Czech Doctors Now Authorized to Prescribe Medical Cannabis for Chronic Pain

Since April 1, all doctors in the Czech Republic have been authorized to prescribe medicinal cannabis to patients suffering from intractable chronic pain.

It marks a shift in the country’s healthcare system, as it expands access to a treatment option that was previously available only through specialists.

Cannabis has been used for medical purposes in the Czech Republic since 2015, and only specialized doctors could prescribe it.

However, the new regulation now allows general practitioners to prescribe medicinal cannabis for pain management, offering an alternative to painkillers such as morphine or fentanyl. Petr Šonka, chairman of the Association of General Practitioners, expressed his support for the change, emphasizing that cannabis is a safer option with fewer side effects compared to traditional opioids.

A nationwide educational program is being implemented, including regional seminars aimed at informing GPs about the prescription of cannabis.

After a slow start in 2015 when medicinal cannabis was legalized, sales reached over 100 kilograms in 2021. In 2024 alone, 320 kilograms were prescribed, representing more than one-third of the total amount dispensed since legalization.

This past decade, around 250 doctors have prescribed it in the country with a total of 937 kilograms. According to the 2024 Report on Illegal Drugs in the Czech Republic, up to 25% of the population over the age of 15 has used cannabis for self-medication.

In 2022, the General Health Insurance Company paid out CZK 17.2 million for medicinal cannabis treatment, benefiting around 3,200 patients. Health insurance companies have been covering a significant portion of the cost since 2020, reimbursing up to 90% for a maximum of 30 grams per month.

The new law includes people under 18 with oncological diseases or incurable diagnoses. They will be able to access cannabis products as part of palliative care for long-term or terminal conditions.

The use of medicinal cannabis is approved for a variety of intractable chronic pain that does not respond to conventional treatments, including:

• Chronic pain related to cancer, degenerative diseases of the musculoskeletal system, and other long-term illnesses.
• Neurological tremors resulting from Parkinson’s disease and other neurological disorders.
• Spasticity associated with multiple sclerosis, spinal cord injuries, and conditions that affect movement or breathing.
• Gilles de la Tourette syndrome, a neurological condition.
• Nausea, vomiting, and loss of appetite linked to cancer treatments, chemotherapy, and HIV.
• Superficial dermatoses and mucosal lesions.

However, the Ministry of Health has stipulated that general practitioners will only be able to prescribe cannabis for chronic intractable pain. For other conditions, such as neurological disorders or cancer, cannabis treatment will remain the responsibility of specialists.

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