivation, sale, processing, and possession of hemp flowers and cannabinoids like CBD, CBG, and CBN outside of approved medical channels.
Under a separate Health Ministry decree from June 2024, CBD can still be used for prescription-only pharmaceutical purposes. But the over-the-counter CBD products, hemp flower shops, and “cannabis light” products that had become common in Italian cities now face severe legal restrictions. The 2025 law bans the importation, trade, transport, and consumption of hemp inflorescences in any form, including extracts, resins, and oils derived from them. The only permitted use of hemp flowers is processing them for agricultural seed production.
What This Means for Visitors and Residents
If you’re an Italian resident with a qualifying condition that hasn’t responded to other treatments, you can work with your doctor to explore a medical cannabis prescription. The process is bureaucratic but functional, and living in a region with reimbursement coverage makes a meaningful financial difference. If you’re a visitor or tourist, Italy’s medical cannabis system is not set up for short-term access. You cannot buy cannabis products at a retail dispensary, and the prescription and pharmacy compounding process requires an established relationship with the Italian healthcare system.
Italy’s position is, in short, medically permissive but tightly controlled. Cannabis is a legitimate treatment option within the public health system, but everything outside that framework, from recreational use to unregulated CBD products, is increasingly restricted.