In France, the rising euphoria for hashish for medical use | EUROtoday

In 1992, Valérie Vedere was first identified. Then aged 32, she discovered that she had AIDS. Twenty years later, in 2012, she found she was affected by throat most cancers. Since then, his day by day life has been punctuated by the ache linked to radiotherapy and antiretroviral therapies for HIV.

So when France introduced, in 2021, that it needed to launch a significant nationwide experiment geared toward testing the usage of medical hashish for sufferers with critical sicknesses, Valérie Vedere was decided to take part. She managed to influence her physician that she was an ideal candidate for the trial and joined the experiment in May 2021, two months after its launch.

“I had already used cannabis to relieve my symptoms illegally. Now, I can do it legally and benefit from regular monitoring from my doctor,” explains this Bordeaux resident, now 58 years outdated. .

“I use it to calm the burning sensation that radiotherapy gives me,” she continues. “But I also have pain due to antiretroviral treatments for HIV. I regularly feel like my hands and feet are caught in a vice, with extreme burning and tingling sensations. I also have muscle spasms that usually occur at the end of the day. Chronic pain which, according to her, cannot be treated with opioid analgesics such as tramadol or morphine, which are responsible for many adverse effects. “It’s not a long-term solution,” she insists.

“I tried all kinds of treatments”

Like Valérie, Mylène, a 26-year-old Parisian, tried a long list of medications to combat her headaches – strong, persistent headaches – before turning to medical cannabis. “They are brutal. The pain is permanent, seven days a week. I have not had a respite since it started, in 2014,” she testifies. “And sometimes I have particularly painful attacks, like two cinder blocks are being pressed against my head.”

“I tried all kinds of treatments. Paracetamol, ibuprofen, opioids like tramadol and even morphine. Either the drugs had no effect on me, or the side effects were too intense,” continues this young radiologist. “So I joined the therapeutic trial on the finish of December 2023 and began taking medical hashish droplets morning and night. It's been nearly three months and I'm already beginning to really feel reduction. I really feel prefer it's actually beginning to work. making impact.”

See alsoCannabis, a plant with multiple uses

A step forward towards the legalization of medical cannabis

Like the two women, the first results of this experiment, published in 2023, show promising results. The majority of patients feel that their symptoms have improved, without unexpected side effects. No cases of drug abuse or addiction are reported.

In detail, the reports of nearly 2,500 patients – out of the more than 3,000 who participated in the experiment – ​​were studied. Half of them were treated for neuropathic pain, 12% for pain linked to multiple sclerosis, 12% in palliative situations or even 8% for symptoms linked to cancer. A third of patients declared an overall and stable improvement in their state of health, a third a significant or very significant reduction in pain, and a third a slight or no improvement.

“Our evaluations show that between 30 and 40% of symptoms such as pain, spasms, quality of life or epileptic seizures, for example, have improved significantly,” summarizes Nicolas Authier, doctor specializing in pharmacology. , drug addiction and pain, president of the scientific committee responsible for monitoring the medical cannabis trial.

Faced with these results, and while the experiment officially came to an end on March 27, the National Medicines Safety Agency (ANSM) promised on February 20 that treatments based on medical cannabis would be available in France in 2025. “The end of experimentation and the availability of cannabis-based medicines by 2025 are being prepared,” she announced in a press release.

“Cannabis-based medicines are currently dispensed in hospitals or hospital pharmacies, but eventually, most of them will also be available in ordinary pharmacies, like any other medicine,” explains Nicolas Authier.

To do this, the ANSM has until December 31, 2024 to authorize on the market cannabis-based products approved for medical use. But questions still remain to be resolved, such as the price of the drug and its reimbursement.

Furthermore, at the end of 2023, the government gave a special status to therapeutic cannabis by integrating it into the social security financing law. The latter stipulates that the ANSM can authorize the sale of cannabis-based medicines without waiting for possible authorization from the European Union, but these authorizations will only be valid for a period of five years, renewable.

In the meantime, the 1,842 patients who are still on therapeutic cannabis today as part of the experiment will be able to continue their treatment. However, no new participants will be able to join the trial.

Cannabis flowers excluded

During the three years of experimentation, patients were also able, depending on their state of health, to be treated with therapeutic cannabis in the form of oil, taken orally, or in the form of dried flowers, inhaled in vaporizers.

Depending on their form, cannabis medicines contain varying degrees of THC and CBD, the two main compounds in the plant known as cannabinoids. THC is the main psychoactive compound, that is, it is responsible for the feeling of euphoria typical of weed that users can experience, but it is also the most effective in combating against pain. CBD, the second most common compound in cannabis, is also psychoactive but does not have the same intoxicating effect as THC.

“The majority of patients received medications in the form of oil because it is the treatment that has the most lasting effect,” explains Nicolas Authier. “But it doesn't forestall extreme ache spikes. So we typically added dried hashish flowers that sufferers may inhale. The results final much less lengthy however are very fast.”

The ANSM, however, decided to exclude therapeutic cannabis in the form of flowers from the legalization procedure. “I was not at the mediation meeting when this decision was taken, so I cannot say with certainty why,” explains Nicolas Authier. “It appears that medical hashish flower is simply too just like hashish flower consumed for [récréatives]. This may due to this fact result in confusion and maybe arouse fears round a potential black market.” “A really questionable argument,” he adds, unconvinced.

For Valérie Vedere, oils like flowers are “indispensable”. Furious at the decision to no longer prescribe medical cannabis in dried flower form, she wrote an open letter to the French Ministry of Health to ask for explanations.

“I don't wish to take opioids. When I’ve sudden assaults of ache, flowers are the one factor that provides me reduction,” she explains. “So I will continue to use the oil prescribed to me but I will also buy dried flowers illegally.”

The industry holds its breath

In total, Nicolas Authier estimates that between 150,000 and 300,000 people could be prescribed cannabis-based medicines in France. An entire industry is holding its breath while waiting for their authorization. According to Le Monde, France could indeed become, with Germany, the largest medical cannabis market in Europe.

But if public opinion is evolving on the subject – 91% of French people say they are in favor of prescribing cannabis-based medicines “for certain serious or chronic illnesses”, according to a survey carried out in 2019 by the French Observatory of Drugs and addictive tendencies – cannabis still remains closely linked to the negative image of narcotics, particularly among political and medical leaders, regrets Nicolas Authier.

A few days ago, during a Senate hearing on the impact of drug trafficking in France, Finance Minister Bruno le Maire reiterated his refusal to decriminalize it. “Cannabis is cool, cocaine is chic. It’s the social representation of drugs,” he said. “But in actuality, they’re two poisons. They are each damaging and contribute to undermining French society as an entire.”

Among the opponents of the undertaking, some repeatedly denounce a course of which might inevitably result in the legalization of hashish for leisure use. “Our goal has always been accessibility. Ensuring that patients have access to these medications and that doctors prescribe them,” retorts Nicolas Authier. “It was never, as some like to believe, a Trojan horse to then legalize cannabis for recreational use. This has absolutely nothing to do with our trial. Opium-based medications exist without heroin being legalized.”

France remains today one of the largest consumers of cannabis in Europe, with one of the strictest legislation on the subject. THC is still considered a narcotic and the maximum level allowed in a cannabis plant is limited to 0.3%. CBD, on the other hand, is legal as long as the cannabis plant does not exceed permitted levels of THC.

California was the first to legalize medical cannabis in 1996. Colorado followed four years later in 2000, then Canada in 2001, the Netherlands in 2003, Israel in 2006, Italy in 2013 and Germany in 2017. To date, around twenty European countries have joined the list, each with their own rules and restrictions. In comparison, it would have been necessary wait until 2018 so that serious discussions on medical cannabis emerge in France. And we had to wait another three years for the trial to begin, in 2021.

“When I was accepted as a participant in the experiment a few months ago, I said to myself ‘finally’”, concludes Mylène. “I see there's a real step forward and I hope it continues. I hope it becomes more easily accessible so that as many people as possible can be treated.”

This article was tailored from English by Cyrielle Cabot. The unique could be discovered right here.