Europe is on the verge of a cannabis boom

These are boom times for the cannabis industry. As countries around the world lift restrictions on the drug, the legal market is soaring. In Europe, momentum is growing for legalisation and many governments are poised to lift restrictions on cannabis, whether in recreational or medical form. There are also calls for more research into medicinal cannabis as its status as a controlled substance has hampered a full understanding of its science. However, the situation is still confusing, raising many associated questions for users and suppliers – including pharmaceutical companies – about how to deliver cannabis to customers.

European Union countries still have a patchwork of complex and varying regulations for cannabis use in each individual country, and the sector is still in its early stages. But that could change, according to market experts. A report released earlier this year by market research group Brightfield Group says that the European medical cannabis market will grow from $316 million in 2018 to nearly $8 billion by 2023. It says the cannabidiol (CBD) market will grow from $318 million in 2018 to nearly $1.7 billion by 2023.

Another report, by Prohibition Partners, offers even bigger numbers. It says that Europe’s cannabis market could be worth up to €123 billon by 2028 (€65 billion for recreational cannabis and €58 billion for medical cannabis), likely becoming the world’s largest legal market over the next five years.

The growth of the cannabis sector is likely to be fuelled by political and regulatory decisions. For example, the World Health Organisation (WHO) in January recommended rescheduling cannabis and removing CBD from international control under the 1961 and 1971 UN Conventions that banned cannabis worldwide. This is feeding into the debate in the US, where the legal situation is moving fast – and BCW last month opened a new cannabis strategic consulting unit to help clients with the challenges ahead.

The EU has, surprisingly, fallen behind the US in some respects, but the mood is changing. The European Parliament voted in February to improve access to medical marijuana, and research its public health effects, urging the European Commission and member states to address regulatory, financial and cultural barriers which burden scientific research and invites them to properly fund research. While non-binding, the Parliament’s resolution showed that there is now wide EU support for cannabis legalisation. MEPs said doctors should be allowed to use their professional judgement in prescribing cannabis-based medicines, and that these should be covered by health insurance schemes like other types of medicine. It even noted that this could translate into additional revenue for public authorities, limiting the black market and ensuring quality and accurate labelling.

However, the main drivers of more liberal cannabis rules will be internal debates within the EU member states, where most regulation takes place. Governments in key markets like France, the United Kingdom and Spain are all reviewing their current legislation. Germany, Italy and the Netherlands, which have all moved to open their markets, are now expanding their existing medical programmes.

The reasons for legalisation, though culturally specific for each country, have broad trends. Medicinal cannabis is often legalised first after the petition by patient groups. The arguments for recreational decriminalisation are often more economic, namely the costs of incarceration.

Although there has been a wave of legalisation of medicinal cannabis, political and regulatory institutions have been slow to create the new legal framework and regulations to support distribution. This reflects how cannabis is not just a health policy issue but also impacts criminal justice, licensing, compliance, packaging, research and research policy.

Medical cannabis is currently legal in most of Europe, with doctors prescribing it for relief of symptoms arising from multiple sclerosis, AIDS, cancer, long-term neurogenic pain, Tourette syndrome, Crohn’s disease and PTSD. In Germany, cannabis is also prescribed for ADHD, headaches, migraine and other widely spread illnesses.

But the process is loaded with bureaucracy. The situation in Britain shows how complicated it can be. Medicinal cannabis was legalised in the UK last year but so far, there have only been a handful of actual treatments with the drug. Since it is currently unlicensed, doctors can prescribe it only if a patient has a need that cannot be met by licensed medicines. Also, the product itself at the moment only comes from a specially regulated site in the Netherlands approved by the Dutch government. The whole process can take up to 28 days: by the time it is completed, the prescription may have expired.

Other hurdles can be seen elsewhere in Europe. In France, Sativex is authorised for use for people suffering from multiple sclerosis but is unavailable for sale due to a lack of price agreement between the laboratory and the health authorities. In Germany, the industry is only now getting on track after very long delays thanks to a combination of conservatism amongst doctors, rapid price surges and pharmacy shortages.

Indeed, one of the key problems facing the roll-out of medical cannabis is the lack of scientific research shaping debates, particularly among health stakeholders. For instance, doctors often fail to prescribe it because they simply do not know about its qualities, and do not have access to experts to educate them.

When it comes to recreational cannabis, it remains the most prevalent illegal drug in Europe: according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDD), 17.2 million young people (14.1%) used it in 2017. The situation is shrouded in legal uncertainty. For example, while recreational cannabis remains illegal in every EU country, cities like Amsterdam and Barcelona are known for their coffee shops and social clubs, and decriminalisation is gaining ground in countries like Portugal, Germany and Spain. Penalties for marijuana possession and consumption vary: some EU countries maintain prison sentences, but others have completely decriminalised possession of small amounts.

With both medical and recreational cannabis, there remain popular prejudices about the drug, partly due to its association with gangs and drop-outs. But there is less discussion on the possible benefits of legalisation and regulation: it could ensure greater quality control (low quality products pose a public health risk), tackle illegal networks and the black market, and even create jobs and raise tax revenues.

With Europeans expecting a standardised and highly regulated product, there remain challenges ahead for policymakers and businesses. They will have to address issues like cross-border supply chains, standardisation, and prescription requirements. Healthcare stakeholders, including user groups and pharmaceutical businesses, will need to watch the policy space closely as the haze clears on cannabis regulation.

Author: Ijeoma Okoye


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