Medical cannabis begins to gain ground in Eastern Euro

Eastern Europe countries are moving away from the restrictive laws of their past. At that time cannabis, like hard drugs, was penalised, although that did not prevent it from being present in the black market. That legacy has made it more difficult for this countries to enter the field of marijuana for medicinal purposes.

Recently in Poland a new bill has been brought to Parliament that will not be so restrictive with regards to the use of medical cannabis. Thus, a parliamentary commission met only a month ago following pressure from the Kukiz'15 political movement; as well as from activists from the NGO Wolne Konopie (Free Cannabis Association) and the medical cannabis coalition constituted by doctors, lawyers, patients and families.

The proposal of the commission emerged from the spokesman of Kukiz'15, the famous rapper Piotr-Liroy Marzec. This newly formed political movement was created by the 'punk rock' musician Pawel Kukiz and currently has 36 seats in the Polish lower house, with a total of 460.

In a meeting prior to the presentation of the new proposal in Parliament, Marzec advocated the liberalization of marijuana cultivation for ill people; However, Polish Health Minister, Konstanty Radziwill, with a much tougher view of cannabis, did not consider it necessary to include this measure, since Polish patients already have access to the use of cannabis-based medicines.

The lack of agreement angered the Kukiz'15 movement. "People die every day because of the current laws. I attend their funerals and so should you, as well as talking to their families and telling them face to face what you say in the media," Marzec told reporters.

However, the proposal has finally reached Parliament. The chairman of the commission, former Minister of Health Bartosz Arlukowicz from the Civic Platform, set a deadline of five weeks, close to its completion, during which committee members will study various projects and proposals on medical cannabis. "It is a good sign that all members are willing to work on the bill, although they are afraid that five weeks will not be enough to study the cases and make the right decisions," says Jakub Gajewski, the director of the NGO Wolne Konopie. Even so, it seems that the government's stance is firm: it opposes domestic cultivation and prefers government regulation and control of marijuana plantations.

The history of cannabis in Poland

In practice it is difficult to obtain such drugs, due to the obstacles to obtaining the permit

Since 2012, three cannabis-derived medicines have been available in Poland: Bediol, Bedrocan and Sativex. The first two, Bedrocan and Bediol, are used to treat drug-resistant epilepsy in children, while Sativex is approved for muscle spasticity associated with multiple sclerosis.

Access to these drugs must be approved by the Ministry of Health. On the one hand, Bediol and Bedrocan come from the Netherlands, with a specific control for each patient through a system called 'preassigned import'; while Sativex can be prescribed by a doctor and can be obtained in some Polish pharmacies. However, in practice it is difficult to obtain such drugs, due to the obstacles to obtaining the permit.

Since 2015, measures have been taken to address these restrictions, and the price of medicines has been lowered. 68% of Poles approve the use of medical cannabis, according to a survey conducted in July 2015. Now we must wait to see what the final decision is on the recent proposal to liberalize the cultivation of marijuana for the treatment of patients, something that Vice President Wanda Nowicka had already proposed, but failed to accomplish.

The legacy of the USSR and the situation in Russia

As we pointed out, in the USSR marijuana was not legal. However, that did not prevent a significant consumption from taking place, as well as traffic and manufacture of narcotic drugs, which also included cannabis.

Today Russia, despite its restrictive anti-drug laws, allows possession of small amounts of marijuana (usually up to 6 grams) for medical use. A measure that is controlled thoroughly by the Government and that can change according to local regulations. Thus, in many places it is not even allowed to possess such an amount.

In addition, its severe legislation penalizes the consumption of marijuana in public, especially around schools. Likewise, the acquisition, storage, transport, production and processing of drugs without a sales purpose may mean an administrative penalty of 4000-5000 rubles (around 63 and 78 euros) or up to fifteen days of arrest if found with small quantities; for example, a joint. In greater amounts the penalty can go from the three to ten years.

Other countries in Eastern Europe

The Czech Republic was one of the first countries in this area to legalize medical cannabis in 2013. Legal purchase and consumption are allowed to patients in possession of valid prescription and as long as they follow the guidelines on dosage, range of indications and age restrictions.

The case of the Czech Republic is striking because it has one of the most modern and progressive drug policies in Europe. However, in the field of medical cannabis, the advances of the country are not so clear. Since 2013, the law allows each patient 30 grams of dry product per month, only by medical prescription and under special electronic prescription for people with specific diseases (AIDS, chronic pain, cancer and polyneuropathies, among others). In addition, it was established that certain companies, under license, could produce or import the product.

However, one of the main problems for many users is that they can't cope with the high prices of the drug they need: unlike in other countries, it is not covered by any insurance or medical care. Only 1 gram amounts to 11 euros, so the maximum monthly dose reaches 330 euros. So far there are many restrictions on cultivation, so it is necessary to import cannabis, which results in its scarcity. This has caused experts and representatives of affected patients to be disappointed and report that, after several months of marketing it in pharmacies, its use is not being effective.

In neighbouring Hungary, things are quite different. It has gone from being a place with a long cannabis tradition to becoming one of the most prohibitive countries in this regard. Medical use is not covered by Hungarian legislation and it does not look like that the situation will change any time soon. However, associations for the sick struggle to make themselves heard and perhaps some isolated drug, such as the famous Sativex, could be approved by the authorities.

Halfway there are other countries, which are increasingly tolerant of cannabis. Croatia and Macedonia have recently approved marijuana for therapeutic use and its sale in pharmacies, while Serbia and Slovenia have also recently legalized cannabis-based products.

In these latter countries, pressure from the sick and their relatives has recently increased. In Slovenia, governmental and non-governmental organizations have asked the country's Ministry of Health to clarify the policy on cannabis and to protect its medical use. There are about 160 patients registered to be treated within a limited program that allows the consumption of synthetic THC. However, the number of Slovenes who do so illegally is around 30,000, a significant amount taking into account its total population of 2 million people.

Dean Herenda, a secretary who worked for the Slovenian Ministry of Infrastructure for 17 years, has become one of the country's most well-known medical cannabis activists. In 2011 she knew of the therapeutic effects of cannabis extract and did not hesitate to defend it. However, her greatest struggle came a few years later because of his family history. In a period of three months she underwent the death of her parents and that of her sentimental partner from different diseases. "Cannabis extract helped them all, but unfortunately it was too late to save their lives," she lamented. Since then she leads a federation of associations for the use of substances like this. "Our goal is to change the inhuman laws on the cultivation, possession and use of cannabis in Slovenia," says Herenda. 

In October 2016, in the presence of Herenda and other activists like Božidar Radišič, a debate on cannabinoid-based medicines began in the Health Committee of the Slovenian Parliament. The members present voted a legal framework that allowed the cultivation, distribution and prescription of cannabis flowers and oils for the treatment of the sick with the costs covered by the public health system. Thus, the Slovenian Ministry of Health is expected to submit a legislative proposal on cannabis by the end of January.

In short, these are some advances that help Eastern Europe to pave the way for more progressive legislation. Even so, much remains to be done in a matter as serious as health and improving the quality of life of patients.