[Therapeutic cannabis: between clinical potential, limitations of available evidence, and practical challenges in...

In recent years, interest in therapeutic cannabis has grown even in Italy alongside expanding knowledge of the endocannabinoid system and its potential clinical applications. Nonetheless, significant challenges persist that hinder its full integration into medical practice. This editorial examines the misalignment between clinical research and therapeutic use, the methodological limitations of a substantial portion of the available literature, the frequent confusion between recreational and medical use, and the lack of detailed operational guidelines. Regulatory aspects, with particular reference to the Italian framework, as well as barriers to treatment access due to organizational and economic factors, are also discussed. Overall, therapeutic cannabis emerges as a field requiring clinical and regulatory updates based on principles of prescribing appropriateness, equitable access to care, current scientific evidence, and evidence-based medicine.