FOPH cannabis exemption — historical process and today's role

Until 31 July 2022, every cannabis prescription required an exemption from the Federal Office of Public Health (FOPH). Since the Narcotics Act revision, it is only needed in exceptional cases.

Old regime: NarcA art. 8 para. 5 (until 31.7.2022) — exemption per patient, renewed annually.

Peak 2021: about 3,700 active exemptions, 90% chronic pain / MS / palliative.

Since 1.8.2022: no exemption needed for prescription cannabis medicines.

Exceptions: raw THC cannabis for research, some extended indications, importation.

Public statistics in the FOPH annual narcotics reports.

Historical process (2011–2022)

From 2011 (introduction of NarcA art. 8 para. 5) until 2022, doctors had to apply for an individual FOPH exemption per patient. The application included diagnosis, prior therapies, preparation, dose and duration. Processing: 4–12 weeks.

Approval rate: about 90% for documented indications (chronic pain, MS spasticity, chemo nausea, palliative), lower for off-label psychiatric use.

Growth in case numbers

The number of active exemptions grew from 30 (2012) to about 3,700 (2021). More than 60% involved dronabinol-based magistral preparations; Sativex® prescriptions often received a combined exemption.

Cantons with the most exemptions: Zurich, Bern, Vaud, Geneva and St. Gallen — correlated with the presence of specialised pain and palliative centres.

When is an exemption still needed?

Since 1 August 2022, the exemption is abolished for prescription cannabis medicines. It remains necessary for:

  • Raw THC cannabis in research projects (cultivation, studies)
  • Importation of preparations approved abroad but unavailable in Switzerland
  • Extended off-label indications outside standard clinical practice

Relation to pilot projects

Current pilot projects (NarcA art. 8a) for regulated recreational cannabis access are a different legal framework — not to be confused with medical exemption. Details: Pilots pillar.

Do I still need a FOPH exemption for my prescription?

Usually no — since August 2022 doctors prescribe directly. Exemptions only for raw THC research, imports of foreign preparations or special off-label cases.

How many exemptions were ever granted?

From 2012 to 2022 more than 20,000 cumulative exemptions. Peak 2021 with ~3,700 active. Details in FOPH annual reports.

What happened to old exemptions in 2022?

Existing exemptions ran to their original expiry date. New prescriptions from 1.8.2022 no longer needed the FOPH procedure.

Where to find the statistics?

FOPH publishes an annual report on medical cannabis use — search 'Medical use of cannabis report'.

This overview is historical. For the current procedure, contact your cantonal office or a cannabis-experienced doctor.