February 19 marked a significant milestone for the Greek medical landscape with the introduction of medical cannabis products to patients holding valid prescriptions. But the journey of medical cannabis through Greece’s healthcare system has been tumultuous and marked by obstacles and frustrations for patients.

Back in 2017, Greece emerged as a pioneer in Europe when it legalized medical cannabis, following a campaign led by Jacqueline Poitras, the founder of MAMAKA, a patient advocacy group. Poitras, along with other mothers of children with severe epilepsy, spearheaded a movement that gathered over 45,000 signatures and culminated in the submission of a petition to the Minister of Health.

Their efforts bore fruit in June 2017, when Prime Minister Tsipras announced the legalization of medical cannabis in Greece. However, despite this initial victory, subsequent regulations focused primarily on cultivation and production left patients without direct access to the therapeutic product.

Poitras highlights the grim reality faced by patients from 2017 to 2024, when severely limited access compelled many to resort to illicit sources or to cultivate their own cannabis for medical use.

Legalization challenges

Jackie Poitras reflects on the arduous journey and the challenges of procuring cannabis-based medications before legalization. She recounts, “From 2014 to 2016, I imported them from abroad, but these medications remained illegal until 2016 when the first shop opened, bringing CBD products to Greece.”

However, it isn’t just products containing CBD, a cannabis derivative which does not have psychoactive properties, which are needed; conditions including autoimmune diseases, arthritis, pain and autism require THC, a different derivative that is psychoactive. The new prescription law was crucial to enable THC to be legally used as a controlled substance for medicinal purposes. Currently, a balanced CBD/THC flower preparation is available, supplied by Tikun Olam Europe, which commenced operations at Greece’s first medical cannabis manufacturing facility in January 2023.

Despite medical cannabis’s considerable potential in the treatment of numerous ailments, an official state initiative aimed at educating the medical community, medical associations, and healthcare professionals in its legality and usage is still absent. As a result, patients have turned to social media platforms and support groups like MAMAKA for help in navigating this uncharted terrain.

December 2022 witnessed a pivotal development with the establishment of the Hellenic Medical Association for Cannabinoids (HMAC) by a group of healthcare professionals. This initiative aims to spearhead activities related to cannabinoid research, education, and therapeutic applications, as well as to provide patients with a credible source of essential information.
However, it isn’t only patients who face an information gap, as Dr. Chryssoula Karanastasi, head of HMAC, explains, emphasizing the need for healthcare professionals to familiarize themselves with the endocannabinoid system (ECS) and cannabinoid drugs, and advocating for their inclusion in medical curricula.

Bridging Gaps: Advocacy & Education

While the National Organization for Medicines in Greece has approved medical cannabis for specific conditions, including chemotherapy-induced nausea, multiple sclerosis-related pain, and resistant chronic pain, there are still some major gaps. For instance, the use of medical cannabis to treat conditions such as epilepsy and autism is not provided for in Greece’s current legalization. Another cause for concern is the absence of provisions for prescribing medical cannabis to patients under the age of 18. This glaring oversight deeply troubles many young patients who have to live with these conditions and their families.

Jackie Poitras and Maria Thakiri, the mother of an autistic child, stand united in advocating for the legalization of medical cannabis in the treatment of a broader spectrum of conditions. They argue that extending the framework to encompass these conditions is a crucial step forward.

Another factor is the significant financial burden associated with medical cannabis use. Dr. Karanastasi stresses the need for healthcare systems to reimburse patients for cannabinoid drugs, particularly when conventional treatments have proven ineffective or intolerable.

Across Europe, countries including Germany and the Netherlands have been piloting pharmaceutical programs for several years which grant people access to cannabis-based treatments with the related expenses reimbursed through the state healthcare system. The UK, which enacted legislation after Greece, has established clinics and is facilitating access to a wide range of the cannabis products currently available on the market.

In the light of recent discussions with Greece’s Minister for Health, Adonis Georgiadis, Jacqueline Poitras remains optimistic about the future and looks ahead to continued collaboration to address patients’ evolving needs in the sphere of medical cannabis.

However, embracing medical cannabis can have social repercussions for patients, who frequently encounter prejudice and skepticism stemming primarily from ignorance. As Jackie Poitras remarks, “We have faced prejudice and skepticism about its effectiveness, but this usually comes from people who have not been properly informed, and believe that cannabis has only one exclusive use for recreational purposes. But those who have followed closely quickly change their minds.”

A significant number of individuals have transcended their preconceptions and found relief through cannabis. And as individuals experience its benefits, they become enthusiastic advocates who spread the word to others. What begins as a personal journey, for oneself or a loved one, frequently expands as they witness positive outcomes, further dismantling barriers of prejudice through practical experience.

Looking ahead to the future of medical cannabis use in Greece, Dr. Karanastasi emphasizes, “Greece is a country which ticks all the boxes for cannabis to ‘bloom’; it has the right climate, it has scientists who excel internationally, and it has patients who want to help us advance our knowledge many steps further. I want to believe that the pharmaceutical uses of cannabinoids will be the next leap forward in therapy, and I want to believe that Greece will serve as a stepping stone for that leap.”