On Wednesday, France prepared to launch a nationwide medical cannabis experiment in the most French of ways: with a committee meeting.
The sixth and final consultation of the expert group, called “Evaluation of the Suitability and Feasibility of Making Therapeutic Cannabis Available in France,” opened with four hours of presentations by patient advocates from organizations such as Epilepsy France and the Rare Diseases Alliance. Their voices cracking with emotion, they alternated between thanking the committee for embracing their struggles and pushing for more inclusivity in the upcoming project.
An “example that is particularly close to my heart is my friend Sebastien Cotte, who is fighting today in the United States. His son Jagger, who is 8 years old, was diagnosed with a rare degenerative condition, Leigh’s disease, when he was one year old. His life expectancy was estimated at four years. Today he is 8. He doubled his life expectancy, and he’s still fighting,” recounted Frédéric Prat of (Im)patient Hope.
Olivier Véran, a neurologist-turned-politician, opened the proceedings with an anecdote of a young man who suffered from migraines so painful he had become suicidal. After three months of treatment with medical cannabis, he said, the man was free of pain and could return to his life. Véran spoke of his frustration as a doctor at not being able to help his patients despite widely accepted evidence that cannabinoids can help treat numerous neurological conditions. The situation is especially frustrating, he said, given that treatment is available just across the border.
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The committee, which is overseen by the National Agency for the Security of Medicine and Health Products (ANSM), has looked to France’s neighbors as it moves towards allowing doctors to prescribe cannabis on a trial basis. Previous committee meetings have featured industry professionals from Germany, Canada, and Italy, including companies like Aurora Cannabis, who have already set up in France while awaiting legalization.
The French public health code currently forbids the production, fabrication, transportation, possession, acquisition, or cessation, of cannabis plants, plant products, resins as well as most tetrahydrocannabinols, but ANSM has the authority to allow cultivation for research purposes.
For the afternoon session Wednesday, local agroindustrial and pharmaceutical representatives were invited to the microphone to present their visions of French medical cannabis production. Despite the cannabis embargo, France is currently the third largest supplier of hemp globally, behind China and Canada, growing low-THC strains destined for textile and industrial uses.
As InterChanvre representative Franck Barbier put it, “France is a leader in hemp production and we hope to keep it that way.” Building on the expertise of his farm collective and emulating best practices elsewhere in Europe, Barbier estimated InterChanvre could be operational in producing medical-grade cannabis in one to two years.
The great French cannabis experiment looks poised to begin much sooner. The draft project plan published last week presents a tidy – and ambitious – calendar: Starting on a date to be decided now that the fact-finding portion of the project is over, the first six months will be dedicated to “mise en place,” during which the program operator will secure medical-grade cannabis in inhalable and liquid forms across a range of five THC to CBD ratios ranging from one part THC per one part CBD, up to 20 parts THC per one part CBD or 50 parts CBD per one part THC.
During this phase doctors who wish to issue prescriptions may volunteer for the program. Only doctors working in approved medical centers who complete an “e-learning” course will be allowed to participate. At the end of the mise en place, accepted patients will be able to fill cannabis prescriptions at hospital pharmacies under the careful supervision of their doctors, who will be required to keep detailed records in a national database.
Only five types of conditions will be eligible for treatment with cannabis during the experiment: neurological pain, epilepsy cases resistant to treatment, cancer patients, palliative care, and painful spasticity.
Patient activists at Wednesday’s committee meeting unanimously pushed back against the limited scope, with some decrying that many conditions for which cannabis could be therapeutic are not eligible. Others pointed out that mandating that prescribing doctors operate out of medical centers will leave large numbers of patients in France’s many “health deserts” untreated.
“We were very careful to limit it to symptoms rather than specific diseases, which would have been even more restrictive,” committee president Nicolas Authier explained to the third activist to speak up about the slim number of conditions.
Over the course of the morning’s presentations, insurance was another sticking point with the activists, many of whom referenced Sativex, a cannabis spray developed to treat symptoms of multiple sclerosis. Sativex has been legal in France since 2014 but has never reached the market since the maker, GW Pharmaceuticals, has been unable to reach an agreement with France’s Ministry of Health on the price.
Despite the limited rollout, the meeting carried a hopeful, anxious tone. While patient advocates came away with hope for effective physical relief, the agricultural representatives present saw opportunity for an economic boost in a sector that has faced great difficulty in recent years.
“We wish to participate because every step taken toward the relief of human suffering, no matter how small, is a step towards dignity, a step towards ethics, and a step towards humanity,” said Eric Correia, a nurse and local councilman speaking on behalf of the pharmaceutical firm Intsel Chimos in the rural Creuse region, adding, “France is catching up, and Creuse is ready.”
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