Greece: six years on is legal access to medicinal cannabis finally in sight?

Patients in Greece are hopeful they will finally see access to legal cannabis medicines in 2023, six years since the law was first amended. 

The development of Greece’s first medicinal cannabis production facility has been a long time coming, say patient advocates in the country, where thousands are still relying on the illicit market despite the rescheduling of medical cannabis in 2017. 

At the end of January, Tikun Olam Europe, a subsidiary of Israel-based cannabis company Tikun Olam, announced operations had begun at Greece’s first medicinal cannabis production plant.

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

The facility has been welcomed by Greek officials and patient organisations, with the first products expected to be on the market later in 2023.

The Minister of Development and Investments, Mr Adonis Georgiadis, described it as 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 the investment in Korinthos, but because today we pave the way for something that did not exist in Greece – a way to provide Greek patients with pharmaceutical cannabis products. But also a way for a product that we will be able to export throughout Europe, because this unit has the ability to make huge exports to all the major countries of Europe and so Greece will play a leading role in the coming years, spearheaded by this factory and the other factories that will come and work on what is called medical cannabis.”

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

The background to medical cannabis in Greece 

The rescheduling of medical cannabis to a schedule two drug, was first announced by the then prime minister in 2017, following a campaign by mothers of children with severe epilepsy, which gathered over 45,000 signatures. 

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

In 2018, a more extensive law was brought in, outlining the licensing requirements for companies wanting to produce medicinal cannabis products in Greece.

But since then progress has been slow. 

A handful of patients have been able to obtain cannabis-based pharmaceutical drugs, such as Epidyolex and Sativex, through individual import requests, but the process is lengthy 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 importing medical cannabis 

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

Sources in the country believe the move was designed to protect the domestic market and offer an ‘incentive’ to outside companies to invest in Greece.

However, it meant any progress towards a robust legal medical cannabis market stalled considerably.

“We were one of the first in Europe [to legalise] and we’re going to be the last ones getting on the boat,” says Jacqueline Poitras, the founder of patient advocacy group MAMAKA who campaigned for access to medicinal cannabis for her daughter.

“The outlawing of the importation of cannabis into Greece was a really big blow for us. [At the time] 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 ban on importation is unlikely to be removed under the current government, unless a company is willing to take legal action in the European courts. 

Founder of MAMAKA, Jacqueline Poitras

Legal cannabinoids and home-grow 

In the meantime, patients in Greece have been forced to continue accessing their medicine through the illicit market, either growing their own or illegally importing oils. 

Many just rely on CBD, which is widely available in retail stores and over-the-counter in pharmacies.

“Fortunately, a very large portion of the population does quite well with CBD and we have a very healthy legal cannabinoid market here. You can find CBG, CBN and pretty much all of the minor cannabinoids,” Ms Poitras explains.

“But anyone who needs THC is ordering it from another country and all patients buying flower are doing so illegally. There’s a huge underground movement of people who are growing their own.”

First legal products expected in 2023

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

An announcement from the government on 3 January 2023 confirmed that the cost of these medicines would not be covered under the country’s public health insurance system and would need to be funded privately by patients. 

Ms Poitras, who also represents Greece in the International Alliance of Cannabinoid Medicines (IACM) Patient Council says the company is aware that its first consideration is to ensure prices are affordable for patients.

“The entire economic onus is on the shoulders of the patients,” she says. 

“We’re expecting the retail price to be slightly higher than the illicit market, at 11-12 euros per gram. For a period of time they will be the only ones on the market, but we have a fairly friendly cooperation with them, and hopefully, we’ll be able to work out ways to make this affordable for patients.”

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

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

“Once we get a little bit of competition on the market that will bring prices down.”

Hope on the horizon?

The recent establishment of a Greek Society for Cannabinoid Medicines (Hellenic Medical Association for Cannabinoids, HMAC) – a body which will officially represent doctors, clinicians and pharmacists who are interested in the field of medical cannabis – is also an ‘important move’ for the sector.

Elsewhere, Ms Poitras is hopeful that the addition of a paediatric neurologist to the committee advising the Greek Pharmaceutical Association on medicinal cannabis, could lead to its approval for use in children with conditions such as epilepsy and autism.

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

“This is a very big moment,” says Ms Poitras.

“Patients are more hopeful now because we’re no longer looking two years ahead before we can get legal products. We’re down to the finish line.”

She adds: “We will continue to fight for cannabis to be covered by health insurance, but as long as we’re paying for it, we should be able to have it prescribed for any condition.”

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