What is Sativex (RX Cannabis Oil) & Differences from Medical Cannabis

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What is Sativex and why do so many countries have nothing against a cannabis-based drug while keeping the whole plant illegal? Read on to find out.

Despite the cannabis movement gaining momentum across the world, the herb still remains illegal in most countries. Currently, only Canada and Uruguay have regulated cannabis markets, with the United States soon to join.

In some places, cannabis has been decriminalized; people are allowed to grow and possess small amounts of the plant for personal use, but they cannot distribute it with the intent to sell.

Other countries may have you put into prison or even sentenced to death for trying to medicate yourself with anything marijuana-related.

At the same time, 28 governments — and counting — don’t appear to have any issues with a pharmaceutical cannabis-based drug. It’s even covered by insurance.

This drug is called Sativex®.

Contrary to what the name might suggest, this is not a corny name for a Sativa-dominant strain of marijuana. It’s a pharmaceutical drug based on the active constituents of marijuana.

Continue reading to learn more about Sativex®, its likely future, and the hypocrisy of Big Pharma.

What is Sativex?

Sativex is a patented cannabis-based pharmaceutical drug made by British manufacturer GW Pharmaceuticals. The drug was designed with the intent to treat painful muscle spasms caused by multiple sclerosis and a few other conditions. It’s currently available in 28 countries.

Yes, you’ve read that correct — even though Sativex® contains compounds from real cannabis, it’s a patented pharmaceutical product, meaning that only GW Pharmaceuticals can sell it.

Sativex isn’t the only cannabinoid-based drug made by pharmaceutical companies. Other drugs include the synthetic Marinol for cancer-induced nausea and Cesamet, a drug used in the treatment of Parkinson’s disease patients.

However, Sativex® is very different from both of these drugs, and from the original cannabis plant, it was derived from.

Sativex® is not synthetic; it comes from the whole cannabis plant where it’s concentrated and converted into a spray. Given this, Sativex is considered chemically consistent in every batch — meaning that every batch is exactly the same. Accomplishing this is nearly impossible to achieve with the natural product.

This also ensures that the concentrations of THC and CBD are reproducible. Sativex contains a 1:1 THC to CBD ratio — meaning that for every molecule of CBD there’s also a molecule of THC in the formula. Once again, this doesn’t happen with naturally-occurring cannabis, let alone other natural cannabinoid-based supplements or medications.

Why Was Sativex Created in First Place?

We’re not big fans of conspiracy theories. However, when trying to figure out why cannabis was banned in the first place, only one reason comes to mind — money and the conflict of interests.

Cannabis has too many health benefits for big pharma to keep it legal, so pharmaceutical companies have used everything in their power over the last century to fuel the anti-marijuana crusade and depict the plant as a deadly drug that has no medical applications whatsoever.

But the potential abuse… Oh boy, do we remember that abused fridge the day we went a bit over the edge with cannabis!

So deadly!

Okay, enough jokes.

Once medical evidence started to pile up in the mid to late 1970s, first cannabis-based pharmaceuticals started to emerge, such as the aforementioned Marinol, a drug consisting of synthetic THC called dronabinol. The drug was first administered to AIDS patients to reduce symptoms of their disease

However, the isolated THC failed to meet the expectations of AIDS patients, as many of them experienced severe side effects after taking the drug:

  • Nausea
  • Anxiety
  • Paranoia

Sativex came as the perfect solution to the problem. The added cannabidiol to the formula, effectively reduced the above side effects while boosting the anti-inflammatory properties of the drug.

GW Pharmaceuticals opened the first shop with Sativex® in the late 1990s and has continued to blaze a path in the medical marijuana industry since then.

What’s the Difference Between Sativex and Marijuana?

To begin with, Sativex is manufactured using modern standardization techniques to make sure that every batch of the spray came with a consistent concentration of its ingredients and a perfect 1:1 ratio of THC to CBD. The extraction results in a chemical compound called Nabiximol.

Marijuana, on the other hand, lacks standardization, which means that the ratio between its chemical compounds may not be consistent in each batch; in fact, it can significantly vary depending on factors such as the way it was grown, how it was stored, and what drying and curing process the grower used while processing their crop. .

Back in the 20th century, medical marijuana users weren’t as savvy in avoiding the negative effects of smoking, as it was their main go-to consumption method. Everything has changed with the introduction of other options, such as vaporizers or sublingual tinctures.

Sativex® can only be consumed orally as a spray. The drug acts faster than marijuana edibles but has a delayed onset time compared to smoking or vaporization, hence the decreasing popularity of Sativex® in recent years.

On top of that, the lack of standardization of chemical compounds in cannabis makes the natural plant-based medicine more adjustable to the personal needs of an individual. Some people need a higher concentration of cannabinoids to achieve the same therapeutic benefits as cannabis.

Since Sativex® has a fixed concentration of THC and CBD, this quality may limit the effectiveness of the drug in more severe cases.

Sativex® vs. CBD Oil

The 1:1 ratio of THC to CBD in Sativex was tested by GW Pharmaceuticals for alleviating an array of symptoms related to multiple sclerosis and other inflammatory conditions involving chronic pain.

CBD oils aren’t subject to such standardization practices, as the vast majority of CBD products are classified as dietary supplements, not drugs. That being said, the ratio of CBD to THC can vary dramatically between different products.

There are also hemp-derived CBD oils which contain negligible amounts of THC. Hemp-derived CBD goods are made to set them apart from other medical marijuana products in terms of legal status.

There’s also one more benefit to using CBD hemp oil; given the low levels of THC in such extracts, it’s virtually impossible to get high using them. This allows individuals to avoid the side effects Sativex® users have reported, including fatigue and dizziness.

What is Sativex® Used For?

Sativex® has undergone a number of clinical trials with a goal to address a variety of medical conditions.

The drug is mainly used to combat multiple sclerosis-related spasticities [1] in 28 countries around the world. Despite being psychoactive, there’s no evidence to prove that its users have developed a substance tolerance throughout a one-year period.

Aside from easing the symptoms of multiple sclerosis, Sativex® can be used to support the following medical conditions:

  • Arthritis
  • Diabetes
  • Epilepsy
  • Neuropathic pain
  • Schizophrenia

Although there are reasons to believe that Sativex® can also combat cancer, it only proved successful in reducing the cancer-related pain, the results published by GW Pharmaceuticals at the beginning of 2015 showed no significant differences between the participants using Sativex® and the placebo group.

How is It Made?

Sativex is manufactured in the United Kingdom by the British company GW Pharmaceuticals.

Here’s a fun fact: marijuana is illegal in the UK, even for medical purposes.

Still, that hasn’t held the manufacturer back from making a marijuana-based drug. The company was issued a governmental license to cultivate marijuana for research and development back in 1998.

Sativex® is extracted from selectively-bred cannabis plants that have been grown to maintain a fixed and balanced amount of active compounds. The drug is produced in a strictly controlled laboratory environment.

Legal Status of Sativex® in the USA

Since Sativex® is derived from the whole cannabis plant, you may think that the FDA and the US government classify it under the same Schedule I category in the Controlled Substances Act.

Well, it looks like both institutions have left themselves some wiggle room due to the fact that the active substance of Sativex® has been patented under the name “Nabiximol”.

So, from the bureaucratic standpoint, it’s not the same as cannabis, although it’s a cannabis extract that contains the same active ingredients.

Pure logic.

This approach has been used by other countries where Sativex® is legal as well.

Sativex® is covered under many insurance plans in the U.S. but not every Sativex-friendly country is keen on paying for your legal cannabis-based treatment.

The drug is ridiculously expensive.

For example, an annual prescription for Sativex® in New Zealand costs upwards of $16,000 USD.

As a result, less than 8% of approved patients end up filling their prescriptions. Many people turn to a black market pot since the benefits and cost-effectiveness far outweigh the potential legal risk in their opinion.

The Current Situation of Sativex® in Europe

Ironically, the continent of the drug’s birth may also be the place of its burial.

Many European countries allow the medical use of marijuana; some of them have gone even further and decriminalized the possession and use of the plant. Recreational reform is now very real in several countries far beyond Dutch borders.

Medical marijuana patients can grow their own plants in those countries and make certain whole-plant extracts to tackle their health concerns. Moreover, local authorities aren’t interested in prosecuting people over a plant that has a long list of benefits and only a few mild side effects just because of the backward regulations.

The legal limbo cannabis is currently stuck in throughout Europe is the only hope for Sativex® to stay competitive to medical and recreational marijuana products.

However, this situation is likely to change in the near future.

What is the Future of Sativex?

Sativex may not go away immediately as marijuana reform continues to roll across Europe, but it will no longer be the only legitimate option for patients. The growing cannabis industry will create plenty of competition.

GW Pharmaceuticals will have to either “redesign” their drug and introduce versions with different ratios between THC and CBD, lower the price, or find another way to stay on the surface. Otherwise, the drug will be thwarted by the more available and versatile marijuana soon to hit the public market.

What’s your take on Sativex®?


  1. Collin, C., et. al. (2010). A Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of Sativex, in Subjects with Symptoms of Spasticity Due to Multiple Sclerosis. Neurological Research, 32(5), 451-459.
  2. Nurmikko, T. J., Serpell, M. G., Hoggart, B., Toomey, P. J., Morlion, B. J., & Haines, D. (2007). Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial. Pain®, 133(1-3), 210-220.
  3. Blake, D. R., Robson, P., Ho, M., Jubb, R. W., & McCabe, C. S. (2006). Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology, 45(1), 50-52.
  4. Russo, E. B., Guy, G. W., & Robson, P. J. (2007). Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex®, a cannabis‐based medicine. Chemistry & biodiversity, 4(8), 1729-1743.

James Reed

James is our in-house cannabis expert and foodie. He earned a Bachelor of Health Sciences with a focus on pharmacology several years ago and has since been working as a writer and editor for cannabis-related blogs and e-commerce brands. In his spare time, he enjoys exploring the landscape around his Crescent City home with his dog Gus.

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About James Reed

James Reed is the founder and editor-in-chief at iSum. He’s a big advocate of marijuana and spent most of his time writing about these topics, sharing what he learned over the years.

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