Shortages of medical cannabis in Malta are leaving patients with no choice but to turn to opioids or the black market, ReLeaf’s Andrew Bonello told Cannabis Health.
Patients have been ‘left in the dark’ after Malta ran out medical cannabis this week – but it’s not the first time this has happened.
According to activist group ReLeaf Malta, which campaigns for the regulation of cannabis in the country, shortages have been an issue since the drug was legalised for medical purposes in 2018.
“The situation has been very challenging in the past weeks, but also throughout 2019 due to out of stock medicine,” said ReLeaf president Andrew Bonello, speaking to Cannabis Health.
“Patients have also frequently complained that some of the medicine – when available – has a close expiry date, even after being out of stock for a long period.”
He added: “Patients have been asking us why there was no official communication from the Medicines Authority or by the Parliamentary Secretary. They highlighted that it is only when ReLeaf and other news portals reported the matter that local authorities turned their attention to their suffering.”
ReLeaf said they have asked multiple stockholders why medicinal cannabis is out of stock but have received conflicting information.
“Importers are explaining that the Medicines Authority requested additional tests, whereas the Medicines Authority explained that the importers are given ample notice regarding applications and compliance,” said Andrew.
“More recently, the Parliamentary Secretary Hon. Deo Debattista claimed that there is currently a global shortage of cannabis. We wrote to one of the leading European medicinal cannabis companies and they informed us that there is no global shortage – we are confused as to what is happening.
“It is difficult to understand what is being done to ensure the right to health of medicinal cannabis patients is being safeguarded.”
Patients are being left with few options, with only Bediol believed to be offered as an alternative to their medical cannabis prescription.
There is a considerable difference in THC levels between Bediol and Bedrocan and Pedanios.
The latter reach a THC level of 22 per cent, whereas Bediol is a CBD dominant strain of only 6.3 per cent THC.
“Any person with the minimum information about cannabis knows that high THC is required for chronic pain and cancer patients,” said Andrew.
“It is therefore baffling, why pharmacists were suggesting to medicinal cannabis patients to get a prescription for Bediol when Bedrocan and Pedanios were out of stock.”
He continued: “It is having a detrimental effect on the patients and potentially endangering their lives when using opioid based medications.
“Patients end up sourcing their cannabis from the illegal market, and thus being exposed to all the negative effects of the illicit market.
“The most tragic reality is that patients are not allowed to grow their own medicine or find a compassionate grower. This continues to further exacerbate their problems and gives no concrete alternatives to address their pain.”
ReLeaf has campaigned for Maltese patients to be allowed to grow a limited number of cannabis plants to ensure they have safe and more affordable access to their medicines.
Under the current system those who require large doses are paying between 500-900EUR a month for their prescriptions.
Meanwhile others are being barred from applying for medical cannabis all together.
According to ReLeaf anyone with a history of problematic substance use, who entered into contact with rehabilitation services, is being refused a prescription on the grounds that medicinal cannabis could lead them down a path to addiction.
“ReLeaf Malta feels that the current system is ostracising those who have already probably faced discrimination and isolation in previous years, said Andrew.
“It is also potentially endangering their lives if prescribed opioid based medications. Overall, it continues to confuse the local population as to what cannabis is and how it relates to the body and mind.”
Despite the stigma of using medical cannabis meaning many Maltese patients are reluctant to speak out, Andrew told Cannabis Health that several had come forward to say they had been affected by the current shortages.
“Various patients reached out to us and complained that they are being left in the dark by a system that is supposedly working to promote public health and their right to access medicinal cannabis,” he said.
“It is clear that the current system is not working in favour of patients’ rights and raises multiple questions on why the law was drafted in a very restrictive way, making it very difficult for patients to secure their right to access medicinal cannabis in an affordable and continuous manner.”
US Congresswoman speaks out about how cannabis helped her depression
Nancy Mace spoke out about using cannabis to help her depression after experiencing a traumatic event as a teenager
A Republican congresswoman who has proposed a federal bill to legalise cannabis has spoken out about her experience using cannabis to combat depression.
It also includes expungement for non-violent cannabis crimes and imposes a revenue tax that would support reinvestment into communities hurt by the war on drugs.
The bill titled the States Reform Act would federally legalise and tax cannabis has been proposed ahead of competing Democrat proposed bills. While the bill was originally proposed in July, Mace shared her story after officially filing the State Reform Act in November.
At the end of the discussion, host, Lisa “Kennedy” Montgomery asked the congresswoman if she smoked cannabis.
Nancy replied: “When I was 16, I was raped. I was given prescription medication that made the feelings I had of depression worsen, and I stopped taking those prescription drugs and I turned to cannabis for a brief period of time in my life.”
She added that she believed her experience with cannabis made her more sympathetic to veterans who may use cannabis for conditions such as post-traumatic stress disorder (PTSD).
— Kennedy (@KennedyNation) November 17, 2021
Bill protection for veterans
The congresswoman explained that the new bill is “particularity protective of veterans, ensuring they are protected, not discriminated against and that the US Department of Veteran Affairs can utilise cannabis for their PTSD.”
She added: “When I talk to vets and I see that pain, it hurts because I felt that pain before in my life. Veteran suicide, we see every single day.”
One other provision in the bill is that cannabis would be under the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau (TTB) instead of the Food and Drug Administration (FDA). The FDA would have some involvement similar to its current control over the alcohol industry.
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Mace has already won an exception for rape and incest victims in a fatal fetal heartbeat bill. She mentioned her history when it came to proposing that bill in 2019.
She said: “I’ve had family that have overdosed from hardcore opiates and prescription drugs. And I’ve mentioned part of this in 2019, at the time I got the exception for rape and incest in the fetal-heartbeat bill I told my story about being raped when I was 16, but I’ve never said this part publicly before: I was prescribed antidepressants afterwards, and it made my feelings a lot worse. And so I started using cannabis for a brief moment, for a time in my life. It helped me. It cut down on my anxiety and helped me get through some dark periods.”
Study: States with full legal access show fewer registered medical cannabis patients
“If true, this could have implications for public health and policy,” say researchers.
Study shows U.S states where cannabis is legal for recreational purposes have experienced a decrease in patients registering for medical cannabis programmes.
The study on different US states, published in the International Drug Journal, revealed that numbers of registered and active medical cannabis consumers increased while it was not legal for recreational use.
Researchers in Arizona took data from the medical cannabis registry from two dozen states between 2013 and 2020. These are mandatory registries that record the number of medical cannabis patients. They analysed the data to see if there were any changes around the times that recreational legalisation was introduced.
There are currently 19 states in the US that have legalised recreational cannabis including New Jersey, Vermont, Arizona and New York. However, more states have medical cannabis programs although some are still not operational. Some states such as Colorado have had recreational access since 2012, the year before the study was started.
Medical cannabis patients
The results confirmed that medical cannabis cardholders increased during times when recreational use was not legal. It then subsequently decreased when it became legal.
It also revealed an increase of 380 patients per 100,000 people per year when just medical cannabis was legal. This corresponded to a decrease of 100 patients per 100,000 after recreational cannabis was allowed. The researchers noted that active registered active male patients decreased faster than women. In states where only medical cannabis was legal, the older age groups (35 or older), increased faster.
They also found that in three states with medical-only use, the results showed significant increases in enrollment from 2016 to 2020 across white, African-American and Hispanic patients.
The researchers wrote: “There is speculation that enrollment in U.S. state medical cannabis programs differs depending on whether adult recreational cannabis use is legal. If true, this could have implications for public health and policy.”
“Findings suggest that recreational cannabis legalisation is associated with decreasing enrollment in medical cannabis programs, particularly for males.”
Fibromyalgia and medical cannabis: “I find my pain is completely gone”
Natalie began experiencing fibromyalgia pain when she was a teenager but wasn’t diagnosed until her 20s.
Natalie talks to Cannabis Health about living with fibromyalgia and how cannabis has helped her with pain relief.
Fibromyalgia can be a debilitating condition leaving patients with chronic pain, fatigue and increased sensitivity. Other side effects can include poor sleep, cognitive issues and headaches. It is thought to affect around 1.5-2 million people in the UK.
Natalie was diagnosed with fibromyalgia when she was in her first year of teaching. She had been experiencing some of the symptoms since she was in her early teens but doctors told her it was growing pains.
“Since I was about 12, I had a lot of pain that came and went with a lot of fatigue,” she explains.
“The doctor’s put it down to growing pains. When I was I was in my first year of teaching, one day I woke up and couldn’t do anything. I was incredibly tired and in so much pain.
“I felt that way for months and I was really struggling. I got my formal diagnosis from a rheumatologist. I had a lot of blood and strength tests to make sure I didn’t have arthritis or lupus because of the similar symptoms.”
Life with fibromyalgia
Once Natalie had her diagnosis, her life began to change. She quit her teaching job as it became too much to cope with when her symptoms were bad. She took on jobs where she could choose her own hours or work part-time.
“I ended up working as a children’s entertainer because it was good money,” she says.
“I could do it over a few days a week and make an acceptable amount of money to cover my bills. I did retail work alongside it.”
When it came to socialising, to stop herself from feeling isolated, Natalie turned to online communities to meet people and make friends.
“I’m not amazing at socialising, so I’ve always found it a struggle. I didn’t stay in touch with a lot of people from university or school because I also have mental health problems that held me back. This isolated me a lot so I did turn to online communities where I met a few people who I’m still friends with now,” says Natalie.
It wasn’t until she joined online fibromyalgia communities that someone suggested that cannabis may have benefits.
“I never really knew about its benefits, although I knew it would relax you,” she admits.
“People in my fibromyalgia groups said they used medical cannabis and found it helpful. It’s only really been the last few years where I’ve used it properly as a medicine.”
Cannabis may help with the pain experienced by fibromyalgia patients. A recent study on patients diagnosed with fibromyalgia and other inflammatory rheumatic diseases reported a reduction in pain levels following medical cannabis use. The study surveyed 319 patients about their use of medical cannabis products. Those with fibromyalgia reported a mean pain level reduction of 77 per cent while 78 per cent also reported sleep quality improvement.
Although Natalie has family members who use medical cannabis in legal states in the US, she hadn’t considered using it herself. Despite being open to the idea of a prescription, she says there was very little mentioned to her about pursuing it by her doctors.
“It’s weird because it’s almost like a whisper network. I would never have known about the private medical thing because it’s not really mentioned and the health sector doesn’t talk about it. They don’t actively tell you about prescriptions,” she says.
Natalie has found that cannabis helps her most with the pain.
“A lot of the time, I get shoulder or lower back pain. If other people knew my pain level, they would have a different idea of what pain is, but I guess I’m used to it,” she says.
““Due to the way I work, I don’t use it until the evening. At the end of the day, I’ll use cannabis and I find my pain is completely gone. Sometimes, if I’m struggling then I’ll have a nice bath, have my cannabis and that’s the perfect combination.”
Natalie is guarded about her cannabis use because of the stigma but also due to her job. She is open with some of her friends but not her family. She chose to use only her first name to avoid being identified.
“My parents are from a different generation and they are quite conservative too. It’s very different for them so they don’t understand how it would help. My clients obviously don’t know, as some wouldn’t like it. [But] I have clients in the Netherlands who don’t drink but will go for a joint but it’s different for me,” she says.
“People still struggle to admit to taking medication because of the attitude. I’ve tried Tramadol, Xanax and all sorts of things that have more impact on how you feel, physically and mentally compared to cannabis. But that’s acceptable because it’s prescribed by a big pharmaceutical company.”
Natalie feels that there is a lot to be changed in terms of education, so that people know the benefit of cannabis when it comes to conditions like fibromyalgia. She also highlighted that there should be more awareness of the options out there when it comes to accessing a prescription.
“More people should be aware of the benefits of what it can do, rather than it being a niche internet topic or having a weird stigma around it,” she adds.
“Medical professionals need to be more aware of how it can help and the different avenues that people can go down to get prescriptions.”
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