# Information for Patients

This article provides a brief introduction to what medical cannabis is, which diagnoses are relevant for prescriptions in our neighboring countries, and opportunities to obtain a prescription in Norway. Medical cannabis can be a safe and effective solution for many different health challenges. It is not one medication, but a group of medications that can be tailored to your specific needs. In Norway, there are now 19 different variants available, and research shows that patients who experience effects report better quality of life, less pain, and better sleep. You can read more below.

# What is Medical Cannabis and How Does It Work?

Medical cannabis (MC) is not one medication but a group of medications. The medications come in administration forms such as capsules, oils, tablets, dried plant material (vaporization), and mouth spray. Each of the products in these categories has a unique combination of active ingredients and administration form. A patient who does not experience effects from one variant of the medication (for example, Sativex) may still experience good effects from another variant and/or administration form. In Norway, we now have 19 variants of MC.

The most well-known active ingredients in MC are THC and CBD. THC can increase appetite and reduce nausea. It can also relieve pain, inflammation, and problems with muscle control. In cases of overdose, THC can produce an euphoric effect (intoxication effect). CBD is not intoxicating but can have a relaxing effect. CBD can reduce pain and inflammation, control epileptic seizures, and be helpful in the treatment of mental illness and addiction. CBD is also available as a health supplement in our neighboring countries. [In addition to this](https://www.mdpi.com/1420-3049/26/9/2774 "https://www.mdpi.com/1420-3049/26/9/2774") we find smaller amounts of other cannabinoids such as CBG, CBN, and THCV, as well as non-cannabinoid phenols, flavonoids, terpenes, and alkaloids. These work together in an entourage effect and contribute to each variant of the medication having unique effects. MC is therefore ideal for personalized treatment.

The active ingredients in cannabis act on a large receptor system in the body called the endocannabinoid system. This consists of three main components:

- endocannabinoids (such as anandamide and 2-AG)
- CB1 and CB2 receptors
- regulatory enzymes

The endocannabinoid system is a large receptor system whose main task is to maintain the body's natural balance, or homeostasis. It acts as a conductor that coordinates all the important body systems we have. It is central to the regulation of many important processes such as anxiety, pain, inflammation, stress, immune responses, mood, and appetite. Dysregulation in the system is also believed to affect the development of symptoms in Huntington's, Alzheimer's, Parkinson's, and MS.

![Endocannabinoid System](./endo.jpg)

The effect on the endocannabinoid system also explains why cannabis has an effect on so many symptoms and diagnoses. Approximately 50% of [prescriptions now issued in England](https://www.bbc.com/news/articles/crgkxv6ljp4o "https://www.bbc.com/news/articles/crgkxv6ljp4o") are for all types of chronic pain, 40% are for various mental health conditions, 6% for neurological conditions, and 4% for other diagnoses.

The most common diagnoses under the main categories in the UK are:

![UK Diagnoses](./diagnoser-UK.jpg)

Conditions that have received approval exemption in Norway as of 2023:

![Norwegian Diagnoses](./diagnoser.jpg)

## Is Medical Cannabis Safe to Use?

### Side Effects and Safety:

Medical cannabis is considered a medication with few serious side effects. This is evident from studies and statements from experienced professionals. The moral and ethical aspects of testing the medication group in real life should therefore be less problematic.

Former medical director of the Norwegian Medicines Agency, Steinar Madsen, stated the following in an [interview with Fagbladet](https://www.lmi.no/2019/06/26/cannabis-er-ikke-medisinsk-risikabelt/ "https://www.lmi.no/2019/06/26/cannabis-er-ikke-medisinsk-risikabelt/") in 2019:

_"There is a widespread misconception that cannabis is a medically risky substance," says Steinar Madsen to Fagbladet Journalen. He emphasizes that cannabis is a medication with few serious side effects._

[The evaluation of the Danish trial program](https://www.ism.dk/Media/637643720599030745/Evaluering%20af%20fors%c3%b8gsordningen%20med%20medicinsk%20cannabis%20-%20November%202020.pdf "https://www.ism.dk/Media/637643720599030745/Evaluering af fors%c3%b8gsordningen med medicinsk cannabis - November 2020.pdf"), which was conducted in 2024, has over 6 years treated 8,785 patients and issued 68,082 prescriptions and concludes with the following:

_"The Danish Medicines Agency has not identified any safety issues based on the side effect reports for cannabis products covered by the trial program." (our emphasis)_

The evaluation from the UK Medical Cannabis Registry, which had followed 8,945 patients over 2 years, finds (Erridge et al. 2025: UK Medical cannabis registry: an updated clinical outcomes analysis across all conditions. Recently accepted for publication in ICRS, but not yet printed):

_"Medical cannabis was largely well-tolerated. Moreover, there was an improvement in health-related quality of life, anxiety, and sleep."_

According to Mikael Sødergren (who is the research leader for this study at Imperial College), the study contains data from 40,000 patients as of June 2025, and he writes the following in an email to us at Stopp lidelsen:

_"We now have >40,000 with a similar safety profile seen"_

A completely [new large randomized study](https://www.nature.com/articles/s41591-025-03977-0), published in Nature Medicine, has followed 800 back pain patients over one year and summarizes as follows:

*Side effects were mainly mild and transient (e.g., fatigue and dizziness). No signs of addiction or withdrawal were observed.*

Cannabis is associated with several misconceptions and stigma related to the active ingredient THC in cannabis also being used as a recreational drug. In medical use, the intoxication effect is considered an unwanted side effect that can occur with THC overdose. In this regard, medical cannabis is not alone. We have several medications that can cause intoxication with overdose. It's all about dosage, titration, acclimation, and content of active ingredients. Titration of THC occurs through an acclimation period, similar to what is done with, for example, Lyrica and benzodiazepines. THC used medically usually ranges between 0.5 - 20 mg **per day**, but this depends on diagnosis and individual circumstances. Starting doses are usually 0.5 - 2.5 mg THC per day. For comparison, one recreational dose is considered to be from 15 mg THC among inexperienced users, and usually over 50 mg **per dose** for experienced users. Variants containing less than 1% THC cannot produce an intoxication effect. This is typically isolated CBD (such as in Epidyolex) or full-spectrum CBD with GMP standard.

Addiction potential is another factor that many are concerned about. This is understandable given the experiences with OxyContin and the aggressive marketing that was conducted in connection with it. MC is considered to have a low potential for physical addiction. An RCT study examining what happens with rapid discontinuation of Sativex finds [no withdrawal problems](https://pubmed.ncbi.nlm.nih.gov/21878454/) after 3 years of use. Another RCT study, which [follows rheumatoid arthritis patients over 5 weeks](https://pubmed.ncbi.nlm.nih.gov/16282192/), shows no problems related to discontinuing treatment. The same is shown by the RCT study from Nature Medicine that lasted for one year: [there were no signs of addiction or withdrawal](https://www.nature.com/articles/s41591-025-03977-0). With recreational use, it is estimated that approximately [9% develop addiction](https://pubmed.ncbi.nlm.nih.gov/17382831/)<u><span>tion</span></u>. Symptoms of this include, for example, sleep problems, restlessness, and irritability that occur with discontinuation and persist for several weeks. The concept of addiction should be used with caution when we talk about medical use. Discontinuing treatment often means that the symptoms MC is used for return. Tolerance development may occur (that doses must be increased), but this is regulated by the doctor monitoring dose development and implementing tapering periods if necessary.

### Which Variants of MC Are Available by Prescription in Norway as of 2025:

**Registered Cannabis Medicines (RCL)**

- Sativex: oral spray extract with 27 mg THC and 25 mg CBD per ml.
- Epidyolex: oral spray extract with 100 mg/ml CBD.

**Cannabis-Based Medical Products with GMP Standard (CBMP)**

- Bediol: dried plant material; 63 mg THC and 80 mg CBD per gram.
- Bedrocan: dried plant material; 220 mg THC and ≤ 10 mg CBD per gram.
- Bedica: dried plant material; 140 mg THC and ≤ 10 mg CBD per gram.
- Bedrobinol: dried plant material; 135 mg THC and ≤ 10 mg CBD per gram.
- Bedrolite: dried plant material; ≤ 10 mg THC and 75 mg CBD per gram.
- Glostrup drops: ≤ 1 mg THC and 20 mg/ml CBD
- Glostrup drops: ≤ 1 mg THC and 50 mg/ml CBD
- Glostrup drops: ≤ 1 mg THC and 100 mg/ml CBD
- Glostrup drops: ≤ 1 mg THC and 300 mg/ml CBD
- Adven drops: ≤ 1 mg THC and 50 mg/ml CBD
- Adven drops: ≤ 1 mg THC and 10 mg/ml CBD
- Adven drops: 10 mg/ml THC and 10 mg/ml CBD
- Adven drops: 20 mg/ml THC and ≤ 1 mg CBD
- Stenocare drops: 2 mg/ml THC and 20 mg/ml CBD
- Stenocare drops: 30 mg/ml THC and 0.1 mg/ml CBD
- Stenocare drops: 15 mg/ml THC and 22.5 mg/ml CBD
- Stenocare Asturm drops: 10 mg/ml THC and 10 mg/ml CBD

In addition, the medications Cesamet and Marino (isolated THC) can also be applied for approval exemption, but they are not registered cannabis medications in Norway today.

Prices:

Most drops cost between 4,000-6,000 kroner per bottle of oil. Some are even more expensive.

Dried plant material costs approximately 900 kroner for 5 grams.

It is possible for patients to convert Bedrolite (dried plant material) into oil. This results in CBD oil for approximately 300 kroner per bottle, with 9% CBD and less than 1% THC.

- Registered cannabis medications can be prescribed in the traditional way.
- Cannabis-based medical products (CMBP) require an application for approval exemption via DMP.

### Who Can Prescribe?

**Regulations on the Requisition of Prohibited Narcotics and Certain Medicines for Human Medical Use Chapter 3** stipulates the rules for requisition of cannabinoids and cannabis-containing medicines. [Regulations on the Requisition of Prohibited Narcotics and Certain Medicines for Human Medical Use - Lovdata](https://lovdata.no/forskrift/2022-09-22-1630/). The regulation § 3-2 stipulates the right to requisition:

_Doctors who can requisition cannabis-containing medicines are doctors who have the right to requisition medicines in prescription group A:_

- § _All doctors can requisition cannabis-containing medicines that are approved or have marketing authorization in Norway.
- § _All doctors can requisition cannabis-containing medicines with THC content below 1% that are not approved or have marketing authorization in Norway.
- § _Doctors with specialist approval who are employed in the public healthcare system or in private hospitals can requisition cannabis-containing medicines with THC content above 1% that are not approved or have marketing authorization in Norway.

This means that general practitioners can prescribe the following products (without reimbursement):

- Sativex and Epidyolex (registered cannabis medications).
- CBMP products with less than 1% THC (approval exemption via DMP).
- Products with less than 10 mg/ml THC (this is considered less than 1%).
- General practitioners can also issue a certificate that patients can take to a foreign doctor for an assessment of whether medical cannabis is a suitable treatment option. A template for the certificate is available on DMP's website and [can be downloaded here](https://www.dmp.no/globalassets/bilder/godkjenning-av-legemidler/narkotika/legeerklaring-eksempel-2024.png "https://www.dmp.no/globalassets/bilder/godkjenning-av-legemidler/narkotika/legeerklaring-eksempel-2024.png").

Specialists working at hospitals can prescribe prescriptions for all products. This applies to both private and public hospitals. A prescription via a public hospital leads to reimbursement of costs on the H-prescription. This has led to most public hospitals now having stopped issuing prescriptions. If the prescription is issued by a specialist working at a private hospital, the patient must cover the costs themselves.

Both Sativex and Epidyolex are marketed medications in Norway. The indication for Sativex is spasms in MS, and for Epidyolex the indication is Dravet syndrome, Lennox Gastaut syndrome, and seizures in tuberous sclerosis. These preparations can also be prescribed off-label for other conditions. Costs for the medication are covered on the H-prescription (Sativex was transferred to the H-prescription on 1.2.2021 and Epidyolex on 1.8.2018). This means that if a specialist at a public hospital issues a prescription, the costs are covered. If another doctor issues a prescription, the patient must cover the costs themselves.

Key sources:

- [Regulations on the Requisition of Prohibited Narcotics and Certain Medicines for Human Medical Use](https://lovdata.no/dokument/SF/forskrift/2022-09-22-1630)
- [Norwegian Medicines Agency: Treatment with cannabis within the current regulations](https://www.dmp.no/godkjenningsfritak/for-leger-og-tannleger/legemidler-det-ofte-er-sporsmal-om-ved-godkjenningsfritak/behandling-med-cannabis-innenfor-dagens-regelverk)
- [Norwegian Medicines Agency: Medicines on travel to Norway](https://www.dmp.no/tilvirkning-import-og-salg/import-av-legemidler-til-personlig-bruk/legemidler-pa-reise-inn-til-norge#CBD-(cannabidiol)-4)

It is particularly the chapters dealing with "Medicines with narcotic effects" and "CBD (cannabidiol)" that are of greatest interest.
