In 2017, Germany began the careful rollout of a national medical cannabis program. Since then, there has been a noticeable shift in European policy towards the medicinal use of the plant. Subtle regulatory changes in Europe and abroad are quickly turning into stronger policy mandates behind the decriminalization, legalization, and regulation of cannabis within the European Union (EU).

 

In a certain sense, the framework of cannabis policy in the EU is unrolling much as it has in the US: piecemeal regulations, significant policy differences from one place to the next, but without supportive regional governance. It is a regulatory puzzle that fails to foster market growth and interstate trade, but it also does little to control a scheduled substance. What is in the cards for EU\’s member states and their burgeoning medical cannabis programs?

 

An Update from WHO, A Dramatic Change in Opinion

 

In January 2019, the World Health Organization (WHO) Expert Committee on Drug Dependence (ECDD) issued a letter to Antonio Guterres recommending the removal of cannabis from Schedule IV of the Single Convention on Narcotic Drugs.

 

The letter, dated January 24, 2019, signed by Director General of the WHO, Dr. Tedros Adhanom Ghebreyesus, outlined several recommendations for the rescheduling of cannabis and related cannabinoids within the 1961 Single Convention on Narcotics. This international treaty strictly regulates the production, trade, and global supply of identified narcotics (with and without a known medicinal application).

 

The WHO\’s new recommendations suggest the removal of cannabis from the most restrictive level scheduling according to the convention, Schedule IV. Under this scheduling, cannabis is regulated due to it\’s \”particularly dangerous properties.\” Cannabis currently shares this international drug classification with synthetic opioids and fentanyl.

 

The WHO also recommends placing synthetic and isolated cannabinoids under a Schedule I mandate. These substances have thus far remained unscheduled by the United Nations (UN). Although less restrictive than Schedule IV, this classification requires medical prescriptions, government authorization, and strict international trade limitations. 

 

The final recommendation included in the letter was for the removal of CBD from the 1961 Single Convention on Narcotics. As a non-intoxicating compound, with growing popular for therapeutic applications, it seems ill-placed under the current definitions of cannabis in the treaty.

 

As is generally the case, international policy moves slowly. Any changes made at the behest of the WHO\’s recommendations will only happen following the next UN meeting in March 2020. Furthermore, changes to the treaty would require agreement by all 53 member states before implementation. It is uncertain what influence the current American scheduling and administration would have over the change in international policy. 

 

An Uncertain American Response

 

The US currently has conflicting policies on cannabis. With 33 states and counting supportive of medical cannabis, and at least 10 allowing for recreational use, more Americans have legal access to the plant than ever before. Still, cannabis at the federal level remains under the strictest drug scheduling under the Controlled Substances Act. As a part of the 1961 Single Convention on Narcotics, there is uncertainty about how internal US policy will dictate the response to the WHO recommendations.

 

The Food and Drug Administration (FDA) requested public comment following the release of the WHO recommendations, with the period of comment closing as of September 2019. According to Regulations.gov, \”The comments received in response to this notice will be considered in preparing the United States\’ position on these proposals for a meeting of the United Nations Commission on Narcotic Drugs (CND) in Vienna, Austria.\”

 

Back in the EU, Members are Launching Pilot Programs

 

The pace of change at an international level is always slow, but there are more rapid changes happening at a state level and within the European Union. There are already several regulatory experiments underway in individual member states, rolling out variations on decriminalization, federally regulated medical cannabis programs, and adult-use legalization. 

 

Germany launched the first major medical cannabis program in the EU in 2017. While the initial rollout has been slow, it seems as if it is finally gaining momentum. Many other countries within the EU are also exploring the possibility of medical cannabis through trial or pilot programs. 

 

Countries making some progress with cannabis legislation include Denmark, Czech Republic, Finland, France, Greece, Ireland, and Norway. Though, these state-based pilot programs may be slow to transform into government regulation (and widespread patient access), there is a growing consensus on the continent about the power of medical cannabis. 

Although more European patients than ever before are acquiring access to medical cannabis, at the continental level, a storm is brewing. As is the case in the US, there is a growing fragmentation among EU member states about what a medical cannabis framework should look like. 

 

Despite the free flow of goods across the EU, there is a noticeable lack of guidance on the free flow of cannabis. As Alexandra Curley, Head of Insights at Prohibition Partners, explained, \”What Europe really needs when it comes to medical cannabis is an overarching infrastructure at the EU level that would facilitate trade, data-sharing and the cross-border transport of supplies.\” 

 

Without even a consistent definition of what cannabis constitutes (an extract, a synthetic, a pharmaceutical, or full-spectrum plant), it\’s going to be exceedingly tricky to grow the EU market in the short term. Peter Homberg, of the European Cannabis Group at Dentons, explained to Labiotech the desperate need for the EU to begin \”harmonizing the definition and legal framework of medical cannabis throughout the EU.\” Without a consistent definition, policy, and protocols, the EU market will continue its fragmented and stagnant growth.

 

Change is Coming, but Patience is Needed

 

Following the WHO recommendations from early 2019, members of the European Parliament (MEPs) began advocating for policy change at the European Parliament. According to a briefing published in February 2019, MEPs are urging parliament to \”take medical use of cannabis seriously.\”

 

Although nonbinding, the European Parliament passed a resolution requesting a definition, \”to draw a clear distinction between medical cannabis and other uses of cannabis.\” Importantly, the resolution also \”calls on the Commission and member states to address regulatory barriers which burden scientific research and invites them to properly fund research and promote greater knowledge of medical cannabis among medical professionals.\”

 

Before medical cannabis can truly take off in the EU, several critical regional and global policy shifts must happen. The European Union must clarify the definition of medical cannabis and facilitate cross- border trade between member states. Once the structural framework is put into place at the regional level, it’s a far less challenging situation to implement an accessible and well-regulated internal medical cannabis program at the state level.

 

A regulatory update on medical cannabis by the EU may currently be held up by the slow rate of change across international organizations, such as the WHO and the UN. It\’s also very uncertain how key members of the Single Convention on Narcotic Drugs, such as the US, will impact international policy shifts on cannabis. Until the major international regulatory organizations like the UN reexamine the current scheduling of cannabis and decide on the WHO\’s recommendations, the EU market will remain fragmented and slow to grow.