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Medical schools give students a limited but important amount of protected time to explore subjects outside the core curriculum. Student-selected modules and placements are often the only opportunity students have to step beyond exam-driven learning, follow their curiosity, and engage with areas of medicine that are still evolving.

Legal under prescription in the UK since 2018, medical cannabis is an actively evolving area of practice. While increasingly relevant to everyday clinical practice, it remains poorly covered in undergraduate medical education.

A new student choice placement for 2026

Dr David Tang, Consultant in Emergency Medicine and member of the MCCS Expert Committee, has had his Year 3 MBChB Student Choice placement submission accepted by Bristol Medical School. The placement, Understanding Medical Cannabis: Mechanisms, Indications and Clinical Integration, will be offered to students in 2026.

Dr Tang explains;“As a first-year medical student in 2000, I chose a module on cannabinoid therapeutics as part of my course. Twenty-six years later, medical cannabis is prescribed legally in the UK, patients are asking about it every day, and clinicians are encountering it across multiple specialties. 

But, most medical students still graduate with little understanding of the endocannabinoid system, prescribing frameworks, or how medical cannabis fits into regulated care pathways.

I think that medical graduates should leave university with a basic, evidence-informed understanding of how medical cannabis works, what it may be prescribed for, and where to find reliable guidance. This matters – whether or not they ever go on to prescribe it themselves, because it supports safer clinical conversations, better decision-making, and more informed patient care.”

The placement has been formally approved by Bristol Medical School and will be offered to Year 3 MBChB students as part of their student-selected studies, with allocation due to take place in February 2026.

What the placement will focus on

The placement introduces students to medical cannabis as a regulated therapeutic intervention within UK clinical practice. Structured around three core themes, mechanisms, indications, and clinical integration, the placement will cover:

Teaching will be delivered through seminar-based sessions and facilitated group discussion. Subject to final arrangements, the placement may also include a visit to an EU GMP-licensed medical cannabis cultivation and manufacturing facility, providing insight into how these products are produced to pharmaceutical standards for clinical use.

Part of a wider commitment to students

Dr Tang’s new medical student placement is part of the Medical Cannabis Clinicians Society’s wider commitment to supporting students and early-career clinicians.

Alongside this module, the Society offers:

These initiatives are about giving students access to good information early, space to ask proper questions, and the confidence to engage with an emerging area of medicine thoughtfully and professionally, as it continues to evolve.

Join the Society today.

This week, the Medical Cannabis Clinicians Society delivered training for healthcare professionals in Romania, with the aim of improving clinical understanding of cannabis-based medicines in preparation for an anticipated change in law to improve real-world access for patients in need.

Led by Professor Mike Barnes, the Medical Cannabis Masterclass: Romania trained 57 clinicians across a wide range of specialties – including oncologists, ophthalmologists, gynaecologists, family medicine doctors, orthopaedic surgeons, psychiatrists, haematologists, dentists, paediatric neurologists, dietitians, GPs, pharmacists and nurses.

Medical Cannabis in Romania: the law, the reality, and the gap in between 

Romania’s current legal framework offers no clear, workable pathway for medical cannabis in clinical practice. While some cannabis derivatives are referenced in existing law, THC remains classified as a high-risk substance with no recognised medical use, effectively blocking access to THC-containing medicines.

The “Victoria” Law (PL-x 631/2019), developed by Asociația Victoria Mea, aims to close this gap. First introduced in 2019, it is still awaiting final parliamentary debate.

At the same time, CBD regulation remains unclear. EU rules permit hemp varieties with up to 0.3% THC, but Romanian authorities often apply a zero-tolerance standard for THC in finished CBD products. This has caused uncertainty for both medical CBD and the broader hemp sector, highlighting the urgent need for credible clinical education and open, evidence-based discussion.

Training to support clinical confidence and reform

This training focused on what the Society does best: equipping clinicians with the knowledge, tools and confidence to practise safely and responsibly. The session covered core clinical topics, including cannabinoid pharmacology, the endocannabinoid system and practical prescribing, all tailored to support Romanian clinicians as they work alongside campaigners to improve access.

The training was organised in partnership with Alexandra Carstea, the Society’s International Ambassador to Romania. A legal educator and founder of Asociația Victoria Mea, Alexandra is reshaping how medical cannabis is understood in Romanian policy and clinical practice. Through her work with the Society, she is ensuring Romanian clinicians have access to the same quality of evidence and education as colleagues in more established systems.

Asociația Victoria Mea is also the organisation that initiated and advanced the ‘Victoria’ Law proposal (PL-x 631/2019), a key legislative effort aimed at creating a workable medical cannabis access framework in Romania.

Professor Barnes explains, “Proper training is the foundation of safe and effective prescribing. As interest in medical cannabis grows worldwide, clinicians need clear, evidence-based education they can trust.” 

Alexandra Carstea said: “The turnout for this training – doctors and healthcare professionals across so many specialties – signals something important: Romania is ready for serious, evidence-based clinical education in cannabinoid medicine, just as patients are ready for solutions that reflect real medical need. 

Together with MCCS and Professor Barnes, we will continue delivering these training sessions every 2 – 3 months to strengthen clinical confidence, support destigmatisation, and contribute constructively to a more informed national conversation. Our aim is clear: Romania needs a workable, responsible framework and we will keep building the professional and scientific foundation that makes meaningful reform possible.”

Global clinical expertise, shared internationally

This training is part of the Society’s growing international programme, led by our International Ambassadors. 

Across Europe and beyond, clinicians are facing many of the same issues: expanding evidence, rising patient demand, and legal frameworks that lag behind both. Many are looking for independent, clinically grounded support to practise safely and advocate effectively.

Wherever you’re based, MCCS can support your team with bespoke training, clinical guidance and peer-to-peer support. We also offer licensed training materials, resource translations, and international training delivery for clinical teams, institutions and organisations.

We have, so far, trained clinicians in Greece, Malaysia, Panama and Malta, in addition to Romania.

International clinicians are welcome to join the Society and access expert education, prescribing guidance, peer support and professional development.

To explore training programmes, translations, or licensed use of our materials, or to learn more about international membership, contact the Society at [email protected].

We’re proud to be the independent voice for medical cannabis clinicians and we look forward to supporting colleagues around the world. 

Each month, we bring together the key news stories shaping the medical cannabis landscape in the UK and beyond. From policy developments and emerging research to clinical practice, patient experience and sector growth, this update highlights the issues driving debate, influencing care, and affecting access for patients and clinicians alike.

It is designed to keep our members and stakeholders informed, grounded in evidence, and connected to what matters most across this rapidly evolving field.

Police given new guidance on medical cannabis patients 

Police forces across the UK have been issued the first official guidance on how to handle interactions with medical cannabis patients. Officers in England and Wales are advised to adopt a ‘patients first, until proven otherwise’ approach when handling encounters involving prescribed medical cannabis. The guidelines, prepared by the Association of Police Controlled Drug Liaison Officers (APCDLO) and approved by the National Police Chiefs’ Council, were compiled after consultation with healthcare partners, government agencies, and the private sector. 

🔗 Read more

Researchers propose THC thresholds for safer cannabis use 

Researchers in the UK have proposed new thresholds for monitoring cannabis use – modelled on alcohol units. Their findings, published in the journal Addiction, established that adults should not exceed 8 THC units per week, equivalent to about 40 mg of THC or 1/3 gram of cannabis flower. The risk of Cannabis Use Disorder (CUD) was said to increase above 8 THC units per week, with the risk of more severe CUD rising above 13 units per week.

While the study wasn’t designed to evaluate medical cannabis, the thresholds are not intended for use as a THC limit for those being prescribed cannabis, co-author Dr Rachel Lees Thorne said prescribing clinicians will need to “balance the harms and risks of the treatment they provide”.

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Medical cannabis sector responds to media misrepresentation

Several patients, clinicians, and industry professionals responded to concerning media coverage, which many feel unfairly misrepresented the prescription of cannabis-based medicines in the UK. The Daily Mail ran a 2000+ word story on the UK’s medical cannabis market, painting medical cannabis patients as ‘benefits claimants’ using ‘shocking loopholes’ to obtain ‘super strength cannabis’. In response, we broke down the facts behind the headlines in our latest blog here.

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France extends medical cannabis programme

France’s Ministry of Health has confirmed that patients currently enrolled in the country’s long-running medical cannabis programme will receive another extension beyond the March 31, 2026, deadline.

After five years of development, France’s generalised medical cannabis framework is technically complete, having been submitted to the EU in March 2025, approved by Brussels in June 2025, and validated by the Conseil d’État in August 2025. Only ministers’ signatures are needed for the bill to be published in the Journal Officiel, but it remains unclear when this will happen. 

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Bosnia and Herzegovina legalises cannabis for medical use

The Council of Ministers of Bosnia and Herzegovina has approved the legalisation of cannabis for medical purposes, marking a significant shift in the country’s approach to cannabis-based treatments. The decision, adopted on 29 December 2025, establishes a regulated framework for medical cannabis that will provide patients with legal access to treatments previously only available through the grey market or abroad. Cannabis, cannabis resins, extracts, and tinctures will be “shifted from a table of banned substances and herbs to a strict monitoring table, which opens the way for medical use”.

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US cannabis rescheduling could have global implications 

ICYMI: At the end of 2025, President Donald Trump signed an executive order to move cannabis from Schedule I to Schedule III under the Controlled Substances Act. This represents a significant shift in US drug policy, acknowledging the medical value of cannabis for the first time, and should ease certain barriers for researchers, enabling larger clinical trials to be conducted. Outside of the US, the rescheduling is expected to have substantial implications for international policy. Experts say clinical data from the US may help inform regulatory guidance, prescriber confidence, and public and private reimbursement discussions internationally.

🔗 Read more

Join the Society

If you want to stay informed, supported, and part of the independent clinical voice shaping medical cannabis in the UK, join the Medical Cannabis Clinicians Society.

Membership gives you access to expert guidance, CPD-accredited education, peer support, and regular sector updates like this one. Join the Society to be part of the conversation and help drive better, evidence-based care.

Recent Freedom of Information (FOI) data from the NHS Business Services Authority has prompted sensational headlines about a sharp rise in private prescriptions for medical cannabis in the UK. On the surface, the figures look dramatic. Between 2023 and 2024, prescriptions more than doubled, rising from around 283,000 to 659,000.

But these numbers need context. Without it, they risk being misunderstood.

This article explains what the data does and does not show, why prescribing has increased, and what this means for patients, clinicians and the NHS.

Prescriptions are not the same as patients

The most important point is this:

The FOI data counts prescriptions, not individual patients.

Medical cannabis is usually prescribed as an ongoing treatment. Patients are reviewed regularly and receive repeat prescriptions, often monthly or every six to eight weeks. One patient may therefore receive multiple prescriptions over a year.

If we use a cautious average of around eight prescriptions per patient per year, 659,000 prescriptions would equate to roughly 82,000 patients. That aligns with wider estimates suggesting there are around 80,000 to 90,000 medical cannabis patients across the UK. In population terms, this remains a very small group, especially when compared with prescribing volumes for many other specialist medicines.

Why are patient numbers increasing?

Medical cannabis has been legal on prescription in the UK since November 2018. However, uptake in the early years was extremely limited.

The increase seen in recent years reflects gradual change rather than sudden expansion.
Several factors are driving this:

Greater clinical understanding
More specialist doctors now have experience of where medical cannabis may have a role, particularly for patients who have not responded to standard treatments or who cannot tolerate their side effects.

Improved guidance and governance
Over time, professional guidance, data collection and clinical frameworks have developed, making prescribing more structured and cautious.

Informed patients seeking options
Many patients turning to medical cannabis are doing so after years of unsuccessful treatment. They are often looking for better symptom control or improved quality of life, not a first-line option.

Prescribing remains tightly regulated. In the UK, unlicensed cannabis-based medicines can only be initiated by doctors on the GMC Specialist Register, with careful assessment, conservative dosing and ongoing monitoring. This pattern of growth is not unique to the UK. Similar trends have been seen in countries such as Australia, Canada and parts of Europe as clinical experience grows.

What benefits do patients most commonly report?

Medical cannabis is not a cure-all, and it does not work for everyone. However, patients commonly report improvements in certain symptoms, including:

Some patients are also able to reduce their use of other medicines, such as opioids, which are associated with significant side effects and risks.

Which conditions are most often treated?

UK data from sources such as Project Twenty21 and the UK Medical Cannabis Registry gives a useful picture of current prescribing patterns.

The most common groups include:

Will numbers of medical cannabis prescriptions continue to grow?

Yes, gradually.

Medical cannabis is increasingly seen by clinicians as one option among many, not a first-line treatment. Growth is likely to continue as more doctors receive appropriate training and gain experience, but prescribing remains cautious and evidence-led.

The Medical Cannabis Clinicians Society supports this approach through CPD-accredited education, prescribing guidance, peer support and ongoing professional development.

Should medical cannabis be available on the NHS?

Where it is clinically appropriate, we believe it should be.

At present, almost all prescriptions are private. Many doctors who prescribe medical cannabis privately also work within the NHS and would prefer to offer this treatment based on clinical need rather than a patient’s ability to pay.

There are also potential system benefits. Better symptom control can mean fewer GP appointments, fewer emergency admissions and shorter hospital stays. In conditions such as treatment-resistant childhood epilepsy, reducing seizures can prevent repeated hospitalisation.

A 2024 health economics study found that prescribing medical cannabis for chronic pain, instead of alternative treatments, could save the NHS around £729 million per year while improving patient outcomes. A separate study by the Centre for Economics and Business Research estimated that wider NHS access could unlock up to £13.3 billion for the UK economy over ten years through better health and increased ability to work.

A final point on regulation and safety

Medical cannabis in the UK is not the same as illicit or recreational cannabis. It is prescribed as a controlled medicine, produced to pharmaceutical standards, monitored closely and governed by strict professional and regulatory safeguards.

Understanding the data properly matters. The FOI figures reflect growing clinical activity within a regulated system.

If medical cannabis is discussed accurately and responsibly, it allows for a more informed public conversation about patient need, clinical decision-making and future access.

Prescribing, referring, or being asked about medical cannabis?

The Medical Cannabis Clinicians Society is the UK’s independent, clinician-led body supporting safe, evidence-led practice in this area.

By joining the Society, you get:

Whether you are already prescribing, considering prescribing, or simply want to respond to patient questions with confidence, the Society provides the structure, knowledge and professional backing to practise safely and responsibly.

Join the Medical Cannabis Clinicians Society and be part of a trusted clinical community shaping best practice in the UK.

Each month, we bring together the key news stories shaping the medical cannabis landscape in the UK and beyond. From policy developments and emerging research to clinical practice, patient experience and sector growth, this update highlights the issues driving debate, influencing care, and affecting access for patients and clinicians alike.

It is designed to keep our members and stakeholders informed, grounded in evidence, and connected to what matters most across this rapidly evolving field.

Families call for action on ‘failures’ of medical cannabis policy

Families marked the seventh anniversary of the legalisation of medical cannabis in the UK with further calls for urgent government action on NHS access. Following the launch of a new awareness video, Medcan Family Foundation hosted a parliamentary event on Tuesday, 4 November, for cross-party MPs, during which the charity also announced that it has secured first-stage funding for a new randomised controlled trial into CBPMs in treatment-resistant epilepsy. Separately, an open letter signed by over 600 families, leading experts and MPs has called for a public inquiry into the Department of Health and Social Care (DHSC)’s failure to implement the 2018 law.

🔗 Read more

New research on cannabis patients and police training needs

Researchers behind a new paper say that police training can significantly improve understanding around prescription CBPMs and reduce stigma to protect patient rights, avoid wrongful enforcement, and build public trust in the police’s handling of medical-cannabis cases. The recent study examined how well UK police officers understand laws introduced in 2018. Researchers delivered a 3-hour knowledge-exchange workshop to 94 trainee constables. The results show that after the session, officers’ knowledge had improved and there was a reduction in stigmatising attitudes.

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Releaf releases findings from 2025 cannabis patient survey

To mark the seventh anniversary of medical cannabis legalisation in the UK, medical cannabis clinic Releaf conducted a nationwide study of 1,669 patients. The findings show that the overwhelming majority of patients (97%) report an improved quality of life since starting treatment, and 91 % would recommend medical cannabis to others who may be eligible. However, only 25 % feel fully confident using their medication outside the home, highlighting continued stigma and uncertainty. Almost half (47.5%) of prescriptions are for chronic pain, followed by 31.4% for mental health conditions.

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Alternaleaf launches UK’s first women’s health cannabis service

Medical cannabis clinic, Alternaleaf, has launched the country’s first women’s health service dedicated to cannabis-based treatments for gynaecological and hormonal conditions.

The new unit, led by the company’s Medical Director and Pharmacist Nabila Chaudhri, aims to address the ‘gender care gap’ as increasing numbers of women seek alternatives to conventional painkillers and long NHS waiting times. A team of gynaecologists and women’s health specialists will focus on conditions such as endometriosis and perimenopause-related symptoms, including anxiety and depression. According to Alternaleaf, the number of female patients has grown by 50% every three months over the past year.

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Curaleaf Laboratories enters partnership with ANTG

Curaleaf Laboratories has announced a new partnership with Australian Natural Therapeutics Group (ANTG), one of Australia’s most respected producers of pharmaceutical-grade medicinal cannabis. Under this agreement, Curaleaf Laboratories will manufacture and distribute ANTG’s range of products across the UK to expand access to medicinal cannabis for eligible patients and healthcare professionals.

🔗 Read more

Join the Society

If you want to stay informed, supported, and part of the independent clinical voice shaping medical cannabis in the UK, join the Medical Cannabis Clinicians Society.

Membership gives you access to expert guidance, CPD-accredited education, peer support, and regular sector updates like this one. Join the Society to be part of the conversation and help drive better, evidence-based care.

By Zul Mamon, Pharmacist and MCCS Executive Committee Member

The General Pharmaceutical Council’s (GPhC) recent thematic review into the supply of cannabis-based products for medicinal use (CBPMs) has revealed an uncomfortable truth: seven years after legalisation, pharmacy practice in this sector remains inconsistent, fragmented, and in some cases unsafe.

As a pharmacist with over 40 years in the profession, including senior roles in medicines distribution, I believe this report is one of the most important regulatory interventions to emerge since CBPMs became legal in 2018.

This review exposes long-standing weaknesses that many of us working in this area have recognised for years, and it sets out changes that are now essential if CBPMs are to be supplied safely.

Below, we outline the core issues highlighted by the GPhC and why the Society supports the reforms proposed, as well as advocating for an additional recommendation.

What the GPhC found

The findings are clear.  Inspection across 25 pharmacies revealed significant problems across governance, safety, training, and clinical oversight, exposing a “postcode lottery” of care, putting many patients at risk. Without better systems, clearer standards, and appropriate clinical information, pharmacists cannot discharge their responsibilities safely, and patients will continue to be put at risk.

Poor governance

The review identified widespread gaps in governance, including pharmacies operating without formal risk assessments for supplying unlicensed cannabis medicines. In online settings, these risks were amplified by a lack of  oversight.

Safeguarding concerns

CBPM patients commonly live with complex and chronic health needs. Despite this, many pharmacies lacked appropriate safeguarding processes, audits, and staff training. In one case, a pharmacist issued a controlled drug to a patient with a known history of drug misuse.

Inconsistent competence

Training provision varied significantly. Some pharmacies relied on unverified or outdated materials. Others allowed unqualified staff to participate  in the dispensing process.Fragmented and siloed care

One of the most serious findings was the absence of shared information between clinics and pharmacies. Many pharmacists were asked to dispense CBPMs without any access to patient records, making safe clinical checks impossible.

Real-world harm

These failures had real consequences for patients, including:

What needs to change: Three urgent reforms

The GPhC recommends three practical and urgent reforms needed to protect patients and build a reliable medical cannabis framework. These findings will inform a larger review by the Advisory Council on the Misuse of Drugs (ACMD). The  Society fully supports these recommendations.

  1. Connect the System: Create shared data systems so that doctors, clinics, and pharmacists can communicate effectively and share information. This is essential for providing joined-up, safe care.
  2. Give Pharmacists the Full Picture: Grant all pharmacies, including private ones, access to patient records. This would allow them to conduct proper clinical checks and prevent harmful drug interactions.
  3. Strengthen Cross-Regulator Cooperation: All regulatory bodies must work together to enforce high standards consistently across the sector. A unified approach is the only way to ensure quality and safety for every patient.

A fourth reform the sector now needs: Specialist training and clear guidance for pharmacists

Alongside the GPhC’s three urgent reforms, there is a fourth requirement that must now be recognised: specialist education for pharmacists dispensing CBPMs.

Pharmacists are responsible for supplying unlicensed Schedule 2 cannabis medicines safely and lawfully. Yet there is no national training standard for this area of practice. This gap contributes directly to the inconsistencies highlighted in the GPhC review.

The Medical Cannabis Clinicians Society has already taken steps to address this and many pharmacists already rely on our guidance to navigate this fast-moving and often poorly defined area of practice. 

In April 2025 we published Guidance for Pharmacists Dispensing CBPMs, developed specifically for pharmacy professionals. This detailed resource gives pharmacists the essential information they need, including:

This guidance is already supporting pharmacists across the UK to build confidence, strengthen clinical checks, and ensure patients receive safe and consistent care.

To build on this foundation, the Society is developing a dedicated online training module for pharmacists, launching in December. This structured, CPD-aligned course will offer the practical, regulator-aligned training that is currently missing from the national landscape.

Together, the guidance and upcoming training form the pharmacy-standard pathway the sector urgently needs, and the fourth reform we believe should sit alongside those recommended by the GPhC.

A turning point for the sector

The UK’s medical cannabis system is at a turning point, and the GPhC review should act as a catalyst for long-overdue change. The evidence shows it is currently failing many of the vulnerable patients it was designed to help. As someone who has worked across community pharmacy, medicines distribution, and specialist practice, I believe these reforms, combined with clearer education and stronger professional support, can finally bring consistency, accountability, and safety to this area of care.

Patients deserve a system that is safe, consistent, and professionally robust. Pharmacists deserve the tools, information, and clinical access required to carry out their duties. And the wider sector needs coherent standards across all regulators and providers. The Society remains committed to supporting pharmacists to meet these expectations and to strengthening standards across the UK. The hope is that these findings will drive meaningful change, leading to a system that is not only legal but also safe, reliable, and effective for all.

Join the Society

If you are a pharmacist working with CBPMs, or seeking to build confidence and competence in this area, we invite you to join the Medical Cannabis Clinicians Society.

Membership provides access to guidance, training, expert commentary, and the UK’s largest peer network of medical cannabis professionals.

Date: 11 March 2026 |  Time: 7:00pm (UK) | Register: Click to register now via Zoom

What happens when a patient comes into hospital, a hospice, or a care setting with a medical cannabis prescription? How should clinical teams respond, and what are the right steps to ensure safe, lawful, and compassionate care?

This webinar is designed to help answer those questions. A companion session to the Managing Medical Cannabis in Hospitals and Care Settings Guide, it supports cannabis-naïve clinicians and healthcare teams working across hospitals, hospices, and community services.

The session explores the safe, legal, and ethical management of cannabis-based medicinal products (CBPMs) in hospitals, hospices, and community care. 

It explains how to apply existing legislation and professional standards to everyday practice, aligning with the Misuse of Drugs Regulations 2001, the Mental Capacity Act 2005, the Equality Act 2010, CQC standards, NICE guidance, and GMC prescribing requirements. The focus is on giving clinicians the confidence to manage CBPMs appropriately and deliver safe, compliant, and patient-centred care.

What you will learn

Who it’s for

This session is designed for multidisciplinary healthcare teams involved in patient care and medicines management, including:

Registration 

The webinar is free to attend. It will be recorded and made available to all registered participants who wish to watch in their own time.

Book your place

This 45-minute session will be followed by a 15-minute open Q&A with Dr Evan Lewis and Dr Dave Tang.

Places are free but limited, so register now to secure your spot and learn how to apply structured, evidence-informed dosing guidance in your clinical work.

The Rules of Football Betting as Explored by Betzoid

Football betting has existed in various forms for well over a century, evolving from informal wagers between spectators on the terraces to a sophisticated, globally regulated industry worth hundreds of billions of dollars annually. As the sport itself has grown into the world’s most-watched and most-followed athletic competition, so too has the ecosystem surrounding it. Understanding the rules that govern football betting is not merely a matter of knowing how to place a wager — it is about grasping the structural, legal, and strategic frameworks that determine how outcomes are assessed, how disputes are resolved, and how responsible participation is maintained. Whether someone is approaching football betting for the first time or seeking to deepen their understanding of its mechanics, a thorough knowledge of its foundational rules is indispensable.

The Foundational Rules of Football Betting Markets

At the core of football betting lies a set of universal rules that govern how bets are accepted, settled, and voided. These rules vary slightly between bookmakers and jurisdictions, but several principles remain consistent across the industry. The most fundamental of these is the concept of the “result at full time,” which refers to the outcome of a match after 90 minutes of regulation play plus any injury time added by the referee. This distinction is critical because it separates standard match betting from markets that account for extra time or penalty shootouts.

In a standard 1X2 market — the most common form of football betting — a punter selects either a home win (1), a draw (X), or an away win (2). The settlement of this bet is based exclusively on the result at the end of regulation time. If a match ends 1-1 after 90 minutes but the home team wins on penalties in a cup competition, a bet placed on the home team in a standard match result market would still be settled as a draw. This rule catches many inexperienced bettors off guard and underscores the importance of reading market-specific terms before placing any wager.

Handicap betting introduces another layer of complexity. In Asian handicap markets, for example, a team might be given a half-goal or whole-goal advantage before the match begins, effectively eliminating the possibility of a draw in certain formats. European handicap markets, by contrast, retain the draw as a possible outcome. The rules surrounding how these handicaps are applied and settled differ significantly between platforms, and bettors must familiarise themselves with the specific terms offered by their chosen operator.

Void bets represent another essential concept. A bet is typically voided when a match is abandoned before completion, when a player listed in a specific market does not participate, or when an event occurs that falls outside the defined parameters of the wager. In such cases, the stake is usually returned to the bettor. However, some operators apply partial void rules in accumulator bets, where the voided selection is simply removed and the remaining legs continue as a reduced accumulator. Understanding these distinctions can have a meaningful financial impact.

Regulatory Frameworks and Responsible Betting Standards

Football betting does not operate in a vacuum. It is subject to a complex web of national and international regulations designed to protect consumers, prevent fraud, and ensure the integrity of sporting competitions. In the United Kingdom, the Gambling Commission oversees all licensed betting activity, enforcing rules around advertising standards, data protection, anti-money laundering procedures, and responsible gambling tools. Similar regulatory bodies exist across Europe, including the Malta Gaming Authority, which licenses many of the continent’s largest online operators.

The relationship between football governing bodies and the betting industry has also become increasingly formalised. UEFA and FIFA both maintain strict codes of conduct prohibiting players, coaches, referees, and officials from betting on matches within their jurisdictions. These rules are enforced through cooperation with national anti-corruption units and betting integrity monitoring organisations such as ESSA (the Sports Wagering Integrity Monitoring Association), which tracks suspicious betting patterns in real time across global markets.

For bettors themselves, responsible gambling rules are now embedded into the operational standards of most licensed platforms. Features such as deposit limits, self-exclusion tools, reality checks, and cooling-off periods are not optional extras but mandatory requirements under many licensing frameworks. These mechanisms reflect a broader shift in the industry toward treating problem gambling as a public health concern rather than simply a personal failing.

Platforms such as Betzoid, which provides detailed analysis and guidance on betting markets, have played a role in educating bettors about these regulatory environments. Resources available at https://betzoid.net/ offer structured information about how different markets operate and what rules apply in specific regions, helping bettors make more informed decisions rather than navigating the landscape blindly. This kind of educational infrastructure is increasingly recognised as a valuable component of responsible betting culture.

Match-fixing regulations represent perhaps the most serious dimension of football betting rules. Operators are legally required to report suspicious betting activity to relevant authorities, and bettors who are found to have engaged in or facilitated match-fixing face criminal prosecution in many jurisdictions. The integrity of the sport depends on the consistent enforcement of these rules, and the betting industry has become an active partner in identifying and reporting anomalies that might indicate corruption.

Bet Types, Settlement Rules, and Common Misconceptions

Beyond the basic match result market, football betting encompasses a vast array of bet types, each governed by its own specific settlement rules. Goals markets, for instance, include over/under bets on the total number of goals scored in a match. A common threshold is 2.5 goals, meaning a bet on “over 2.5” requires at least three goals to be scored for the wager to succeed. These bets are settled based solely on goals scored in regulation time, excluding own goals in some markets depending on the operator’s terms.

Both teams to score (BTTS) markets have surged in popularity over the past decade, partly because they remove the dependency on predicting the winner of a match. Under the standard rules, both teams must score at least one goal each during the 90 minutes of regulation play for a “yes” selection to win. A match ending 1-0 would result in a “no” outcome. Again, the 90-minute rule applies strictly unless the market is specifically defined to include extra time.

Correct score markets carry their own set of rules and are among the most difficult to predict accurately. Settlement is straightforward — the bet wins only if the exact scoreline matches the selection — but the odds reflect the difficulty of this precision. Betzoid analysts have noted that correct score markets are particularly susceptible to late goals, which can shift outcomes dramatically in the final minutes of a match.

First goalscorer and anytime goalscorer markets introduce player-specific rules. If the selected player does not participate in the match, the bet is typically voided and the stake returned. However, if the player comes on as a substitute after the first goal has already been scored, the first goalscorer bet is lost rather than voided, since the market was active during the period in question. This nuance is frequently misunderstood and has been the source of numerous disputes between bettors and operators.

Accumulator bets, known colloquially as “accas,” combine multiple selections into a single wager where all legs must be correct for the bet to win. The rules governing accumulators vary in how they handle postponed matches, abandoned games, and void selections. Some operators automatically remove void legs and recalculate the accumulator at reduced odds, while others may offer “acca insurance” promotions that refund the stake if one leg lets down an otherwise successful combination. Reading the terms associated with accumulator promotions is essential before committing to these types of bets.

In-play betting has transformed the football wagering experience over the past two decades. Live markets allow bettors to place wagers as the action unfolds, with odds updating in real time based on match events. The rules governing in-play bets are particularly strict regarding the timing of acceptance. If a goal is scored in the fraction of a second between a bettor submitting a wager and the operator accepting it, the bet may be voided or settled at revised odds depending on the platform’s policy. Most operators include a clause stating that bets placed after a significant event but before the odds have been updated will be voided.

The Historical Evolution of Football Betting Rules

The rules governing football betting did not emerge overnight. They developed gradually alongside the sport itself, shaped by legal precedents, technological advances, and the growing sophistication of both operators and bettors. In the early twentieth century, football pools were the dominant form of football wagering in Britain, requiring participants to predict the outcomes of multiple matches simultaneously. The rules of pools betting were relatively simple but strictly enforced, with the Football Association initially resistant to any formal association between the sport and gambling.

The legalisation of off-course betting shops in the United Kingdom in 1961 marked a turning point. For the first time, bettors could legally place wagers on individual football matches in a regulated environment. The rules established during this period — covering settlement procedures, void conditions, and dispute resolution — formed the foundation of the modern betting framework. Over subsequent decades, these rules were refined and standardised as the industry grew and competition between operators intensified.

The advent of the internet in the 1990s and the subsequent rise of online betting platforms fundamentally altered the landscape once more. Operators were now able to offer a far wider range of markets than had been possible in physical betting shops, and the rules governing these markets became correspondingly more complex. The introduction of live betting, cash-out features, and exchange platforms each required new regulatory thinking and the development of updated rule sets.

Betzoid has documented many of these historical shifts, providing context for how current rules came to exist and why certain conventions persist even as the industry continues to evolve. Understanding this historical trajectory helps bettors appreciate that the rules they encounter today are not arbitrary impositions but the product of decades of negotiation between operators, regulators, and the broader sporting community. This perspective is valuable not only for making sense of current practices but for anticipating how the regulatory environment might continue to develop in response to emerging technologies such as blockchain-based betting platforms and artificial intelligence-driven odds compilation.

As football continues to expand its global reach — with major leagues now attracting audiences across Asia, North America, and Africa — the rules governing football betting will inevitably continue to evolve. Harmonisation of regulations across jurisdictions remains a significant challenge, and the ongoing dialogue between governing bodies, operators, and consumer protection advocates will shape the standards of the next generation of football betting. For anyone engaged with this market, staying informed about these developments is not optional — it is a fundamental aspect of participation.

Football betting, when approached with a clear understanding of its rules and regulations, represents a structured and analytically engaging activity. The complexity of its rule systems reflects the complexity of the sport itself, and navigating that complexity successfully requires ongoing education, careful attention to terms and conditions, and a commitment to responsible participation within the frameworks established by regulators and operators alike.

Speakers

Dr Evan Lewis, Paediatric Neurologist & Clinical Neurophysiologist
Dr Evan Lewis is an Executive Committee member of the Society and a Paediatric Neurologist and Clinical Neurophysiologist specialising in epilepsy. He is the founder and director of the Neurology Centre of Toronto (NCT) and serves as an Assistant Professor in the Department of Paediatrics at the Hospital for Sick Children and the University of Toronto. Dr Lewis is internationally recognised for his clinical and academic contributions, and for his leadership in advancing safe, evidence-informed approaches to medical cannabis in paediatric neurology.

Dr David Tang, Consultant in Emergency Medicine
Dr David Tang sits on the Society’s Executive Committee and is a Consultant in Emergency Medicine with specialist expertise in musculoskeletal conditions, sports injuries, and chronic pain. His clinical practice bridges acute care and longer-term symptom management, and he brings valuable insight into how medical cannabis can support patients with complex or persistent pain presentations.

Date: Tuesday 24 February 2026 |  Time: 7:00pm (UK) | Register: Click to register now via Zoom

Join The Medical Cannabis Clinicians Society and Curaleaf Laboratories for an in-depth exploration of emerging delivery systems for cannabis-based medicinal products (CBPMs). This webinar is designed for prescribers, pharmacists, nurses, and healthcare professionals involved in medical cannabis care.

As clinical practice evolves beyond traditional oil and flower preparations, new formulations – such as cartridges, capsules, pastilles, creams, and inhaler devices – offer diverse options for patients and prescribers alike. This session will examine the science, safety, and clinical application of these formats, with expert insight from three leading UK clinicians.

What you will learn

This event builds on the Society’s aims to help healthcare professionals prescribe confidently, safely, and in line with best practice guidance.

Who should attend?

Doctors, pharmacists, nurses, and professionals involved in prescribing, dispensing, or advising on CBPMs who want to expand their knowledge of new delivery methods and clinical applications.

Register for Free

This 45-minute session will be followed by a 15-minute open Q&A with Dr Niraj Singh, Dr Rob Forbes, and Matthew Rawdings, Pharmacist from Curaleaf Laboratories.

This webinar is kindly supported by Curaleaf. We are grateful for their ongoing support of clinician education. If your organisation is interested in supporting the Society’s work, please get in touch.

Places are free but limited, so register now to secure your spot and learn how to apply structured, evidence-informed dosing guidance in your clinical work.

Speakers

Dr Niraj Singh, Consultant Psychiatrist
Dr Niraj Singh is an Executive Committee member and an experienced Consultant Psychiatrist specialising in depression, anxiety disorders, ADHD, and Autism. With a holistic clinical approach, he has a strong interest in emerging and alternative treatments. Dr Singh is committed to ensuring that patients who may benefit from medical cannabis receive safe, well-monitored access under specialist care.

Dr Rob Forbes, Consultant Anaesthetist

Dr Rob Forbes is an Executive Committee Member, Consultant Anaesthetist and Chronic Pain Specialist with over 20 years of experience. He has led local chronic pain services, developed primary care guidance, and managed complex pain syndromes. Since 2018, Dr Forbes has specialised in medicinal cannabis, co-founding Borders Pain Clinic and advocating for NHS access while educating professionals and supporting patient care initiatives.

Matty Rawding, Pharmacist
Matty Rawding is a member of the Society’s Executive Committee and a Medical Cannabis Specialist Pharmacist at Curaleaf Laboratories, the first UK facility to produce medical cannabis domestically. A practising pharmacist since 2019, he is completing a PhD in cannabinoid science at the University of Birmingham. Matty is recognised for his leadership in improving patient access, supporting prescribers, and shaping clinical understanding of medical cannabis across the UK.

By Zul Mamon,  Expert Committee Member

This article summarises the crucial insights shared during my presentation “The Role of the Pharmacist: Best Practices for Dispensing CBPM” at the Cannabis Health Symposium on 25 November 2025, which explored how pharmacists can optimise patient outcomes and drive clinical excellence, offering a roadmap for pharmacists navigating this complex and growing area of practice.

Sarah’s Story

Let’s consider Sarah’s story. Like many patients, Sarah experienced confusion and delays when trying to access her CBPM prescription.

Sarah is a 45-year-old mother of two, living with chronic pain that has made even the simplest tasks unbearable. After years of trying traditional treatments with little success, Sarah was told by a friend to try cannabis, which is now legally available on prescription.

Sarah did some research, as we all do, using Google and found a clinic which could help her, and proceeded to complete an online form She managed to get an appointment during which an independent prescriber triaged her. The appointment lasted around 15 minutes to confirm her eligibility. Shortly afterwards, she had an appointment with a Specialist Prescriber. This lasted around 10 minutes.

She was prescribed medication, and after a wait of around a day, Sarah received a payment link from a pharmacy that was connected to the clinic. Sarah was hopeful, but she had to wait to receive her prescription medicines.  There was hardly any communication from the pharmacy or the clinic.

When she contacted the online pharmacy by email, it took several days to receive a reply. This left Sarah feeling frustrated and uncertain about her treatment.

Eventually, the medication arrived by secure post.  Unsure how to use her medication, Sarah contacted the pharmacist again by email as it was the only mode of communication available. The pharmacist was unable to provide comprehensive guidance.

This scenario is more common than we’d like to admit, and something the MCCS is working hard to ensure becomes a thing of the past. 

In this article we explore how pharmacists can ensure patients like Sarah receive the guidance, support, and care they need to achieve the best outcomes.

Pharmacists are often the last point of contact in a patient’s journey for CBPMs and are responsible for providing the proper guidance and support. By implementing best practices, we can transform the experience for patients like Sarah, ensuring they receive the high-quality care they deserve.

The Pharmacist’s Pivotal Role in the CBPM Pathway

The pharmacist’s function in the CBPM clinical pathway is multifaceted and vital. It extends far beyond simply dispensing medication. It begins with a prescription assessment to ensure legality and accuracy, followed by safe dispensing protocols.

However, the role doesn’t end there. Patient education is a cornerstone of adequate care. Pharmacists must provide clear guidance on dosage, administration methods, and potential side effects. Finally, ongoing monitoring enables tracking of therapeutic outcomes and the prompt management of issues that arise during treatment. Without access to clinical data and direct patient contact, significant gaps can emerge, leading to reduced patient education, ineffective safeguarding, and missed opportunities for clinical intervention.

Insights from the GPhC 2025 Report

The General Pharmaceutical Council (GPhC) 2025 thematic report served as a critical reference point, providing a snapshot of how CBPMs are managed across the UK. The report highlighted significant gaps in governance, safeguarding, and clinical oversight, serving as a wake-up call for the industry.

The GPhC brought two critical issues to the forefront:

1.Lack of Access to Clinical Records

Many pharmacies operate without access to a patient’s medical history. This severely limits the ability to perform meaningful safety checks for potential drug interactions, contraindications, or therapy duplications, thereby increasing the risk of adverse events.

2. Inappropriate Prescribing

The report noted instances of inappropriate prescribing, such as providing controlled drugs to individuals with a history of substance misuse. Access to clinical records would empower pharmacists to identify and flag these risks and to take appropriate action to safeguard patients.

These findings underscore the need for systemic changes to ensure pharmacists have the tools required to meet the highest standards of care.

A Framework for Best Practice in CBPM Management

To address the identified challenges, a robust best-practice framework is essential. This framework should be built on four key pillars:

This involves more than just a standard check. It means confirming the prescriber is on the Specialist Register and ensuring the prescription is appropriate and complies with the Misuse of Drugs Regulations 2001. Pharmacists must document all such checks.

Dispensing CBPMs requires a deep understanding of patient safety. This includes assessing medical history and monitoring for side effects.

Patients need clear, non-technical information about their medication. Pharmacists should explain dosage, administration, storage, and handling. It’s also vital to manage expectations and clarify the difference between medicinal and recreational cannabis.

Seamless communication and coordinated efforts across the healthcare team are non-negotiable. This ensures a holistic approach to patient care, reducing the risk of errors and miscommunication.

Navigating Common Challenges in CBPM Practice

The path to optimising CBPM dispensing is not without its obstacles. Three common challenges frequently impact patient care:

Many CBPMs are imported, leading to limited availability, variable product quality, and complex procurement processes. These factors can disrupt consistent patient access to medication.

Knowledge gaps among pharmacy teams, coupled with the stigma surrounding cannabis, can create significant barriers. The GPhC report noted that many pharmacies were using unverified sources for training, highlighting a need for standardised education.

Complex dosing regimens and poor side-effect management can make it difficult for patients to adhere to their treatment plans.

Practical Solutions for Real-World Problems

Overcoming these challenges requires practical and proactive solutions.

For supply chain management, pharmacists should establish robust supplier relationships, identify backup procurement sources, and implement digital inventory-tracking systems. Developing clear communication protocols to inform patients of supply disruptions is also crucial.

To improve education and training, regular team training on CBPM knowledge is essential. Working with industry partners to develop standardised patient information resources and counselling aids can help bridge communication gaps and empower patients with clear, accessible information.

Building Confidence: The Three Pillars of Professional Development

Building confidence in CBPM practice is a continuous journey. A professional development strategy grounded in the following three pillars can help pharmacists enhance their competence and provide the best possible care.

The field of CBPMs is rapidly evolving. Pharmacists must stay current with emerging research, regulatory changes, and new clinical guidelines.

Engaging with specialist groups like the Medical Cannabis Clinicians Society (MCCS), attending symposiums, and participating in peer support forums are excellent ways to share knowledge and learn from others. These networks provide a platform for collaboration and discussion.

Implementing systematic quality measures is vital. Conducting regular audits, seeking patient feedback, and refining protocols are critical steps to ensure the highest standard of care is not just met, but exceeded.

A Call to Action for Pharmacists

Let’s return to Sarah. Imagine if her pharmacist was well-trained in CBPMs, had access to her clinical records, and could offer clear, confident guidance. She would feel supported and reassured, knowing she is in capable hands. This is the tangible impact we can have.

By embracing our role in the clinical pathway, implementing best practices, and collaborating effectively with the wider healthcare team, we can ensure that every patient receives the care they deserve.

Let’s work together to raise the standard of CBPM practice and make a real difference in our patients’ lives.

If you’re a pharmacist working with CBPMs – or want to build your confidence in this area – now is the ideal time to join the Medical Cannabis Clinicians Society. Membership for pharmacists is just £60 a year and gives you access to peer support from pharmacy colleagues, specialist guidance, practical dispensing resources, and CPD-accredited training designed for busy clinicians.

Come le Free Bet hanno Trasformato il Mercato delle Scommesse in Italia secondo Scommezoid

Il mercato delle scommesse sportive in Italia ha subito una trasformazione profonda nel corso dell’ultimo decennio, e tra i fattori che hanno contribuito maggiormente a questo cambiamento vi è la diffusione delle cosiddette free bet, ovvero le scommesse gratuite offerte dagli operatori come strumento promozionale. Quello che inizialmente sembrava un semplice incentivo commerciale si è rivelato un meccanismo capace di ridisegnare le abitudini degli scommettitori, il posizionamento competitivo degli operatori e persino le logiche regolatorie del settore. Per comprendere appieno questa evoluzione, è necessario analizzare le origini del fenomeno, il contesto normativo italiano e le dinamiche che hanno portato le free bet a diventare un elemento strutturale dell’offerta di gioco legale nel paese.

Le origini delle free bet e il loro arrivo nel mercato italiano

Le scommesse gratuite come strumento di acquisizione clienti nascono nel mercato anglosassone, in particolare nel Regno Unito, dove già nei primi anni 2000 gli operatori online iniziarono a utilizzarle per differenziarsi in un panorama sempre più affollato. Il principio è semplice: all’utente viene offerto un credito di scommessa senza dover rischiare denaro proprio, con la possibilità di trattenere le eventuali vincite (al netto della puntata stessa, nella maggior parte dei casi). Questo modello si è dimostrato efficace nel ridurre la barriera d’ingresso per i nuovi scommettitori, abbassando il rischio percepito nella fase di registrazione.

In Italia, il contesto è stato a lungo differente. Il monopolio statale gestito dai Monopoli di Stato ha dominato il settore fino alla liberalizzazione progressiva avviata nei primi anni 2000. Con il decreto Bersani del 2006, il governo italiano aprì ufficialmente il mercato delle scommesse a operatori privati, a condizione che ottenessero una concessione dall’Agenzia delle Dogane e dei Monopoli (ADM, già AAMS). Questo passaggio ha creato le condizioni per l’introduzione delle pratiche promozionali già consolidate altrove in Europa, comprese le free bet. Tuttavia, la loro diffusione su larga scala in Italia è avvenuta in modo graduale, accelerandosi in modo significativo tra il 2015 e il 2020, quando la concorrenza tra operatori è diventata particolarmente intensa.

Va sottolineato che le free bet non sono mai state una forma di gioco d’azzardo in senso stretto, ma piuttosto uno strumento di marketing regolamentato. La distinzione è rilevante dal punto di vista normativo: l’ADM ha nel tempo precisato le condizioni entro cui queste offerte possono essere pubblicizzate e fruite, imponendo requisiti di trasparenza sui termini e sulle condizioni, inclusi i requisiti di puntata (wagering requirements) che determinano quando e come le vincite possono essere convertite in denaro reale.

L’impatto competitivo e il cambiamento nelle strategie degli operatori

L’introduzione massiccia delle free bet ha modificato in modo sostanziale le strategie commerciali degli operatori autorizzati in Italia. Prima della loro diffusione, la competizione si giocava principalmente su quote più competitive e su un’offerta più ampia di eventi. Con l’avvento delle scommesse gratuite, si è aggiunta una nuova dimensione: quella dell’acquisizione e della fidelizzazione del cliente attraverso bonus e promozioni strutturate.

Operatori di grandi dimensioni come Bet365, Snai, Sisal, Lottomatica e Betfair hanno investito risorse crescenti nella progettazione di offerte promozionali calibrate per diversi segmenti di utenza. Le free bet sono state integrate in sistemi di benvenuto articolati, spesso abbinati a bonus sul deposito iniziale o a promozioni legate a eventi sportivi specifici, come le partite di Champions League o i Gran Premi di Formula 1. Questa strategia ha reso il momento della registrazione un’esperienza ad alto valore percepito per l’utente, aumentando significativamente i tassi di conversione.

Parallelamente, si è sviluppato un ecosistema informativo dedicato all’analisi e al confronto di queste offerte. Piattaforme specializzate hanno iniziato a raccogliere e classificare le proposte disponibili sul mercato italiano, permettendo agli scommettitori di orientarsi in un panorama sempre più frammentato. Tra le risorse disponibili in lingua italiana, una raccolta sistematica delle offerte attive si trova su http://www.scommezoid.com/siti-scommesse-free-bet/, dove vengono elencati e descritti i principali operatori che propongono questo tipo di promozione, con dettagli sui termini applicabili. Questo tipo di aggregazione informativa ha avuto un ruolo non secondario nel rendere le free bet accessibili anche a utenti meno esperti, contribuendo alla loro normalizzazione come strumento ordinario del mercato.

Un effetto collaterale di questa competizione è stato l’aumento della complessità delle offerte. I termini e le condizioni delle free bet sono diventati progressivamente più articolati, con moltiplicatori di puntata, restrizioni sulle quote minime ammissibili e limiti temporali stringenti. Questo ha generato una domanda crescente di contenuti informativi e comparativi, alimentando a sua volta la crescita di siti editoriali specializzati nel settore delle scommesse online.

Il quadro normativo italiano e le restrizioni sulla pubblicità

Un capitolo fondamentale nella storia delle free bet in Italia riguarda il cosiddetto Decreto Dignità, entrato in vigore nell’agosto del 2018 con il decreto-legge n. 87, successivamente convertito in legge. Questa normativa ha introdotto un divieto quasi totale di pubblicità per il gioco d’azzardo e le scommesse su tutti i mezzi di comunicazione, incluse televisione, radio, internet e stampa. Il provvedimento ha avuto conseguenze dirette sulle modalità con cui gli operatori potevano promuovere le proprie offerte, comprese le free bet.

In pratica, il Decreto Dignità ha costretto gli operatori a ripensare integralmente le proprie strategie di comunicazione. La pubblicità tradizionale, che fino al 2018 aveva dominato gli spazi televisivi durante le trasmissioni sportive, è diventata illegale. Gli operatori hanno quindi spostato parte dei propri investimenti verso canali meno regolamentati o verso forme di comunicazione che non rientrano tecnicamente nella definizione di pubblicità, come i contenuti editoriali, le partnership con affiliati e i siti di comparazione. Questo spostamento ha paradossalmente aumentato l’importanza delle piattaforme informative indipendenti, che sono diventate uno dei principali canali attraverso cui gli scommettitori italiani vengono a conoscenza delle offerte disponibili.

L’ADM ha continuato a svolgere un ruolo di vigilanza attiva, sanzionando gli operatori che violavano il divieto pubblicitario o che non rispettavano i requisiti di trasparenza nelle condizioni delle promozioni. Tra il 2019 e il 2022, sono stati emessi numerosi provvedimenti sanzionatori nei confronti di operatori che avevano comunicato le proprie free bet in modo non conforme alla normativa vigente. Questo ha spinto il settore verso una maggiore standardizzazione dei termini e delle condizioni, rendendo le offerte più comparabili tra loro.

Vale la pena notare che il dibattito sulla revisione del Decreto Dignità è rimasto aperto negli anni successivi alla sua entrata in vigore. Alcune associazioni di categoria, come il Consiglio Nazionale dell’Economia e del Lavoro (CNEL) e vari operatori del settore, hanno sostenuto che il divieto assoluto di pubblicità non avrebbe ridotto il gioco, ma avrebbe semplicemente spostato gli utenti verso operatori non autorizzati, privi delle tutele previste dalla normativa italiana. Questo argomento ha alimentato un dibattito politico e regolatorio ancora irrisolto al momento della redazione di questo articolo.

Le free bet come strumento di analisi del comportamento degli scommettitori

Al di là del loro valore commerciale immediato, le free bet hanno acquisito una rilevanza crescente anche come fonte di dati sul comportamento degli scommettitori. Gli operatori che le offrono raccolgono informazioni dettagliate su come vengono utilizzate: quali sport vengono scelti, in quale fascia oraria, con quale frequenza e con quali quote. Questi dati permettono di costruire profili comportamentali che vengono poi utilizzati per personalizzare le offerte successive, aumentare la retention degli utenti e identificare eventuali segnali di gioco problematico.

In Italia, la questione della responsabilità sociale nel gioco è diventata sempre più centrale nel dibattito pubblico. L’ADM ha introdotto requisiti specifici per gli operatori in materia di gioco responsabile, inclusi strumenti di autoesclusione, limiti di deposito e sistemi di allerta per comportamenti anomali. Le free bet, in questo contesto, sono state oggetto di attenzione da parte dei ricercatori che studiano il gioco d’azzardo problematico: alcune ricerche condotte in ambito europeo suggeriscono che le promozioni di benvenuto possono aumentare la frequenza delle sessioni di gioco nei mesi immediatamente successivi alla registrazione, anche se il nesso causale tra free bet e dipendenza patologica rimane oggetto di discussione scientifica.

Scommezoid, tra le piattaforme che si occupano di analizzare il mercato italiano delle scommesse, ha contribuito a diffondere informazioni sui meccanismi di funzionamento delle free bet, aiutando gli utenti a distinguere tra offerte con condizioni favorevoli e quelle con requisiti di puntata particolarmente elevati. Questo tipo di alfabetizzazione finanziaria applicata alle scommesse rappresenta un contributo concreto alla tutela del consumatore, in un settore dove la complessità delle condizioni contrattuali può facilmente sfuggire all’utente non esperto.

In conclusione, le free bet hanno rappresentato molto più di una semplice leva promozionale nel mercato italiano delle scommesse: hanno ridefinito le dinamiche competitive tra operatori, stimolato la nascita di un ecosistema informativo specializzato, influenzato il quadro normativo e aperto nuove questioni sul piano della responsabilità sociale. Comprendere il loro funzionamento e le condizioni che le regolano è diventato parte integrante della competenza necessaria per orientarsi consapevolmente in un mercato che, nonostante le restrizioni degli ultimi anni, continua a evolversi rapidamente. Piattaforme come Scommezoid svolgono in questo senso un ruolo utile nel rendere accessibili informazioni che altrimenti richiederebbero un’analisi approfondita e dispendiosa in termini di tempo.

Join today and strengthen your role in safe, effective CBPM care.

About the author

Zul Mamon is a member of the Expert Committee at the Medical Cannabis Clinicians Society, a pharmacist and a Responsible Person with extensive experience across community pharmacy and the medical cannabis sector. As the founder of Pharma Experts and co-founder of both Amber Green Clinics and Blue Angel Care, he has developed a unique perspective on the evolving landscape of modern healthcare.

Driven by a passion for advancing the profession, Zul focuses on navigating the complex challenges and identifying key opportunities within the field. He is committed to sharing his insights to help enhance patient care, improve clinical governance, and support the professional development of his peers.

The minutes from the latest meeting of the All-Party Parliamentary Group (APPG) on Medical Cannabis under Prescription, held on 3 November 2025, are now available.

You can download the full document here: APPG on Medical Cannabis Under Prescription – Minutes of Meeting, 3 November 2025

This update provides an overview of discussions, priorities, and next steps for parliamentary engagement.

The APPG on Medical Cannabis under Prescription will hold its next meeting and AGM on Tuesday 13 January 2026, 12–1pm.

How American Sportsbook Regulation Evolved Over the Last Decade, based on expert review

The American sports betting landscape has undergone a transformation so significant over the past decade that it is difficult to overstate its scope. What was once a tightly restricted activity confined almost entirely to Nevada has become a multi-billion-dollar regulated industry operating across more than three dozen states. This shift did not happen overnight, nor did it result from a single legislative decision. Instead, it emerged through a combination of federal court rulings, state-level legislative action, lobbying from professional sports leagues, and a gradual cultural normalization of sports wagering as a form of entertainment. Understanding how this evolution unfolded requires examining the legal, political, and commercial forces that converged over the course of roughly ten years.

The PASPA Era and Its Collapse

To understand where American sportsbook regulation stands today, it is necessary to start with the Professional and Amateur Sports Protection Act of 1992, commonly known as PASPA. This federal law effectively prohibited state-authorized sports betting across the United States, with grandfathered exceptions for Nevada, Delaware, Montana, and Oregon. For over two decades, PASPA served as the primary legal barrier preventing states from establishing their own regulated sports wagering markets. The law was not without its critics, and several states attempted to challenge or circumvent it throughout the 2000s and early 2010s.

New Jersey became the central figure in the legal battle against PASPA. After voters approved a 2011 constitutional amendment permitting sports betting, the state legislature passed enabling legislation in 2012. The major professional sports leagues — the NFL, NBA, MLB, NHL, and NCAA — immediately filed suit to block implementation. What followed was years of federal litigation, with New Jersey losing at the district and appellate court levels. The state’s persistence, however, ultimately paid off. In May 2018, the United States Supreme Court ruled in Murphy v. National Collegiate Athletic Association that PASPA was unconstitutional, citing the anti-commandeering doctrine under the Tenth Amendment. The Court held that Congress could not compel states to maintain laws prohibiting sports gambling. This ruling dismantled the federal framework overnight and left it entirely to individual states to decide whether and how to regulate sports betting.

The State-by-State Regulatory Scramble: 2018 to 2022

Within weeks of the Murphy decision, New Jersey launched legal sports betting, and other states moved quickly to follow. Delaware was the first to accept legal bets under the new framework, doing so just days after the ruling. Pennsylvania, West Virginia, Mississippi, and Rhode Island all enacted legislation and launched operations within the first year. By the end of 2019, more than a dozen states had either launched regulated markets or passed enabling legislation awaiting implementation.

The regulatory models adopted by states varied considerably. Some, like Nevada, maintained their existing frameworks with relatively modest adjustments. Others built regulatory structures from scratch. New Jersey opted for a competitive, multi-operator model that allowed both retail sportsbooks at casinos and racetracks as well as online and mobile wagering. This approach attracted operators from Europe — particularly companies like DraftKings, FanDuel, BetMGM, and PointsBet — who had been waiting for the American market to open. New Jersey’s model became something of a template, though not universally adopted. States like Montana chose a state-run lottery model with far fewer operators and more restricted access.

One of the most consequential regulatory decisions during this period was how states treated mobile and online betting. States that permitted statewide mobile wagering — meaning bettors could place wagers from anywhere within state borders rather than only at physical locations — saw dramatically higher revenue figures. New Jersey demonstrated this clearly; within two years of launching, it surpassed Nevada in total sports wagering handle, driven almost entirely by mobile volume. This data point influenced subsequent state-level debates significantly. Regulators and legislators in states like Illinois, which initially required in-person registration at a casino before permitting mobile access, eventually reversed course after observing the revenue gap between mobile-friendly and mobile-restricted markets.

The period from 2018 to 2022 also saw the professional sports leagues reverse their longstanding opposition to legalized betting. Having fought against PASPA repeal for years, the leagues pivoted quickly once the legal landscape changed. The NBA and MLB began lobbying for so-called “integrity fees” — a percentage of betting handle paid directly to the leagues — arguing that their intellectual property underpinned the wagering activity. Most states rejected these proposals outright, viewing them as an unjustified tax on operators and consumers. However, the leagues did succeed in securing official data mandates in several states, requiring sportsbooks to use league-supplied data for in-game wagering rather than third-party feeds. Tennessee and Illinois included such provisions in their initial legislation, though enforcement and implementation proved complicated in practice.

Maturing Regulation and Consumer Protection Frameworks

By 2022 and into 2023, the conversation around American sportsbook regulation began shifting from expansion to refinement. With legal markets operating in states representing a substantial portion of the U.S. population, attention turned to consumer protection, responsible gambling obligations, advertising standards, and the integrity of the wagering markets themselves. This maturation phase is where the regulatory divergence between states became most apparent and, in some respects, most consequential for bettors and operators alike.

Responsible gambling requirements became a more prominent feature of state licensing conditions. Many states began mandating that operators maintain self-exclusion programs, provide deposit limit tools, and display responsible gambling messaging prominently within their platforms. The American Gaming Association’s responsible gambling framework, known as Have A Game Plan, provided voluntary industry standards, but state regulators increasingly codified similar requirements into law. Massachusetts, which launched its regulated market in 2023, included some of the most detailed responsible gambling provisions of any state to that point, including restrictions on certain types of promotional offers and requirements for operator staff training.

Advertising practices became a flashpoint during this period. The sheer volume of sportsbook advertising that accompanied the post-PASPA expansion drew criticism from public health advocates, lawmakers, and even some within the industry. Promotional offers — particularly “risk-free bet” promotions that critics argued were misleading because losses were typically refunded in site credit rather than cash — attracted regulatory scrutiny. The Federal Trade Commission signaled interest in examining sports betting advertising, and several state attorneys general began reviewing promotional terms for potential deceptive practices. Some operators voluntarily revised their marketing language, while others waited for formal regulatory guidance.

Tax rate structures also evolved as states accumulated operational data. Early adopters had set tax rates based on limited information and political compromise. As revenue figures matured, some states revisited their frameworks. New York, which launched mobile betting in January 2022, set an unusually high tax rate of 51 percent on gross gaming revenue — a figure that drew widespread criticism from operators who argued it would limit market competition and innovation. Despite these concerns, New York generated over one billion dollars in tax revenue within its first year of mobile operations, which emboldened other states to consider similarly aggressive tax structures. Ohio launched in January 2023 with a 10 percent tax rate but moved to raise it to 20 percent by mid-2023, reflecting a broader trend of states reassessing the balance between operator profitability and public revenue extraction.

The question of what constitutes a well-functioning regulated sportsbook market has been explored from multiple angles, including by researchers and analysts who have evaluated state frameworks against measurable outcomes. Assessments conducted based on expert review of licensing criteria, consumer protection provisions, and market competitiveness have helped inform how regulators in newer states structure their own frameworks, drawing lessons from the experiences of early movers like New Jersey and Colorado.

Federal Involvement and the Road Ahead

Despite the state-by-state structure that emerged after Murphy, federal involvement in sports betting regulation has not disappeared entirely. The Department of Justice has continued to assert jurisdiction over certain aspects of online gambling under the Wire Act of 1961, though its interpretation of that statute has shifted between administrations. A 2019 DOJ opinion reversed a 2011 interpretation and argued the Wire Act applied to all forms of interstate online gambling, not just sports betting. This position created significant uncertainty for operators and state lotteries. Subsequent legal challenges led to conflicting federal court rulings, and the matter remained unresolved as of the mid-2020s, creating ongoing compliance uncertainty for multi-state operators.

Congress has periodically considered federal legislation that would establish minimum standards for state sports betting regulation, create a federal registry for problem gamblers, or address advertising practices. None of these proposals had advanced to enactment as of 2024, but the legislative interest reflects growing recognition that a purely fragmented state-by-state system creates inconsistencies that may ultimately require some federal floor of consumer protection standards.

Tribal gaming interests have also played an increasingly important role in shaping state regulatory outcomes. In states like California, Arizona, and Michigan, tribal compact negotiations significantly influenced the structure of legalized sports betting. California’s 2022 ballot measures — both of which failed — illustrated how tribal opposition or support could determine whether a state market launched at all. Arizona’s 2021 framework, which included both tribal and commercial operators, offered a model for balancing competing interests, and it produced a competitive market that generated substantial tax revenue relatively quickly.

The technological dimension of regulation has grown more complex as well. The rise of in-game and micro-market wagering, the integration of sportsbooks with media platforms, and the emergence of peer-to-peer betting exchanges have all presented regulatory challenges that existing frameworks were not designed to address. Regulators in several states have begun convening working groups and soliciting public comment on how to approach these newer product types, recognizing that rules written in 2018 or 2019 may not be adequate for the market as it exists today.

The decade of change in American sportsbook regulation represents one of the most rapid expansions of a regulated gambling market in modern history. From a near-total federal prohibition to a patchwork of state markets generating tens of billions of dollars in annual wagering handle, the transformation has been driven by legal precedent, commercial pressure, and evolving public attitudes. The work of regulation is far from complete. States continue to refine their frameworks, address consumer harms, and grapple with the appropriate balance between market competitiveness and public interest obligations. The coming years will likely see continued consolidation among operators, more sophisticated responsible gambling requirements, and potentially some degree of federal coordination — all of which will determine whether the American sports betting market matures into a genuinely well-governed industry or remains a fragmented system of inconsistent standards.