During the recent United Nation’s General Assembly Special Session on drug policy, a growing number of government representatives called for cannabis policy reform, drawing particular attention to new evidence and changing attitudes regarding cannabis for medical use.

Paying close attention were member states of the European Union. While free to set their own drug laws, all are obliged to uphold the UN Single Convention on Narcotic Drugs, which defines THC as a Schedule-1 illicit drug. Taking liberties with the interpretation and enforcement of that policy, many EU nations are moving forward with agendas to make medical cannabis available to their citizens. For example:

Netherlands: For 10 years, physicians have been able to prescribe cannabis. The nation is home to Bedrocan BV, the only source of cannabis to Finland, Germany, Italy and Norway.

England: The only legal medical cannabis-related drug is Sativex, a product of UK-based GW Pharmaceuticals. However, Sativex is rarely prescribed to patients in England.

Germany: The Federal Institute for Drugs and Medical Devices has authorized cannabis for some cases, and allows patients to cultivate cannabis plants for personal use. Costs are very high (the equivalent of $800 to $1000 per month for those patients who don’t grow their own). Selection is limited to strains offered Bedrocan BV. Currently no health insurance covers the cost of cannabis.

Italy: In 2013, therapeutic use of cannabis was authorized for patients with prescriptions. Related legislation is in flux, but appears to be trending toward having costs covered by the Regional Health System, through a hospital pharmacy or the patient’s health insurance.

Medical cannabis has been legalized or decriminalized in Spain, France, Romania and the Czech Republic.

It’s notable that a significant issue regarding legalization and administration has to do less with cannabis in general than the form in which it is prescribed and consumed. Smoking cannabis doesn’t deliver the drug in a consistent, predictable way—anathema to many physicians. That’s a major reason for the push on many fronts to introduce cannabis extracts, in liquid or gel cap form. Extracts can be processed to express precise quantities and ratios of active agents such as THC and CBD. Such standardization means that cannabis could be administered in a fashion identical to “conventional” drugs, and thereby being more likely to be considered by physicians for their patients and by government and private health insurance systems for routine coverage.

It may be in the best interests of health insurers to use their influence to forward pro-cannabis initiatives in the EU. With more widespread use, it’s possible (probable?) cannabis will be shown to effectively replace other prescription drugs, with potentially lower cost and certainly lower risk of negative side effects. Attendant with that change must come lower prices and increased availability.

How efforts from patients, healthcare providers, insurers and governments to adopt medical cannabis will accord with international treaties remains a puzzle. At this year’s meeting of the Commission on Narcotic Drugs, Canadian assistant deputy minister of health, Hilary Geller, spoke out on Canada’s new liberal-controlled government’s intention to move from the “war on drugs” strategy to one emphasizing harm reduction. She received prolonged ovations for her presentation.

While Canada appears to be taking a leading role, it seems clear attitudes in most developed countries have reached a tipping point and that medical cannabis is destined— sooner than later—to be accepted as a viable and widely-recommended medicine.