Greece welcomes ‘new era’ of medical cannabis after seven-year wait

A seven year wait has finally come to an end for patients in Greece, as the first legal medical cannabis prescriptions were issued this week. 

A 60-year-old mother of three, Anna Paga, who has psoriatic arthritis, became one of the country’s first patients to receive a prescription for a whole-plant cannabis product, seven years after the legislation was first passed. 

Greece was among the first in Europe to legalise medical cannabis in 2017, following a high-profile campaign led by mothers of children with severe epilepsy.

But a controversial ban on imports and a slow start to the establishment of a domestic market left thousands of patients relying on illegal sources or growing their own cannabis to treat serious medical conditions.

A handful of patients were able to obtain cannabis-based pharmaceuticals, such as Epidyolex and Sativex, through individual import requests in what was described as a lengthy and complicated battle, which in some cases took up to 18 months.

Now cannabis products can be prescribed by specialist doctors to treat conditions including nausea and vomiting from chemotherapy, radiotherapy, and combination therapy against HIV or hepatitis C; chronic pain; spasticity associated with multiple sclerosis and spinal cord injuries; and as an appetite suppressant in palliative care.

Doctors who are permitted to prescribe include anaesthetists, neurologists, and pathologists specialising in cancer, infections, and rheumatism.

Once an initial prescription is granted, it can be reissued by any doctor every six months, though the treatment must then be re-evaluated by a specialist.

Jacqueline Poitras, Chrysoula Karanastasi president of the Greek Medical Society for Cannabinoids, Elias Grammatikakis pharmacist and Anna Paga.

Only one product is currently available, a balanced CBD/THC flower preparation supplied by Tikun Olam Europe, which began operations at Greece’s first medical cannabis manufacturing facility in January 2023.

Products containing higher levels of THC are expected to be released in the coming months. 

However, costs are likely to remain high until more products enter the market, with prices currently at €82.96 for a five gram package, or €165.91 for a 10-gram package, equating to more than €16.50 per gram.

As cannabis is considered a ‘non-reimbursed treatment’ patients will be required to cover the full cost of their prescription.

Jacqueline Poitras, founder of patient advocacy group MAMAKA, told Cannabis Health: “It was a long time coming, since the original change in the law in 2017 that would allow medical access, to the date when the first patient was prescribed a Greek produced medicinal cannabis product. Only flower is available for the time being, from Tikun Olam— the only company that has managed to work it’s way through the maze of bureaucracy and legislation adjustments, but a few more varieties will follow soon and oils in a few months time.”

She added: “It’s a beginning, and there is still much work to be done, but Anna went home tonight with her package in hand, knowing that she now has safe and legal access to her medicine. MAMAKA is proud to have been a part of this journey.”

Anna Paga is interviewed by local media after collecting her prescription

Anna commented: “It is a great joy that I can access my prescription for my medication after all those years. I can feel the joy of all the patients that were also waiting for this to happen, and I hope that all people in Greece know now that cannabis can be a tool to aid their recovery.”

The long road to medical cannabis access 

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

In 2018, a more extensive law was brought in, permitting the cultivation of cannabis-based products with a THC content of over 0.3%, but domestic production has been slow.

Then, in November 2021, the Greek government introduced a ban on the importation of cannabis products, in what was described as a ‘violation of fundamental EU principles’ under Article 28 of the EU Treaty, the free movement of goods between member states. 

Elias Grammatikakis, pharmacist, issues the first prescription

“It was a long wait, but worth it,” said Elias Grammatikakis, the pharmacist who issued the first prescription and who has been an advocate for access to medical cannabis in Greece.

“Hundreds of patients will finally have access to their treatment, with legal, certified, trusted medicinal products.

“Unfortunately, the cost of the product is not yet reimbursed by the national health system, but hopefully this will change in the future. Seeing Anna, our first patient, leave my pharmacy so relieved and excited, was truly the highlight of the day.”

Dr Chrysoula Karanastasi, president of the Greek Medical Society for Cannabinoids, added: “The Hellenic Society for Cannabinoid Medicines was founded in December 2022 by a group of healthcare practitioners with a special interest in this exciting field of therapeutics. All of us became engaged in cannabis and the endocannabinoid system because our patients showed us there is more to the plant than recreational effects. Today is a special day for everyone who fought these battles; but it is also the beginning of a new era: a lot still needs to be done, but as we say in Greece, ‘the start is already halfway there’.”