Medical cannabis on prescription in Spain: how access works.
Spain’s Ministry of Health and medicines agency (AEMPS) have established the country’s first national framework for prescribed cannabis preparations under Royal Decree 903/2025. Access is strictly controlled, hospital-based, and rolling out progressively across Spanish hospital pharmacies from late October 2026.
What Royal Decree 903/2025 changed in Spain
For years, Spain had no legal prescription route for medical cannabis. Patients either travelled abroad or were left without regulated clinical support. Following parliamentary subcommission reviews and formal approval by the Council of Ministers, Royal Decree 903/2025 created Spain's first official pathway.
The law establishes strict regulatory control through Spain's medicines agency (AEMPS). Cannabis is classified as a hospital-only medicine: it is formulated by hospital pharmacists and prescribed exclusively by hospital specialists for documented, treatment-resistant conditions.
Authorised medical conditions under AEMPS
Spain does not operate a broad "card" or general wellness system. The decree authorises medical cannabis preparations only for specific clinical scenarios where conventional therapies have failed:
First hospital orders arrive from late October 2026, the rollout is gradual, and most hospitals will not have it yet.
The Three Steps of Hospital Access in Spain
A hospital specialist assesses you
Only hospital specialists can prescribe, for example in a pain unit or neurology. GPs cannot.
Authorised conditions check
They check your case against the authorised conditions, which include chronic pain that has not responded to standard treatment, and need documented clinical justification.
Hospital pharmacy dispensing
The hospital pharmacy prepares and dispenses it. Not a high street pharmacy. Follow-up stays with the hospital team.
Not part of this
- Cannabis flowerOnly standardised oils and extracts are permitted under the decree.
- Prescriptions from GPs or general clinicsPrescribing authority is restricted strictly to hospital specialists.
- Collection from community pharmaciesDispensing is handled exclusively by hospital pharmacy units.
Not valid in Spain
- US medical cannabis cardsState cards hold no legal recognition or dispensing validity in Spain.
- UK or German prescriptions used in Spanish pharmaciesForeign prescriptions cannot be dispensed or filled by Spanish hospital pharmacies.
- Anything sold as "medical cannabis" outside a hospital pharmacyCommercial retail or street shops are not authorised prescription providers.
Check how prepared you are
Six quick questions. This does not tell you whether you qualify. Only a hospital specialist can decide that. It shows how ready your paperwork is and what to gather first.
What are you hoping to be assessed for?
The authorised conditions are being set out by Spain's medicines agency, AEMPS; chronic pain that has not responded to treatment is one of them.
How we help
We are an English-speaking guidance service. We can organise and translate medical records, prepare you for the specialist appointment, help you find which hospitals are actually dispensing, and go with you if you want support. We do not prescribe, supply cannabis or promise outcomes. The specialist always decides.
Frequently asked questions
You need to be seen through a Spanish hospital, which means access to the Spanish public system or a hospital that accepts private or insured patients.
Reports say public hospital pharmacy prescriptions are free to patients, but private hospitals may set their own fees. Always confirm with the hospital.
Yes. Your GP cannot prescribe cannabis but can refer you to the relevant hospital specialist.
Yes. Honesty helps them judge safety and interactions.
General information, not medical or legal advice. Rules and availability are changing. Last reviewed October 2026.