Chapter 2: Legal Regulations and Institutionalization of Medical Cannabis Around the World Chapter 3: Regulation and Institutional Challenges of Medical Cannabis in Japan4especially among young users or those with a history of psychiatric conditions. These symptoms can lead to panic, erratic behavior, or even secondary accidents such as injuries or traffic incidents. To mitigate such risks, countries with legal frameworks for medical cannabis have implemented potency limits and product-type restrictions to prevent overconsumption. Additional measures include prohibiting cannabis use while driving or operating heavy machinery, recommending low initial doses for first-time or returning users, and advising against combining cannabis with alcohol or other drugs. On an individual level, these guidelines aim to promote responsible use and reduce potential harm. In extreme cases involving intense hallucinations, paranoia, or threats to self or others, it is recommended to ensure safety and seek immediate medical attention. Thus, countries that have institutionalized medical cannabis are striving to balance “access to essential treatment for patients” with “the suppression of risks such as addiction and acute psychiatric symptoms.” These efforts take the form of layered approaches that combine regulation, monitoring, and public education.a continued emphasis on punitive measures rather than a focus on support and treatment for addiction. Another major hurdle lies in the deep-rooted societal stigma toward cannabis in Japan. Many people harbor extreme perceptions, such as the belief that “using it even once ruins your life.” The strong social condemnation often seen in media coverage of celebrities involved with cannabis exemplifies this cultural climate. Such societal attitudes present an additional barrier to the introduction of medical cannabis. Moving forward, it will be essential not only to refine legal and regulatory frameworks but also to promote public awareness and education based on scientific evidence, as well as to strengthen support systems for addiction treatment. Only then can Japan foster an informed and balanced public discourse free from prejudice. When The institutionalization of medical cannabis varies by country. In nations such as the United States, the United Kingdom, Germany, Spain, Portugal, Finland, and Israel, the use of medical cannabis has been legalized for specific conditions based on a physician's diagnosis and prescription. In these countries, the government strictly controls the quality and distribution of cannabis products to prevent health hazards caused by contamination or excessive concentrations of active ingredients. Some countries, like Canada, have taken an even stricter approach by t ightening packag ing and advert ising regulations. Measures include child-resistant packaging, plain labeling, mandatory health warnings, clear indication of THC (tetrahydrocannabinol) content, and a complete ban on advertising. These efforts aim to limit unnecessary appeal to youth and prevent inappropriate use. For edible products, THC content is restricted to 10 mg per package, significantly reducing the risk of overdose or dependence. This raises a critical question: “Even for medical use, is cannabis truly non-addictive?” and “Could its use potentially lead to secondary accidents or harm?” The conclusion is that, even in regulated legal markets, products with high THC content or excessive consumption can cause temporary psychotic symptoms such as hallucinations or delusions— In Japan, the Cannabis Control Act, enacted in 1948, has long imposed strict regulations on the possession, use, cultivation, and import of cannabis. Notably, the use of cannabis for medical purposes has not been permitted, and this rigid regulatory framework has remained in place for decades. In recent years, however, there have been signs of change. In 2023, a legal amendment was passed allowing limited use of cannabis-derived pharmaceuticals, provided they undergo clinical trials and obtain regulatory approval. This shift opens up the possibility of new treatment options for patients suffering from certain intractable diseases. Nonetheless, significant institutional challenges remain. For example, the regulation of THC content in CBD products is extremely strict, which could substantially impact market viability and distribution. Moreover, the same legal amendment introduced a new criminal offense specifically targeting the act of cannabis use itself. This addition reflects
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