The 1st of January 2018 marked the last day that cannabis products were illegal in Denmark. The legislation changed with the introduction of a new 4 year medicinal cannabis pilot programme that allows doctors to prescribe new type of cannabis product and offers patients a lawful way of testing treatment with medicinal cannabis if they have not benefited from usual pharmaceutical medicines. The goal is to provide a better understanding of the use of medicinal cannabis and the results so far are very encouraging.

    More than 2000 patients have already subscribed and are receving treatment for some of the following indications:

    • Painful spasms caused by multiple sclerosis
    • Painful spasms caused by spinal cord damage
    • Nausea after chemotherapy
    • Neuropathic pain, i.e. pain due to a disease of the brain, spinal cord or nerves.

    Patients were primarily women between 42 and 64 years of age, with the lead use being treatment of symptoms related to neuropathic pain. The Danish Medicines Agency has issued guidelines for doctors to base their therapeutic decisions on whether or not there is scientific evidence to support the treatment and on their experience with the individual patient and his or her wishes. This is an important aspect of the programme which has been neglected here in the UK with contradicting reports from the NHS and the National Institue for Health and Care Excellence(NICE) leaving the medical world unequipped to prescribe cannabis products even after the 2018 UK legalization and leading patients to turn to private clinics and paying up to £800 a month to treat epilepsy.

    Additionally, the Danish Parliament has developed a separate programme that allows companies to provide cannabis products to the pilot programme. As a result, Denmark is one of the few countries in Europe to permit the domestic production of cannabis for medical use. After an 18 month trial the first company to be approved to produce medicinal cannabis in Denmark is Spectrum Cannabis a joint venture between Canopy Growth Corporation (“Canopy Growth”), the largest cannabis company in the world, and Danish Cannabis ApS (“Danish Cannabis”), a leading European hemp producer. In 2017 the company invested in a hi-tech Greenhouse at Odense, Denmark and established a 40,000 m2 production facility that could serve the needs of approximately 60,000 patients.

    The pilot programme has undergone some legislative changes with the most recent being the change to the THC limit in cannabis based products. The threshold was raised to 0.2% THC which makes it possible to produce and sell cannabis-based products without infringing current Danish laws. Regulatory matters are not harmonized across Europe and standardization is needed for the industry to grow and patients to be allowed access to CBD based medicines. Denmark is also leading on that end, introducing a special reimbursement scheme for medicinal cannabis products in the four-year pilot programme. Under this scheme, people in Denmark are reimbursed at the rate of 50% for cannabis products in the pilot programme. The reimbursement amount is deducted automatically at purchase in the pharmacy. People who have been granted reimbursement for the terminally ill receive full reimbursement for products in the pilot programme.

    The major growth of cannabis companies investing in Denmark and the demand from the patients has also led to the introduction of a specialized international exhibition the North Grow Cannabis Expo which aims to be a transformative power that will shape the medical cannabis perception of nations and cultures. The expo also will in effect increase awareness of Denmark as a major leader in the domain.

    It is clear that the Scandinavian country wants to become a European leader in the field with decisive legislative steps, solid research foundations, a firm medical pilot programme and strong support for the companies that want to invest in the cannabis industry.

    Will the United Kingdom follow the example?

    Image credit: Smurrayinchester

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