German health authorities have allowed seven severely ill patients to buy marijuana at pharmacies for medicinal purposes. Permission was granted after a High Court ruling in 2005, and four years of discussions about the precise circumstances in which the drug can be used.

The first patient received approval in late January from the Federal Opium Agency, which is a division of the Federal Institute for Drugs and Medical Devices (BfArM), Germany’s medicines and drug regulator.

Winfried Kleinert, acting director of the agency, told the BMJ that six additional approvals have been issued since then, and more than 20 are still pending. He estimated that at least 1000 …