Sativex is a pharmaceutical product manufactured by British company GW Pharmaceuticals. As the name suggests, real cannabis is in the drug. However, it is a patented pharma product – a peppermint flavoured mouth spray.

Sativex has been approved in 28 countries. It is used to treat painful muscle spasms caused by MS and other conditions. It did not catch on in the U.S.

It falls into the same category as a few other commercially available cannabinoid-based drugs. This includes lab-created synthetic drug Marinol/dronabinol. It also includes Cesamet. This is commonly prescribed for Parkinson’s patients.

Sativex is different from both of these drugs and from actual cannabis. It is made from the whole plant and is not synthetic. It is made from a concentrate and delivered as a mouth spray. This means that it is chemically consistent in every batch. That is obviously not the case when it comes to the natural product.

In this case, that also means reproducible concentrations of THC and CBD. Further, Sativex is manufactured with a 1:1 THC to CBD ratio. That is not the case with every strain of cannabis, or other cannabinoid-based meds for that matter.

Sativex mouth spray


Despite all the hocus pocus surrounding the plant, the reality is that cannabinoids have scientifically measurable impact. They stimulate the endocannabinoid system. This is true whether they are “natural” or chemically imitated (as is the case with Marinol and others).

Sativex works. Furthermore, medical users give it higher marks than Marinol. Why? It is easier to use. Controlling dosing is also much more convenient. Much like smoking a joint, users can control how much they ingest as they ingest it. Users also feel the impact of this drug in a different way. This is a mouth spray. As a result, it works slightly slower than smoking cannabis and slightly faster than eating it.

In terms of its similarity to what is on the market now? It is essentially a cannabis-based extract, delivered orally. Some people do not react well to the mouth spray.

That said, unlike medical cannabis everywhere, Sativex is covered under health insurance.

Medical cannabis is not.

The reality? Cannabis patients end up paying about the same no matter what they buy. For that reason, many prefer just to get cannabis flower where both are available. Failing that, some just turn directly back to the black market.

Patients who are given a choice usually prefer the real thing to the pharma product.

And therein lies the rub.


One of the biggest reasons that cannabis was banned in the first place was pharma competition. As medical evidence mounted in the mid to late 1970’s, every attempt was made to short circuit the distribution of the actual flower.

In the early part of the 1980’s, dronabinol was introduced to the market as a relief for nausea. That it was first administered to AIDS patients was only part of the problem. This was done at a time when state activists were trying to get the drug covered under federal health insurance in the U.S.

Sativex came out of this discussion. Even though the cultivation of marijuana is illegal in the UK, the company set up shop with the blessing of British authorities in the late 1990’s. Ever since then, GW Pharma has continued to blaze a path in the medical marijuana industry.

Sativex and Marinol health insurance


Sativex, like Marinol, is available in Europe. It is also covered much more widely under health insurance. However, it is clearly not reaching the right people. This is why governments are trying to figure out how to manoeuvre marijuana reform right now. In Germany, for example, the clear preference is to distribute some kind of manufactured product. It is unclear how well this will succeed. The market is ready for recreational reform. Policies that harken back 30 years to failed programs may be tried again. They also stand a good chance of failing.


Recreational reform is now very real in several countries. It is coming to Europe far beyond Dutch borders. Still, patients who are really desperate will just continue growing their own.

It is increasingly hard to be prosecuted for growing as a patient, although authorities are doing their best to dissuade people. This can often be unpleasant. It is not as bad as it is in the United States. Even as the law moves forward, patients, as usual, are being left in a place where they have fewer choices than they want.

This is a situation that is likely to continue for some time.

Further, “whole plant” medication is finally coming into its own. It is also likely that patients will engage in illicit practices and continue to get away with them.


In the short-term, nobody knows. Long-term, it is clear that Sativex will not go away as marijuana reform continues to sweep Europe. However, it will no longer be the main “go-to” solution here. There will be lots of competition.

At some point, comprehensive recreational reform will hit Europe. At that point, the market changes again. However, it is already clear that medical users are being actively discouraged from consuming the plant directly.

End result? There will be more competition for Sativex. And even if consumers are not completely happy about being forced into a pharma market, they are in line for more choices very soon.


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