The process of expansion has begun. In February the Canadian cannabis company Organigram acquired Sanity Group, a German medical cannabis company, for around $285 million. In April, Tilray, one of America’s cannabis juggernauts, acquired Lyphe, a leading British medical cannabis provider, not long after picking up a popular craft beer company. Not to be outdone, the United States’ largest cannabis company, Curaleaf, soon followed suit by completing the buyout of Four 20 Pharma, a major German medical cannabis producer and distributor.

Those are just the mergers. American companies are also moving directly into the European market. This year Curaleaf rolled out a public advertisement campaign in Britain with ads on the London Underground and on television, rebranded its Polish subsidiary as Curaleaf Centrum Medyczne and became the first company to supply medical marijuana in Spain. Curaleaf isn’t alone in making inroads. A recent report found that Canadian cannabis exports to Britain grew by more than 560 percent in a single year.

These are early days for legal marijuana in Europe. So far, only Germany, Malta, Luxembourg and the Czech Republic have legalized recreational cannabis. None follow the heavily commercialized model of North America, although there are pilot programs for retailing cannabis in Switzerland and the Netherlands. Medical marijuana, however, is legal in many countries, including Italy, France and Britain. Europe’s medical cannabis market is already approaching $1.7 billion in value.

With this influx comes challenges. In America, legalization — despite some of its social equity ambitions — has tended to place profit over public health. For the most part, the cannabis industry has adopted many of the same aggressive marketing practices associated with the tobacco and alcohol industries, including lobbying for favorable regulation, increasing the potency of products and targeting a small number of frequent users. The cost is clear. A recent study found that this underregulated and overcommercialized approach gives rise to increased use disorders and psychic distress.

Already there are signs of these issues emerging in Europe. In March, Curaleaf found itself in trouble in Britain after prescribing medical cannabis to Oliver Robinson, a 34-year-old man with a history of mental health issues who then took his own life. The coroner who led the inquest into his death found that industry practices meant there was a real risk of more deaths. It’s not hard to see how. In Germany lax prescription through apps and teleclinics led to a rise in imports of 400 percent in the first half of 2025, prompting the government to restrict online sales.