Cannabis Postcards from Portugal

I got used to a certain kind of convenience when I lived in Denver, where cannabis is widely available, for both medical and adult use (formerly called recreational, back when we still tiptoed around the word weed).

That same level of access extends across much of Colorado, from cities to small towns. You walk into a dispensary, chat with a well-informed budtender about terpenes and THC percentages, and leave a few minutes later with a labeled product and a receipt. Medical users get added perks – lower taxes, higher limits, and access to more targeted products. 

It’s regulated, normalized, and, while far from perfect, it’s a workable system. Colorado was one of the earliest to legalize and normalize cannabis in this way – and it set a precedent. As of 2025, 38 U.S. states have legalized medical cannabis, and 24 have legalized adult use.

At the conference, the phrase “heavily stigmatized industry” had a way of surfacing, usually tied to two well-known sticking points: One is a bottleneck in the Portuguese medical system according to expert observers. Doctors are legally allowed to prescribe cannabis for certain conditions, like multiple sclerosis, chronic pain, and severe epilepsy, but many are hesitant to do so. They aren’t adequately trained, the murky rules make them hesitant to put their names on a prescription, and the list of approved products is extremely limited, as many working in the field acknowledge. The result is a domestic system that exists on paper but barely functions in practice.

Another factor, echoed in hallway conversations and informal exchanges during the conference, is cultural. Despite the country’s progressive reputation, when it comes to cannabis the stigma runs deep. It’s said that many older folks still seem uneasy, not necessarily out of fear, but more likely due to a lack of exposure. Cannabis hasn’t been part of public discourse, mainstream healthcare, or daily life. It was never legalized, never sold openly, never explained in simple terms. And because it never moved into the light through storefronts, advertising, or education, people never had the chance to see it as something normal.

Even now, with medical cannabis technically allowed, it still lives in the shadows. And so, many people just do the obvious, they buy on the underground market. It’s not ideal, but it works … kind of (given decriminalization that I discuss below).

The conference made one thing clear: Portugal’s medical cannabis system wasn’t built with patients in mind. Licensed producers are growing at scale, legally and successfully, but the system they operate in is geared toward export – not domestic care.

Whether anyone has the will, or plan, to shift that focus toward Portuguese patients doesn’t appear clear. And adult-use legalization? Not even part of the conversation.

It’s both everywhere and nowhere 

Back in 2001, Portugal made global headlines for decriminalizing all drugs, cannabis included, earning praise for its forward-thinking approach to public health. But over two decades later, even as it ships out tons of high grade medical cannabis each year to other countries, the idea of a Portuguese person legally accessing that same product underscores an uncomfortable truth: Portugal built a world-class cannabis industry for export, not for the care of its own.