Throughout the centuries, the cannabis plant has proven to be a source of healing powers, serving a wide range of physical and mental ills and inconveniences. While going through them you first feel the urge of enthusiastically listing the matter, until you find yourself in such a flood that you decide to drop back. The list is huge. Let’s see if we can disentangle some of the complexities with the focus on Europe.

Where do the healing powers of cannabis come from? There is one word that you come across all the time in relation to the medical effects of cannabis: cannabinoids. OK, so you wonder: what are they and what can they do? Well, Cannabinoids are chemical compounds in the plant, originally meant to protect them against natural enemies and ...” But wait! We already talked about chemical compounds in the plant, but then they were terpenes and now you are telling me there are other healing compounds as well called cannabinoids?” Yes, there are. In fact, the current idea is that cannabinoids and terpenes work together in something called the entourage effect, which means that cannabinoids such as THC and CBD, along with the hundreds of other compounds, among which terpenes, are meant to cooperate to do their healing job. Although many studies have indicated that the curing abilities of cannabis are for real, the problem is that they cannot be called ‘scientific’, because of their small scope. This makes the ground on which authorities make their judgements and decisions rather thin, however cannabinoids are an exception here. They have been subject of investigation for a long time, with the result that eventually medicine could be produced with these components. A relief because there are hardly any countries in Europe where people can legally grow their own medical cannabis.
There are medicines fully made of cannabis, like Savitex-spray, available in twenty-eight European countries.

Another is European market leader Bedrocan with all kinds of cannabis products and accessories. Both have their own (dis)advantages. All Bedrocan products are for instance being treated with gamma radiation to remove pesticides, heavy metals and micro-organisms. A requirement from above, but one that has made patients worry about its effectiveness and safety. Many of them prefer to buy cannabis on the free market instead of going to the pharmacies. Furthermore, price, supply and regulations are obstacles. Because of that projects are being implemented to lower the price of medical cannabis products. In the Czech Republic this is done under the wings and with the knowledge of Bedrocan itself and in Italy the army has been made responsible, not only for the safety, but also for the production of medical cannabis! This year they are trying to produce half of what is normally being purchased from abroad. The quality? Time will tell. 

< Cannabis Flos from Dutch producer Bedrocan

And then there are the single-molecular, synthetic THC products like Dronabinol and Nabilone (available as Marinol and Cesamet). Thirty years ago these were allowed to be developed but they have never been popular with patients and care-professionals. Although they have been prescribed much more often than Savitex, it looks as if the latter is rapidly overtaking because of its availability, acceptation, effects and popularity. It will be a good step in the direction of the acknowledgement of the superior medical value of fully-cannabis-made products in comparison with the synthetic single-molecule.

And what about regulation? If you look at Europe, you see most countries moving but many in different ways. The Netherlands, The Czech Republic and Spain are the countries that are most positive towards medical cannabis. Very remarkable is The Czech Republic, because of the pace in which this country has turned away from the heritage of the Soviet Union and has introduced a modern, progressive drugs-policy with which they belong to the pioneers in Europe. These three countries are closely followed by Germany and Italy, who are making rapid progress. Belgium has an ambiguous attitude towards cannabis, but nevertheless many patients have easy access to medical cannabis, or they can grow it themselves (one plant at the time). Several eastern European countries have only just started to get rid of the drugs-policy from the Soviet period and from which signs are still to be found everywhere in this area. Some of these countries, among which Slovenia, Macedonia, Croatia and Serbia have gradually become more tolerant towards cannabis. We may expect progress here. And there are countries where we can see some movement, but where medical cannabis is not available yet, apart from some specific cases, or who do not intend to discuss the necessary changes in legislation. We are talking about countries like France, Ireland, Iceland, Portugal, the Baltic States and the Scandinavian countries. The real laggards are Greece and Russia, who still breathe an atmosphere of prosecution. The situation is complex and is therefore European-wide still at the preliminary stage. In some countries for instance that have adopted legislation for legal medical cannabis the actual use of the stuff is prohibited. In other countries certain cannabis derived products or synthetic cannabinoids are being prescribed, whereas the plant as such is illegal. However, there are also countries with a smooth legislation that allows the growth of medical cannabis for personal use, as well as cannabis clubs that provide users with medical cannabis.

We are confronted with a patchwork of different regulations and agreements, but with an ever-growing mutual overlap. Let’s just trust the ongoing and upgoing line, grab it firmly and hold on tight.