Norway: towards a reform of medical cannabis?

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Norway, one of the most cautious states in Europe when it comes to cannabis liberalisation, recently held a public meeting to discuss access to medical cannabis.

The event, which took place in Oslo on January 20, 2023, brought together politicians from across the political spectrum, alongside healthcare professionals, patient representatives and industry stakeholders.

According to MedCan Norway, which organized the event alongside Normal Norge and FTR Oslo, it was the first such event in the country, representing the “very first steps” towards reform.

With Norway’s first medical cannabis conference slated to take place this year and medical cannabis studies underway at Oslo University Hospital, Norway may soon be catching up with its neighbors when it comes to cannabis.

Cannabis in Norway

The small Scandinavian country, which has a population of just over 5.4 million, is one of around 15 countries in Europe to have technically legalized medical cannabis.

In 2016, the Norwegian Medicines Agency approved GW Pharma’s Sativex for the treatment of multiple sclerosis, while issuing new guidelines for a specific medical cannabis approval framework.

While it is understood that other products are available “in special circumstances”, it remains incredibly difficult for any patient to access medical cannabis.

According to an annual survey conducted by the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) in collaboration with the Norwegian Institute of Public Health, just under a quarter (24.5%) of the Norwegian population aged 16 to 64 year olds have tried cannabis at least once in their life, with 5.3% reporting having used it in the last 12 months.

Another survey by Norml Norge suggested that medical users make up about 29% of the total cannabis users in the country, and only about 5.9% of them get it from their doctors, of which only 0.8 % have it delivered to a Norwegian pharmacy.

Due to difficulties in obtaining medical cannabis, 72.4% of patients obtain it on the black market, while 3.8% grow it themselves and 1.5% buy it abroad.

CBD is also classified as a prescription medicine in Norway, which means that you can only buy limited amounts of CBD on prescription, and you cannot order it privately, in the country or abroad. .

Despite this, Norway appeared to lead its neighbors in terms of drug reform in 2017, when it voted to decriminalize drugs and focus on harm reduction and treatment rather than punishment. However, these progressive reforms were then rejected three years later, in 2021.

Barriers to Access

According to Norml Norge: “Medical cannabis is technically legal in Norway, but it is extremely difficult to obtain, and doctors don’t know much about it or become downright hostile to patients seeking treatment. Therefore, many Norwegians seek treatment in the Netherlands or Denmark. »

Thomas Skovlund Schnegelsberg, CEO of Stenocare, who spoke on both panels at the recent Oslo event, says several hurdles were raised.

After chatting with one of the three politicians present about Norwegians’ state of mind when it comes to cannabis, he said he “feels that in Norway you are quickly stigmatized if you are a self-medicating patient with medical cannabis.

“If the doctors, by chance, realize that you have been self-medicating, you will actually be blacklisted, which means there will be a lot of treatment offers that you will never get. . »

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Stenocare logo

He goes on to say that based on discussions among the medical professionals present, including Sigurd Hortemo of the Norwegian Medicines Agency, the body responsible for approving new products, many opinions continue to be based on research. published more than ten years ago.

A white paper published in 2012 “concluded that the side effects were too severe” because there was little research at the time “that could support that medical cannabis had utility and value”, thus the notion of reform was “completely ruled out”.

“So that’s still the starting point, ten years later, but it was also mentioned during the debate that they expected a new white paper to be published, most likely this year. Of course, it will be based on all the new research and evidence published since,” added Schnegelsberg.

Steps to progress

While the ‘sober’, ‘factual’ and ‘patient-centred’ debate clearly highlighted the problems facing the sector in Norway, it also raised hopes that change could be on the way.

MedCan Norway President Julie Welde told BusinessCann, “The situation in Norway is very unclear at the moment, and many patients are now losing their prescriptions.

“Awareness of cannabis as a medicine in Norway is generally very low, which is why it is almost never prescribed. This is what MedCan Norway wants to change”.

The group says it is working on a number of initiatives to spread knowledge to “doctors, politicians and anyone working in healthcare”, including launching more events throughout the year.

“We also anticipate and hope that Norway’s first conference focused on medical cannabis will take place in 2023.”

Oslo University Hospital has also requested funding to launch a study on medical cannabis, which could have a significant impact on prescribing attitudes in the country.

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