When the Italian state legalized the medical use of cannabis, it forgot a small detail: a clear and coherent regulation that decrees the suitability of the guide for who takes this type of drug.

Most people who take cannabis with regular therapeutic prescription are now at a crossroads: Can one drive a car after consuming marijuana for therapeutic purposes? How does license renewal work for those who choose to follow this type of therapy?

Giving a straightforward answer to this question is impossible because the law is not clear in this regard. Moreover, many testimonies decree different behaviours and choices on the part of the medical commissions that make decisions regarding the revocation and granting of the driving license following the prescription and taking of medical cannabis therapies.

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The fact is that many people who choose to cure themselves with cannabis (a path that is already tortuous, as you can see in this article) find themselves having to decide whether to give up their license, to run the risk of driving and being identified as offenders following a check or to take a legal course to request an individual assessment on their fitness to drive. The truth is that many faced with this type of difficulty are forced to give up hemp therapy, because very often the commissions do not propose favourable outcomes (even with therapies with low or moderate THC levels) and because the license is usually an indispensable asset for its independence and its livelihood. With pain, it is possible to cohabit, unlike without a job or the possibility of shopping or other daily chores. So, in order not to risk dismissal, isolation and the inability to provide for themselves, many renounce their cannabis-based drug therapy in order not to risk the withdrawal of a driving license and perhaps a complaint from the forces of order.

What does the Italian law on therapeutic cannabis and the driving license say?

As we have said, there is no specific law that requires the withdrawal of the license for cannabis prescribed to therapeutic holders; with regards to the subject, we must refer to the general provisions of Legislative Decree 59/2011 (Annex III), which deals with the case of “habitual consumption of medicines”, stating that “The driving license must neither be issued nor renewed to the candidate or driver who abuses or habitually uses any medicine or combination of drugs in the event that the quantity assumed is such as to have influence on driving skills. The relative assessment of the existence of the psychophysical suitability requirements for driving motor vehicles is entrusted to the local medical commission.”

This phrase indicates that when renewing or issuing a driving license, a specific assessment of the driving ability of the subject that takes into account the intrinsic effects of the drug on the psychomotor skills of those mentioned above must be implemented. It is the local medical commission that must determine whether the use of a particular drug at a specific dosage may or may not adversely affect the driving ability of the subject.

The local medical commission, as is the case for all those who are subjected to a survey for the issue or renewal of the license, submits the subject in question to a general assessment and considers the type of treatment in progress, the extent of the pathologies afflicting the person, the prescribed therapeutic cannabis dosages and any concomitant therapies.

All of this information leads the commission to decide whether the subject has the requisite psychophysical fitness to maintain or obtain a license.

There is another critical piece of legislation that guides the decision of the Commissions for the issuance or renewal of the license: the Lorenzin decree, issued in 2015. It recommends abstention “from driving vehicles or carrying out work requiring alert mental and physical coordination for at least 24 hours after the last administration with cannabis for medical use.”

What does this decree imply? The wording of Lorenzin give an essential instruction to the commission to assess the ability to drive: if the delivery time prescribed by a doctor is such as to allow the subject to drive at least 24 hours after the administration of therapeutic cannabis, then there will be a higher chance that a driving license will be granted. But surely this could be a severe limitation for those with daily prescriptions of marijuana? Yes, this might be so, but once again, it is the commission that must evaluate this while bearing in mind the correct prescription dosage.

This is a significant fact when framing the subject’s abilities (as the low levels of THC in therapeutic cannabis indicate the weak psychotropic effect of the drug).

A decision dictated by chance and prejudice

Ultimately, there is no foreclosure implicit in the driving fitness of people whose treatment plans indicate the daily intake of cannabinoid preparations but only a specific assessment by a Commission that always applies generic and non-standardized criteria.

The result is a non-homogeneous treatment that is very often calibrated downwards (with few concessions to drivers who take therapeutic cannabis) because we are usually faced with a group of non-competent evaluators who do not even want to consider the possibility that a person under the influence of therapeutic cannabis might be perfectly capable of driving.

Without a shadow of a doubt, this is too important to be left to chance (or prejudice) because it could discriminate against those who choose to undergo treatment with medical cannabis under the guidance of a doctor, and the need for legislation to regulate the issue is clear.