NORWAY, one of the most cautious states in Europe when it comes to cannabis liberalisation, recently held a public meeting to discuss access to medical cannabis.
The event, which took place in Oslo on January 20, 2023, brought together politicians from across the political spectrum, alongside medical professionals, patient representatives and industry stakeholders.
According to MedCan Norway, which held the event alongside Normal Norge and FTR Oslo, this was the first event of its kind in the country, representing the ‘very early first steps’ towards reform.
With plans for Norway’s first medical cannabis conference set to take place this year, and medical cannabis studies understood to be in the works at Oslo University Hospital, Norway could soon move to catch up with its neighbours on cannabis.
Cannabis in Norway
The small Scandinavian country, which has a population of just over 5.4m, is one of the roughly 15 countries in Europe to have technically legalised medical cannabis.
In 2016, the Norwegian Medicines Agency approved GW Pharma’s Sativex for treatment of multiple sclerosis, while publishing new guidelines for a specific framework for medical cannabis approval.
While other products are understood to be available ‘under special circumstances’, it remains incredibly difficult for any patient to gain access to medical cannabis.
According to an annual survey conducted by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), in collaboration with the Norwegian Institute for Public Health, just under a quarter (24.5%) of Norway’s population aged between 16 and 64 have tried cannabis at least once, with 5.3% stating they had consumed cannabis in the past 12 months.
A further survey conducted by Normal Norge suggested that medical users accounted for around 29% of the total cannabis users in the country, and only around 5.9% of those get it from their doctor, of which just 0.8% get it delivered to a Norwegian pharmacy.
Due to the difficulties in obtaining medical cannabis, 72.4% of patients obtain medical cannabis from the black market, while 3.8% grow it themselves, and 1.5% buy it from abroad.
CBD is also classified as a prescription drug in Norway, meaning that you can purchase limited amounts of CBD only with a prescription, and cannot order it privately, domestically or from abroad.
Despite this, Norway looked to take the lead over its neighbours in terms of drug reform in 2017, when it voted to decriminalise drugs and focus on harm reduction and treatment rather than punishment. However, these progressive reforms were subsequently voted down three years later in 2021.
Barriers to access
According to Normal Norge: “Medical cannabis is technically legal in Norway, but it is extremely difficult to get hold of, and doctors either don’t know much about it or become downright hostile towards patients who are seeking treatment. As a result, many Norwegians seek treatment either in the Netherlands or in Denmark.”
Stenocare’s CEO Thomas Skovlund Schnegelsberg, who spoke on both panels at the recent event in Oslo, explained that a number of barriers were discussed.
After speaking with one of the three politicians in attendance regarding the mindset of Norwegians when it came to cannabis, he said he ‘got the sense that in Norway you quickly get stigmatised if you are a patient self-medicating with medical cannabis’.
“If doctors, by chance, figure out that you have been self-medicating, you will actually be put on a black list, meaning there’ll be a lot of the treatment offerings you will never get.”
He continued that according to discussions between the medical professionals in attendance, including Sigurd Hortemo of the Norwegian Medicines Agency, the organisation responsible for approving new products, many opinions continue to be based on research published more than a decade ago.
A white paper published in 2012 is understood to have ‘concluded that side effects were too severe’, as there was little research around at the time ‘that could argue that medical cannabis had any use and any value’, therefore the notion of reform was ‘totally dismissed’.
“So, that’s kind of the starting point still, ten years later, but it was also mentioned during the debate that they were expecting a new white paper to be published, most likely this calendar year. Of course, it would be based on every piece of new research and evidence that’s been published since,” Mr Schnegelsberg added.
Steps towards progress
While the ‘sober’, ‘factual’ and ‘patient oriented’ debate was clear on the issues facing the industry in Norway, it also provided ‘hope’ that change could be on the way.
MedCan Norway’s Chairwoman, Julie Welde, told BusinessCann: “The situation in Norway is very unclear at the moment, and many patients are now losing their prescriptions.
“The knowledge of cannabis as medicine in Norway is in general very low, and that’s why it’s almost never prescribed. That’s what MedCan Norway wants to change.”
The group says it is working on a number of initiatives to spread knowledge to ‘doctors, politicians, and anyone working in health’, including launching more events throughout the year.
“We also plan and hope that Norway’s first conference with focus on medical cannabis will happen in 2023.”
BusinessCann also understands that Oslo University Hospital has applied for funding to launch a medical cannabis study, which could have a significant impact on attitudes to prescribing in the country.
We have contacted the hospital for further information on these applications, but are yet to receive a response at the time of writing.
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