The cannabis industry has undergone some changes over the past few months, shaping, step by step, the way we understand the use of medicinal cannabis and fighting against prejudice towards this natural alternative.
Taking into account new scientific discoveries and the need for patients to access this alternative treatment, governments have been pressured to change legislation to facilitate or control access to the substance. In this article, we will highlight some of the most important episodes and situations that have allowed the therapeutic use of medicinal cannabis.
General understanding on the use of medicinal cannabis and its regulation
Following the publication of an information document of the IDPC (International Drug Policy Consortium) in 2018, we can recognize two main types of regulations:
- Those born of the will of the government to improve public health and the result of a policy. In most cases, this regulation also coexists with the recreational use of cannabis. The most famous example would be Canada. The country allows the sale of cannabis under specific regulations of the region.
- Those regulations in which the legislative reform was a consequence of the citizens' initiative and social pressure. This type of reform would cover the need of some patients under certain requirements and allow access to cannabis only as a pharmaceutical product. The case of the United Kingdom should be highlighted. This country offers a legal license to patients who meet the stringent requirements, allowing them access to cannabis-based medicines.
In what terrain are the new regulations?
Nowadays, for countries to adopt new regulations that allow access and use of medicinal cannabis, there must be absolute and irrefutable evidence about the therapeutic uses of this substance, a requirement that is not necessary for other therapeutic treatments. Therefore, for the new regulations to be feasible, they must rely on a solid base based on irrefutable scientific evidence. Something that the medicinal cannabis industry does not have yet, since research on the subject has been limited in several ways.
On the other hand, the cannabis plant has a wide variety of components ranging from more than 100 different types of cannabinoids, various types of terpenes, flavonoids, etc. Therefore, the complexity of the plant combined with the legal limits that researchers must face. investigation. Consequently, building a solid scientific basis required by legal frameworks to allow medicinal cannabis becomes a very difficult task.
A summary of the countries willing to regulate medicinal cannabis
We will focus this section on European countries that have or will develop a legal land that allows controlled access to medical cannabis.
First, the only conditions for which medical cannabis is allowed are: spasticity associated with multiple sclerosis, nausea and vomiting induced by chemotherapy and refractory epilepsy. Secondly, only patients in whom all types of conventional treatments have failed previously they can apply for a license to the extent that there is evidence that cannabis could help with their condition and after they have consulted an expert medical adviser in the subject. Only by submitting all of these requirements will the Department of Health determine whether the patient can obtain access to cannabis-based medications.
Some sectors (both patients and professionals) have complained about this new legislation by saying that, instead of opening doors, it restricts everything even more, since no patient who does not have any of the conditions mentioned above can apply for a license. And, in case they find a way to apply, the health system can not obtain funds for treatment and the cost of such treatment could reach thousands of pounds a year.
Germany has become one of the first countries in the world to include medicinal cannabis covered by public and private health sectors. Medical cannabis was legalized in Germany in 2017 and doctors can prescribe pharmaceutical products containing tetrahydrocannabinol (THC) to patients with serious conditions, most of them in the form of flowers or extracts.
Health insurance companies have established a reimbursement plan. To begin medical cannabis treatment, patients must initiate an application with the required health insurance company. In addition, insurers can reject applications if they have significant reasons to do so. On the other hand, the German government also established a cannabis agency that is part of the German Federal Institute of Medicines and Medical Devices (BfArM, for its acronym in English). In addition, companies can apply for a cultivation license if they have sufficient experience with cannabis cultivation and BfArM allows companies to collaborate with international cannabis growers and with experience to apply for a license. Therefore, it is fair to say that Germany will grow medicinal cannabis this 2019.
Next on our list, we find Italy. The Italian Ministry of Health launched the project in November 2015 "Galenic formulations based on cannabis". Within this new legislation, doctors can prescribe medicinal cannabis to treat any condition if there is enough scientific literature defending its use in that condition.
Once the patient has the doctor's prescription, it is delivered to the pharmacist. The pharmacist has a key role in this process, as he is in charge of make the request to obtain medicinal cannabis from an official entity recognized by the government. One of these recognized official entities is the "Stabilimento Chimico Farmaceutico Militare", a military pharmaceutical factory in charge of the production of medicines for rare diseases.
When the pharmacist has made the official request for medicinal cannabis to one of these entities, it receives the flower and can then manufacture the required medication in the manner prescribed by the doctor. Public Healthcare will cover the cost of treatment for any of the following conditions: multiple sclerosis, chronic pain, anorexia, HIV, CINV and Tourette's syndrome, but only if it is demonstrated that conventional treatments have previously failed in the patient, as conventional medications they are still the first option on the part of the medical sector and doctors.
The objective of this project is control the amount of medicinal cannabis that is harvested in the countryIt provides the pharmacist with a key role and allows the manufacture of a standardized product. The doctor must also specify which strain and which route of administration should be used on the patient.
The Danish Parliament decided to start the "Medicinal Cannabis Pilot Program" in January 2018 will allow doctors to prescribe medicinal cannabis products. This pilot program will last four years and aims to offer patients a legal basis to test cannabis-based medicines, if other standard treatments have failed.
The cannabis-based substances allowed within the program are controlled and standardized, but have not been accepted as medicines. In addition, the substances have not yet been tested in clinical trials, so doctors have less information about their side effects. The Danish Medicines Agency has established restrictions on the conditions under which medicinal cannabis can be used. These include: multiple sclerosis, painful spasms caused by spinal cord damage, CINV, and neuropathic pain. The intention is evaluate on a better basis the use of cannabis-based drugs at the end of the pilot program.
This country classifies the substances within the Opium Law (the legal section that covers psychotropic drugs) and, unlike other nations, the Netherlands places cannabis in a lower classification (Category II of the Opium Law). In addition, in 2001, the Medicinal Cannabis Office (OMC) was established. The WTO is the agency responsible for the sale and production of medicinal cannabis in the country. The quality of cannabis is constantly monitored by tests carried out by official laboratories. All the cannabis that passes through the WTO has been produced by Bedrocan. Bedrocan is the only company in the Netherlands authorized by the Ministry of Health to produce cannabis flowers (female dried flowers). Then, these medications can be purchased at pharmacies with a prior prescription provided by a doctor.
In the Netherlands, doctors have the authority and judgment to decide when to prescribe cannabis. The only requirement is that all conventional treatments have previously failed in the patient and medical cannabis is the last possible option. Physicians must also determine the tension required for the patient, although this is limited by the number of strains currently provided by Bedrocan. So far, there are 5 types of medicinal cannabis: Bedrocan, Bedrobinol, Bedica, Bediol and Bedrolite. All of them manufactured by Bedrocan and with differences in the amount of THC and CBD. Determine what is needed by the patient will be decided based on the patient's clinical needs.
The Netherlands is a unique example as it does not present the stigma that still prevails in other countries. The prescription of medicinal cannabis is quite common and doctors do not face prejudices or damage their reputation by doing so.
The consequences of legalizing the use of medicinal cannabis
In the informative document published by the IDPC, they studied and explained the consequences of legalizing medicinal cannabis. It has been said on many occasions that allowing people to access medical cannabis could easily lead people to recreational illicit use. But this statement does not seem to be true. For example, the use of recreational cannabis among adolescents has remained stable in parts of the United States. Where medical use has been allowed. In addition, there has been no increase in traffic accidents in those legal frameworks where the use of medical cannabis has been allowed.
And finally, there are no reports of deaths caused by cannabis poisoning. On the contrary, patients in whom medicinal cannabis has been administered show a better survival rate and a better quality of life.
Medical cannabis as a necessity
In a landmark statement published by the World Health Organization (WHO) in January this year, the Expert Committee on Drug Dependence (ECDD) recommended that cannabis and cannabis resin be removed from Schedule IV of the Single Convention on Narcotics This means that the WHO recommends stopping considering cannabis as a dangerous substance and encourages institutions to recognize its therapeutic importance. On the other hand, a proposed law launched by the European Parliament in 2018 recognizes, among other things, that medical cannabis research has not received sufficient funds and that therapeutic uses of cannabis should be recognized as priorities.
The fact that two entities, such as the WHO and the European Parliament, talk about cannabis means that many official institutions are aware of the medical need to use cannabis and are willing to break the boundaries between research and prejudice.
In fact, it is clear that awareness is increasing between governments and the public. The IDPC has recommended that governments include patients in the decision-making process, offer technical assistance to doctors, increase public education about cannabis, and allow and promote research. These aspects are key if we are willing to use medicinal cannabis as a medicine.
Did you like this post? Make an assessment. This post has been made based on existing research until the date of publication of the article. Due to the increase of studies around medical cannabis, the information exposed may vary over time and we will inform in subsequent writings.
Current European legal framework on the use of medicinal cannabis
Discover some of the most important episodes and situations that have allowed the therapeutic use of medicinal cannabis.
Here’s what you want to know before visiting your local medical dispensary:You may require a physician’s recommendation, medical cannabis certificate, and/or whatever appropriate documentation is required by your state. Ordinarily, you need to be 18 or older to qualify for a medical authorization, but exceptions could be made in some states for minors with especially debilitating problems. You will usually enroll with a medicinal dispensary. This is to maintain your medical cannabis recommendation or certificate on file for legal and regulatory purposes. There will be a waiting space. This is to control the flow of product and patients, but a straightforward dividing wall gives patients privacy and direct one-on-one contact with a budtender to discuss medical issues. Many times, but not necessarily, your purchases will be monitored by medical dispensaries. This procedure can help budtenders and patients track effective medication as well as possess a living listing of manufacturers and goods for future reference and follow up. Medicinal dispensaries usually permit you to smell and examine the buds before purchase. This might differ from state-to-state.
DOES AN APPLICANT NEED MUNICIPAL APPROVAL BEFORE RECEIVING A RETAIL CANNABIS LICENSE? Yes, municipal approval is necessary before the AGLC will subject a retail cannabis license. Applicants should get in touch with their planned municipality to learn requirements concerning municipal retail cannabis laws, zoning requirements, land-use restrictions, and place requirements concerning how near a retail shop is to a provincial health care centre, school, or parcel of land designated as a college reserve.
Keep non-medical cannabis legal Adults who are 19 decades or older are able to:Have up to 30 gram of legal dried cannabis or the equivalent in their person. Share up to 30 gram of legal cannabis along with other adults in Canada. Purchase cannabis goods from a Yukon Liquor Corporation licensed merchant. Grow up to four crops per household. It is illegal to provide non invasive cannabis to anyone below the age of 19 and for anyone under the age of 19 to possess any amount of anti inflammatory cannabis in Yukon.It is illegal and dangerous to drive while under the influence of cannabis or other intoxicants.