Malta’s legal cannabis clubs could provide relief for struggling patients

Malta legalised medical cannabis in 2018, but according to advocates the ecosystem is prohibitive and focused on industry profit over patient welfare. Could soon-to-open legal cannabis social clubs provide a trusted alternative?

Malta made waves in 2021 when it became the first EU country to legalise recreational cannabis for adult use. Under the law, adults are allowed to carry up to seven grams of cannabis and grow four plants for personal use. 

But rather than purchasing cannabis products through dispensaries or pharmacies, consumers are required to join non-profit cannabis cooperatives. These cannabis social clubs have yet to materialise and consumers interested in legal cannabis outside of the medical community will need to wait until next year. The Authority on the Responsible Use of Cannabis (ARUC), established to oversee recreational cannabis legalisation, will begin accepting applications for prospective cannabis co-ops starting February 2023.

Medical cannabis has been legal in Malta since the passing of the Drug Dependence (Treatment not Imprisonment) (Amendment) Act, 2018. Malta’s medical community grew to around 400 patients in 2019, and is now reported to be more than 1,300.

The law states, however, that practitioners are only allowed to prescribe medical cannabis if they consider there to be ‘no viable alternative’ and accessing medical cannabis seems like an uphill battle.

Speaking to Cannabis Health, Andrew Bonello, president of Releaf Malta,  community non-profit NGO advocating for a social, equitable approach to cannabis reform in the country, painted a stark picture of Malta’s medical cannabis ecosystem.

Medical cannabis in Malta – more for profit than patients?

Mr Bonello explains: “Patients need to declare that they have tried all other conventional medicine before applying for medicinal cannabis.

“They need to obtain a narcotics control card, [which is a] permit to consume a narcotic medicine, as well as a prescription to access cannabis. Patients in Malta have access to a limited number of strains and products, in fact only flowers are available [with CBD oil introduced this year].”

Accessing medical cannabis in Malta is also prohibitive for those with previous problematic substance use issues, despite studies suggesting that cannabis, particularly CBD, may help to alleviate opioid addiction. Anyone registered on an ‘addicts registry’ is barred from accessing medical cannabis in Malta, even if they’ve been addiction free for over 10 years, says Mr Bonello. 

Andrew Bonello, president of Releaf Malta.

With no patient grievance body and no real representation of patient voices as part of the policy process, he argues that Malta’s medical cannabis law was written in a way that favours industry over patient welfare.

“The medicinal cannabis law has been drafted in a way to shut out patients and focus on the industry,” he continues.

“ReLeaf has, since the very beginning, denounced the industry-driven law which continues to view patients as criminals or as a money making venture.”

Mr Bonello is referring to the substantial commercial opportunities that opened up once the production, cultivation and processing of medical cannabis became legal in Malta.

Following the legalisation of medical cannabis in 2018, Malta passed the complementary Production of Cannabis for Medicinal and Research Purposes Act. This allows in-country industrial production of cannabis flower, seeds, oil and other cannabis-based products for medicinal and research purposes only. 

Europe’s medical cannabis market is only expected to grow and Malta could be positioning itself as a key player. By the end of 2020, the medical cannabis market in Europe had an estimated value of €230.7 million and is expected to reach €3.2 billion in 2025, based on research by Prohibition Partners. 

The Malta Medicines Authority has since granted operational licences to a number of pharmaceutical companies including Materia Malta, ASG Pharma, ZenPharm, Panaxia Pharmaceutical, and MPXI.

Materia Malta became the first company in the country to start exporting medical cannabis, selling cannabis commercially to Germany in June 2022. Germany has the biggest medical cannabis market in Europe and has also announced plans to legalise recreational cannabis for adult-use.

“Presently the pharmaceutical industry is trying to monopolise CBD,” says Mr Bonello.

“Patients are now being asked to provide the control card to access [CBD], a non-mind altering substance considered as a novel food in the EU. Yet [the medical cannabis companies in Malta are being] given the certificate of Good Manufacturing Practice (GMP) [which means] they can increase prices and further monopolise the market.”

Malta’s co-op cannabis clubs could be an alternative for patients

ReLeaf Malta has worked to ensure that the country’s legal cannabis model was developed within a human rights framework that prioritises the well-being of the community before that of the industry.

If developed with social equity at its core, Malta’s legal cannabis clubs could provide a reliable alternative for patients struggling to navigate an overly-complicated and cautious medical system. This approach could also contribute to environmentally-friendly and sustainable practices amongst the cannabis co-op community.

“ReLeaf has been proposing the importance of advancing the rights of patients,” explains Mr Bonello.

“This includes ensuring cannabis associations or social clubs cater for the specific needs of patients by providing a better match between doctor recommendations, ailments, and method of consumption and strains, and also by providing discounts and a more humane approach.”

Yet a recent shakeup at the ARUC is causing concerns amongst Malta’s cannabis advocates. In November 2022, ARUC’s first chairperson Mariella Dimech was fired and replaced with Leonid McKay, the former president of catholic charity Caritas Malta. In a 2017 public statement, Caritas Malta shared that they have a ‘serious concern about any form of legislation of the so-called ‘recreational’ use of cannabis’.

“Dubious appointments might derail the whole human rights framework and transform it into a semi-monopolised framework for a few friends in high places,” says Mr Bonello.

Despite this, he is giving McKay the benefit of the doubt, and with the opening of the country’s first social cannabis clubs next year, hope is not lost for those seeking cannabis-based care in Malta.

He adds: “One augurs that the new chairperson of ARUC understands his pivotal human-centred role of advancing social justice whilst being courageous enough to denounce unjust practices negatively impacting medicinal cannabis patients.”

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