🇮🇹 Medical cannabis in Italy

B — controlled national programme. Cannabis is a distinct medical category (Decreto Ministeriale 9 novembre 2015) embedded in the public system: state production/import, prescription by any doctor, preparation by pharmacies, regional reimbursement rules.

The Decreto del Ministero della Salute 9 novembre 2015 'Funzioni di Organismo statale per la cannabis previsto dagli articoli 23 e 28 della convenzione unica sugli stupefacenti del 1961' (Ministry of Health decree establishing the State Cannabis Agency) makes the Ufficio centrale stupefacenti of the Ministry the Organismo statale per la cannabis: it authorises cultivation, sets quotas and manages distribution. Art. 18-quater of Decreto-legge 148/2017 (converted by Legge 172/2017) authorises the Stabilimento chimico farmaceutico militare di Firenze (military chemical-pharmaceutical plant, Florence) to cultivate and process cannabis for pharmacies under GMP, allows the State Agency to authorise imports when national output is insufficient, and provides that pharmacies dispense doctor-prescribed magistral preparations on a non-repeatable prescription.

Source: Decreto 9 novembre 2015 (GU n. 279, 30.11.2015) — PDF hosted by ISS EpiCentro · read 27 September 2026

Pharmacy-made magistral preparations from cannabis flower (dried flower for decoction or vaporiser; pharmacies also make oils and capsules). There is no authorised finished cannabis-flower medicine; cannabinoid medicines (e.g. nabiximols) exist separately.

The Allegato tecnico of the DM 9.11.2015 (par. 4.1) lists the uses for which the state supply is intended: pain in spasticity (multiple sclerosis, spinal cord injury), chronic neuropathic pain resistant to conventional treatment, nausea/vomiting from chemo- or radiotherapy, appetite stimulation in cancer cachexia and AIDS, resistant glaucoma, and Gilles de la Tourette syndrome; the decree describes 'preparazioni magistrali a base di cannabis' (magistral cannabis preparations) taken orally as a decoction or by vaporiser. Art. 18-quater c. 1 DL 148/2017 authorises the Florence military plant to cultivate and transform cannabis into 'preparazioni vegetali' for pharmacies. The names, THC/CBD content and current list of state-supplied varieties (national FM-2/FM-1 and imported Dutch varieties) are published on the Ministry of Health site, which could not be opened in this session (bot-protection page); they are therefore not quoted here.

Source: Decreto 9 novembre 2015, Allegato tecnico (ISS EpiCentro PDF) · read 27 September 2026

Any licensed physician may prescribe, on their own clinical judgement; no prior authorisation from the regulator is needed. Regional reimbursement schemes may restrict which doctors (specialists/centres) can prescribe at the health service's expense.

The DM 9.11.2015 Allegato tecnico frames prescription as a decision of the physician within their clinical judgement, recording age, sex, dosage in grams of cannabis and the treatment need on the monitoring form for the ISS. The ISS monitoring report 2019–2024 states that in January 2025 more than 2,500 prescribers were accredited on the regional monitoring platforms across 19 regions plus the autonomous provinces of Trento and Bolzano, mostly specialists (anaesthetists/pain therapists, rheumatologists, neurologists, oncologists); it also notes that accreditation is linked to regional reimbursement registration and does not capture all prescribing.

Source: ISS — Relazione monitoraggio prescrizioni magistrali cannabis 2019–2024 (ISS monitoring report) · read 27 September 2026

A 'ricetta medica non ripetibile' (non-repeatable prescription) for a magistral preparation, on which the doctor must state the dose and the treatment need; the pharmacist prepares it.

DM 9.11.2015 Allegato tecnico: prescription under art. 5 of Decreto-legge 17 febbraio 1998 n. 23 (converted by Legge 94/1998, the 'legge Di Bella' rule for magistral preparations), i.e. a non-repeatable prescription; the doctor must record 'età, sesso, posologia in peso di cannabis ed esigenza di trattamento' (age, sex, dose by weight of cannabis, treatment need) and obtain the patient's consent. Art. 18-quater c. 5–6 DL 148/2017 confirms dispensing 'dietro ricetta medica non ripetibile'. Validity period and whether the prescription may be issued in dematerialised (electronic) form were not verified from an official page in this session.

Source: Art. 18-quater DL 148/2017 (conv. L. 172/2017) — text reproduced by Consiglio regionale della Calabria · read 27 September 2026

No official rule specific to cannabis and telemedicine was found. Italian law neither names video consultation as a permitted way to start a cannabis prescription nor prohibits it; national telemedicine guidelines and the non-repeatable-prescription rules apply.

Not published: neither the DM 9.11.2015 nor art. 18-quater DL 148/2017 mention the consultation mode. Whether a first prescription may be issued remotely is governed by general rules (national telemedicine guidelines and the requirement for a non-repeatable prescription), which could not be opened from an official page in this session (Ministry of Health site returned a bot-protection page).

Source: Decreto 9 novembre 2015 (no telemedicine provision) · read 27 September 2026

Community and hospital pharmacies that compound: the pharmacist prepares the decoction sachets, oil or capsules from state-supplied flower. Not every pharmacy stocks cannabis; there is no official list of those that do.

Art. 18-quater c. 1 DL 148/2017: the Florence military plant produces 'preparazioni vegetali' 'per le farmacie' and the state guarantees the national requirement; c. 5–6: pharmacies dispense the doctor-prescribed magistral preparations on a non-repeatable prescription according to Ministry of Health guidance. Mail order or home delivery of these narcotic preparations is not addressed in the texts opened; no official rule permitting it was found.

Source: Art. 18-quater DL 148/2017 (conv. L. 172/2017) · read 27 September 2026

Depends on your region. National law puts pain-therapy preparations at the charge of the Servizio sanitario nazionale within its funding limits, but each Region decides the indications, prescribers and dispensing route under which it actually pays; otherwise you pay.

DM 9.11.2015 Allegato tecnico: 'La rimborsabilità a carico del Servizio sanitario regionale è subordinata alle indicazioni emanate da parte delle Regioni' (reimbursement by the regional health service is subject to regional rules). Art. 18-quater c. 6 DL 148/2017: preparations for pain therapy are 'a carico del Servizio sanitario nazionale, nei limiti del livello del finanziamento del fabbisogno sanitario nazionale standard'. The ISS report notes that regional reimbursement schemes require doctor registration on the regional platform, which is why monitoring data cover reimbursed prescriptions rather than all prescriptions.

Source: Decreto 9 novembre 2015, Allegato tecnico; art. 18-quater DL 148/2017 · read 27 September 2026

No public patient price could be verified from an official page in this session. The state sets the price at which flower is supplied to pharmacies; the patient price of a compounded preparation is the pharmacy's tariff unless the region reimburses.

Not published here: the Ministry of Health / Agenzia Industrie Difesa pages listing the supply price per gram of FM-2/FM-1 could not be opened (bot protection / connection timeout). Pharmacy compounding tariffs are set by the Tariffa nazionale dei medicinali and vary by preparation; no official patient-price table was found.

Source: Decreto 9 novembre 2015 (no price provision) · read 27 September 2026

Italy penalises driving after taking narcotic substances under art. 187 of the Codice della Strada (Highway Code) with no legal THC threshold; the 2015 decree tells patients not to drive for at least 24 hours after the last dose. Having a prescription does not by itself exempt you from a positive test.

DM 9.11.2015 Allegato tecnico: 'I soggetti in terapia ... dovrebbero essere esentati dalla guida di veicoli ... per almeno 24 ore dopo l'ultima somministrazione' (patients should refrain from driving for at least 24 hours after the last dose). The statutory text of art. 187 D.Lgs. 285/1992 as amended by Legge 25 novembre 2024 n. 177 (which reworded the offence around driving after having taken narcotic substances rather than proven impairment) could not be opened from Normattiva or Gazzetta Ufficiale in this session, so penalties and the exact current wording are not quoted; treat this as unverified and check the statute.

Source: Decreto 9 novembre 2015, Allegato tecnico (driving warning) · read 27 September 2026

Italy is in Schengen, so residents of another Schengen state carrying their own prescribed cannabis normally need the Schengen Art. 75 certificate (max 30 days); Italian residents leaving need the same certificate from their local health authority (ASL). The official Italian page describing this could not be opened in this session.

Not verified from an official Italian page: the Ministry of Health pages 'Uso medico della cannabis' and 'Permessi di importazione ed esportazione' and the Agenzia delle Dogane traveller page all returned bot-protection or 403 pages. The Schengen Convention Art. 75 mechanism (certificate for up to 30 days of treatment) applies to Italy as a Schengen state; national rules for non-Schengen and non-EU travellers (personal-use import of narcotic medicines under DPR 309/1990) are not quoted because the text could not be opened.

Source: Ministero della Salute — Uso medico della cannabis (page could not be opened: bot-protection) · read 27 September 2026

No Italian rule bars a non-resident from being prescribed cannabis; the practical gate is finding a doctor and a compounding pharmacy, and paying privately. A cannabis prescription from another EU country is unlikely to be accepted, because narcotic preparations are outside the EU cross-border prescription rule; bring your own supply only with the Schengen certificate.

(1) Non-residents: neither the DM 9.11.2015 nor art. 18-quater DL 148/2017 impose residency, tax-code or insurance conditions on a private (self-paid) prescription; regional reimbursement is for regional health-service patients. (2) Foreign EU prescriptions: Directive 2011/24/EU Art. 11(6) excludes medicinal products subject to special medical prescription from mutual recognition; Italy transposed the directive by Decreto legislativo 4 marzo 2014 n. 38, whose text could not be opened in this session, so the Italian wording on narcotic prescriptions is not quoted — not published here. (3) Bringing medicine in: Schengen Art. 75 certificate for Schengen residents (max 30 days); the Italian import rule for non-Schengen/non-EU travellers is not published here (official pages could not be opened). (4) Foreign telemedicine prescription: follows from (2) — a magistral cannabis prescription issued abroad is not a prescription an Italian pharmacy can compound under Italian narcotic rules; not published as an explicit official statement.

Source: Directive 2011/24/EU (EUR-Lex), Art. 11 · read 27 September 2026

No confirmed pending change to the medical programme could be verified from an official page in this session. The main recent change affecting patients is the 2024 Highway Code reform on driving after drug use.

Not published here: the Ministry of Health news pages could not be opened. The ISS monitoring page (updated 31 luglio 2025) reports the programme continuing under the DM 9.11.2015 framework; the ISS report 2019–2024 was published 20.02.2025. Legge 177/2024 (Highway Code reform) is the notable 2024–2025 change but its text could not be opened here.

Source: ISS EpiCentro — Cannabis ad uso medico, aggiornamenti · read 27 September 2026

The Istituto Superiore di Sanità counted about 100,000 magistral cannabis prescriptions for about 28,000 patients in 2019–2024 on the regional monitoring platforms (reimbursed prescriptions only; median age 60, 78% for chronic pain).

ISS 'Relazione sul monitoraggio delle prescrizioni magistrali di cannabis ad uso medico 2019–2024' (published 20.02.2025): ~100,000 prescriptions, ~28,000 patients with at least one prescription, average 3.5 prescriptions per patient, F:M 2.3:1, 36% over 65, 9% under 40; chronic pain 78%, spasticity-related pain 20%, anti-nausea/appetite ~2%; two products account for >60% of prescriptions; >2,500 accredited prescribers in January 2025. The ISS states the data do not represent all national prescribing because not all regions require registration for non-reimbursed prescriptions.

Source: ISS — Relazione monitoraggio prescrizioni cannabis 2019–2024 · read 27 September 2026