In the EU, access to medical cannabis is a matter of national policy. A group of citizens wants to change that by leveraging a citizens' initiative and prompting the European Commission to act.

European citizens' initiative on medical cannabis

In February 2024, a group of organisers succeeded in registering a  European citizens' initiative on medical cannabis. A citizens' initiative is a form of direct democracy; when a group believes that there is a gap in EU law, they can leverage the procedure set out in Regulation (EU) 2019/788 to prompt the European Commission to take action. The procedure has three phases: first, register the initiative; second, collect the required number of signatures; finally, a hearing takes place in the European Parliament and then the Commission responds.

Not every initiative gets registered as certain conditions must be. This group has completed this first phase, resulting in  Commission Implementing Decision (EU) 2024/588. As a next step, the organisers have six months to open the signature collection. If the initiative receives one million statements of support within one year from at least seven different Member States, then they move on to the third and final phase.

The opportunity: improving access to medical cannabis in the EU

The organisers believe that the EU's prohibitive cannabis policy is  misguided and outdated. They refer to changes in the laws of EU member states, UN recommendations and human rights concerns.

The registered initiative has two aims:

  • foster access to medical cannabis, and allow patients to transport cannabis prescribed for therapeutic uses throughout the Union;
  • allocate the necessary resources for researching cannabis for its therapeutic uses.

The initiative's initial objectives were more ambitious, but they faced a rigid Commission.

The legal obstacles

Trying to evoke change via EU legislation has the obvious benefit of scale: success means change is implemented across the Union. But there is an important caveat. The EU may only act within the limits of the competences conferred upon it by the EU Treaties (TEU and TFEU).

This is where complications arise. The EU's powers to promote medical cannabis are not particularly firm. Considering the topic from a public health angle, Union action can only complement national policy (Article 168 TFEU). Seen from the criminal law angle, the EU's powers are limited to establishing minimum rules for drug trafficking (Article 83 TFEU, see for example  Council Framework Decision 2004/757/JHA). This is not to say that change at the EU legislative level is impossible, far from it. But change requires creativity and a willing legislator; and at this point, the Commission is not showing any appetite.

When the group of organisers presented their initial list of objectives, the Commission pushed back on their ambition. For example, the group also called on the Commission to relax criminal and administrative penalties for adult use, possession, and the cultivation of cannabis for personal purposes. The Commission refused to make this part of the initiative, commenting that excluding conduct from being deemed criminal exceeds its powers. Furthermore, in a recent response to a  parliamentary question, the Commission firmly stated that it has no plans to propose further harmonisation regarding medical cannabis within the EU's legal framework.

So, what can be expected from the initiative? If it reaches one million signatures, then the Commission must respond but is not under an obligation to take affirmative action. One possible outcome is that the Commission proposes a Council recommendation to promote access to medical cannabis. Harmonisation of national legislation is, however, not on the agenda.

Cannabis policy is slowly changing in the EU but primarily through national efforts. The EU citizens' initiative on medical cannabis presents a rare opportunity to evoke change at the EU level. The initiative also brings to light legal challenges.  The EU's powers to promote medical cannabis are not very strong, with the Commission displaying little appetite to take the lead. If the citizens' initiative reaches one million signatures, then the Commission will have to respond. One possible outcome is that the Commission proposes a Council  recommendation to promote access to medical cannabis.

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