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

Greek patients hope to finally gain access to legal cannabis-based medications in 2023, six years after the first amendment to the law.

The construction of Greece's first medical cannabis production facility has been a long time coming, and thousands of patients still rely on the illicit market despite the Reclassification of medical cannabis in 2017.

In late January, Tikun Olam Europe, a subsidiary of the Israel-based cannabis company Tikun Olam, announced that operations had begun at Greece's first medical cannabis production facility.

The vertically integrated production facility is located on a 56,000-square-meter private lot in Korinthos, following an investment of more than 40 million euros.

The facility has been well received by Greek authorities and patient advocacy groups, with the first products expected to be launched in 2023.

The Minister of Development and Investment, Mr. Adonis Georgiadis, called this event a «historic day» for Europe and a step toward providing Greek patients with «cannabis-based pharmaceuticals.».

Mr. Georgiadis commented: «Today is a historic day not only for Europe and investment in Corinth, but also because today we are paving the way for something that did not exist in Greece—a way to provide Greek patients with cannabis-based pharmaceuticals. But also a way for a product that we can export throughout Europe, because this facility has the capacity to generate massive exports to all the major European countries; therefore, Greece will play a leading role in the coming years, spearheaded by this plant and the other plants that will be established to produce what is known as medical cannabis. »

Georgios Psychogios, the SYRIZA member of parliament for Corinth, added: «I would like to emphasize that although this framework was criticized by many when it was first established, I am pleased that we are now here to oversee the development of medical cannabis for both investors and patients, who will now be able to access these medications.»

The Context of Medical Cannabis in Greece

The reclassification of medical cannabis to Schedule 2 was first announced by the then-prime minister in 2017, following a campaign led by mothers of children with severe epilepsy, which gathered more than 45,000 signatures.

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

In 2018, A more comprehensive law was introduced, describing the licensing requirements for companies wishing to produce medical cannabis products in Greece.

But since then, progress has been slow.

A handful of patients were able to obtain pharmaceutical cannabis-based medications, such as Epidyolex and Sativex, through individual import requests, but the process is long and complicated. By the end of 2022, the first patient in Greece to receive Sativex had done so after an 18-month battle.

A ban on importing medical cannabis

In November 2021, the Greek government imposed a ban on the import of cannabis-based products, which, as an EU member, runs counter to free-market regulations.

According to sources in the country, this measure was intended to protect the domestic market and encourage foreign companies to invest in Greece.

However, this means that any progress toward a robust legal market for medical cannabis has slowed considerably.

«We were among the first in Europe [to legalize it], and we’re going to be the last to jump on board,» says Jacqueline Poitras, founder of the patient advocacy group MAMAKA, who campaigned for access to medical cannabis for her daughter.

«The ban on importing cannabis into Greece was a huge blow to us. [At the time] we were in talks with companies that were trying to source products here… but the ban meant we just had to sit back and wait.»

Ms. Poitras believes that the import ban is unlikely to be lifted under the current government, unless a company is willing to file a lawsuit in European courts.

Jacqueline Poitras, Founder of MAMAKA

Legal Cannabinoids and Home Cultivation

In the meantime, Greek patients have been forced to continue obtaining their medications through the black market, by growing their own crops, or by illegally importing oils.

Many people are satisfied with CBD, which is widely available in retail stores and sold over the counter at pharmacies.

«Fortunately, a very large portion of the population tolerates CBD quite well, and we have a very healthy legal cannabinoid market here. You can find CBG, CBN, and just about every minor cannabinoid,» explains Ms. Poitras.

«But everyone who needs THC orders it from abroad, and all patients who buy flower do so illegally. There’s a huge underground movement of people growing their own.»

The first legal products are expected in 2023

Tikun Europe's First Flower-Based Products are expected later in 2023, as the oils are not expected to be ready until the first quarter of 2024.

A government announcement on January 3, 2023, confirmed that the cost of these medications would not be covered by the country’s public health insurance system and would have to be paid for privately by patients.

Ms. Poitras, who also represents Greece on the patient council of the International Alliance for Cannabinoid Medicines (AIMC), says the company recognizes that its top priority is to ensure that prices remain affordable for patients.

«The entire financial burden falls on the patients» shoulders,” she said.

«We expect the retail price to be slightly higher than that on the black market—11–12 euros per gram. For a while, they’ll be the only ones on the market, but we have a fairly friendly working relationship with them, and hopefully we’ll be able to find ways to make this product affordable for patients.»

A number of other companies are reportedly at various stages of the licensing process, and additional facilities are expected to be operational by 2024.

«A healthy market needs variety; it needs competition,» adds Ms. Poitras.

«Once we have a little competition in the market, it will drive prices down.».

Is there hope on the horizon?

The recent establishment of a Greek company specializing in cannabinoid-based medications (Hellenic Medical Association for Cannabinoids, HMAC) — an organization that will officially represent doctors, clinicians, and pharmacists interested in the field of medical cannabis — also represents a «significant step forward» for the sector.

In addition, Ms. Poitras hopes that the addition of a pediatric neurologist to the committee advising the Hellenic Pharmaceutical Association on medical cannabis could lead to the approval of its use for children with epilepsy and autism.

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

«This is a very important moment,» says Ms. Poitras.

«Patients have more hope now because we’re no longer looking two years down the road before we can get legal products. We’re at 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 get a prescription for it for any condition.»