More than just bringing patients one step closer to critical medicine, France’s medical cannabis pilot experiment will also serve as a helpful litmus test for the rest of Europe. And, as one of the EU’s most powerful economies explores cannabis, onlookers should be reminded the latest pilot isn’t the first in France.
In fact, the country has a rich history at the intersection of medicine, cannabis and cultural taboos.
What is the french medical cannabis pilot?
In 2013, France legalised the use of cannabis derivatives for manufacturing medicines, but a market had yet to form around the legislation. Not dissimilar to the agenda of the current cannabis pilot, only patients with a legal prescription were allowed access to the few available products.
A year later, officials allowed Sativex, the first cannabis-based medicine, to enter the market.
It’s a mouth spray from British outfit G.W. Pharmaceuticals and meant to treat symptoms associated with sclerosis and other muscular dysfunctions. Relative to the rest of Europe, France was very late to let Sativex enter the country.
(Source: Seeking Alpha)
At the time, a spokesperson for a Sativex distributor said:
‘It’s good news for French patients who are nearly the last in Europe to have access to Sativex. The approval to sell Sativex in France represents the successful end of three years of talks. It was a delicate case in an explosive environment.’
Unfortunately for patients, the product was marketed at a price of €440 per 22 days. Often, users needed up to four sprays per day, which, in sum, comes out to €600 per month. These treatments, it should be reminded, were also exclusive to individuals with real medical problems. Indeed, these patients needed the medicine, and to pay such premiums borders on immorality.
Part of France’s late adoption of Sativex also revolves around the country’s incredibly firm stance on all things cannabis-related. In some aggravated circumstances, life sentences and fines of nearly €8 million exist for those attempting to supply the drug.
Although this type of punishment is unusual, it is a menace for those who may not be able to access traditional medical channels. In one extreme case, authorities arrested a French woman for growing 49 cannabis plants on her property. In her defence, the plants were not used for resale, but instead to soothe her symptoms associated with terminal cancer.
Since then, however, a lot has changed. France is looking to soften these laws following the thorough examination of cannabis’ role in medicine. This is, in part, the reason behind the launch of the cannabis pilot experiment in France.
The French cannabis pilot began in September 2018, when the ANSM, a French health agency responsible for evaluating the risks associated with medical products, formed a 13-member committee (CSST) to explore this exact topic. According to the agency, the committee would be responsible for examining all the ‘available scientific data and experience from other countries’ and to evaluate similar therapeutic and medical uses of cannabis in France.
Members included in this committee are primarily medical professionals made up of pharmacists, neurologists, sclerosis and pain experts as well as various academics.
The committee’s first recommendation in December 2018 was positive and outlined which medical conditions could be included when prescribing cannabis products. Helene Moore of PharmBD told Marijuana Business Daily that:
‘In their communication from (last week) the committee already provided some basic guidelines, defining therapeutic cannabis as going beyond the classic pharmaceutical products, probably including [full-spectrum] products.’
According to this first-round of recommendations, eligible patients would also need to be closely monitored to weigh the benefits and risks associated with a cannabis-based medication. The committee also indicated several preferred administration methods, of which smoking was excluded.
Many of these findings in December 2018 were based on available research from around the world, according to reports.
The second and final round of recommendations surfaced in June 2019. The committee detailed the specifics of how such a market would form, including distribution channels, types of products, mechanisms for monitoring patients and advice on the best ways such products should be consumed. The committee concluded with a basic framework for the practical implementation of an operational medical cannabis market.
A month after the suggested framework was put forward, the ANSM greenlit the pilot and noted that implementation would begin later in 2019. Specifically, the trial is to last two years and will rely heavily on imports to supply the cannabis experiment in France, according to sources close to the matter.
The beginning of the first six-month phase launched in October 2019, following two formal directives from the ANSM.
#CannabisTherapeutique Nous avons créé un comité scientifique pluridisciplinaire pour mettre en place les conditions pratiques de l'expérimentation:
🔸Formations des professionnels de santé
🔸Conditions du suivi des patients
— ANSM (@ansm) October 25, 2019
And this is where the pilot stands for now. Few official reports have yet emerged, but one should expect data to begin rolling in by May 2020.
Although the above indeed looks promising for the future of French cannabis, a similar trend coursed through the country almost 200 years ago.
A blast from the past – France’s history with cannabis
Cannabis historian Davd A. Guba, Jr., wrote:
‘As the French government looks to reform the nation’s drug laws to address the rise in drug-related incarceration and the growing popular demand for cannabis legalisation, there is no better time than now to explore the largely untold and living history of cannabis in colonial France.’
Guba’s book, ‘Taming Cannabis: Drugs and Empire in Nineteenth-Century France’, will outline this intriguing history upon release in August 2020. Before the account is published, though, members of the cannabis community still have a plethora of resources to examine France’s history with cannabis.
This history is deeply interlinked with the country’s colonial ambitions and, specifically, the importation of hash.
In the 1830s and 1840s, hashish became the subject of medical attention and considered to be a sort of ‘miracle drug’. Doctors and pharmacists prescribed the drug, often incorrectly, for everything from the plague and cholera to mental illnesses. In an article for The Conversation, Guba said that medical professionals ‘staked their careers on hashish, publishing dissertations, monographs and peer-review articles on its medicinal and scientific benefits.’
Guba also astutely points out the social aspects of the original cannabis craze. Insofar as hashish was imported from North Africa, the product became associated with the Muslim world. Many of these associations have been left intact as the industry enters the new decade, too. Such a dynamic can be highly-problematic for several reasons.
What often emerges is a stereotype between certain demographics and behaviours or products. These stereotypes typically result in inaccurate or ineffective public policy around the world.
The American Civil Liberties Union (ACLU) reported that while ‘marijuana use is roughly equal among blacks and whites, […] blacks are 3.73 times as likely to be arrested for marijuana possession.’ This statistic is indicative of many features of broader American society in which racial bias within the justice system is only one.
In her TED talk, Dorothy Roberts, an American scholar and social justice advocate, explained that ‘[race-based] medicine also leaves patients of colour especially vulnerable to harmful biases and stereotypes.’
France suffers a similar issue in regard to its Muslim population. The rise of far-right populism over the past ten years is evidence of this. Now, and as Guba argues, France must ‘dissociate cannabis intoxicants and medicines from colonial notions of “Oriental” otherness and Muslim violence.’
Failing to do so could skew access to medicines for the afflicted population; in this case, French Muslims.
In sum, understanding the cultural nuances of a country is critical for implementing effective policies. As citizens of France gear up for what could be a pivotal moment in their relationship with cannabis, it’s important to keep this thesis front and centre.
Failing to see the grander picture, not just medically, could spell turmoil long into the future.