1. Medical cannabis availability in Central & Eastern Europe
Pavel Kubů, Jovana Arsenijevic, Vendula Běláčková,
Jakub Marcin Gajewski, Vasil Haralampiev,
Božidar Radišič
19 | 11 | 2015

2. CEE Region
Medical cannabis availability in Central/Eastern Europe

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Czech Republic
Cannabis is legal for medical use upon eligible physician’s specializations prescription for enlisted diagnosis and symptoms (full list at
Clinical trials with whole-plant material approved
Prescription adoption curve starting slowly
Lack of CME and prescription guidance for eligible physician’s specializations
Issues with central ePrescription system
Healthcare insurance refundation barrier removed February 2016
Market supply from imported Bedrocan strains
First medical cannabis locally produced reaching pharmacies in March 2016
More tenders for growing licenses expected
Medical Cannabis Conference 2017 in Prague
CME accredited event for cannabis scientist, physicians and other healthcare professionals
Medical cannabis availability in Central/Eastern Europe

4. Croatia
Medical cannabis available, Ministry of health regulations implemented
Indications:
Multiple sclerosis
Cancer
Epilepsy
AIDS
Cannabis based medication import
THC, dronabinol, nabinol – only in pharmacies
Can be prescribed by GPs, must be recommended by specialists
THC medications prescribed maximally for 30 days
Total amount of prescribed THC cannot exceed 0,75g
Medical cannabis availability in Central/Eastern Europe

5. Poland
The only legal way is a complicated individual import procedure for particular patient
Prescription needed
Refundation for Sativex, Bediol and Bedrocan
Pharmaceutical preparations: option viable – however, physicians lack the knowledge to prescribe
A new law is being debated in the Polish parliament right now; the outcome is hard to predict and the creation of the actual law is uncertain
Medical cannabis availability in Central/Eastern Europe

6. Republic of Serbia Cannabis for medical use – advocated since 2014
3 cannabis-based medicines
Dronabinol for weight loss in HIV, AIDS patients, nausea caused by chemotherapy
Nabilone for nausea caused by chemotherapy
Sativex for MS patients on muscle spasms only if spasms not adequately controlled by conventional therapies
Free for patients, paid for by National Health Insurance Fund (NHIF)
Medicines will be available this mid-year for prescribtion by certified doctors
Ministry of Health did not legalize cannabis oil – reason: lack of production and quality standards
Medical cannabis availability in Central/Eastern Europe

7. Macedonia Production, possession, selling, use – all illegal
Draft of law for medical cannabis
Passed first stages of parliamentary discussion; now amendments are being negotiated
One of those amendments mentions growing cannabis by patients
Parliamentary vote should be within weeks
Medical cannabis availability in Central/Eastern Europe

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Slovenia
Cannabis production is illegal, users demanding self- supply
Synthetic THC and CBD-based medicines available in pharmacies
Will be extended to natural-based registered drugs within weeks
Cannabis debate very vivid
Use of substances is not a criminal offense in Slovenia
The proceedings are happening on the parliamentary level
Slovenia moved cannabis extracts to Sch.II, but the plant itself is still Sch. I
Medical cannabis availability in Central/Eastern Europe

9. Cannabis for Patients Availability Matrix*
A: PATIENT AUTHORISATION
B: SOURCES OF CANNABIS SUPPLY
I. HERBAL CANNABIS
II. PHARMACEUTICAL PREPARATIONS
B1: No legitimate supply of cannabis, sourced from illegal market (not medicinal grade)
B2: Patients / caregivers can cultivate cannabis (not medicinal grade)
B3: Authorised imported herbal cannabis (medicinal grade)
B4: Herbal cannabis (medicinal grade) grown domestically by licensed producers
B5: Pharmaceutical preparations (medicinal grade)
A1: Specific exemptions from criminal law based on patient diagnoses
 Macedonia – proposal stage
A2: Specific exemptions from criminal law based on doctor´s recommendation for medicinal cannabis use (dispensaries)
A3: Authorisation of patients via prescription system (pharmacies)
Czech
Poland
Slovenia – if extended as expected
Croatia
Serbia
Slovenia
* Belackova, V., Ritter, A., Shanahan, M., Chalmers, J., Hughes, C. Barratt, M. & Lancaster, K. (2015). Medicinal cannabis in Australia – Framing the regulatory options. Sydney: Drug Policy Modelling Program.
Medical cannabis availability in Central/Eastern Europe

10. Bosnia and Herzegovina
Albania
No medical cannabis policy, no treatment, no use
No advocacy, limited debates
Bosnia and Herzegovina
Cannabis is still treated as an illegal drug; no use for medical purposes
No initiative for decriminalization of medical use
Ministry of Civil Affairs plans to establish expert group to propose laws and regulations for medical use
No time estimates available
Medical cannabis availability in Central/Eastern Europe 10

11. Bulgaria
No difference between medical and recreational use – all penalized by 2 to 6 years in prison.
Banned by the National Council on Drugs, included in prohibition list 1. Not only the substance, but also recommendations are penalized.
No exceptions (cases of sentenced patients.)
Movement to integrate patient-oriented regulation for medicinal cannabis.
Since 2010, at least two clinical trials of “Sativex”.
Farmers growing hemp can process stems and seeds but not flowers and foliage.
CBD is legitimate, but the extraction of hemp is illegal.
Medical cannabis patients’ union (Restart), IMCPC members.
Protest on April 24 demands legalization for medical purposes, decriminalization for personal use, and allowing the production of industrial hemp.
Medical cannabis availability in Central/Eastern Europe

12. Montenegro Romania Slovakia Banned completely
March 2016 – first legalization campaign for medical use
Romania
Cannabis is an indexed drug with no exceptions
No real advocacy or debate
Slovakia
No legal access to medical cannabis
Opposition MPs raising the topic into public discussion without any legislative proposals issued
Medical cannabis availability in Central/Eastern Europe