France to Publish Medical Cannabis Rules as Opioid Study Surfaces

France’s government has committed to publishing the long-delayed regulations needed to open its permanent medical cannabis market, ending five years of administrative limbo for thousands of patients. France’s health minister, Stéphanie Rist, confirmed to Agence France-Presse that the missing texts will be published in July 2026. The commitment landed only after a government-commissioned study France had kept sealed for nine months showed patients cut their use of opioids and other painkillers after starting cannabis treatment.

The two events are linked. The study, known as U.CANNABIS, was forced into public view by the Union des industriels pour la valorisation des extraits de chanvre (UIVEC), a French hemp-extracts industry group, which filed a transparency request with the national commission that governs access to administrative documents. Industry coverage that reviewed the document reported its results, and only once those figures circulated did the minister give a firm date.

What the texts would unblock

The regulations at issue are two decrees that together decide whether France’s framework can function at all. One decree, validated by the Conseil d’État — France’s highest administrative court — in summer 2025, lets the national medicines regulator, ANSM, process applications and authorise cannabis-based medicines. The second lets the Haute Autorité de Santé (HAS), the public health-technology assessor, decide whether those medicines deliver enough therapeutic value to justify reimbursement.

Neither has appeared in the Journal officiel, and that gap has frozen everything downstream. Without the evaluation decree, HAS cannot issue a reimbursement opinion; without that opinion, companies cannot register products with ANSM; and without registered products, generalised prescribing cannot begin. The framework is, in the words of French stakeholders, complete on paper but absent from the statute book.

That distinction is worth holding onto. A ministerial commitment to publish is not an enforceable framework. The texts were drafted, notified to the European Commission in March 2025, cleared by Brussels in June 2025, and validated at home last summer. What has been missing is the signature and publication that give them legal force, held up by budget fights and a churn of health ministers rather than by any remaining dispute over substance.

A withheld study, and what it actually shows

U.CANNABIS was commissioned by ANSM as the official scientific evaluation of France’s medical cannabis experiment, and carried out by researchers at the national health-research institute Inserm and the Université de Bordeaux. Rather than rely on what patients reported, the team cross-referenced the experiment’s clinical registry against France’s national health-insurance reimbursement database, tracking what nearly 2,000 patients actually claimed in the year before and the six months after they started treatment.

Here the caveats matter as much as the headline. The results are associational, not causal. As an observational study with no control group, U.CANNABIS can identify changes in healthcare use that coincide with cannabis initiation, but it cannot prove the treatment caused them, and its authors describe the overall effect as positive but of low intensity.

According to industry coverage that reviewed the document, the clearest signal came from the largest patient group, those with refractory neuropathic pain: the share receiving painkillers fell by roughly four in every 100 after starting cannabis, with smaller declines in strong opioids, benzodiazepines and gabapentinoids. In palliative care the reductions ran larger, with about 21 in every 100 patients fewer on strong opioids. The authors note that painkiller use was already falling in some groups before treatment began, which complicates any direct attribution.

Evidence drawn from actual reimbursement claims rather than surveys is precisely what HAS must weigh when it decides whether cannabis medicines displace existing treatments or merely add to them. It sits alongside a safety record from the experiment that has logged no cases of dependence or misuse, with adverse events concentrated in neurological and psychiatric symptoms rather than addiction.

What happens next

France launched its medical cannabis pilot in 2021 as a two-year proof of concept. Five years on, the number of patients still treated under exceptional authorisations has fallen from a peak of around 3,000 to roughly 700. A 2024 social-security financing law turned generalisation from an aspiration into a legal obligation, which is why the remaining delay is procedural rather than political.

The framework that emerges will be strict and pharmaceutical in character: cannabis remains a last-resort therapy, only specially trained physicians may prescribe it, and only licensed pharmaceutical establishments may bring products to market. International suppliers have been positioning for the opening for months, and growers such as Dutch producer PGP Farmer have been trialling strains for the French market. France would also join a wider European tilt toward prescribed cannabis medicines, after regulators in Germany and Austria approved a cannabis-based drug for chronic back pain.

Even on the new timeline, patients should not expect prescriptions imminently. If the decrees appear in July as promised, clear administrative review, and HAS delivers its reimbursement opinion in the autumn as expected, the first prescriptions under the generalised framework are unlikely before 2027. For an industry that has watched France edge toward this market for half a decade, the July texts would mark the start of the final stretch, not the finish line.