In a new series, Cannabis Health News talks to women who have experienced emigration in search of safe, legal cannabis access.
Imagine packing your entire life into boxes and emigrating with your family to a new country just to be able to easily access your medication.
Emigration is sadly nothing new to Ireland. Over the years, thousands have left to access a better life abroad in places such as England, Canada and America. The numbers are staggering with the highest year of emigration recorded as over 54,000 in 2012 at the height of the recession.
While those figures are slowing down due to the growth in the Irish economy post-recession, there remains a steady flow out of the country. Adding to the broad range of reasons for leaving is the state of the Irish medical cannabis system.
There are currently two systems in place: the ministerial license which allows patients to receive their medication from the Netherlands and the Medical Cannabis Access Programme (MCAP). The MCAP only considers epilepsy, cancer nausea and multiple sclerosis. There has been widespread criticism that this does not go far enough to recognise the broad spectrum of patients who use cannabis especially chronic pain patients.
Alicia Maher is one of the most high profile cannabis patients in Ireland. She emigrated from Cork to live in Spain for a few months during lockdown but now cannot travel home.
“I went into hospital to have my tonsils removed and there were complications. I ended up having three operations and was in the hospital for three months. While I was in there, I started to bleed from the bowel then they said I had ulcerative colitis or Crohn’s disease. They couldn’t figure out at the time what it was because my colon was so badly damaged.”
“One night when I was in the hospital, my large intestine broke and I had emergency surgery to remove my entire colon. I woke up with a bag on my stomach. When I went to have this removed a few years later, they discovered precancerous cells in my rectum. They needed to remove my rectum immediately which meant the bag on my stomach became permanent.”
Sadly the surgery meant more complications as Alicia developed Methicillin-resistant Staphylococcus aureus (MRSA) which took years for the wounds to heal. MRSA is a type of bacteria that’s resistant to several widely used antibiotics and is often referred to as a superbug. It can be extremely difficult to treat.
“I had to heal from the inside out but it took years. It was the first time I’d ever had pain like that. I eventually found out that my coccyx bone was actually broken. I had to give up work because the pain was just too much. My doctor started me on medication like Tramadol with injections every three months. I developed sciatica where you get pain down your leg and I couldn’t walk at all. They upped the pain medication I was on and added Lyrica and Amitriptyline. I had to wear patches all the time. The side effects were atrocious.”
Alicia found she was sleeping most of the time as a result of the tablets. A fall on her broken coccyx bone sent her to hospital in 2018. The staff treated her as if she was looking for medication rather than being in pain. They refused to even X-ray saying there was no point as they knew it was already broken.
It was then that Alicia decided to try cannabis.
A family friend in America sent over a vape for her to try. Despite never trying cannabis before, she was surprised that it worked from the very first time. She was determined to reduce the 30 different opioid tablets she was on which took about 6 months. As she detoxed from the pain medication, it was then that she started to think about the issues surrounding access in Ireland.
“I needed to speak to my GP to tell him I had come off half my medication. I was so worried thinking he was going to give out to me but looked at me and said he had seen a difference straight away when I walked in.
He said he would apply for the ministerial licence. However, I needed a pain consultant which I didn’t have as mine had left the HSE. They said they weren’t denying the license but because its chronic pain, they couldn’t do it until I had a consultant.”
This started a series of appeals to get the ministerial license granted. Alicia was eventually given an appointment with a consultant who agreed with her doctor that the cannabis was working for her. It finally came through in May 2020 but there was one huge problem, the COVID crisis had begun.
Emigration to Spain
By this time, Alicia had moved to Spain and lockdown had begun. Spain had one of the toughest lockdowns in Europe among spiralling cases of COVID. Alicia and her husband had decided to move after a few bad experiences with accessing cannabis illegally in Ireland. They decided to leave their PhDs, families and life at the University of Limerick to move. They initially moved out in November with a view to returning in March.
She had begun to look into the cost of cannabis through her license in Ireland but it was then she discovered that it would EUR€2,500 every three months for her medication.
In Ireland, medical cards can be granted to certain patients to cover the cost of their medication. The cards are means-tested and cover the cost of a patient’s medications. Alicia discovered that there was no coverage on the medical card because it was for chronic pain.
“How was I supposed to pay €10,000 a year for the cannabis prescription because there is no coverage on the medical card? They said if I suffered from epilepsy, multiple sclerosis or vomiting associated with chemotherapy then I would get refunded. The only reason they won’t refund it is because its chronic pain which feels like discrimination based on the condition you have.”
Alicia chose Spain because of the access to the cannabis clubs. The cannabis social clubs are private, non-profit organisations where users can register to access their medication safely. However, during Covid, all the clubs suddenly closed for lockdown.
“It was perfect at the start due to the cannabis clubs but then they closed for three months. I got in touch with a clinic in Madrid and sent them my prescription so they took me on. They knew I was stuck here and had a prescription at home so it was on a discretionary basis. They posted my order down to me every month at a fifth of the price of back home.”
One of the hardest parts of emigration is the difficulty in returning home once you have established a life in a new city. Each passing year means more roots, connections and ties to your new home. Prescriptions not being recognised and spiralling costs add another layer of difficulty into the mix. The threat of something happening to a loved one during lockdown has been especially difficult for those away from home.
“It’s hard not being able to go home when I want to especially during covid. I was afraid something would happen to someone at home. I contacted the International Narcotics Control Board who are the regulatory people for medicines across the EU for controlled drugs. I said I had an import license to bring cannabis into Ireland and a prescription from my doctor too. I asked if I needed to, could I bring my medication with me? They referred me to the HSE who said absolutely not.”
“I’ve emailed the Minister for Health, Stephen Donnelly and Frank Feighan over twenty times. I only got a response last week which was identical copy and paste responses from the internet. I was disgusted when I saw the emails. Two different departments and identical emails, that felt insulting. I emailed a five-page letter about my medical history and my family back home. They sent back information which was freely available on the internet.”
So what would Alicia say to anyone thinking about emigration for medical cannabis?
“If someone was waiting in Ireland until pain is added as a qualifying condition, I would tell them not to waste time. I got a call from Gino Kenny, a politician from People Before Profit who said he thinks they may not add it until the end of the pilot scheme for MCAP which isn’t even up and running yet. It could take about five years. He doesn’t think reimbursement is going to happen either.”
“I would just tell people if they are thinking about it, relocate because you will get better access somewhere like here with the cannabis clubs. If it’s for quality of life purposes then there is no question whatsoever.”
ADHD Awareness Month: “There is more to ADHD than just annoying stereotypes”
To mark ADHD Awareness Month, we are focusing on patient’s stories of using cannabis to help their symptoms and manage their daily lives.
For ADHD awareness month, Cannabis Health meets patients who use cannabis to treat the symptoms of the condition.
In the first of our series on ADHD, we meet Jakob Fullagar who was diagnosed with the condition as a teenager. He treats his condition with a combination of prescription medication and cannabis.
What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition. It can affect people’s behaviour in that they can seem restless, they may have trouble concentrating and seem impulsive. While a lot of people are diagnosed at a young age, there are adults being diagnosed with the disorder.
It is thought that ADHD presents in three different ways:
Inattentive: An individual may struggle to organise or complete tasks, pay attention to details, follow instructions or conversations. It also causes a person to be easily distracted or to forget parts of their daily routine.
Hyperactive: A person with hyperactivity may fidget or move or talk a lot. They can struggle with sitting still for a long period of time due to feeling restless. They also struggle with impulsivity and may interrupt frequently, speak at inappropriate times or fail to wait for their turn. They may be more accident-prone.
Combination: They present symptoms of both hyperactivity and inattentiveness.
ADHD and Jakob
Jakob was diagnosed with ADHD as a teenager. As with a lot of ADHD children, he was labelled the naughty child and was placed into therapy. ADHD symptoms are often mistaken for emotional or disciplinary problems. It is estimated that ADHD children hear an average of 20,000 more negative messages than neurotypical children by the time they are 10-years-old.
In Jakob’s case, teachers also failed to recognise signs of the condition in his behaviour.
“I was a troublemaker as I caused problems and couldn’t concentrate. It took about seven to eight years of therapy before a psychiatrist said it actually might be ADHD, which made a lot more sense.
“I was straight away labelled as a naughty problem child and there was no point where a teacher turned around and said there may be something underlying there,” said Jakob.
As well as therapy, Jakob was placed on a low dose of Concerta. Concerta is a common ADHD medication containing methylphenidate similar to Ritalin. It is thought to improve focus in attentive presentations and also decrease risky or hyperactive behaviour.
He continued: “They just kept increasing it in three or four weekly increments. It tends to work fairly well. I can normally get about a year and a half before I feel I need an increase.”
Jakob had been consuming cannabis recreationally before he realised that it could be beneficial for his ADHD. It wasn’t until he received his diagnosis that he realised he had been subconsciously medicating with it.
“I started [using cannabis] before I actually knew I had ADHD, a friend recommended it,” he said.
“It wasn’t until I got diagnosed and talked about it with doctors that we realised I had been unknowingly self-medicating and self-managing. But it does work. I realised I could chill a little bit and I’m less all over the place.”
The studies of cannabis on ADHD are few but promising. A small Israeli study from 2020 on medical cannabis patients suggested that CBN may help to reduce symptoms. The study involved 59 patients who were asked to record their ADHD, sleep, anxiety patterns using questionnaires. Those on a higher dose of CBN recorded less medication use while those on the lower doses recorded less anxiety. CBN is a controlled substance in the UK as it is created when THC breaks down and becomes oxygenated.
Jakob finds that medical cannabis has pros and cons when it comes to symptom management.
“In terms of benefits, it’s absolutely taken me down a bit when it comes to energy levels. I am able to think things through after I’ve consumed. I’ll happily be able to sit and properly think out a process rather than just jumping straight in. I’ll take a step back.”
ADHD people can struggle with blurting things out, acting without thinking or failing to recognise risks as they act on impulse. This can have negative effects on their jobs, home lives and relationships. It can be difficult to take a step back to recognise the potential for danger, upset or difficulties.
He added: “I can process and choose an appropriate response. When it comes to being social, it’s much better to be able to navigate situations where I may upset someone by speaking before thinking.”
While ADHD diagnoses are on the rise, there is still a lot of confusion surrounding the condition. This can cause ADHD people to lose jobs, relationships and friendships. A survey from the US ADHD Awareness Coalition showed that more than half of those who participated said they had lost or changed a job because of their ADHD symptoms. A further 36 percent said they had four or more jobs in the past ten years with 6.5 percent saying they had more than 10.
Jakob is honest at work about his ADHD. Although he has just started working in a butchers, the smells, sights and textures don’t bother him. However, he admits that noise is a problem with distraction.
“I started working at a butchers about two months ago and it’s noticeable that I take longer to learn,” he said.
“At the minute, I’m constantly learning new things every day so I explained to everyone at work and said I have a learning difficulty so please be patient with me.
“They have to show me things a few times and supervise me while I try it myself. It takes all of that while I crack a process. Then there are the sensory processing issues that come with it. There is constantly fans, fridges and machinery going on and it’s a running joke that I can’t hear anything unless people shout.”
Sensory overload can happen when a person has input from their five senses that they can process. Multiple conversations, flashing lights, or a loud party can all produce the symptoms. It is common in ADHD, autism, fibromyalgia and PTSD.
ADHD and cannabis stigma
While Jakob is open at work about his diagnosis, he does get frustrated that people feel it’s about just being a stereotype. He believes that cannabis use and ADHD still carries a stigma.
“I think especially around ADHD, there is a stigma. You tell someone you have the condition and they think it’s about hyperactivity, being energetic and funny. There is a lot more to ADHD than just annoying stereotypes,” he said.
“When it comes to cannabis, I think a lot of opinions have changed over time so I don’t tend to say that I use it a lot of the time but the majority of people know that I do. I think the main reason people don’t like cannabis these days is because of the negative connotations around it.”
Jakob added: “I wish people knew we are all trying our best with the resources and strategies we have at that moment but we have to try that little bit harder, unfortunately.
“It’s not all balancing, happiness and excitement, as it can be really stressful.”
CBD brand created by a Welsh athlete releases report on potential health benefits of CBD
The Healthcare Technology Centre (HTC) partners with Welsh brand Hemp Heroes to discover the potential health benefits of CBD products.
The Healthcare Technology Centre (HTC) partners with Welsh brand Hemp Heros to discover the potential health benefits of CBD products.
The Welsh HTC led by Swansea University Medical School collaborated with Swansea and Ireland based company, Hemp Heros. Hemp Heros was co-founded by David Hartigan and martial arts athlete John Philips.
The report was the result of several months of research into the benefits of CBD- based products on a range of conditions. These included epilepsy, side effects of chemotherapy, multiple sclerosis (MS), stress and anxiety.
Speaking with Cannabis Health News, Hemp Heros co-founder David Hartigan explains how an interest in martial arts helped him to meet John and start the company.
Athletes and CBD
David said: “It’s a bit of an interesting story how myself and John met. My background is in business consultancy and I’ve always been into martial arts since I was a kid. John asked my brother who is a musician to do some walkout music for UFC. As John was only newly signed at that time, I wondered if he had anyone to help him with marketing and sponsors. I became John’s manager.”
He added: “I started looking at CBD companies because athletes were starting to use it. I thought there was a huge opportunity to get John sponsored by a company. We did get a few samples from different companies but the quality was hit or miss. Even the instructions when you were trying to read it could be confusing.”
John’s first experience with CBD was not actually on himself but his dog, Alfie. When he became ill, John began treating him with CBD after realising that Tramadol was not working. The vet had exhausted all options for treatment but CBD helped him to recover.
David said: “I have an uncle who is a powerlifter and he has a couple of Irish records. He has a number of injuries he started taking CBD for pain and inflammation. At one stage, he couldn’t even change the gear stick in his car but he has much better mobility and pain management now. So between my story, John’s and the lack of transparency in the industry in the market, we decided to try an investigation.”
David spent six to eight months researching the whole industry speaking to anyone he could about hemp or CBD. He also joined the board for the Irish Hemp Cooperative. They spent months researching everything before finding a supplier to get them started. The brand has now grown from three or four products to over twenty including a successful pet range.
Welsh university study
The brand partnered with Swansea University and are part of the accelerator programme there. They had planned to participate in studies on CBD but unfortunately, COVID hit just as they began to start the studies. The Welsh Accelerate programme aims to create lasting economic value by helping innovators in Wales to translate their ideas into solutions, enabling them to be adopted in health and care.
David explained: “Dr Daniel Rees, who is one of the researchers at Swansea University reached out to us. He had seen our products around the place and wanted to know if we would be interested to do some studies in the life sciences department.”
“The whole idea of the Accelerator programme is to identify potential services or products that can have a positive impact on people’s lives. It improves the lives of the end-user. Dan highlighted that very little research was done on CBD in this context. We are passionate about transparency so we really wanted to push the research. However just as we had hoped to start lab tests, COVID hit.”
The COVID situation didn’t force a complete shutdown but changed the direction of the study for the researchers. As the colleges were closed, there were no ways of getting anyone into a lab for testing so David and the team decided to go down the road of research producing a report on the effectiveness of CBD. The initial study paves the way for future research activities around four key pillars: pain, sleep, anxiety, and recovery.
Lab study to research reports
“What we did was change gears so instead of a lab-based study, we are going to do a more research-based one. We researched the case studies for CBD and hemp-based products along with the history behind them. We looked at different cannabinoids like CBD or CBDA, different terpenes and then unique extraction methods. We went into deep dives on what studies were there for cancer, sleep, inflammation, pain and took them as different pillars. This is what our report contains.”
He added: “We wanted to show some form of evidence for how CBD could possibly work for Parkinson’s by looking at the findings, how the studies are performed? What is the wider picture for sleep or inflammation? This could give us a foundation to build on.”
The next step
Hemp Heros started to submit an application called Smart Partnership to the University for the management side. This would allow them to secure funding to get an associate who would work between the Welsh brand and the university.
“It gives the company the tools and techniques to use these findings and apply them so you can continue your work. We have all of this anecdotal evidence on why people use our products but then the smart partnership would allow us to do a deeper dive and validate what our understandings are.”
He explained: “We have set out three pillars essentially. Sleep is one that we want to investigate and they have a sleep lab there. We want to start out with something quite simple like 20 participants with sleep issues and give them a protocol. They log everything then they take a set dose of our product for a week to see what the impact is. The next step would be to go into the sleep lab to actually monitor what someone’s sleep pattern is, how quickly it works and what the effects are.”
As well as the studies and research they have conducted, the brand is still planning to work with different athletes.
“Should athletes be using prescription pain medications to help with their pain to get through the day? They could have a more natural alternative with no side effects. Your body is already built for cannabinoids, not really for painkillers. That’s why a lot of people have issues with their kidneys when they are on painkillers for so long because they are trying to process everything.”
David is also involved in the advocacy side. He believes that Ireland needs to match the European level to make sure it isn’t left behind. He sits on the Irish Hemp Cooperative Board who are trying to change the laws.
“There are a couple of TDS (Ministers) who said that they would be interested in the sports angle. We aren’t looking for full-blown cannabis legal for everyone but we actually want to just look at hemp and the production because you can get a license but then technically what you grow is illegal. There is a massive gap in the law where the two laws don’t match and we don’t match at the European level. We need to make sure we are on par with our international counterparts.”
Emigration: Access is more than just medical access, it’s also about business
As Ireland continues to enforce prohibition, we meet Aoife McConnell who has moved her yoga business to Spain
In a new series, Cannabis Health News talks to people who have experienced emigration in search of safe, legal cannabis access.
Previous stories have focused on the difficulty of packing your entire life into boxes and emigrating with your family to a new country for access. But there is more to Irish prohibition than patients and access, it’s the loss of local businesses moving abroad.
In our fourth instalment, we speak to yoga expert, Aoife McConnell about moving her life and yoga business, Puff Puff Pose to Spain.
Aoife left Ireland during the summer of 2021 so has only recently arrived in Granada. She packed her entire life into boxes to get better access to cannabis and also, set up a yoga studio with a difference. She runs the popular, Puff Puff Pose, cannabis yoga studio which encourages practitioners to combine relaxing yoga with cannabis. The studio went online during the pandemic but she hopes to be able to establish a physical space now that she has left Ireland.
Safe, legal access abroad
Like most people in Ireland, her use started as recreational when she shared cannabis with friends. While she acknowledges the recreational side, she says she gets all the benefits of cannabis.
Prohibition in Ireland, and all over the world means that most people when they consume cannabis, often they have no idea what they are actually being given. Unlike legal states in America where someone can select what they need and know the THC or CBD content of a strain. Once Aoife became involved in the community, she realised how prohibition also stifles education about the plant.
Her use is mainly recreational however, while in Ireland she was forced to run her cannabis yoga business online or outdoors as it was illegal.
“In the last two or three years, I’ve become a lot more involved in the community of cannabis. Before then, I had no idea that were even strains of cannabis like Indica or Sativa. You were given what you were given. There is no source of understanding because there is no education around the whole thing. It could have been anything in a bag as we wouldn’t know the difference.”
She added: “When you realise they actually have completely different profiles or effects then that matters for someone who needs the plant for medicinal purposes. It matters how it’s grown, taken care of or what the product actually is. I think it was just teenage ignorance but I didn’t even think of the fact there was so much to it. You just take what you are given and like it.”
Finding a space
Prohibition meant her classes were unable to find a space despite their emphasis on wellness and relaxation. Aoife began to consider the longevity of her business especially as COVID rules relaxing meant people were starting to look for offline classes again. She realised it was time to leave Ireland.
“I’ve been doing my classes mostly online or outdoors because it’s unregulated or illegal. It’s hard to get into a space to facilitate those classes. I wondered where I could go in Europe that could facilitate those classes. The Netherlands are starting to pull back their laws a bit and get more strict, especially after COVID so you never know how they are going to react. Spain is moving in the opposite direction.”
The global cannabis industry is expected to reach $90.4 by 2026 thanks to the growing acceptance of cannabis consumption along with the medical side. This is everything from edibles to dispensaries to products. Ireland currently allows CBD and medical cannabis but the recreational side is still illegal. The current systems in place for medical cannabis are not functional with the MCAP program yet to even start despite being introduced in 2019.
It has been highlighted that the tax and profits raised by a legal recreational system could contribute to some of the financial problems experienced by the country. Legal systems in countries such as Atlanta Georgia, California and Massachusetts have proven to be successful. Sales in Massachusetts recently topped $2 billion which is almost double what the state reported in November 2020. Cannabis was legalised for adult use in late 2018.
Access to the Spanish model
While Spain has legalised the growth of up to two plants in your own home, there are still issues with the system. There have been reports of cannabis clubs, where it is legal to consume cannabis, being potentially closed. But for the meantime, a patient must sign to say they are addicted to cannabis and a resident before being allowed entry to one of the clubs.
“There are a lot of regulations around the clubs. You have to sign an affidavit to say you are addicted to cannabis and seeking out the club to facilitate your addiction. You have to say the club is not enticing you or advertising in any way. Most of them look like a door and you wouldn’t even know apart from the smell.”
Once you are inside, there is a loophole that allows this club to operate as cannabis is a ‘hobby.’ The illegal part is the buying and selling of the cannabis. I’m not sure where the government thinks they are getting this cannabis from. So I started to think that Spain was where I wanted to be.”
Deciding where to go in Spain was easy. Aoife had a friend based in Granada in the south so she chose to go there. She visited during the summer and fell in love with the architecture, history and feel of the city. She felt it was the perfect place to move the business. Aoife also teaches English online so her day job was perfectly suited to moving abroad.
“I quit my job and went on a tour of Europe. I’m still settling in here and learning the siesta way of life. But so far so good. There are a lot of experts here and everyone understands where I am coming from so they are very helpful.
Aoife highlights how the leap into the unknown is often the hardest part of emigration. She feels she has never been this self-sufficient. Her day starts with tutoring online to pay bills but she will be opening the yoga business soon. In an unusual move, Aoife’s previous experience was as an airline hostess.
“It’s exciting to be stepping out and owning my own business. I’m still terrified about it but also really excited. I used to work for an international airline, Emirates when I lived in Dubai. I travelled everywhere. I was always looking for a studio or thinking about building my own.”
“I struggled to make friends in yoga class especially when moving to a new city. In my classes, at the beginning, we always consume together then chat. I’ll always bring orange juice, kombucha and biscuits. We sit around for as long as people want. It’s a real community-building atmosphere.”
Time to leave
Aoife is proud to be Irish but explains the problems with the country mean she is not thinking about staying.
“I love the fact I’m Irish and that part of my personality. I would love for my kids to have that much Irish in them. I couldn’t afford to live there as we are being priced out of the country. I couldn’t afford the type of lifestyle I would like to have. It’s ridiculous. The fact that we didn’t have a green passport for so long. We’re the only country in the EU who weren’t ready when that was rolled out speaks volumes.”
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