SPAIN could now see the regulation and distribution of medical cannabis rolled out before the end of the year after new proposals were endorsed by five congressional parties. 

On Tuesday June 21, Spain’s Congress voted to approve a set of proposals put forward by the medical cannabis subcommittee, which if granted final approval next week, will be put into practice within 6 months. 

Following over a year of research and months of debate, the vote is understood to have come down to the wire, seeing last minute demands for amendments put forward with threats to vote against the report entirely if they weren’t met. 

The proposals now given the green light will allow Spaniards much broader access to medical cannabis than initially suggested, with amendments opening up the possibility of private prescriptions and expanding the list of covered conditions. 

What Happened?

Earlier this month BusinessCann reported that the subcommittee, set up on May 13 2021 and tasked with investigating medical cannabis frameworks throughout the world, was set to put forward its proposals for a framework in Spain before the end of the month. 

Now, after each party has been given the opportunity to examine the proposals and suggest their own amendments, they have received support from five out of nine political groups. 

Those who voted in favour included the PSOE (The Spanish Socialist Workers’ Party), which made a U-turn on its position regarding medical cannabis in May, Unidas Podemos (United We Can), Citizens, Basque Nationalist Party (PNV) and The Catalan European Democratic Party (PDeCAT). 

Meanwhile the Republican Left of Catalonia (ERC) and EH Bildu voted to abstain, while the conservative People’s Party (PP) and Vox voted against the report, to little surprise. 

The report, which puts forward guidelines for the Government on how the country’s medical cannabis framework should look, will still need to receive final approval from the Health Commission, with a vote expected to take place on June 28 2022. 

From there, the Spanish Agency for Medicines and Health Products (AEMPS) will be tasked with ensuring the proposals “fit into the regulations and are viable, allowing the availability in the pharmaceutical market of extracts or standardised preparations of cannabis”.

As requested by the PNV, this process will need to be completed ‘within six months’. 

While some have remained cautious of celebrating the news until the proposals have received approval from the Health Commission next week, others have suggested this is simply a formality. 

According to Spanish online newspaper elDiario.es, ‘parliamentary sources express little doubt the program will go ahead’, at which point the report will become ‘a defacto mandate’. 

The Proposals 

It is understood that while the report is not in itself a regulatory proposal, it establishes the basic guidelines on which the Government must build its medical cannabis framework. 

Despite continued resistance from the PSOE, interventions from the Spanish Observatory of Medical Cannabis (OECM) have meant that these proposals now cover a far wider cohort of potential patients than initially proposed. 

Previously the OECM had cautioned that plans to limit dispensaries to hospital pharmacies, as opposed to Spain’s 22,000 local pharmacies, could make access so cumbersome patients would be driven towards the black market. 

Under the new proposals ‘competent pharmacy services’ will now be allowed to distribute ‘master formulas from extracts or standardised cannabis preparations’. 

Furthermore, doctors able to prescribe will no longer be limited to those from the National Health System or those will a specialist licence, an ammendement which will enable a private market to flourish.

The number of conditions doctors will be able to prescribe for has also been expanded since the initial proposals were introduced, and will now also include ‘cancer pain’ and ‘endometriosis’, significantly expanding the potential patient demographic.  

According to the report, the indications will include ‘spasticity in patients with multiple sclerosis, some forms of epilepsy, nausea and vomiting derived from chemotherapy, endometriosis, cancer pain and chronic non-cancer pain (including neuropathic pain), and may be extended to other therapeutic indications when the studies provide consistent indications’.

Patients prescribed with medical cannabis will be added to a centralised registry, a contentious point among the voting parties, and must have a ‘defined and controllable’ treatment duration. 

This latter point forms part of the report’s efforts to curb a subsequent increase of non-medical usage throughout Spain.

According to Prohibition Partners, the prevalence of cannabis use in Spain sits at around 10% of the adult population, or just under 4 million adult users each year, many of whom are likely using it for medical purposes. 

Despite Spain already moving to decriminalise cannabis for personal use, and some parties pushing for the creation of a second subcommittee to explore a recreational market, these recommendations state it is ‘absolutely necessary’ to prevent confusion of medical use and a ‘generic invocation of the general use’ of cannabis. 

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