Cannabis will soon be available to sufferers of cancer and multiple sclerosis after the government agreed to allow a four-year trial starting in 2018.
The deal was struck by a broad coalition in parliament, who set aside 22 million kroner over the period to run the trial and carry out research into cannabis’ efficacy as a medicine.
Some synthetic cannabis products and extracts are currently legal. But the trial will enable doctors to prescribe the actual cannabis plant – ordinarily the flowering “buds” – to patients suffering from a select list of illnesses.
“Some of the patients who currently self medicate with illegal products will now have a legal alternative, while also providing them with a safer framework for its consumption,” the parties state in a press release.
Not a medicine
The only party to refuse to back the proposal is the Conservative Peoples Party (Konservative) who emphasised the fact that no cannabis products have been approved as medicines by the Danish Medicines Agency (Lægemiddelstyrelsen).
“I am worried that this will start a slippery slope in which politicians start approving medicines based on referendums,” MP Rasmus Jarlov stated in a press release. “We should take expert knowledge seriously and wait to accept cannabis until we know we can support it.”
Jarlov’s hesitation follows similar concerns voiced by Danish Medical Association (Lægeforening) chairman Andreas Rudkjøbing.
“It is problematic that we are in a situation where politicians have legislated their way to declaring cannabis a medicine. They have thereby circumvented the normal medicine approval model, which is based on documented effects,” Rudkjøbing told DR.
“Its an extremely problematic situation to be in as a doctor, that they have to take responsibility for something even though they don’t know how it works,” he said, adding that it was vital that cannabis is properly tested that before it is prescribed as a medicines.
Positive experiences from abroad
Liberal Alliance health spokesperson MP May-Britt Kattrup acknowledges the lack of scientific evidence that proves cannabis is an effective medicine. Kattrup argues, however, that there is enough anecdotal evidence to justify the trial.
“In the Netherlands, for example, medical cannabis has been legal for more than 10 years. Experiences have been positive and show no sign of side-effects or other problems. Had there been any negative experiences I bet they wouldn’t have continued for so long,” she said.
According to Kattrup, the Danish Health Authority (Sundhedsstyrelsen) is creating guidelines for doctors based in the experiences of countries such as the Netherlands, Canada and Israel with which to create guidelines for doctors. She adds that many doctors have supported the trial.
The Alternative are also strong supporters of the law change, and in March even proposed legalising recreational use, with the state serving as the sole legal supplier.
MP Carolina Magdalene Maier argues that even though cannabis has not been approved as a medicine, enough trials have demonstrated its potential.
“It is often smaller research projects or projects that don’t satisfy the normal criteria’s for medical evidence. That doesn’t mean that we shouldn’t have more research, because we think that we should. But it is sufficient evidence to back the pilot scheme in Denmark, in which we can measure the effect,” Maier explained.
“So even though the Danish Medical Association isn’t fan of medical cannabis, we shouldn’t ignore the good results from abroad.”
Epileptics miss out
In addition to MS sufferers and cancer patients receiving chemotherapy, Doctors may only prescribe cannabis to patients with spinal chord injuries and chronic pain. Epileptics will miss out, much to the disappointment of the Danish Epilepsy Association.
“I have a hard time understanding why epilepsy is not included,” chairman Lone Nørager Kristensen said.
“I understand that the Lægemiddelstyrelsen is playing an important role here, and they think there is little to no evidence [to support prescribing cannabis] in our field. But I think it’s unbelievable that they wouldn’t want to provide a better and safer framework for our patient group when we know they are forced to interact with an unregulated market where there is no type of independent control with the producers – especially when leading practitioners recommend that epileptics ought to be included in the trial.”
Doctors could curb it
Rikke Jacobsen, chairman of the medical cannabis association (Medicinsk Cannabis Forening Danmark) is concerned that doctors might not be eager to prescribe cannabis, even though it is an option.
“As it is formulated, doctors have to take full responsibility for prescribing medical cannabis. Which might potentially prevent them from doing so,” she told Berlingske, adding that it should be patients that accept the responsibility instead.
“They’ve used to it when buying illegal cannabis, so it shouldn’t be a problem” she said.
According to Politiken newspaper, the government is likely to purchase the cannabis from Dutch firm Bedrocan BV. They currently supply cannabis products to around 1,500 patients, none of which have reported side effects.
According to the Dutch health ministry, however, consuming cannabis products can bring about a number of side effects that include mood-altering effects, insomnia and heart palpitations.
“Other effects are: relaxation, fits of laughter, feeling hungry, heightened sensitivity to the perception of e.g. colour and music, lethargy and distorted temporal and spatial awareness. Your reaction time may also be slower, especially during the first hours after use.” M