Advocates and patients alike were happy when the Spanish government decided in June to let people with a wide range of health problems use the public health system to get medical cannabis.
Although Spanish researchers have been at the forefront of ground-breaking cannabinoid research on cancer and neurological illnesses for numerous years, until recently, it was not possible to receive a prescription for standardised and controlled medical cannabis products from a doctor in Spain.
Before this, patients tended to exist in legal limbo. There are several clubs around the nation where people may legally purchase cannabis. Alternately, those who were so motivated may have taken the chance of cultivating their cannabis plants (so long as they weren’t in plain sight).
To this end, the government has issued licences to a handful of Spanish manufacturers to grow medical-grade cannabis, but exclusively for export to nations like Germany, Poland, and the United Kingdom.
LONG ROAD TO REGULATION
What Were The Steps That Led Up To This Point?
The Spanish Medical Cannabis Observatory has been persistently meeting with Spanish political parties for the past seven years, with President Carola Pérez and Vice President Professor Manuel Guzmán at the helm. Until not too long ago, most Spanish political parties were against any changes to the regulatory framework.
“At times it looked like there was a cul-de-sac with no escape,” says Professor Guzmán of Project CBD. “At other times we were extremely positive and other times gloomy, because at certain stages it seemed that there was a cul-de-sac with no exit.”
The first indicators, which resulted from the socialist party now in power (PSOE) taking an overly cautious approach, indicated that access would be limited, with many ailments known to benefit from cannabis being excluded from the program.
Patients with endometriosis, multiple sclerosis, epilepsy, chemotherapy-related nausea and vomiting, cancer pain, and non-cancer pain (including neuropathic pain) will be eligible for the study. However, due to some last-minute negotiations, it was agreed that these patients would be suitable.
Even though it is thought that 300,000 patients in Spain could benefit from the medical cannabis programme when it is finally put in place, many more patients with conditions like fibromyalgia, inflammatory bowel disease, cancer-related cachexia, and glaucoma will still have to buy their cannabis medicine from cannabis clubs, the black market, or grow their own cannabis plants.
“I recognize that there is room for improvement in everything,” Guzmán said. “Of course, we would have preferred for there to have been additional signals included… On the other hand, if you had told me two or three years ago what we have today, I would have thought that it’s fairly excellent. “
FLOWERS IN PHARMACIES
It all depends on how the Spanish Health Agency interprets the first draught of the rules for those who qualify, which has until the end of the year to develop a medical cannabis program.
They specify that cannabis-based preparations – including magistral formulas with varying THC: CBD ratios that are made onsite in pharmacies for individual patients – will be prescribed by specialist doctors and dispensed by hospital pharmacies. However, Guzmán and his colleagues at the Observatory hope that this will be extended to general practitioners and community pharmacies as well.
Many patients vape cannabis flowers to control sudden pain and nausea. They are worried about future access through regulated channels, since it isn’t clear if cannabis flowers, which aren’t specifically mentioned in the draft, would be included in the program.
Guzmán feels that the success of a medical cannabis programme will depend on the amount of money and resources that are placed behind it. This is in addition to whether or not a programme can be implemented in six months.
It is necessary to provide medical professionals with education and training on the medicinal applications of cannabis, and there should be products accessible for both prescription and personal use. “If there is a regulation but there are no goods or physicians, then it will be meaningless,” adds Guzman. “If there is a regulation but there are no products or doctors.”
The patient’s out-of-pocket expense for filling cannabis prescriptions will also be an essential factor. Guzmán expects the majority of the costs to be covered by the country’s social security system; however, the Spanish Health Agency will ultimately decide who will bear the financial burden.
He states, “We (the Medical Cannabis Observatory) will have to keep a very close eye on things to determine whether or not the primary criteria are satisfied.” “We still have a part to play in the process, but we must keep observing and being as engaged as possible to have the greatest and most generous program possible.”
In any case, 2023 will be the year when, after a hard-fought campaign, at least some patients in Spain will finally be able to get a legal prescription for medicinal cannabis.