1. EUFAS survey 2017 Medical cannabis in Europe
Jørgen G. Bramness, Geert Dom, Toni Gual, Karl Mann, Frieder Wurst

2. Low evidence supporting the use of cannabinoids in the treatment of
Moderate evidence supporting use of cannabinoids in the treatment of chronic pain and spams
Low evidence supporting the use of cannabinoids in the treatment of
Nausea and vomiting following chemo therapy
Wasting after HIV/AIDS
Insomnia
Tourette's syndrome
Associated with increased risk of acute adverse events

3. Medical cannabis in US

4. Aim of study
To what extent is cannabis and different types of derivatives allowed for medical use in Europe pr. summer 2017?
What products have a market authorization?
To what extent do clinicians interview about cannabis use?

5. Method Web-based survey in member societies
2 waves: all 26 member societies asked to name up to five responders
If no answer 2-3 reminders
Personalized to these (to avoid spam-filter)
Asking any EUFAS council members for additional contacts

6. Material 28 responders from 17 European countries
Where > 1 response – a collapsed response constructed
unclear or obviously faulty answers rechecked
Supplied by web-information:
Still --- these are preliminary results

7. Medical cannabis products
Synthetic cannabis
Cannabis extract
Standardized cannabis
Growing for personal use
Wild type cannabis
Nabilone Dronabinol (Marinol; synthetic THC)
Nabiximol (Sativex)
Bedrocan, Bedrobinol, Bediol, Bedrolite, Bedica

8. General clinical awareness of cannabis? Do clinicians ask about:
Frequency of cannabis consumption
Quantities consumed on a typical smoking occasion 
(grams of cannabis, number of joints, etc)
Derivate type consumed
(e.g. marijuana, hashish, etc.)  
Usual administration form
(e.g. smoking, happing, eating etc.)
Co-use of tobacco
Potencies used
(e.g. % of 9-THC, other information indicative of the potency like indoor / outdoor cannabis, Indica / Sativa etc.)
Source of cannabis 
(e.g. street cannabis, self cultivation, etc)
Response
Points
Never
Rarely 1
Sometimes 2
Very often 3
Always 4
Don´t know
missing
Average Interviewing score
0-4

9. Marked authorization of cannabis products for medical use in Europe
Country
(number of responders)
Synthetic cannabis
(Marinol, dronabinol)
Cannabis extract
(nabiximol; Sativex)
Standardized cannabis
(Bedrocan, Bedrolite etc.)
Growing for personal use
Wild type cannabis
Austria (2)
yes no
Belgium (1)
Croatia (web)
unclear
Cyprus (web)
Czech Republic (web)
Denmark (1)
Finland (2)
France (1)
Germany (2)
Greece (web)
Ireland (web)
Italy (1)
Lithuania (2)
Malta (web)
Netherlands (1)
Norway (5)
Poland (1)
Portugal (1)
Romania (1)
Russia (1)
Slovenia (web)
Spain (3)
Sweden (1)
United Kingdom (1)

10. Uses of cannabis products
Synthetic cannabis
Cannabis extract
Standardized cannabis
Growing personally
Wild type cannabis
Labelled use
Glaucoma
Nausea (chemo)
Vomiting
Pain (also MS)
Spasticity (MS)
Palliative medicine
Tourette
Pain (neuropathic and MS)
Multiple sclerosis (spasticity; some only treatment resistant)
Spasticity in other neurological disorders
HIV/AIDS
Depression
Sleeplessness
Off-label use (other)
Cannabis use disorder
Mental disorders
Cannabis use disorders
Inflammatory bowel disorder
Cancer glioma
Treatment-resistant epilepsy
Many indications (more diffuse mentions)
Intoxication purposes
Muscle pains
Spasms
Stress
Spain: cannabis clubs

11. Nabiximols; Sativex in Europe
Answers
Yes
unclear No
No answer

12. Standardized cannabis in Europe (Bedrocan, Bedrolite etc.)
Answers
Yes
unclear No
No answer

13. Interviewing Score Country Interviewing score Sweden 0,71 Norway 0,73
Poland
0,86
Romania
Austria
1,00
Belgium
Denmark
Germany
Spain
1,19
Lithuania
1,21
United Kingdom
1,36
Portugal
1,43
Finland
1,50
Netherlands
1,57
France
3,00
Russia
3,71
Italy
3,75

14. Interviewing Score Country Interviewing score Sweden 0,71 Norway 0,73
Poland
0,86
Romania
Austria
1,00
Belgium
Denmark
Germany
Spain
1,19
Lithuania
1,21
United Kingdom
1,36
Portugal
1,43
Finland
1,50
Netherlands
1,57
France
3,00
Russia
3,71
Italy
3,75

15. Non-response Or talk to me in the break! j.g.bramness@medisin.uio.no
Albania
Belarus
Bosnia
Bulgaria
Check republic (web)
Croatia (web)
Estonia
Greece (web)
Hungary
Iceland
Ireland (web)
Kosovo
Latvia
Luxembourg
Macedonia
Moldova
Montenegro
Serbia
Slovakia (web)
Slovenia
Switzerland
Ukraine
Please send an !
Or talk to me in the break!

16. Conclusion Nabiximols are available throughout many European countries
Standardized cannabis is available in 3 countries only
Home grown and wild type not readily available
5 countries have synthetic cannabinoids available
Interviewing about cannabis obviously varies