Greece: six years later, is legal access to medical cannabis finally in sight?

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Greek patients hope to finally have access to legal cannabis-based medicines in 2023, six years after the law was first amended.

The construction of the first medical cannabis production facility in Greece has been slow to materialize and thousands of patients still rely on the illicit market despite the medical cannabis reclassification in 2017.

In late January, Tikun Olam Europe, a subsidiary of Israel-based cannabis company Tikun Olam, announced that operations had begun at Greece’s first medical cannabis production plant.

The vertically integrated production unit is located on a private plot of 56,000 square meters in Korinthos, following an investment of more than 40 million euros.

The installation has been welcomed by the Greek authorities and patient associations, with the first products expected to be brought to market in the course of 2023.

The Minister of Development and Investments, Mr Adonis Georgiadis, called the event a “historic day” for Europe and a step towards providing Greek patients with “pharmaceutical cannabis products”.

Mr. Georgiadis commented: “Today is a historic day not only for Europe and investment in Korinthos, but also because today we are paving the way for something that did not exist in Greece – a way to provide Greek patients with pharmaceutical cannabis products. But also a means for a product that we can export all over Europe, because this unit has the capacity to make huge exports to all the major countries in Europe and therefore Greece will play a leading role in the years to come, spearheaded by this factory and the other factories that will come to work on what is called medical cannabis. »

SYRIZA MP for Korinthos, Georgios Psychogios, added: “I would like to point out that despite the fact that when this framework was made it was objectionable to many, I am happy that we are now here to monitor the development of medical cannabis. both for investors and for patients who will now be able to access these drugs. »

The context of medical cannabis in Greece

The reclassification of medical cannabis to Schedule 2, was first announced by the then Prime Minister in 2017, following a campaign by mothers of children with severe epilepsy, who collected more than 45,000 signatures.

This meant that cannabis could be legally prescribed and was then approved for use for three conditions: multiple sclerosis (MS), chronic pain and cancer-related cachexia.

In 2018, a more extensive law was introduced outlining licensing requirements for companies wishing to produce medical cannabis products in Greece.

But since then, progress has been slow.

A handful of patients have been able to obtain pharmaceutical cannabis drugs, such as Epidyolex and Sativex, through individual import applications, but the process is long and complicated. At the end of 2022, the first patient in Greece to receive Sativex did so after an 18-month battle.

A ban on the import of medical cannabis

In November 2021, the Greek government introduced a ban on the import of cannabis products, which as a member of the EU goes against free market regulations.

According to sources in the country, this measure was aimed at protecting the internal market and encouraging foreign companies to invest in Greece.

However, this means that any progress towards a robust legal medical cannabis market has slowed considerably.

“We were one of the first in Europe [à légaliser] and we’re going to be the last to get on the boat,” says Jacqueline Poitras, founder of patient advocacy group MAMAKA, which has campaigned for access to medical cannabis for her daughter.

“The cannabis import ban in Greece was a very hard blow for us. [À l’époque] we were in conversation with companies trying to get products here…but the ban meant we just had to sit and wait. »

Ms Poitras believes the import ban is unlikely to be lifted under the current government unless a company is prepared to take legal action in European courts.

Jacqueline Poitras, Founder of MAMAKA

Jacqueline Poitras, Founder of MAMAKA

Legal cannabinoids and home cultivation

In the meantime, Greek patients have been forced to continue to access their medicines through the illicit market, by growing their products themselves or importing oils illegally.

Many make do with CBD, which is widely available in retail stores and over the counter in pharmacies.

“Fortunately, a very large portion of the population is doing quite well with CBD and we have a very healthy legal cannabinoid market here. You can find CBG, CBN, and just about every minor cannabinoid,” says Poitras.

“But everyone who needs THC orders it from abroad and everyone who buys flowers does so illegally. There is a huge underground movement of people growing their own product. »

The first legal products are expected in 2023

The first flower products from Tikun Europe are expected later in 2023, with the oils not expected to be ready until the first quarter of 2024.

A government announcement on January 3, 2023 confirmed that the cost of these drugs would not be covered by the country’s public health insurance system and would have to be funded privately by patients.

Ms Poitras, who also represents Greece on the International Cannabinoid Medicine Alliance (AIMC) patient council, says the company is aware that its primary concern is to ensure prices are affordable for patients. .

“The entire economic burden rests on the shoulders of the patients,” she says.

“We expect the retail price to be slightly higher than the illicit market, i.e. 11-12 euros per gram. For a while they will be the only ones in the market, but we have quite friendly cooperation with them and hopefully we can find ways to make this product affordable for patients. »

A number of other companies are reportedly in various stages of the licensing process, with more facilities expected to be operational by 2024.

“A healthy market needs variety; it needs competition,” adds Ms. Poitras.

“Once we have a bit of competition in the market, it will bring prices down.”

Hope on the horizon?

The recent creation of a Greek company for cannabinoid drugs (Hellenic Medical Association for Cannabinoids, HMAC) – a body that will officially represent doctors, clinicians and pharmacists interested in the field of medical cannabis – is also a “significant step forward” for the sector.

Separately, Ms Poitras hopes the addition of a pediatric neurologist to the committee advising the Greek Pharmaceutical Association on medical cannabis could lead to approval for its use for children with epilepsy and autism. .

Expanding the range of conditions for which cannabis can be prescribed is a cause for which MAMAKA and other patient advocates in Greece continue to campaign.

“It’s a very important moment,” says Ms. Poitras.

“Patients have more hope now because we no longer look two years ahead before we can get legal products. We are at the finish line”.

She adds, “We will continue to fight for cannabis to be covered by health insurance, but as long as we pay, we should be able to get it prescribed for any condition. »

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