2019年欧洲大麻报告（P209）the European Cannabis Report 4th Edition

The
European
Cannabis
Report
JANUARY 2019
Edition 4
The European Cannabis Report™ About Us
ABOUT
PROHIBITION PARTNERS
Advancing the global cannabis industry

Data, analytics and business intelligence
on the international cannabis industry
1
About Us
Founded in 2017, Prohibition Partners was established We specialise in explaining the latest legislative
with a mission to provide cutting edge information and developments and key industry trends in the cannabis
business intelligence on the international cannabis industry - our research has been cited by political leaders,
industry. Our team provide independent advisory and data Fortune 500 companies, entrepreneurs and investors. Our
services to the key stakeholders in this emerging frontier - advisors will help you understand the cannabis industry
working with regulators, entrepreneurs and investors and its increasingly segmented sectors through
across legal markets. At Prohibition Partners, we believe authoritative research and unique strategic advice on
that data, insights and understanding will ultimately licensing, regulatory and business opportunities.
unlock the societal and commercial potential of cannabis.
Services
Data Bespoke Research, Polling, Consumer Insight, Pricing, Market Forecasting.
Intelligence Policy & Compliance, Market Analysis, Supply / Demand.
Strategy
Market Entry / Expansion, Regulatory Guidance, Licensing,
Partnerships, Business Development.
Stephen Murphy Daragh Anglim David Attwood Eoin Keenan Alexandra Curley
Co-Founder Managing Director Head of Consulting Head of Content Head Of Insights
Cannabis remains illegal in some European countries so please reference your local laws in relation to medical or recreational use. This report has been compiled
for informational purposes only. It should not be construed as a research report for investment, legal, medical, health or tax advice. © 2019 PP Intelligence LTD.
The European Cannabis Report™ About Us
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and entrepreneurs, and creating more than 6 million social have a keen interest in the cannabis market. As companies
impressions annually, Prohibition Partners is the number and investors scramble to get a foothold in the market, this
one source for data in the global cannabis industry. is an invaluable opportunity to put your brand front and
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The European Cannabis Report™ Table of Contents
TABLE OF
CONTENTS
ABOUT US 1
3
INTRODUCTION 7
LEAD SPONSOR FOREWORD 7
EXECUTIVE SUMMARY 10
DEFINITIONS 13
MARKET OVERVIEW 15
KEY INSIGHTS 18
MEDICAL BENEFITS OF CANNABIS 20
LEGISLATION 24
REGULATION 29
COMMERCIAL OPPORTUNITIES 35
EXPERT ANALYSIS: EUROPEAN STRATEGY 41
KEY COUNTRIES 46
4
GERMANY 47
ITALY 54
FRANCE 61
SPAIN 68
THE NETHERLANDS 74
UK 81
DENMARK 89
PORTUGAL 94
POLAND 98
GREECE 103
MACEDONIA 108
IRELAND 112
CZECH REPUBLIC 117

5
ISRAEL 122
BELGIUM 127
AUSTRIA 131
MALTA 136
SWITZERLAND 139
LUXEMBOURG 144
NORWAY 148
FINLAND 152
SWEDEN 157
CROATIA 161
SERBIA 166
ESTONIA 170
TURKEY 174
6
SLOVENIA 178
ROMANIA 182
LATVIA 186
LITHUANIA 189
SLOVAKIA 192
LEBANON 195
GEORGIA 198
APPENDIX 201
The European Cannabis Report™ Introduction
INTRODUCTION
Throughout 2018, the European cannabis market’s industry. It examines legislation, regulation, market
value has skyrocketed. €300 million has now been size and market opportunities in 33 European
invested in the market, which so far has been focused countries, analysing myriad data points.
on distributing cannabis-based medicines and
allocating cultivation licences. I would like to thank our sponsors and members of our
European Country Panel for their support, plus the
Throughout Europe, countries are reconsidering the dedicated team at Prohibition Partners for their
region-wide moratorium on medical cannabis. Key commitment to providing the most comprehensive
markets like France, the UK, and Spain are reviewing
their current legislation while the industry leaders;
data and insights on Europe’s cannabis industry. I
hope you enjoy the report.
7
Germany, Italy and The Netherlands focus on
expanding existing medical programmes. Daragh Anglim
Managing Director
The European Cannabis Report™: Edition 4 is the most Prohibition Partners
extensive review to date of the European cannabis
LEAD SPONSOR FOREWORD

The global cannabis market is expanding at an world, covers demand, supply and distribution. This
unprecedented rate, with new developments in includes our recently announced acquisition of CC
diverse markets occurring daily. Europe boasts some Pharma, a leading distributor of pharmaceutical
of the world’s fastest evolving and most significant products to more than 13,000 pharmacies, and the
opportunities in medical cannabis. Canada construction of one of the largest state of the art
established a high bar for the successful GMP-certified cannabis vaults. This will secure a
implementation of a regulated medical cannabis constant delivery of imported cannabis for German
industry; now Europe and the world are looking to us patients. Our European presence also extends to
to predict their future markets. several other emerging and rapidly evolving markets.
Cannabis is already an important part of the global
As a leading global cannabis company headquartered medical landscape, but we’ve only scratched the
in Leamington, Ontario, the greenhouse capital of surface of the plant’s medical potential. Aphria is well
Canada, Aphria has been setting the standard for safe, placed to conduct high quality, pre-clinical and clinical
clean and pure pharmaceutical grade cannabis, grown research projects, and is simultaneously involved in a
at scale in the most natural conditions possible. number of significant clinical trials with leading
Today, with a presence in strategic international international partners. These cover pain management
markets across Europe, Oceania, Africa, Latin America in oncology patients and the treatment of Refractory
and the Caribbean, we have the strong foundation, Epilepsy in children.
relationships and infrastructure to capture significant
future growth as international markets evolve. Aphria is driven by an unrelenting commitment to our
people, product quality and innovation. We know that
In Europe, Aphria continues to expand its footprint tomorrow’s cannabis products will revolutionise the
through a diversified approach to innovation, strategic way patients and consumers integrate cannabis into
partnerships and expansion. Our subsidiary ASG their lives. As medical cannabis markets evolve across
Pharma is a high capacity EU GMP-certified lab in Europe, Aphria is uniquely positioned to lead the
Malta, well positioned to become a cornerstone in European and global medical cannabis industries into
testing, research and development of medical the future.
cannabis in Europe - and ndeed a leading hub for the
export of medical annabis. Jakob Ripshtein
President
Our comprehensive presence in Germany, one of the Aphria Inc.
most sought after medical cannabis markets in the
The European Cannabis Report™ Sponsored Message
The European Cannabis Report™ Executive Summary
EXECUTIVE SUMMARY
Europe’s Burgeoning Legal Cannabis Industry
Home to more than 740 million people, a population anticipate substantial growth in the medical arena.
more than double that of the US and Canada Although we understand cannabis can alleviate over
combined, Europe is set to become the world’s largest 60+ conditions, there is currently a lack of clinical data
legal cannabis market over the next five years. which can help unlock the full market potential of
medical cannabis. Reliable and replicable research
Over the last twelve months, the European cannabis will be vital in persuading governments to enact
industry has grown more than it has in the last six reform. 10
years. Six countries have announced new legislation
and over €500m has been invested in the European Europeans also expect levels of regulation and
cannabis businesses. According to our findings, standardisation across medical cannabis products to
Europe’s cannabis market is estimated to be worth up be perfected. A forthcoming review of the evidence
to €123b by 2028 and will likely become the world’s surrounding medical cannabis from the World Health
largest legal market over the next five years. Organization (WHO) and the European Union (EU),
could lead to a recommendation on its legal status.
In our view, these developments present an enormous The outcome is expected to add to the ranks of the
opportunity. Our report demonstrates that the countries recognising the legitimacy of medicinal
momentum in Europe clearly supports a shift towards cannabis.
legalising medical cannabis and bringing visibility and
maturity to this growth industry. This offers a number Our report also draws attention to the economic
of key opportunities to policymakers, investors, opportunities a regulated medical cannabis market
businesses and academic and medical researchers. could bring to Europe’s power centres and its smaller
economies. A regulated cannabis industry would give
As with any culturally diverse region with individual a welcome boost to those countries hardest impacted
laws and languages – Europe is home to 50 countries by the recession of 2008, including Spain, Portugal,
speaking 24 official languages - we anticipate several Italy and Poland. The cannabis industry could also
challenges on the road towards legislation. European prove important to more severely affected countries
policymakers and businesses will have to find like Greece and Macedonia who are utilising cannabis
consensus on laws covering cross-border supply cultivation to support an ailing agriculture industry.
chains, the standardisation of products and
commercial agreements. The versatility of cannabis could also will have a
significant impact across multiple sectors, including
The European Cannabis Report™: Edition 4 highlights beauty and wellbeing, leisure, manufacturing, textiles,
that governments and their legislative arms are and food and beverage. Widespread applications for
already becoming increasingly pro-cannabis. This is cannabis, coupled with high consumption rates and
largely due to growing public support in favour of exclusive pricing indicate a potential market worth up
legalisation as commercial and social benefits to €123b by 2028. Europe’s burgeoning legal cannabis
become apparent. Factors such as new employment industry represents an exciting green-field
opportunities, additional tax incomes, a reduction in opportunity, provided stakeholders take a
crime and the scope for greater clinical research are all knowledge-based and considered approach.
driving forces for the establishment of a legal cannabis
market. Lack of credible research or analysis into the value of
tax revenues and employment opportunities is another
The debate over cannabis in Europe has also matured challenge. European policymakers and economists
as politicians, healthcare professionals and may look to North America, Canada and Australia for
entrepreneurs have followed the growth of the replicable impacts within these economies. The US
industry in the US and Canada where investments cannabis industry is expected to outpace
quadrupled in value in 2018. While Europeans do not manufacturing job creation by 2020, and cannabis
expect a similar regulated recreational market in the sales are set to exceed both liquor and wine markets in
immediate future, policymakers and businesses do Canada in 2019. Ultimately there will be thousands of
The European Cannabis Report™ Executive Summary
opportunities in every country across the supply chain, summer the European Parliament’s Environment
as well as ancillary products and platforms. This is a Public Health and Food Safety Committee called on
fact politicians on either side of the political spectrum the European Commission to create an EU-wide policy
can no longer ignore. for medical cannabis.
But while some think the EU’s most valued Faced with a myriad of questions about data,
fundamentals are at risk, our analysis shows the region legislation and commercial opportunities The
is more resilient than just its 28 member states. In all European Cannabis Report™: Edition 4 supports
aspects of legislation and standardisation, the bloc’s entrepreneurs, regulators and investors as they
governments, industries and citizens have excelled at navigate the complex legislative framework and
finding innovative solutions. The cannabis debate has growing segmentation of this emerging frontier.
already reached the European Union, where last
11
The European Cannabis Report™ Methodology
per gram has been modelled based on
METHODOLOGY post-legalisation pricing trends from a number of

markets. This has been factored into the market size
calculations with price modelling incorporated into the
The market sizing contained within this report YOY forecasts.
assumes that, by 2023, all countries profiled have
legalised medical cannabis, and regulated recreational Patient numbers have been modelled on existing
use. It is our view that Moore’s law is at play within the markets where medicinal cannabis has already been
global cannabis industry; momentum is building pace legalised and regulated. It is not calculated as the sum
and is hitting a critical mass. We anticipate that of patients who suffer from qualifying conditions,
medical cannabis consumption (as a percentage of the primarily because patients may suffer from multiple
population) will increase faster than seen in early qualifying conditions for which cannabis can be
adopter nations and states. prescribed. Value forecasts can includes pharmaceutical
and CBD medical products.
12
Market size and segmentation have been calculated
following extensive analysis of the dynamics and
performance of fully regulated cannabis markets
including Uruguay, Canada, Germany, Israel, the
RECREATIONAL
Netherlands and some states in the United States of
America. Our recreational cannabis market sizes include the
black market. Taking the UNODC prevalence figures
Quantitative analysis of socio-economic data, as a starting point, this has been multiplied by average
consumption trends, cannabis requirements, and annual consumption and average prices for cannabis
pricing has been informed by a wide range of (herb). The growth rate has been modelled on trends
reputable datasets including the United Nations seen around the world and pricing trends have been
Office for Drug Control (UNODC), the World Bank, the informed by research published in more mature
Organisation for Economic Co-operation and markets on the impact of legalisation and regulation
Development (OECD) and the International Narcotics on the average cost per gram on the black market. We
Control Board (INCB). have assumed that the price per gram of cannabis will
either be the same or lower than the most recently
Qualitative intelligence is gathered through published available pricing data.
reports and papers from the world of academia,
business and medicine, and also draws on a range of
research techniques including digital tracking,
discourse analysis and in-depth interviews with
industry experts. MARKET VALUE
The Commercial Opportunities section of each For the purposes of this report, medicinal market sizes
country profiled, represents our best estimate of include pharmaceutical cannabis and medical
market size, segmentation and future performance. cannabis as sold as flowers, oils, topicals etc.
However, market size, segmentation and performance,
as well as cannabis prevalence and consumption
volume may change as more data becomes available.
MEDICINAL
The medicinal market size estimates and forecasts
contained within this report, represent a calculation of
average price per gram of cannabis multiplied by the
expected usage, multiplied by the estimated potential
patient population. Price per gram of medicinal
cannabis differs to street value prices and the price
The European Cannabis Report™ Definitions
DEFINITIONS
Medical cannabis
Medical cannabis refers to plant-based or plant-derived cannabis
products prescribed by a medical practitioner for the treatment of a
specific conditions or diseases (eg, epilepsy, pain, MS). Medical cannabis
uses the whole unprocessed plant, the processed plant or the chemicals 13
contained within it. It can include high CBD and low THC products
though CBD products may also appear as consumer goods. Medical
cannabis products are currently prepared as plant materials, oils,
tinctures, edibles or capsules.
Pharmaceutical cannabis
For the purposes of this report, pharmaceutical cannabis refers to
products formulated using pure cannabinoids (either plant extracted or
synthetic) that have been through full clinical trials and licensed as a
medicine. Examples of products include Sativex, Epidiolex, Cesamet,
Marinol and Syndros.
Recreational cannabis
Recreational cannabis refers to any cannabis used for non-medical
purposes. It includes black market products. It ordinarily has a higher
concentration of THC, the psychoactive properties of the cannabis plant.
It is illegal in many countries and states. People tend to smoke (or
consume via edibles) recreational cannabis or use oils and vaporised
products. For the purposes of this report, usage is assumed to be in
people aged 15+.
CBD
Throughout this report, reference is made to CBD. Whilst there is an
emergent market for CBD-infused consumer goods, capsules and oils,
these have been excluded from the market size calculations due to a lack
of sales data. Although these products may be used for wellness
purposes such as to aid sleep, or for pain or anxiety management, they do
not require a prescription and have therefore been excluded from the
medical market sizing.
14
www.indica.fund
THE FUND
The Indica Strategy Fund invests
in companies profiting indirectly
from the global cannabis industry
- the ‘picks and shovels’
INVESTMENT
OBJECTIVE
To achieve long-term capital apprecia-
tion by investing in low risk ancillary
services, brands and consumer
applications that support the
legalized cannabis industry
THE MANAGER
Nesta Holding Co. Ltd, a leading private
equity firm whose principals have been
active in the North American cannabis
industry since 2013
A fully registered and audited cannabis related fund

ISIN: NL0012727424 BLOOMBERG: INDSTR1 NA
The European Cannabis Report™ Market Overview
MARKET OVERVIEW
Key Statistics for the European Cannabis Industry
Population (m): Total Healthcare Average price 15

743
GDP (€ t): per gram of recreational
16.6
Expenditure (€t)2:
2.3 cannabis (€)
8.33
Estimated Estimated recreational

Estimated Cannabis medicinal3 cannabis cannabis market Estimated cannabis
Market Value, (€b)1 market value, (€b)1 value, (€b)1 users aged 15-64 (m)
2028 2028 2028 2018
123 58 65 25
1Estimates assume that by 2023, all countries profiled in this report have legalised medical cannabis and regulated recreational use
2Estimate based on average regional healthcare expenditure as % of GDP
3 Includes medical and pharmaceutical cannabis
Source: Prohibition Partners
The European Cannabis Report™: Edition 4 focuses

on the primary market for medical and recreational
cannabis. By 2028, Prohibition Partners estimates MEDICINAL
Europe’s legal cannabis industry will be worth up to
€123b.
There is a good reason to be optimistic about Europe’s Estimated €58b by 2028

future cannabis industry, given the current high price market value
of cannabis and relatively high usage rates. In mature
markets, like North America, Prohibition Partners has With a market of over 742 million people and total
noted an increase in recreational consumption healthcare spend of €2.3t, Europe will be the largest
following the legalisation of the recreational market. medical cannabis market in the world. In 2018, public
and private interests have simultaneously begun to
In the mid to long-term, cannabis consumption could recognise the commercial and social value of legal
penetrate a far higher proportion of Europe’s medical cannabis. Both business and government
population, particularly if used to treat mental health realise that this thriving industry has a future but it
issues like anxiety and depression. Recreational must be based on conclusive research. A record level
cannabis legalisation would drive the market forward of investment in research and development has seen
if enacted. Large populations, extensive cannabis new facilities opening across Europe - from Ireland
consumption and innovation across multiple verticals and the UK to Portugal and the Czech Republic. One
(such as food, beverages and wellness) would also add of the results has been the ever-increasing list of
to a high market valuation. conditions that cannabis can treat. As the list grows,
so too does the potential patient base. Europeans will
expect a standardised and highly regulated product,
which will clearly mark the European medical cannabis market while Luxembourg has promised to
cannabis market as a key target for pharmaceutical introduce a regulated adult use market before 2023.
companies over the next 5-10 years.
Factors such as new employment opportunities,
The European medicinal cannabis market could be additional tax income, reduction in crime and greater
worth up to €58b once all markets have implemented clinical research are going to become key driving
legislation and enacted an efficient market forces for the establishment of a legal recreational
infrastructure. We estimate that this will likely be cannabis market in Europe.
enacted by 2022 and developed by 2028.
CBD
The health and economic benefits of medical
cannabis have already been recognised by a number
of leading insurance companies including Sun Life, 16
AOK, TK, Barmer and Cigna. While still illegal in a
number of European countries, insurance companies
Cannabidiol (CBD) is one of the many cannabinoids
across Israel, Italy, Denmark and Germany have
found in the cannabis plant. The compound is
changed their stance and are now covering cannabis
non-psychotropic and can easily be mixed with a
prescriptions in these markets. The requirement of
carrier oil to create CBD oil. It is currently experiencing
insurance companies to cover European patients will
a growth in interest owing to its numerous health
be taken on a state by state basis.
benefits (with no reported side-effects even at
high-doses). The versatility of CBD means it can be
Early indicators from leading cannabis programmes
used in many formats including teas, oils, tinctures,
suggest that fulfilling medical cannabis prescriptions
capsules and balms and increasingly used as a food
will become a basic requirement of any public
supplement and as an ingredient in cosmetics.
healthcare policy. This will be a core difference
between European cannabis programmes and North
The retail value of Europe’s health and wellness
American cannabis programmes, whereby private
market was estimated to be worth some €180 billion in
practices are increasingly common in regions such as
2018, a rise in value from €151 billion in 2013. This
British Columbia, California and Colorado.
growth is attributable to growing health literacy across
Europe with people becoming better-versed in how to
improve their health through changes in lifestyles and
RECREATIONAL
supplementation. As a result, people are taking
greater responsibility for their mental health and
physical well-being. Figures published by the WHO
estimate that some 25% of Europe’s population
suffers from depression or anxiety, and given the
Estimated €65b by 2028
mood-enhancing benefits of CBD, demand for
market value CBD-based products that can boost mental health will
experience strong growth. Segment performance will
be further propelled by growing availability of CBD
Cannabis accounts for the lion's share of the €40b+ consumer goods through ingredient innovation from
illegal drug market in 2018. By 2028, we estimate that big brands in mainstream consumer goods markets.
the European recreational cannabis market will be
worth €65b. New products, distribution and supply Figures the Canadian market for health products
channels have further advanced cannabis suggest that CBD products account for an estimated
consumption and presence throughout Europe over 0.05% of the health and wellness market value and we
the last ten years. With the exception of Catalonia and would expect the European CBD market to account
Luxembourg, Europe is mostly focused on legislation for a similar, if not larger share of the region’s wellness
for medical cannabis and CBD products. However, as market value by 2028. The launch of CBD-infused
countries adopt medical cannabis programmes and beverages, for example, will help drive value sales of
economic studies show the benefits of a regulated CBD products higher. Furthermore, as food and drinks
market, many European states are opening up the trends often filter into other consumer goods markets,
recreational cannabis debate. Since the beginning of Prohibition Partners predicts that sales will also be
2018, Germany, Denmark, Malta, Greece and Italy bolstered by rising demand for CBD-infusions in
have all discussed the possibility of a fully regulated beauty products and possibly even household
products in the future. In addition, the lack of a

regulated market has helped drive demand for CBD
products in Europe as the only legal means to access
the therapeutic properties of cannabis. Furthermore,
legal markets in the US show a high demand for high
CBD and minimal THC recreational cannabis and
Europe is expected to follow a similar trend.
Europe’s cultivation capacity and processing

infrastructure will quickly put the region on par with
the North American market for hemp CBD products.
However the battle for control and classification of the
category will intensify as major pharmaceutical 17
companies enter the space.
The European Cannabis Report™ Insigths
INSIGHTS
Multinational Regulation
After Canada became the first G7 country to fully legalise recreational
cannabis, and with growing demand for medical cannabis legalisation
across Europe, the World Health Organisation is reviewing the legal
status of cannabis. In addition, the European Parliament Committee on 18
the Environment, Public Health and Food Safety has proposed a draft bill
to establish a regionwide regulatory framework on medical cannabis.
Initial findings and responses have been positive from both
organisations; favourable results would likely lead to a wave of regulatory
changes in 2019.
Professional Education
Physicians often play catch up in the wake of regulatory changes to
national cannabis policy. While medical cannabis demand in Germany
and Italy is on the rise, formal educational programmes for medical
professionals are not yet in place. The need for extensive and credible
education for licenced health professionals is quickly becoming a
priority.
Domestic Cultivation
Until now, European medical cannabis programmes have depended on
Canadian imports and joint ventures to supply the burgeoning demand
for cannabis medicines. Industry leading EU nations; Germany, Italy and
The Netherlands are developing tenders for domestic cultivation
licences, seeking to build a domestic industry with localised supply of
medical cannabis.
Southern European nations are beginning to develop domestic

cultivation programmes which will offer a low-cost product available via
intra-EU trade networks.
Market Penetration
Cannabis is slowly but surely entering new European markets. Health,
beauty and wellness were the first to capitalise, but food, beverages and
financial markets are creeping in. Announcements and investments from
AB Inbev, Constellation Brands and BlackRock are evidence cannabis
stocks are becoming mainstream.
19
The European Cannabis Report™ Medical Benefits of Cannabis
MEDICAL BENEFITS OF CANNABIS
An Introduction
to Medical Cannabis
Professor Michael Barnes,
MD FRCP, Honorary Professor 20
of Neurological Rehabilitation
The beauty of cannabis is that all it is doing is
supplementing the body's natural cannabis system,
called the endocannabinoid system. Humans, as well
as many other animals, have this natural system
throughout the body. The system, in the brain for
example, has an effect on memory, control of
movement, modulation of pain, development of nerve
growth and plasticity, and the adaptability of the
nervous system. It has an influence on sleep, appetite,
anxiety and social behaviour, to name but a few
important functions. Outside the brain the
endocannabinoid system is also widespread, and has
effects on the bladder, the bowels, the reproductive
system, the heart, the hormonal and metabolic
systems, and has a role in the control of cancer. In
other words, it is one of the body’s most important
systems - yet one of the least understood.
We know there are at least two cannabinoid receptors

in the body, CB1 and CB2, but in the next few years we
are certain more receptors will be isolated. There are
natural chemicals circulating in the body that attach to
CB1
these receptors and it is through this chemical
attachment that the endocannabinoid system
performs its functions. The natural plant cannabinoids
are supplementing and assisting the body's natural
circulation of cannabis-like chemicals. Thus, it is not
surprising that the plant has many medical benefits.
One clear fact is the whole cannabis plant has medical

CB2
value, rather than just the constituent parts. Over a
hundred different cannabinoids exist, but we only
know a substantial amount about two (THC and CBD),
a little about ten of them and virtually nothing about
the others. To understand all the different properties
and potential medical benefits of cannabinoids will be
a long journey.
(Source: Sensi Pharma)
Despite such complexities, there are two main

cannabis chemicals known to be leading components
with the most medical benefit; THC and CBD. THC
(tetrahydrocannabinol) is psychoactive, giving
individuals the cannabis high. CBD is not psychoactive
and indeed, to an extent, counteracts the high of the
THC. The balance between THC and CBD is one of the
most crucial factors in understanding which particular
effects will be seen in a particular cannabis variety. We
know both CBD and THC have medical properties. One
of CBD's most important effects is as an
anticonvulsant. To illustrate the complexity of the
plant, whilst CBD is a very potent anticonvulsant, many 21
children with epilepsy respond even better when there
is a little THC added into the medicine. This shows how
the whole plant has a better effect than individual
components. This is known as the entourage effect.
Cannabis medication plays an important role in death

reduction from opioid poisoning. We know that when
legal cannabis is introduced into a population, opioid
deaths reduce by at least 25%, and cannabis can offer
a safer form of pain-killing medication.
Will cannabis be used in future healthcare systems?

The answer is definitely yes. Cannabis is now legal for
medical purposes in 44 global countries; this number is
increasing month by month. It is, in my view, the most
exciting medical development of the early 21st century.
Total Cannabis Usage

Within Europe, cannabis use varies by country
depending on medical necessities, cannabis culture
255
tonnes of
and the penalisation of cultivation, trade, possession million users cannabis
and use. consuming annually.
around
Europe has a burgeoning cannabis market with cities
like Amsterdam, which has over 160 cannabis selling In France the number of teenagers using cannabis is
coffee shops, and Barcelona which has over 700 higher than in any other EU country. According to a
cannabis social clubs, serving as hotspots for 2016 WHO survey, France had the highest number of
cannabis tourism. teenage cannabis users in the world. 22
N THE EUROPEAN UNION (EU)
700,000
AND NORWAY
23
million people
12
million people
daily cannabis users
in France
around
41% of the French

adult population
have used
cannabis at least
once in their
6.8% of 3.6% of lives.
15-64 year olds 15-64 year olds
have consumed have consumed
cannabis in the cannabis in the
past year past month
The Nordic countries, which typically held very
stringent cannabis laws, show higher usage among
younger cohorts. In Denmark, around 12% of youths
between 15 and 16 years of age use cannabis. In
Sweden, Norway and Finland, the prevalence of
cannabis use among teenagers lies between 7 and 8%.
In contrast, there are nations like The Netherlands,

Recreational cannabis use tends to be higher in Spain and Portugal where cannabis use has remained
countries where laws are less stringent. In contrast, relatively stable after decriminalisation. In The
cannabis use usually stabilises if it is tolerated to a Netherlands, some 15.7% of the young adult
degree, whether through legislation or social population uses cannabis, according to a 2018
acceptance. Despite this, both the UK and France EMCCDA report. The same report indicates Spain has
have very restrictive laws; they also have among the a slightly higher rate of cannabis use among young
largest base of regular cannabis users in Europe. The adults at 17.1%.
British cannabis black market is estimated at €2.9
billion.
23
The European Cannabis Report™ Legislation
LEGISLATION
Overview
Europe is seeing a fast paced wave of regulatory and proposed new cannabis bills, or committees to review
legislative change. Throughout 2018, a swathe of the legal status of medical cannabis.
European countries introduced, reviewed or
announced future legislation to advance the legal Across Europe there is growing media and public
cannabis agenda. The UK, Portugal and Malta have discourse on cannabis laws. Advocates for progressive
legalised medical cannabis products. The cannabis laws cite increased efficacy of healthcare
Netherlands, Denmark and Germany have either systems, reduction in crime and the growth of 24
issued cultivation licences or plan to introduce a commercial opportunities in legal markets. Opponents
tender for global cannabis producers. Even and conservative legislators claim that medical
conservative governments in France and Ireland have legalisation can lead to the abuse of cannabis.
LEGAL STATUS
Pharmaceutical Medical Recreational
Cannabis Cannabis Cannabis CBD
Pharmaceutical cannabis Medical cannabis refers to

(THC < 0.3%) and hemp
refers to products plant-based or Recreational cannabis
are legal in the majority of
formulated using pure plant-derived cannabis refers to any THC European countries, but
cannabinoids (either products prescribed by a cannabis used for sometimes require a
plant extracted or medical practitioner. non-medical purposes. licence to produce and/or
synthetic) that have been Medical cannabis products Although currently a doctor’s prescription to
are prepared as plant illegal, attitudes are
through full clinical trials procure. CBD wellness
materials, oils, tinctures,
and licensed as a changing and there is a and food products are
edibles or capsules.
medicine. Products are moderate probability of also commonly available
Medical cannabis is
accessible via a medical legalisation in the although lack clear and
already legal or will be in
prescription from a medium term (three to obvious regulations.
the short term (within three
licensed doctor. years) across Europe. five years).
PHARMACEUTICAL
Growing demand for cannabis based medicines over pharmaceutical products based on mainstream
the past year has pushed national medical authorities medical opinion. These countries have begun to
into action. EU countries have initiated medical establish medicinal cannabis programmes based on
treatment programmes using pharmaceutical pharmaceutical products.
cannabis products.
Contrastingly in Germany, Italy and The Netherlands,
Patient advocacy groups have focused on legalising medical cannabis treatments revolve primarily around
cannabis flowers for medical purposes, but several cannabis flowers.
countries; the UK, France, Sweden and Ireland favour
With ongoing research into the best cannabis Any licencing for production and prescription would
compositions and delivery methods for different be strictly regulated. Nevertheless, the growing
illnesses, it is very likely scientific evidence validating demand for medical cannabis could push regulations
treatment, either in pharmaceutical forms or for and lead to a broader market, as in Germany where
flowers, will become an accepted mode of therapy. tenders for domestic medical cannabis production
have recently been issued.
As clinical evidence for medical benefits of cannabis
increases and becomes accepted by the European With Italy’s medical cannabis market showing similar
medical community, private health insurance growth patterns, the Italian government may well
companies and government health agencies will start follow Germany. All subsequent medical cannabis
recognising pharmaceutical cannabis treatments. legalisation could lead to a broadening of the medical
Once that occurs, many more medical professionals cannabis market across Europe.
may prescribe cannabis medicines than at present. 25
While medical cannabis has been legal in several
For pharmaceutical cannabis medicines, price is European countries for a number of years, very few
another major factor for concern. In France the countries have the infrastructure or proper legislation
National Agency for Drugs, on authority from the in place to supply patients. Bedrocan and Canadian
Ministry of Health, is seeking to negotiate a low price imports have become the most common medical
with the country’s Sativex distributor. cannabis imports in the region.
Presently, pharmaceutical cannabis products like The growth of the CBD market in Europe is currently
Epidiolex are about to enter European markets. If hampered by lack of official categorisation. CBD can
similar price disputes arise with other pharmaceutical be categorised as a medicinal product but is also
cannabis medications, the market could lose its share available as a food and wellness product which falls
to medical cannabis flowers. under a different regulatory jurisdiction. With debate
over product licencing and regulated supply and
Depending on clinical trials for medical cannabis, distribution channels, availability of qualified CBD
European nations could adopt a discretionary products in Europe is limited.
approach; recommending pharmaceutical cannabis
medicines and/or medicinal cannab on a case by case
basis.
Progressive
Progressive Average
MEDICAL Conservative Average
Conservative
The most significant medical cannabis event of 2018

occurred on November 1st, when the UK legalised the
prescription of medical cannabis products. This came
after the first legal and regulated medical cannabis
market was launched, with Germany taking the lead
and paving the way for other European countries to
follow.
Europe will become a hotbed for market development;

new legislative bills on medical cannabis are being
prepared for local parliament in at least five other
countries.
The move towards European medical cannabis has

been slow, but the political and legal situation is
shifting positively. The European parliament is The map represents the regulatory approach to medical
deliberating on liberalising medical cannabis cannabis.
restrictions. If laws are passed, they would pave the
way towards easily available medical cannabis across
the EU.
Cannabis remains part of the wider European ‘war on
RECREATIONAL
drugs’ approach by Interpol and drug enforcement
groups. Despite soundbites and pledges from
politicians, no credible bill or legislation exists to
challenge the legal status of recreational cannabis.
European recreational cannabis is mostly illegal,
however several regions and cities operate on the New legislative proposals are likely in the next two
fringes of the law. Cities like Barcelona, Amsterdam years, as the case gathers strength on the back of
and Copenhagen are well known for private member international learnings.
clubs and coffee shops but none presently offer a
tenable solution for recreational cannabis legalisation.
The decriminalisation of recreational cannabis use is

gaining ground in Europe. Portugal pioneered the
CBD 26
policy decades ago, but in recent years Germany,
Spain, Switzerland, Croatia and Greece have all
Cannabidiol, or CBD can be legally purchased in most
gradually decriminalised cannabis possession in small
European countries, except in Denmark and Malta
amounts, and reduced punishments from fines and
where it can only be purchased with a doctor’s
prison sentences to fines and/or rehabilitation
prescription. It also remains illegal in Slovakia.
treatments.
The legislation around CBD is currently in a grey state.
Israel decriminalised recreational cannabis in July
While certain CBD products are used as a medicine,
2018 for the first three occasions someone is caught
requiring marketing authorisation and clinical testing,
for personal use, only opening a criminal case for the
other CBD products are classified as foods and
fourth incident.
wellness products.
In addition, Luxembourg has pledged to introduce a
There are restrictions on the claims producers and
fully regulated recreational cannabis market by 2023.
sellers of CBD oil products can make on packaging or
through marketing. These claims cannot be medically
Each country has its own approach to tackling
based unless there is compelling medical literature
cannabis, from decriminalisation to reduced status.
supporting them, and the company has received a
marketing licence or authorisation from the specific
Progressive
country’s government body to advertise them as
medical products.
Progressive Average
Conservative Average
Conservative
The map represents the regulatory approach to

recreational cannabis.
The Process of Legal These bodies play a predominant role in cultivating,
Reform
taxing or funding, prescribing, dispensing and
approving licences, and granting patients access to
the cannabis market.
European countries have implemented cannabis Some areas of law require amendment; others need to
regulatory frameworks since the 1970s, with The be created. The criminality of cannabis and associated
Netherlands the first country to implement a system of penalties must be reformed to permit legal uses;
limited distribution. Other forms of legislation cultivation, manufacture, distribution and
followed, allowing for closed systems of cannabis consumption (medically or recreationally). In some
cultivation, distribution (e.g. social clubs in Spain) and countries, this may be a matter of amending the
importation. In some countries without regulatory classification of cannabis under national law. There
frameworks for a legal market, legislators have are multiple laws that require amendment, including: 27
decriminalised or depenalised the cultivation,
distribution and use of cannabis. • Criminalisation and Penalisation
• Licencing model
Legal reform is country specific, with each adopting • Trade regulations (e.g. importation, state monopoly,
their own penal or criminal code, controlled drug private cultivation)
scheduling system and health services. This contrasts • Distribution channels (e.g. postal, dispensary,
with the US, where legalisation has often followed the pharmacy, caregiver, home grow, cannabis clubs)
result of a voter referendum. In Europe, cannabis • Compliance mechanisms (e.g. lab facilities,
legalisation has rarely been the result of a public vote. potency, tracking systems)
Whilst European countries permit referendums as a • Product labelling, packaging and advertising
possible avenue for legal action, parliamentary
legislation is more effective; referendums are generally A final factor to recognise is the strategic use of the
non-binding legal decisions. media and medical research. Support for legalisation
increases through medical evidence, personal success
There are two effective ways of advancing cannabis stories and empathetic connections to the plant,
legislation in Europe: politics and people. Changing public perceptions of
cannabis, its uses and opportunities is fundamentally
connected to the advancement of legal reform.
1. Lobbying efforts directed at lawmaking officials
2. Bringing specific cannabis cases to court
Prior to initiating a bill, act or policy in favour of

legalisation, there are various steps politicians may
take to garner support. The process of collating
information about cannabis legalisation may include
technical reports and public hearings. Another
effective method legislators use to expedite
implementation of legislation is organising a
committee to assess cannabis legalisation (e.g.
medical uses, economic opportunities or public health
concerns).
Although approaching parliament and legislators is

key in passing a regulatory framework to legalise
cannabis, other governmental bodies must also be
involved in the process of reform, typically including
the offices of:
• Ministry of Health
• Ministry of Agriculture
• Public Health officials
• Interior Ministry
28
The European Cannabis Report™ Regulation
REGULATION
History of Cannabis in Europe
5th 13th 19th 20th 21st

Century Century Century Century Century 29
Cannabis Marco Polo Medical International Medical
arrives brings medical cannabis cannabis
leagues outlaw use is
in Britain reports of becomes cannabis use
cannabis to reintroduced
popular in and recreational
mainland
Europe Western cannabis is
medicine debated
1 2 3 4 5
Cannabis has a long history in Europe. While hemp increased in the aftermath of World War I when a
had long been in use, psychoactive cannabis came in transnational movement to ban it emerged.
through Germanic tribes. These tribes were most likely
exposed to cannabis through the nomadic Scythians, Specifically, the League of Nations’ 1925 Convention
who are likely to have brought cannabis into what is on Narcotics Control outlawed cannabis in Europe.
today Southeast Russia and Ukraine. This convention was later succeeded by three United
Nations Conventions, beginning with the 1961 Single
Cannabis arrived in Britain around the fifth century AD Convention on Narcotic Drugs (SCND) that kept
with the Anglo Saxon invasions. Some Viking ships cannabis banned worldwide all through the 20th
dated around the mid ninth century AD had cannabis century.
seeds on board. Evidence suggests that both Vikings
and Germanic tribespeople used cannabis for pain At the turn of the 21st century, voters and political
relief. parties began advocating for cannabis law reform,
beginning with the 2002 effort by the Labour
Marco Polo is thought to have brought the first government to relax UK cannabis laws and the
medical reports on psychoactive cannabis to mainland legalisation of medical cannabis in The Netherlands in
Europe in the late 1200s. By the 19th century, cannabis 2003.
medical use was widely discussed by academics and
physicians, as cannabis based medical formulations In the 2010s, cannabis use for medical purposes
became widely available. Irish physician William became increasingly accepted. Simultaneously,
Brooke O'Shaughnessy is credited for bringing recreational cannabis use became hotly debated all
cannabis formally into Western European medicine. over Europe, particularly since individual states in the
US began to allow cannabis use. In March 2017, the
Soon, with the advent of the 20th century, recreational German government legalised medical cannabis. The
cannabis use grew throughout Europe. Smoking was legislative change preceded a rapid growth in the
the most common method of consumption but support for medical cannabis; many other EU nations
cannabis was generally considered a poor man’s relief have followed suit.
and inferior to tobacco. Nevertheless, cannabis use
European Political Analysis

Recent analysis finds the European cannabis industry cannabis black market with more than three million
in a wave of legal and administrative reforms. The consumers. Unreliable product quality and high cost
extent of these changes and the governmental policies pose a danger to public health and local economies.
fuelling them are wide ranging. Simultaneously, the financial burden of cracking down
on illegal cannabis sale and trade would be eliminated
There are many reasons; medical, social and through legalisation.
commercial which explain why European nations are
moving towards at least limited cannabis For the purposes of this analysis, we have categorised
decriminalisation. Proponents have cited the three tiers of reform as follows:
economic potential of what is now a €2.9 billion UK 30
Tier 1: those countries and regional authorities moving forward with

Leading the Way
significant changes to laws and policies on medical and/or
recreational cannabis
Tier 2: countries and regional authorities with active, ongoing reviews of

Poised to Move
medical and/or recreational cannabis laws and regulations, and
likely to embark on liberalisation within the short term
Tier 3: countries where historical or unique cultural characteristics

Not Yet Ready for Change
make it unlikely that there will be much, if any, liberalisation of
medical and/or recreational cannabis in the short term
To understand the nature and the true value of the committed to establishing a fully regulated adult use
European cannabis market, a number of factors need market by 2023.
to be considered. While each country has a differing
approach to medical cannabis legalisation, the Portugal is notable for progress made since its
opinions of medical professionals and politicians are parliament voted to legalise a wide range of cannabis
generally positive. Recreational cannabis legalisation based medicines in June 2018. All medicines will be
has not received as much positive attention. licenced under Infarmed, the country’s primary
Leading the Way

regulatory body, which has responsibility for licencing
the cultivation of high THC plants in central Portugal
which started in 2017.
Top among those countries Leading the Way is
Germany, which in the past two years has legalised Across the border, Spain is also leading the way with a
medical cannabis. The EU’s biggest economy, its favourable environment for cannabis consumption.
cannabis market is now third only to the US and While private consumption remains illegal in a
Canada in terms of market size. Since legalisation technical sense, political developments and cultural
came into effect, German cannabis patient numbers practices are chipping away at the laws. The province
have grown from 1,000 to over 40,000. Germany’s of Catalonia looks benignly on cannabis clubs, with
government is resorting to imports to cope with local authorities permitting cannabis clubs, open to
demand, while establishing its domestic production citizens aged 21 and older, to operate with limited legal
capabilities. The country’s medicines authority, sanction. A 2015 legal reform decriminalised private
BfArm, has had to reissue licences owing to the surge cannabis cultivation, leading to a surge in cannabis
in demand for medical cannabis. clubs across more liberal regions.
Although comparatively small in market size, Italy legalised medical cannabis in 2013. Minor
Luxembourg appears to be one of the first countries in offences relating to cultivation and research were
the region set to fully legalise recreational cannabis. decriminalised. In 2015, an overwhelming number of
Details are slowly emerging but the government has the country’s politicians supported further reform in
Italian cannabis laws. As a result, the Italian market is Meanwhile, powers that be in Romania show few signs
slowly opening up to national and international of willingness to liberalise legal curbs on cannabis use;
companies. the majority of the public oppose any cannabis law
reform. Similarly, in Turkey politicians and the majority
The Netherlands, long known as a haven for cannabis of citizens view personal cannabis use as a criminal
enthusiasts with Amsterdam the most prominent offence, due in part to the country’s location as a
destination for cannabis tourism in the EU, has been crossroads between drug producing nations in the
slow to innovate towards medical cannabis. For Middle East. This influences the government’s focus
medical cannabis, the legal system in the Netherlands on controlling drug trafficking.
requires users to renew their prescription for every
Non EU Countries
new purchase; patients cannot decide what type of
cannabis product they are prescribed. Doctors retain
the sole right to write prescriptions as they see fit. In
early 2019, the Dutch government is expected to open
31
Cannabis legalisation is not a phenomenon limited to
an application process for a second cannabis North America and the EU. While these remain the
cultivation licence. most profitable markets worldwide, there are several
Poised to Move
countries in or near Europe which are considering
legalisation at some level.
The UK is among those Poised to Move; its recent Lebanon, Georgia, Switzerland and Macedonia are
rescheduling of cannabis based products has allowed moving towards a regulated cannabis market. In
limited access for patients suffering from a range of Macedonia and Lebanon, the potential economic
conditions. The UK government remains unwilling to value of cannabis legalisation has received broad
consider recreational cannabis legalisation for now. support across the political spectrum. Serbia
Change comes against the backdrop of the country’s continues to retain a strict anti-cannabis stance
pending EU exit. Some analysts have argued that despite the considerable economic opportunities
Brexit could create opportunities for the UK to become opening up for neighbouring nations.
a leader in a wide range of cannabis related
businesses. All foreign companies investing in Europe’s cannabis
market have placed their capital in EU nations,
In France, Health Minister Agnés Buzyn has gone as predominantly across Germany, Italy, The Czech
far as indicating she is “not against” the legalisation of Republic, The Netherlands, Spain and Portugal. While
medical cannabis cigarettes, provided this is deemed Macedonia and Israel will attract attention the EU
the best drug delivery system. Further, the National market will probably determine future investment and
Agency for the Safety of Medicine and Health business development in the rest of Europe.
Products (ANSM) set up a committee to evaluate, ‘the
relevance and feasibility of the provision of medical Another key advantage EU nations enjoy is intellectual
cannabis in France’. On 13 December 2018 the property value for the cannabis market in countries
committee found that it is “pertinent to authorise the like The Netherlands, Spain, Germany and The Czech
use of medical cannabis” for patients with certain Republic. The free movement of workers and capital
specified conditions. will allow expertise to spread within the EU. As a
result, expect non-EU countries to lag behind in
cannabis research and innovation.
Not Yet Ready for Change

A notable number of countries are Not Yet Ready for
Change. The emergence of right wing governments in
Hungary and Austria will likely hamper the cause of
legalisation. While Austrian citizens can legally
possess up to five grams of cannabis, the country still
retains other cannabis laws which outlaw its
cultivation, selling and distribution. Violators can be
punished with up to five years in prison based on
product quantities.
Countries not belonging

to the European Union
Norway
Switzerland
Serbia
Macedonia
32
Georgia
Lebanon
Israel
EU Standards
The European Parliament has begun work on regulations that govern their activities.
legislation to integrate medical cannabis into the
existing regulatory fold. This resolution was first The major challenge facing tender applicants in
introduced in late June 2018 by The Committee on the Germany is they must develop intricate theoretical
Environment, Public Health and Food Safety and plans for how their facilities must be built, without
seeks to establish a regionwide regulatory body for prior knowledge of how a cannabis manufacturing
medical cannabis. facility operates, nor which problems cannabis
manufacturers face, plus how to integrate everything
For the purposes of this report, in our review of EU within a GMP environment.
Standards vis-a-vis cannabis production and
distribution we focus on Good Manufacturing There exist several regulatory bodies with scope over
Practices (GMP) that have evolved for the manufacturing pharmaceutical products. The
pharmaceutical industry. (See, also: Medical Cannabis European Medicines Agency works to ‘enable timely
in Europe: The GMP Standards Guide). patient access to new medicines’ and offers ‘scientific
guidelines on requirements for the quality, safety, and
GMP in pharmaceuticals have evolved through efficacy of testing medicines’. EudraLex is the body
harmonised efforts, so that countries may abide by that publishes the ‘rules governing medicinal products
similar guidelines that are adopted as legislation. The in the European Union’. It publishes the Guidelines for
best examples are the World Health Organisation and Good Manufacturing Practices for medicinal products
International Conference on Harmonisation. Both of human and veterinary use. It also publishes
organisations have taken a global view and worked to guidelines on Pharmacovigilance, a practice which
create guidelines that ensure pharmaceutical product collects, detects, assesses, monitors and prevents
safety regardless of country of manufacture. adverse events of pharmaceutical products.
Presently there is a lack of understanding on how
these pharmaceutical regulations, that is, GMP, apply While there is no centralised process for EU cannabis
to cannabis manufacture. Applying GMP to different marketing authorisations, these bodies still provide
segments of the EU medical cannabis supply chain pharmaceutical regulatory guidelines that must be
requires thorough understanding of manufacturing followed. National competent authorities ultimately
and pharmaceutical GMP. Regardless of the step in defer to and seek guidance from these EU regulatory
the supply chain, the purpose of GMP is to ensure bodies. Parties interested in the manufacture,
there is no product adulteration. This means any party distribution, medical use and safety of cannabis
involved in the supply chain must comply with products must follow suit.
There are several authorities involved in allowing a

manufacturer to legally produce herbal drug
substances and herbal drug products. EU member
states have their own respective national competent
authority, with cannabis programmes including an
additional line of oversight through a respective
national cannabis agency. These two authorities work
to meet the requirements of the UN Conventions, and
ensure that public health is protected.
It is key for a manufacturer to fully understand the

processes and procedures of these agencies to
successfully operate. Without full GMP compliance to 33
the specifications of these important stakeholders, no
manufacturer can distribute products within their
member state, nor export to other member states,
posing a significant risk to stakeholders of companies
seeking to utilise this model.
34
The European Cannabis Report™ Commercial Opportunities
COMMERCIAL OPPORTUNITIES
Core Distribution
Segment Production Processing Digital Ancillary
& Retail
Sub-segment Commercial Industrial

seed growers Processing Distribution
and suppliers Information Real Estate
Production Industrial Transport

equipment Manufacturing (standard and
manufacturers Communities Legal
secure)
& suppliers
35
Cultivation of Medicinal Online
Medical grade Data Finance
Processing (ecommerce)
Cannabis
Cultivation Medicinal Off line

of Recreational Marketing Consulting
Manufacturing (Bricks & Mortar)
grade Marijuana
Cultivation of Recreational
Industrial grade Software Technology
Processing
Hemp
Testing & Recreational

Quality Control Manufacturing
Production
Germany, Italy, The Netherlands, Denmark, Portugal tenders to invite more companies to invest in its
and Greece will be the forerunners in medical domestic cannabis cultivation programme.
production. Smaller markets like Macedonia, despite
their lack of an official medical cannabis access Italian cannabis cultivation was being handled by the
programme, plus Malta, will also offer cultivation military. But demand has outstripped government
licences and export opportunities. Southern European supply. Hence, the government issued a cannabis
nations maintain climatological advantages but cultivation and import tender to bridge the gap. The
Northern and Western European nations (particularly tender was won by Aurora, a Canadian company,
Germany, The Czech Republic and The Netherlands) which has already begun providing cannabis.
have focussed on creating rigid pharmaceutical grade
standards for their production facilities. The Dutch, Danish and Czechs are also making strides
towards their own domestic cannabis cultivation
Outside Europe, Israel, Canada and Latin American facilities. The Netherlands has a particular advantage
nations will be major hubs for research and innovation, in this area due to its knowledgeable and experienced
leading to a rapid expansion in cannabis cultivation cultivators and well established cannabis trade
volumes and associated techniques. channels.
Presently, the government tender in Germany and Italy In Denmark, Canopy Growth, a Canadian
is woefully inadequate to cater for growing demand. In cannabusiness, has joined hands with Danish
just one year, Germany has raised its required Cannabis and established what may be the biggest
domestic cultivation and import limit from 6,600 cannabis production site in Europe at Odense. When
kilograms to 10,400 kilograms. It has also issued new fully operational, the plant will potentially provide high
grade medical cannabis to 60,000 patients across by international cannabis companies, in an attempt to
Europe. import products into the region.
Manufacture
In June 2018, the WHO’s Expert Committee on Drug
Dependance (ECDD) recommended that CBD should
and Processing
not be placed under international drug control. If CBD
is deregulated, the distribution markets for all kinds of
CBD products will receive a significant boost. This
would help develop the infrastructure for the
distribution of medical cannabis.
National governments will impose high standards on
cannabis processing and manufacturing. In Europe,
Ancillary
companies will have to comply with EU GMP
guidelines. 36
There are two sub domains in cannabis and Digital
manufacturing. Professional industrial level cultivation
and private home grow cultivation. While the former of
these two garners most attention from industry
experts, the latter is not expected to be legalised in any European digital platforms and ancillary services are
widespread capacity. Although self cultivation is also developing. While many entrepreneurs and
popular in certain Mediterranean regions, European manufacturers are forbidden access to THC rich
demand for highly regulated and standardised product cannabis, a secondary market has developed.
by regulators will likely suppress this market. Cannabis is a new industry, without legacy processes
and systems that nearly all traditional industries are
Israel has a clear advantage for spurring innovation in faced with. There is a major opportunity to build the
manufacturing practices. The grey of decriminalised right platforms from day one to serve and optimise the
legal status of cannabis in countries like The sector for years to come. Ancillary digital platforms will
Netherlands, Spain, Portugal and The Czech Republic become the cornerstone of the industry, including
has given rise to a formidable body of knowledge and product quality tracking, data management, business
experience among private growers. Therefore, these software, delivery solutions and trading exchanges
nations have tremendous potential for generating that help producers sell and retailers buy at the right
considerable cannabis manufacturing innovation if market price.
brought under the protection of the law. North
American industry leaders are acquiring processing Early stage European companies have recognised the
and manufacturing labs throughout key markets, in an importance of brand, positioning and data, along with
attempt to ensure their production facilities comply quality product and services as key unique selling
with local regulations. points (USPs). Some are reaping the rewards of a
unique brand in an increasingly competitive market.
Opportunities for digital and ancillary services in
Distribution
Europe are limited but available.
Legal services are in high demand due to the influx of

cannabis producers and the increasing demand for
medical cannabis. Specialist law firms or departments
Domestic and international companies in Europe have are sprouting in cities like London and Berlin to
begun developing a strong distribution network, in support foreign investment, licensing applications and
anticipation of the impending legalisation of medical compliance.
cannabis. North American companies like Tilray and
Maricann are rapidly expanding distribution networks
across Europe. The biggest concentration of these
distribution networks is within the industry leaders;
Germany, The Czech Republic and Italy, where
medical cannabis programmes have been approved
and patient numbers are rising. German and UK
pharmaceutical distributors are quickly being targeted
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Corporate Social
Responsibility Environmental
commitment
Many global firms are implementing Corporate Social European businesses must
Responsibility (CSR) strategies into their businesses; commit to environmental
cannabis firms cannot be the exception. Ethical sustainability. This requires a
questions regarding the social and environmental lowering of industrial carbon
responsibility of business are rarely discussed within footprint by focusing on outdoor
the cannabis community. CSR is being implemented cultivation, conscious use of
by only a few organisations through external advocacy pesticides, reduction of plastic
groups such as the Drug Policy Alliance, the Transform packaging and implementing best 38
Drug Policy Foundation, the National Association of cultivation practices. These more
Cannabis Businesses or local consultancy firms such effectively manage water and
as Kind Colorado in the US. other costly natural resources.
European cannabis businesses could create an While seeking guidance on how

industry that sets new standards regarding ethical to develop a CSR strategy,
business practices. The first step would end European cannabis organisations
perception of CSR as a cost factor or a risk, and start should strive to create their own
seeing it as an innovation source. The five main CSR framework. Businesses should
aspects that the European cannabis industry should not seek guidance from
focus on are: education, transparency, regulation, legalisation models in the US
corporate citizenship and environmental commitment. since their conflict between state
and federal legislation hinders
the development of a consistent
Education CSR strategy. More centralised

approaches like the Uruguayan
The goal is to gather and provide cannabis model can provide
all the tools necessary to enable insights, by addressing cannabis
educated consumer decisions. consumption as public health
Therefore, businesses must and not as a law enforcement
inform and educate patients, issue, and by implementing
consumers, and the general regulations into social
public, as well as keeping development policies.
themselves constantly informed
and educated. Now is the time for the nascent
European cannabis industry to
implement sound CSR strategies.
By successfully implementing
CSR policy, European businesses
Transparency
could differentiate themselves
from their international
counterparts, gaining a
Maintaining impartiality, fostering
competitive edge in the European
accountability and contributing to
market. In addition to increasing
the demystification of cannabis.
corporate value, adopting such
This can be achieved by providing
strategies would help evolve
objective information, regularly
public perception as well as the
reporting on CSR activities, and
general narrative surrounding
changing the narrative surrounding
cannabis. It might even pave the
cannabis to create an image
way for further liberalisation.
of professionalism and reliability.
Regulation
To prevent uncontrolled market
growth, businesses should
respond to a regulatory entity
that monitors the market. The
goal is to strike a balance
between responsible regulation
and entrepreneurial freedom,
while guaranteeing quality
standards and consistency in
cannabis products. 39
Corporate
citizenship
European cannabis businesses
need to be seen as assets to the
community. To do so, they need to
be active community members and
do more than what the law
requires. This involves establishing
direct lines of communication with
communities, collaboration with
stakeholder networks and
structuring their businesses to
encourage social justice, child and
youth protection and worker rights.
STORZ & BICKEL is a medical device manufacturer

based in Tuttlingen, Germany.
40
The company produces medical devices for the
inhalation of Cannabinoids in accordance with high
quality standards and DIN EN ISO 13485.
The VOLCANO MEDIC and the MIGHTY MEDIC
inhalation of cannabinoids available in Canada,

Europe and Israel.
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+49 7461 969 70 70 · info@vapormed.com
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The European Cannabis Report™ Expert Analysis: European Strategy
EXPERT ANALYSIS:
European Strategy
Scott Boyes,
President & CEO,
MPX Bioceutical
41
On the advantage for early
movers in Europe…
When I walked into a couple of vape shops in the UK Europe is the big apple right now so companies are
and saw what CBD products were selling for I nearly putting in the groundwork here. For instance, we’re
fell out of my chair. CBD products here are selling for bringing politicians to review our assets to show how
more than high THC recreational products would in you work with an established framework and help get
most legal US states. So if those margins exist for the them up the learning curve as quickly as we can.
CBD market I can only imagine what it will be like for Alternatively, North American companies will look at
the first mover advantage when the medical markets entering the European CBD market. We’ve even talked
truly begin to expand. about setting up an MPX CBD business in the UK
while working with lobbying groups in order to develop
The cost of acquiring cannabinoid-based businesses our interests and push forward legislation.
in the US is also skyrocketing. We bought a business
for $18 million in late 2017. That same company today My attention switched to Europe at Cannabis Europa
costs you $40 or $50 million because groups like London. I didn’t participate, I just sat back and
Medmen and Acreage have come out with observed but when you see that many people turn up
unbelievably high market caps, contributing to a and that many people show an interest you knew it
higher expected valuation for smaller companies. As a was going to happen faster than anyone thought.
result, North American firms will be looking for value in
foreign markets.
On the development of cannabis

markets...
You can see clearly what has happened in the US and “reefer madness” rhetoric that we have been fed for
most markets will follow this curve. decades is unfounded. Hospital costs regularly go
down, tax revenue goes up and the jurisdiction then
Each market starts as CBD only and then moves on to starts to realise that cannabis is useful from a social
restricted medical programmes where it is very and economic standpoint. At this point, countries
difficult to get access to cannabis medicines. After a begin to adopt a recreational market. Every legal
short while, the programme opens up a little bit and as jurisdiction we see in the states has gone through
soon as we allow for conditions like chronic pain then these steps. The first-mover advantage here will be
the medical market explodes. After a certain period of vital for those who can get the early medical licences.
time everyone gets used to the idea that maybe all the
On attracting European
investors to a North American
market…
Everyone is reading about what is happening in book on Friday we were at $27 million. We probably
Canada and the US and a lot of investors want to get could have raised $50 million there was that much
into the game. When I came over to the UK for finance demand for access into the space.
I couldn’t get any of the North American banks into the
business. They were concerned about the federal The value for money can be higher in Europe. For
legality of the industry and busy raising finances for instance, we can buy a licence in Florida for $60
the major LP’s. million, a bare-bones licence, and you will need
another $40 million to build the facilities. So in total,
42
A majority of our funding comes from the UK and it you have $100 million invested in a medical market
was a great deal for investors. They were buying for 1 which will stay restricted for two years. Alternatively,
times revenue and the Canadian LP’s were selling for can you take that $100 million and make seed
1000 times revenue. In the fall of 2016, I came over on investments in Europe. Maintain a lower competitive
a Sunday to raise $20 million. That Monday they profile and probably get a lot more bang for your buck.
offered me $25 million and by the time we closed the
On developing an international
cannabis business...
MPX Bioceutical has announced a merger with outside of the US. We are so enthusiastic about the
iAnthus and the merger will move all of MPX’s US prospects for the international market, that
assets into iAnthus. However, the non-US assets of notwithstanding the opportunity to participate in the
MPX Bioceutical are being spun out into a new entity management and growth of the merged MPX
to be called MPX International Corporation. The new Bioceutical/iAnthus company, the entire
company will trade on the Canadian Securities Toronto-based executive team have elected to stay
Exchange under the symbol “MPXI” and will be totally with MPX International and commit themselves to
focused on building a portfolio of cannabis assets building a truly multi-national cannabis corporation.
Nav Dhaliwal,
CEO,
The Supreme Cannabis Company
On the European opportunity…

There are four key differences that we are noticing documents and receive their products via mail
across the European market order. Whereas in Germany, for instance, it’s going
directly into a pharmaceutical distribution system
1. Looking at the current state of the Canadian so things will move much quicker.
market producers are looking elsewhere for value
and expansion. Europe is seeing new markets 3. Europe has many different countries in an
come online which are great to sell into. Germany, economic region that now have a G7 country to
for instance, has high demand but does not have look at for medical and recreational examples. As a
domestic and so it’s an ideal market to export to. result, we will see countries go legal much quicker
because of international research and successful
2. In Canada distribution methods are diversifying. programmes in Canada and US states. But Europe
A patient can get a doctors note of medical will be a more fragmented region in terms of the
supply chain. For instance, you can grow in Greece 4. Lastly, the EU has very high standards of
and distribute in Germany. We don’t know exactly regulation and standards which will create a high
how it will work yet but the EU, over the next 5-10 barrier to entry but will also raise the bar in terms of
years is going to be the largest and most the quality of processes and production.
sophisticated market to operate in.
On prioritising European
markets…
Short-term everyone expects the market to be volatile. businesses and try to build competitive advantage in
There is so much excitement and media attention on key markets. Grow quality cannabis, scale it and get 43
the market that there is bound to be volatility. This has premium pricing for it.
been true if you look back across more mature
markets. Thirdly, there are many different stages. In the EU,
once you’re exporting from Canada it’s about early
Secondly, every company takes a different approach licensing opportunities. Find a jurisdiction which has
to Europe and towards their expansion strategy. We an optimal framework, get the licence and set up a
have a long-term view in terms of how we build team to start executing the business plan.
On the future development of

the market…
I think you’ll see a bifurcation of different medical and understand the global opportunity of the market.
recreational markets over time. Companies will have to
diversify their brand so producers will likely establish Investment is only going to increase in my view.
standalone medical businesses in the international Canada was just the first G7 to legalise federally both
market. medical and recreational but that market is actually
International trade will take time. For instance, quite small in terms of the international opportunity.
although there is no trade happening at a federal level Although we are building international expertise and
in the US. Canadian companies on US stock markets we can export intellectual property, larger markets are
are executing exports to the US for research purposes. coming online and will develop much faster in terms of
These things are happening. Canada had a programme distribution. Right now, Germany is arguably the most
for 20 years and will undoubtedly be a leader in the highly prioritised market in the world.
market but it takes society and government time to
Sean McNulty,
Co-Founder,
Canopy Rivers
On identifying target markets...

Canopy Rivers are interested in any market globally When we look for investment opportunities in Europe
which has regulations which govern a legal cannabis we always look for some select attributes. They need
market. We don’t invest in the US, as it’s a fragmented to be an entrepreneur, they need to have a specialised
market. In Europe, however, almost every week we see and influential local network and they need to have a
a country within the European Union of Eastern track record of success in European markets. What
Europe which is beginning to develop their own we’re looking for is a local partner that can leverage
regulatory environment. their local networks or partnerships either for
distribution opportunities of regulatory influence.
What we offer is an established track record in a G7

market. We can show regulators that we have gotten
this right in Canada and we have the capital to inject it
into the local market.
On the potential development of

the European market...
In Europe specifically, we have seen the vast majority crisis. We have some initial, but not enough, evidence
of the markets develop initially in the form of that medical cannabis can provide a suitable
hemp-based CBD products later developing into a alternative to treat pain and chronic pain. 44
medical cannabis market. Data validating the medical
properties of cannabis is limited globally. But for Medical legalisation is an easier path than recreational
therapeutic purposes the anecdotal evidence is legalisation for regulators and politicians. It’s naive to
overwhelming and you can begin to see the think that regulated cannabis is not going to be
development of empirical evidence as market develop abused because it will be but when you consider the
and clinical studies receive further investment. risk against something like tobacco and alcohol then
you can understand the move. Similarly, for regulators,
In Canada, the market progressed as a result of a the risk is lower to legalise non-psychoactive CBD
challenge to the constitution and you can see this products. That’s why you see the initial proliferation of
beginning to occur in Europe. Germany, for instance, the market in favour of CBD or hemp products. You’re
legalised medical cannabis to support patients that going to see hemp-based CBD and hemp products
considered medical cannabis an viable alternative before you see any recreational products on European
treatment for their conditions. This is how it is going to shelves.
work worldwide. In addition, we have a global opiate
On local European partners...

We only have a small number of local partners at experience and a strong brand name our local partners
Canopy Rivers despite the fact that we get hundreds can help us navigate local regulations and distribution
of pitches a day. We look for a number of key strengths networks. When we move to a new market we need
and expertise that we can leverage. We try and identify access to local hospitals, local universities, politicians
CBG experts, logistics experts, retail experts and and regulators. First and foremost we invest in the
branding experts that can offer competitive value in people presenting, not the market they represent.
the European market. While we bring established
45
46
The scale and diversity of Europe can make it a challenge

to identify and quantify the opportunity to hand. In this
report, we have profiled the key markets in the European
cannabis industry, examining the regulatory framework,
current legislation, commercial opportunities and
healthcare models across 33 countries.
While the preference is to look at Europe as a single

market, the early stages of a legal cannabis industry will be
predominantly led by individual states. Understanding the
political and economic environments, as well as the
significant cultural nuances will be absolutely essential for
companies looking to enter the European industry.
Detailed reports on key countries can be found in our

European Country Review section on
prohibitionpartners.com
Key
Countries
The European Cannabis Report™ Germany
47
GERMANY
MARKET OVERVIEW
Population (m) 82.2
GDP (€t) 3.1

Coalition - Social
Ruling Democratic Party,
Government Christian Democratic
Union, and Christian
Party Social Union
In favour of medical
Party Stance legalisation but
recreational legalisation
on Cannabis is unlikely before 2022
Total Healthcare
Expenditure (€b) 352
13.4
Alcohol Consumption
(Litres Per Capita Germany boasts the largest economy in Europe - a
Per Year)
global leader across multiple industries and the
Prevalence forerunner of the European cannabis industry.
of Tobacco 30.6
Users (%)
Germany, Europe’s largest potential market, opened
Number up in March 2017 with the introduction of new medical
of Cannabis 3.3 cannabis legislation and the creation of eleven
Users (m)
production licences. Controversially, the system to
Average Price allocate licences was geared towards experienced
Per Gram 9.4 international companies partnering or creating joint
of Cannabis*
ventures with local companies.
*Prices refer to black market cannabis prices
Source: World Bank/ WHO/ UNODC/ Prohibition Partners
The original German medical cannabis licensing production industry is in the top five in Europe and is
process was scrapped when several companies which expected to grow in 2018. The country is poised for
had applied for licences claimed BfArM mishandled further reform, including decriminalisation, which was
their application. A week after the process was called for by the head of the police union in February
cancelled, BfArM issued a new tender with an updated 2018.
maximum cultivation limit. (see Expert Input).
At present, domestic cultivation commands the
Recreational use is currently illegal in Germany, attention of the national government. Though the
although punishments have become increasingly initial application costs have been high, the barriers to
lenient in recent years as attitudes shift. While entry may be removed as domestic groups continue to
dwarfed by France, Germany’s industrial hemp oppose preference for international partnerships.
48
REGULATORY ENVIRONMENT

Cannabis Cannabis Cannabis CBD/Hemp Oil
Legislation Legislation Legislation Legislation
Consumption and Inconsistent.

Sativex, Dronabinol, cultivation are legal with
Possession is illegal. CBD and hemp products
Nabilone for medical special permission from
Although amounts up to (under 0.2% THC) are
purposes are legal the "Federal Institute for
6 - 15 grams (depending legal
Drugs and Medical
Devices". on region) are tolerated.
Summary
Germany is the largest medicinal cannabis market in will be served in 2018 with imports of 22,000 kg.
Europe and allows the sale of most cannabis
medications like Sativex, Dronabinol, Nabilone and To meet the increasing demand for medical cannabis,
others. Germany is dependent on the import of medical
cannabis from abroad. As the Federal Ministry of
Germany has permitted the use of cannabis flowers for Health announced, eleven applicants have applied to
medicinal purposes since 2017. The medical cannabis the Federal Institute for Drugs and Medical Devices
programmes in the country are still being developed (BfArM) for an import permit for cannabis for medical
but will be among the most robust in Europe. purposes. In the period from September 2017 to March
2018, Germany imported 2100 kg of medical cannabis
Since March 2017, medical cannabis has been legal in from abroad, the maximum allowed by the initial
Germany. Previously, the law had only accepted legislation.
applications from around 1,000 patients. However, as
of March 2018, the number of applications to the However, according to the Ministry of Health, further
health insurance companies rose to 13,000. The applications are still being processed. Since
health insurance companies have to bear the costs of September 2017, the existing import permit holders
care for patients prescribed medical cannabis, and have applied to increase their annual quotas to 10,900
60% of requests for reimbursement have been kg. Two additional applications with a total volume of
approved. Cannamedical Pharma, one of the leaders in 10,400 kg are also being processed. A prerequisite for
supplying German patients, estimates 30,000 patients the import is that the cannabis can be traced back to
its original source, which must be a licensed medical

producer under the exporting state’s control. These Extensive security measures must be introduced and
laws are the result of an international treaty to prohibit demonstrated by the importer, including storage in
the production and supply of specific drugs (the 1961 closets, safe rooms and electrical monitoring systems
Single Convention on Narcotic Drugs). connected to the police. The products must also
comply with the guidelines of good practice for the
Owing to legal complications in the previous tender, collection and cultivation of medicinal plants (Good
BfArM issued a new tender with an updated maximum Agricultural and Collection Practice, GACP). In
limit of 10,400 kilograms of cannabis import. This is a addition, the cannabis must also comply with the
significantly higher amount than the previous 6,600 provisions of the monograph "cannabis flowers" of the
kilograms. It is important to note however that the German Pharmacopeia and other relevant
aforementioned cannabis volume will be produced monographs. The Federal Opium Agency is
over the next four years. Currently, Germany plans to
award licences to at least three companies to meet
responsible for the application process for the import
licence.
49
this requirement. Also, the current production limit is
set at 1,000 kilograms per company per year. However, With regard to further legislation, there is a
this will not meet the growing demand and so, well-established advocacy community in Germany,
Germany will be importing cannabis at least till 2020. accompanied by a strong research environment.
Though decriminalisation looks likely, a regulated
At present, import applicants must obtain permits for market for adult use is unlikely to be achieved before
cannabis testing, nationwide official permits by the 2022 (or until the next election).
Medicines Act, the import permit, the wholesale
license, and the manufacturing authorisation. The The legal framework for CBD is ambiguous. Hemp
importing company must appoint a narcotics officer derivatives have seemed to be treated as legal in
who has sufficient expertise. This expertise can Germany, but there has been a recent clamp-down on
include a university degree in biology, chemistry, a hemp bar selling dried hemp flowers in the form of
pharmacy or human/veterinary medicine, or tea. One of the bar’s owners is now pending trial.
vocational training as a wholesale pharmaceutical Indeed, the German Hemp/Cannabis Association
merchant. believes the legal framework is currently so opaque it
recommends not trading in hemp flower in Germany.
HEALTHCARE ANALYSIS
Total
Total Estimated Approved
Total Medicinal
Pharmaceutical Cannabis-
Healthcare Cannabis
Spending based
Expenditure Allowance
(€b) Products
(€b) 2018 (grams)
Sativex
Cannabidiol
352 60.7 5,000,000 Nabilone
Dronabinol
Cannabis flower
Source: WHO/ INCB/ Prohibition Partners
As of January 2017, public health insurers, which insurance scheme covers all cannabis treatments and
provide cover to 90% of the population, were required does not specify which conditions are covered.
to cover cannabis medication (up to five ounces or
141.75 grams per month), making Germany one of the However, it is difficult for patients to obtain a medical
most potentially valuabe markets in Europe. The cannabis prescription. In fact, physicians are often
wary of issuing medical cannabis prescriptions for a improve the quality of public health, and it lowers their
number of reasons. These have to do with scrutiny costs, they could ultimately become the industry’s
from regulatory bodies and insurance agencies, strongest allies.
damage to reputation from association with perceived
drug users, ambiguity on its medical efficacy, and The approval rate of the top three insurers (AOK, TK,
legal liability in case the patient has an adverse and Barmer) is between 62% and 64% for medical
reaction to cannabis etc. cannabis patient applications. However, for patients
without health insurance cover, medical cannabis in
The German Health Fund looks for medications that Germany can cost between €1,500 and €2,400
improve the quality of life but are wary of insuring depending on the state of supplies. In addition,
pharmaceutical products in general. Since the pharmacies can charge around seven euros per gram
German Pharmacopeia only accepts cannabis flowers in order to grind cannabis for medical use.
at the moment, the associated costs can be rather
high, particularly when compared to other The government has prioritised funds for research and
50
cannabis-derived medications. However, if insurance development into cannabis treatments for epilepsy,
companies are persuaded that cannabinoids actually which is estimated to affect about 540,000 Germans.
Forecast Forecast
Medicinal Recreational Total
Cannabis Cannabis 2028 (€b)
Market Value Market Value
2028 (€b) 2028 (€b)
Total 7.7 8.5 16.2
Germany has the largest consumer base for cannabis ventures with German firms such as Spektrum,
among all EU nations. Its estimated medical cannabis Pedanios, Nuuvera, and Cannamed. Delays in the
market alone is will be worth €7.7 billion. Further, if licensing process have resulted in these same firms
recreational cannabis is included in the estimate, then the building cultivation and production facilities
value rises to €16.2 billion. This makes the German elsewhere in Europe. With a presence in Portugal and
cannabis market extremely enticing for cannabis Denmark, German-Canadian partnerships will look to
companies within Germany, EU, and other nations as well. Italy and Greece next.
Germany plans to pursue domestic cultivation of Lower cost producers from across the globe are now
cannabis for medical purposes. However, companies targeting Germany with medical cannabis products,
entering this space might need to spend between €30 anticipating at least an 18 month supply shortage
- €60 million as a result of the high application fees before domestic cultivation begins.
and strict requirements. These costs will remain high
over the next 18 months at least, as supply deficits The German medical and insurance system is
guarantee strong sales and high market prices for any embracing digitalisation, and so innovation in the tech
successful applicant. In addition, applicants are sector is also likely. The barrier to market entry is high
required to show experience producing both federally though, and potential applicants will require an
legal cannabis and a product that is GMP certified. understanding and experience of IT security, banking,
European privacy law, and data protection.
So far, major Canadian and Dutch firms are
dominating the cultivation opportunities through joint
FORECAST MEDICINAL CANNABIS MARKET VALUE: 2018 - 2028
€7.7b
Projected Market Value (€)

51
Sharp growth in the first half of the
forecast period, Levelling out and then
accelerating again as more patients join
the market.
€133m
2018 2028
(est) (proj)
Prohibition Partners predicts that by 2024, the number Prohibition Partners forecasts that demand for
of medical cannabis patients in Germany will break medical cannabis in the country will grow. The average
through the 1 million barrier. The fact that most spend per patient is set to decline over the forecast
cannabis medications are available for purchase in the period to 2028.
country means that a wider range of conditions can be
treated. This has helped to bolster the expected value
of Germany’s medical cannabis market.
CONSUMPTION
Cannabis
Young adults reporting
use in the last year
13,3%
11% 15.6% 52
30
55-60 1.1% 25
20
45-54 2.8%
15
35-44 4.7%
10
25-34 9.3% 5
18-24 19.5% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
Local Expert Analysis

Kai-Friedrich Niermann, Lawyer
Recreational
A most recently published expertise, commissioned by Cannabis Control Act, to the German Federal
the German Hemp Association, assumes that there Parliament, proposing the legalization of recreational
are 250 tons per year in the black market. In case of cannabis. The law provided for a complete
legalization 20.000 new jobs could be created, and a decriminalization of users and a regulated market for
tax revenue of up to €3 billion could be generated. The cultivation, wholesale, retail, processing, and import.
author of the study, Prof. Dr. Haucap, one of the most Business parties could open cultivation facilities,
influential German economists for regulated markets, wholesale and retail companies etc. without any
introduced this study at the end of November at a restriction, there would have only been requirements
legalization congress in Berlin. His estimation is very to quality and social responsibility (the shops must
conservative, as he explained, there could also be up have a social concept and well-trained staff).
to 600 tons in the black market right now as there are
only insufficient data due to the illegal conditions of Except of the two conservative parties, the CDU and
distributing. the AfD, every party in the Bundestag is for
legalization by now. But the CDU is now prepared to
There is still a strong debate on legalization. In July allow model testing for the distribution of recreational
2017, The Greens proposed a bill, known as the cannabis to see if there is societal benefit in
developing other distribution options rather than the buy them makes no sense. At regulatory level, two
black market. options are available in the EU: firstly, the inclusion of
CBD products in the Community list of permissible
As the Green party will assumedly play a major role in health claims of the European Commission can be
the next government, as they have excellent polls right requested (EU Register of nutrition and health claims
now (15-20%), the Cannabis Control Act might be the made on food). Secondly, there is the option of
blueprint for any legalization law making. If the WHO registering the relevant CBD product as a traditional
reschedules cannabis within the system of the single herbal medicine (such as ginkgo), so that
conventions on narcotic drugs, it will be another strong pharmacological effects can also be communicated.
argument for drug policy makers to change the
repressive approach of dealing with cannabis in
respect to criminalization and distribution. If Canada
and the legalized US markets will show positive 53
societal effects and experiences with legalization, and
the US legalizes cannabis with a federal reform,
Germany will soon follow.
Tender
The tender was delayed to mid-December 2018 due to
a litigation procedure from October. According to the
tender conditions applicants must prove that they
have sold 50kg of GMP produced medical cannabis (or
medical herbs) to a federal cannabis agency in the last
three years, which means that only the sales of Dutch
and Canadian companies can be considered. One of
the applicants found fault with the conditions of the
tender again and tried to coerce the cannabis agency
to review the conditions by appealing to the
responsible federal court, but the complaint was
dismissed. Remedies have not been exhausted yet
though. So, it may come to another delay or the tender
must be cancelled at all like the first attempt to
establish cultivation in Germany. It seems that the
German public procurement law and the legal
framework of the single conventions on narcotic
drugs, which must be obeyed when establishing
cultivation in a member state, are incompatible. If the
second tender procedure also fails, the pressure on
the legislator to change the legal regime will become
even stronger as the domestic demand will
continuously rise with the numbers of patients.
CBD
The problem with CBD remains that no health
promises may be made for the currently customary
dietary supplements, i.e. products below the threshold
of medical use, unless scientific proof is provided.
Companies must continue to invest in research in
order to exploit the full market potential of CBD
products in the long run. Placing products on the
market at great financial and organisational expense
without being able to say why the consumer should
The European Cannabis Report™ Italy
54
ITALY
MARKET OVERVIEW
Population (m) 60.5
GDP (€t) 1.6
Ruling Seven party

Government coalition
Party
Party Stance In favour

of medical
on Cannabis cannabis
146
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 6.7 Italy has already established itself as a European
Per Year)
forerunner when it comes to progressive cannabis
Prevalence legislation. Medical cannabis has been available to
of Tobacco 23.7 patients in Italy since 2013. However, due to a lack of
Users (%)
domestic cultivation, cannabis was initially only
Number available via import from the Netherlands. This has
of Cannabis
Users (m)
3.5 resulted in a price range which was out of reach for the
majority of Italian patients.
Average Price
Per Gram 7.6
of Cannabis* In 2017, the Military Chemical and Pharmaceutical
Plant (SCFM), based in Florence was granted
exclusivity of the country’s cannabis production and in the short-term, at least, cultivation licensing and
distribution. Later in the same year, the Italian Senate further cannabis reform will take a back seat behind
passed a law permitting the cultivation of cannabis more urgent matters, such as establishing a stable and
without the need for authorisation in the food, functioning government.
cosmetics and energy sectors.
Cannabis Light (THC content < 0.5%) became legal in
This demonstrated a willingness from the previous Italy from the beginning of 2018 and demand is
government to relinquish the army’s monopoly on booming, although the hemp flowers are labelled ‘not
domestic cannabis production. In January 2018, for for human consumption’, and are technically sold as
instance, the Italian government issued the first of “collectors items”. The burgeoning market has given
seven import licences for medical cannabis, to rise to shops selling cannabis products as well as new
attempt to reduce the current supply shortage the franchising brands, and farmers associations are
country is experiencing. However, it is unclear whether viewing wide-scale hemp production as a possible 55
the future government will hold the same stance and solution to Italy’s agricultural slump.

Legal as a Possession/cultivation/
prescribed consumption of high
Sativex, Dronabinol. medication since Legal
CBD, low THC cannabis
2013. is legal.
Summary
Pharmaceutically produced cannabis products are Currently, medical cannabis use is regulated very
legal in Italy. Patients have a variety of options to closely and only severe health problems merit a
choose from ranging from specific cannabis medicines prescription of medical cannabis. A limited number of
like Sativex and Dronabinol. persons or entities are allowed to cultivate cannabis.
However, they are subject to fines should they be
found in violation of laws.
Cannabis flowers and extracts for medical purposes
are currently produced by the Italian military though Similarly, any person or entity found engaged in
the government has entered into partnerships with growing or distributing cannabis is liable to face
misdemeanour charges along with suspension of
companies to provide for the supply deficit.
official documents like driver’s licence. In case of
Recreational cannabis use remains illegal in Italy but illegal sale or possessing large quantities of cannabis,
CBD and all other hemp products are legal in Italy. persons may face fines of up to €75,000 and possible
imprisonment from two to six years.
Currently, the Italian parliament has been presented

with a bill regarding cannabis legalisation for
Legislative timeline
The The In April, in an effort to
Iervolino-Vassalli Silvio Berlusconi introduced Fini-Giovanardi
the Fini-Giovanardi law which develop attitudes towards
law saw newly law was deemed cannabis even further, The
classified ‘soft reclassified cannabis to be on unconstitutional
par with cocaine and heroin - Radicali Italiani Movement
drugs’, including and cannabis was announced plans to
cannabis, carry far implementing far harsher again reclassified
penalties for any cultivation, introduce a bill that
lighter, as a ‘soft drug’ in proposed the full
non-criminal distribution or personal use of the Italian legal
the drug. legalisation of adult
penalties. system. cannabis use.
56
1990 2006 2014 2017
recreational purposes. Broadly speaking, any bill fight consumption among adolescents”. He also
cleared on this matter will allow private citizens to brought attention to the economic benefits of the
possess 5 grams of cannabis in public and 15 grams at industry, saying that a legal cannabis market would
home. They will also be permitted to grow up to 5 also “move money from traffickers’ accounts into the
plants on privately owned property. At present, state's coffers".
however, the tolerated limit for carrying cannabis is 1.5
grams though if the same person is caught repeatedly, In practice, cannabis consumption in small amounts is
then they may face bigger charges. mostly overlooked by the Italian police. Further, a few
noteworthy cases of acquittals for cultivating cannabis
Benedetto della Vedova, President of Forza Europa plants at home have appeared over the past few years.
and Libertiamo, a libertarian association within the However, the acquittals only came about when the
political party Future and Freedom (FLI), stated on his defendants declared in court that their intent was not
personal Facebook page that legal cannabis would to sell the plants for profit but for personal
“take profits from the mafia, free police to do other consumption.
work, control substances that are in circulation and
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Dronabinol
Sativex
Cannabis Flowers
146 35.1 1,200,000 Cannabis Tea
Cannabis Oil
Cannabis
Capsules
The Italian National Health Service (Servizio Sanitario Qualifying conditions include:
Nazionale) was set up in 1978. It is regionally based
and organised at the national, regional, and local MS
levels. Under the Italian constitution, the central
government controls the distribution of tax revenue for Glaucoma
publicly financed healthcare and defines a national
statutory benefits package to be offered to all Chronic pain
residents in every region. Public financing accounted
for 75.8% of total health spending in 2014, with total Tourette’s Syndrome
expenditure standing at 9.1% of GDP. Nausea
In order to access medical cannabis, Italian patients Spinal cord injury
must obtain a doctor’s prescription and ministerial
approval for products containing THC, although a Anorexia
57
formal medical cannabis access scheme is in the
process of being established in the medium term. Cachexia
In some regions of the country like Toscana, Puglia, The popularity of Italy’s medical cannabis has grown to
Liguria, Emilia Romagna, Veneto, Friuli Venezia Giulia, the extent that the nation is experiencing a supply
and Piemonte, cannabis treatments can be covered by shortage. To address this, the government has issued
the national insurance but in some cases patients seven medical cannabis import licences.
have to pay in full. The government is working to Toronto-based Nuuvera has acquired Genoa-based
create a more consistent and reliable system of FL-Group, which holds one of these licences.
reimbursement. Pedanios, the German subsidiary of Alberta-based
Aurora Cannabis has won an exclusive tender to
supply 100 kilograms of medical cannabis to the Italian
government through the Italian Ministry of Defence.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 7.5 8.2 15.7
The commercial opportunities in Italy could be market. The future looks bright for cannabis light, with
significant, with the value of the illegal cannabis large exports of flowers and derivatives expected to
market in Italy estimated at between €7.2 billion and reach other EU countries in the mid to long term.
€30 billion. A figure like this would certainly be
attractive to a nation that is still struggling to recover The commercial potential for Italian cannabis can
from a three-year recession. already be safely assumed by the current success of
Easy Joint, a ‘cannabis light’ brand that contains a
High-CBD, low-THC cannabis, known as ‘cannabis small amount of THC (less than 0.6%) that can be sold
light’ is currently being sold all over the country, in legally in Italy.
tobacconists and general stores, and is skyrocketing in
popularity, although high THC cannabis, for Since its launch at a Bologna fair in May 2017, Easy
recreational users, is still only available on the black Joint sales have risen to the extent that the website
crashed and stores holding the product had to Similarly, LGC Capital, a company collaborating with
instigate crowd-control measures. According to Luca Italian company Evolution BNk announced that
Marola, head of Easy Joint, his company alone has 20,000 square feet of its 70,000 square feet facility
sold over 17, 000 kilograms of cannabis light. Another has been planted with cannabis seeds. The remaining
company CROP recently announced its 25 acre 50,000 sq. feet will be plant by the end of the year.
cultivation facility has produced 600,000 plants
categorized as ‘Cannabis Light’ in the country. Italy’s hemp industry is also set for a substantial
upturn. A reform implemented last year has boosted
In a development in late 2017, the Italian Senate Italy’s fledgling hemp industry, with an 80% increase
passed a law permitting the cultivation of cannabis in acreage of cultivated land. The new legislation has
without the need for authorisation for producers of resulted in the removal of substantial red tape from
cannabis for food, cosmetics, industry and energy. hemp production.
In January 2018, Canadian cannabis company Aurora

58
The current restrictions on cannabis (in all its forms)
Cannabis won the tender to be sole supplier for 100 are increasingly relaxed, and this is encouraging
kilogram of cannabis in Italy. Aurora and its wholly entrepreneurship. In recent months new Italian
owned German subsidiary Pedanois have GMP startup Weedentity has launched a range of medical
certifications and this was instrumental in their cannabis products to treat anxious and depressed
selection. The company has since then delivered its dogs and cats. The products, made from oils
first batch of medical cannabis to Italy through containing 5% levels of active ingredient CBD, are
Pedanois and is slated to continue its Italian export produced from cannabis sativa plants grown in
operations. Switzerland and tested in Swiss and Italian
laboratories.
Maricann has also entered the Italian cannabis market
through a non-binding contract with San Martino SS, As restrictions ease, it is likely that the Italian army will
which is an agro enterprise from Piedmont, Italy. The be unable to retain their exclusivity over cannabis
University of Eastern Piedmont is also part of the cultivation and production and this would create
collaboration and will contribute to the ongoing space for future entrepreneurs to enter the Italian
production for high CBD cannabis. The venture will market.
also look to target the THC market as it opens up.
€7.5b
Projected Market Value (€) 59

Similar growth to the UK albeit from a
higher base to a lower end value – growth
ramping up pace in the middle of the
forecast period before it slows (whilst
still remaining buoyant)
€38m
2018 2028
(est) (proj)
Despite a forecast population decline of almost three relatively low with between 60-70,000 people
quarters of a million in the next ten years, the market estimated to have spinal cord injuries in Italy, there are
for medical cannabis is expected to grow in Italy. By some 68,000 MS sufferers and around 180,000 living
2026, the number of Italian cannabis patients could be with anorexia. However, other conditions that have
approaching the 1 million mark if the country follows a found to be helped by cannabis medication include
similar medical cannabis adoption rate as seen in Parkinson’s patients (of which there are almost
other more mature markets such as Canada. 150,000 sufferers in Italy). Medical cannabis also has
health applications for insomnia, pain and anxiety and
Multiple Sclerosis, cachexia (wasting of the body), 2017 research conducted by Italian drug agency AIFA
glaucoma, and chronic pain, are amongst the noted an 8% increase in the use of drugs to treat
qualifying conditions for medical cannabis in Italy, anxiety, nervousness, panic attacks and insomnia in
although other conditions that qualify include the country with some 6% of the population (around
relatively niche conditions and syndromes such as 3.6 million) having been prescribed antidepressants in
Tourette’s (affecting around 1% of the population), 2017. The potential market for medical cannabis in Italy
anorexia (affecting 0.3% of the population), and spinal could be significantly higher than our conservative
cord injuries. estimates, should it be made available as a treatment of
people suffering from a mental illness.
Patient numbers for existing qualifying conditions are
CONSUMPTION
Cannabis
19%
14.1% 23.7% 60
30
55-60 1% 25
20
45-54 3.6%
15
35-44 7.6%
10
25-34 16.8% 5
18-24 21.6% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Expert Input
source: EMCDDA
Marco Perduca, International Programme Coordinator,

Luca Coscioni Association,
The centre-right coalition, which received the most coalition. In November 2016, a citizens’ initiative
votes, does not support drug policy reform, while the calling for the legal regulation of cannabis was
populist Five Stars Movement, which is the biggest presented to the parliament with the support of
party in parliament right now, has called for the legal 68,000 signatures.
regulation of cannabis for all purposes, but did not
give any priority to the matter during their electoral Italy re-legalised industrial hemp in December 2016
campaign. The centre-left coalition, primarily after some 40 years of prohibition. That change in the
represented in the parliament by the Democratic law has allowed the opening of over 400 hemp shows
Party, which has been the senior party in the governing around the country. There remain numerous
coalition for the last five years, is mildly in favor of bureaucratic problems, but judging from the speed at
reforming drug laws, but has mixed views on the issue. which shops have been opened, the fact that
cannabis light products sold out on the day of their
The election results will only allow a government that launch, and keeping in mind that Italy has some 4
is either supported by a mixed coalition of those that million cannabis users, the development of a strong
secured the most votes in the elections, or a industry is plausible.
government of technocrats with the external support
of all political parties. In either case, the regulation of
cannabis will not be a popular policy in any successful
The European Cannabis Report™ France
61
FRANCE
MARKET OVERVIEW
Population (m) 67.4
GDP (€t) 2.2
Ruling La République
Government En Marche!
Party
Party Stance In support of

on Cannabis decriminalisation
Total Healthcare
Expenditure (€b) 251.3
12.6
Alcohol Consumption
(Litres Per Capita France is emblematic of the hypocritical cannabis
Per Year)
policies exhibited in Western Europe. The French
Prevalence government has maintained a conservative stance on
of Tobacco 32.7 both medical and recreational cannabis despite
Users (%)
France being one of the highest cannabis consuming
Number and hemp producing nations in the world.
of Cannabis 4.7
Users (m)
Amazingly, Sativex was licensed for market
Average Price authorisation in 2014 but, four years later, the
Per Gram 7.9 sublingual cannabis-based spray used to treat
of Cannabis*
spasticity in multiple sclerosis patients is still In September 2018, it was announced that the French
unavailable, due to a pricing dispute between the National Agency for the Safety of Medicines and
producers and French authorities. The country’s Health Products (ANSM) had launched a temporary
health minister Agnés Buzyn recently expressed her scientific committee to evaluate the necessity and
support for the arrival of medical cannabis in the feasibility of creating a medical cannabis market, and
country, however, it remains largely inaccessible to how such a market could be accessed. The committee
those who need it. announced in 2018 that it would recommend the use
of medicinal cannabis products. From 8 February
France was set to reform the criminalisation of 2019, France will host its first professional meeting on
cannabis users after the introduction of a new cannabis, Cannabis Europa, at the Maison de la
parliamentary report in early 2017. In fact, the Chimie (House of Chemistry) in Paris.
decriminalisation bill does little to support medical
cannabis users and even less to generate a viable
cannabis industry. Introduced on 24 February 2018,
Cannabis Europa will bring together leaders in politics
and policy-making, patient advocacy, science, and
62
the report recommended introducing a fixed fine of business, to help shape the future of the medical
€150 to €200 (later raised to €300) instead of cannabis industry in Europe. However, France is a
mandatory prison sentences. The ‘solution’ was borne potentially huge cannabis market, with over five
out of a need to control court congestion rather than million consumers and 300,000 unofficial growers.
any effort to liberate medical cannabis users. The growing industry in neighbouring Germany and
Spain will surely ignite further debate on the archaic
prohibitionist laws instilled in French legislation.

Sativex is legal in Medical cannabis Still illegal but CBD oil with less than
France is illegal in France penalised with an on 0.2% THC is legal
the spot fine.
Summary
France currently approves only of Sativex, Marinol and illegal in France.
Epidiolex with the latter two being approved
tentatively. However, actual medical access to these Pharmaceutical cannabis was legalised in 2013 in
drugs is effectively absent from the French market due France, however, there are still no cannabis-based
to a number of reasons. products for sale in the country, and it remains out of
reach of patients. Sativex, a THC-CBD oral spray, was
Medical cannabis is currently illegal in France other approved in 2014 to treat symptoms of multiple
than through a special compassionate-use permit that sclerosis, however, the high cost of the drug and the
allows for the prescription of unlicensed cannabis French health authority’s low 15% reimbursement rate
medicines. Without any cannabis-based drugs sold in for Sativex, compared with up to 80% for other MS
pharmacies, patients are forced to go abroad to buy drugs, have effectively curtailed its potential use.
their medication and are still subject to cannabis being
Currently, two other cannabinoid-based drugs are French public opinion, formerly conservative on this
allowed in France: Marinol, a synthetic THC issue, may be changing. The public support for the
prescription medicine used to treat nausea and introduction of fines for possession, rather than the
vomiting associated with cancer chemotherapy and continuation of mandatory prison sentences, was
appetite loss associated with weight loss in people reported at 69% in June 2017 (Odoxa - June 2017).
with AIDS; and Epidiolex, a CBD-based drug for According to a 2018 study by Terra Nova and ECHO
treating epilepsy. Citizen, 51% of French people were in favour of the
"regulation and supervision of cannabis" while 82%
Despite recreational cannabis use being highly supported cannabis for medical use.
popular in France and consumption rates among the
French being one of highest in Europe, France has yet In practice, the popularity of the consumption of
to legalise recreational cannabis. However, recent cannabis has prompted the French police to change
legislation has instructed the imposition of fines rather
than prison sentences.
their approach to enforcing the law. People carrying 63
small quantities of cannabis now rarely get arrested.
Further, only a small fraction for all drug-related
This recent revision of cannabis laws was the first criminal proceedings actually result in imprisonment.
since they were introduced in 1970. There are currently In 2015, out of an estimated 140,000 drug possession
political disagreements about whether criminal charges, only 1,283 actually led to conviction and
sanctions should apply if fines for possession are not prison sentences.
paid. The current French President, Emmanuel
Macron, has voiced support for limited cannabis CBD being recognised as a non-psychoactive
reforms, but he is unlikely to support recreational substance is currently legal in France and can be sold
legalisation. France’s finance minister Bruno Lemaire in selected shops.
has also expressed his reservations with regard to
softening France’s laws relating to smoking cannabis.
HEALTHCARE ANALYSIS
Total
Total
Pharmaceutical Medicinal Cannabis-
Healthcare
Spending Cannabis based
Expenditure
(€b) Allowance Products
(€b) 2018 (grams)
Sativex
Bedrocan
251.3 44.4 699,880 Bediol
Bedica
France has a universal healthcare system, largely Since the decree of 5 June 2013, cannabinoid-based
financed by government national health insurance drugs are theoretically no longer banned in France but
(77%). In 2011, France spent 11.6% of GDP on for a drug to be marketed in France, it must receive a
healthcare, a figure much higher than the European Marketing Authorisation (MA). The only
average of 9.6%. cannabis-based medicine that has an MA is Sativex
(as of 2014) but, due to a dispute over pricing between
The French government generally refunds patients the French authorities and the producers, the product
78.3% of healthcare costs, rising to 100% in cases of is still unavailable in pharmacies.
costly or long-term conditions. Supplemental
coverage may be bought from private insurers, most of Sativex can only be prescribed for MS and a limited
them non-profit, mutual insurers. number of other conditions. The National Health
Insurance would partly cover the cost of the Sativex In order for patients to access cannabis flowers, medical
purchases if they were available. A potential reason for specialists must recommend medical cannabis before
Sativex not entering the French market is pricing doctors can prescribe it, although no French patient has
differences between the producing company, Almirall, been allocated medical cannabis before.
and France’s Economic Committee for Health
Products (CEPS). While Almirall wants to price the Patients must have special permission for a
product at €350 per box the CEPS set the price at €60. compassionate-use permit (similar to a cannabis card
An agreement is yet to be reached between the two in the US). Also known as the temporary authorisation
sides. for use (ATU), the scheme allows the exceptional and
temporary use of unlicensed medicines outside of a
Further, it seems that the French National Authority clinical trial to a single or a group of patients to treat
on Health has classified Sativex’s effectiveness in serious or rare diseases when no appropriate
treating spasticity in MS patients as “weak”. This is
likely the reason why the reimbursement rate for
treatment exists. ATU drugs can only be prescribed in
hospitals after the approval of the French drug
64
Sativex is at 15% while other MS medicines get 80% regulatory body (ANSM). To date, cannabis has not
reimbursement. This effectively makes Sativex been prescribed on this scheme.
unaffordable for French MS patients.
Nevertheless, the French scientific community lately
At present, France is permitting the sale of two more has been coming out in support of cannabis-derived
cannabis-based medications: Marinol and Epidiolex. medicines.
The former is a synthetic THC drug meant for treating
nausea and vomiting experienced by patients Very recently, a special committee has been tasked by
undergoing chemotherapy treatment or loss of the National Agency of Drug Safety (ANSM) to work on
appetite experienced by AIDS patients. The latter is making available medical cannabis. Their report is due
based on CBD, the non-toxic compound in cannabis before the end of 2018.
plants and is meant for treating patients suffering from
epilepsy.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 9.5 9.7 18.6
France is the world’s leader in hemp seed production, used for hemp cultivation. This is a significant chunk
currently responsible for 59% of the total seeds of the total land being used to cultivate hemp in
globally. The country also dominates the market for Europe at 33,000 hectares. Naturally, these factors
use of hemp fibre, accounting for over 50% of make France an appealing hemp market and potential
hemp-based pulp and paper production in Europe, cannabis market to cannabis investors and CBD
even though only 20 specific strains are allowed to be entrepreneurs, should any more lenient legislation be
cultivated legally. enacted.
France is also the leader in industrial hemp cultivation. In a recent statement, Cristophe Castaner, the new
It has over 17,000 hectares of agricultural land being Home Minister, said that there are over 1.2 million
regular cannabis users in France. This is significantly producer of hemp could still make the country an
higher than the 700,000 estimated regular cannabis attractive proposition to manufacturers should
users in France as per the French National policies be relaxed/ the stance on medical cannabis
Observatory for Drugs and Drug Abuse. be revisited.
Further, a recent WHO report suggested that France At present though, the country’s strict laws prevail. In
has a considerably high number of teen cannabis recent months the government has been taking steps
users. The survey was conducted with a sample of 42 to close a number of “coffeeshop” premises that are
developed nations and put French teen cannabis opening in the Paris region, taking advantage of a legal
consumption at the top of the list. This position had ‘grey area’, following a clarification that national law
been taken by Canada in earlier editions, where the allows for sales of low-THC, high-CBD strains of
drug is actually legal. cannabis. The products contain just 0.2% THC and are
In light of these facts, it is no surprise that France’s

being sold in several formats, some clearly labelled
“do not smoke”.
65
black market is estimated to be worth an annual €8.3b
per annum. This marketplace, although currently The government has admitted that it had been caught
illegal, demonstrates great potential for a legal ‘on the hop’ by the surge in the number of businesses
cannabis economy in the future. According to a report offering the low dosage product, and the Health
published in October 2016 by French think tank Terra Minister said that the shops were a threat to public
Nova, legalisation would generate between €1.3b and health, as they were encouraging drug use. She has
€2.1b in tax revenue and create 13,000 jobs in the pledged to close the legal loophole and put the shops
trade industry. out of business “within weeks”, also admitting that the
0.2% legislation was “a little vague” and that it would
Whilst current French policies place limitations on the be reviewed.
potential of the market in France, its experience as a
Projected Market Value (€) €9.5b

Growth will experience a sluggish start in
France where accessibility has damp-
ened growth. Once this is resolved, we
expect to see aggressive growth in the
second half of the forecast period,
slowing towards 2028.
€1.7m
2018 2028
(est) (proj)
A lack of availability of cannabis medicines in France Bediol and Bedica are not as restrictive in terms of the
is suppressing potential market value in the ailments they can treat, those patients requiring a
short-term. Although it has been legal for almost five prescription for these drugs must be in possession of a
years, and despite a potential patient base of more Special Permission for Compassionate Use permit.
than half a million, no cannabinoid-based drug has
been sold in the country. France has one of the highest In its current form, the complexity surrounding patient
cancer rates in the world and currently has more than accessibility to cannabis in the country will stymie
450,000 battling the disease. In addition, France is growth potential. However, France has taken the initial
home to more than 200,000 people living with HIV or steps to review their stance on medical cannabis
AIDS and over 120,000 Parkinson’s sufferers. In legislation and could soon see the beginning of a
France, Sativex is only prescribed to help treat MS (of burgeoning industry. Prohibition Partners predicts that
which there are 60,000 sufferers) and a very limited the French market for medical cannabis could be
number of other conditions. Although Bedrocan, worth almost €9.5b in 2028. 66
CONSUMPTION
Cannabis
22.1%
16.3% 27.9%
30
55-60 1.6% 25
20
45-54 4.4%
15
35-44 8%
10
25-34 17.5% 5
18-24 27.1% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
Expert Input
Sébastien Béguerie, CEO, AlphaCAT Lab
Sativex was meant to be introduced into the French actually become available in French pharmacies.
market through an amendment in the national laws
made in June 2013. However, even though the ANSM Nevertheless, the legal decree allowing Sativex in
permitted Sativex to be sold in France, the healthcare French medical markets still stands. This can be
expenses reimbursement authority disagreed on the potentially used for importing cannabis medicines. But
quoted price for the product. Thus, Sativex has yet to they will need to apply for a licence first. Yet, the
opinion among professional pharmacists across On a medical side, we finally could see the availability
France is not very favourable to cannabis medicines. of medical cannabis with the not yet released
Thus, France needs to reintroduce cannabis as part of conclusions of the aforementioned special committee
the French pharmacopoeia and facilitate amendments commissioned by the National Agency on Drug Safety
in the 2013 decree restrictive to Sativex to allow for (ANSM). If it rules that there is a potential plus-value
imports of other cannabis-based medicines. for patients, pharmaceutical forms of medical
cannabis could be quickly released.
At present, the combined lack of cannabis knowledge
among medical professionals and the high cost and Renaud Large, Associate Director,
physical effort required on part of cannabis patient is
keeping the market marginalised. To increase the Plead agency
knowledge of medical cannabis among professionals, Economic and financial arguments are beginning to
the UFCM I CARE has been organising an annual
cannabis event since 2012.
emerge at the heart of the debate around cannabis 67
legalisation and this could explain recent changes in
public opinion. According to a poll released on June
Similar to the medical cannabis market in France, the 11th by Terra Nova, an influential French think tank,
hemp market also suffers from a restrictive 82% of the French population supports legalisation of
monopolisation. Currently, Hemp-it is the only hemp medical marijuana and 56% thinks that it should be
producer in France with authorisation to grow hemp covered by social security. Furthermore, 51% think that
varieties other than EU-approved ones. recreational use should be legal. In fact, the economic
appeal of cannabis tech in the US, Canada, Israel,
Further, hemp cultivators are only legally allowed to Germany, Luxembourg, and Greece creates a tidal
process the stalk and seeds of the plant. They cannot effect, highlighting the economic stakes of cannabis
use the flowers for any purposes and thus, CBD is legalisation in France. France could be one of the
practically illegal in the country. However, the largest potential emerging markets in Europe with an
aforementioned June 2013 decree does allow for estimated €8.9b underlying market including a €7.2b
processing cannabis flowers if they are meant for a medical market.
registered and regulated medical product.
In France, the cultivation, import, export, industrial
Aurélien Bernard, Founder, and commercial use of cannabis (fibre and seeds) is
Newsweed France permitted, provided the THC content does not exceed
0.2%. Sale and consumption of cannabidiol (CBD), as
Although France is making the first changes to its medicine, e-cigarette liquid or hemp are not
cannabis laws since 1970, in 2018 we cannot class prohibited, and recently businesses have begun to sell
these changes as decriminalisation, as the French these products. However, the French government has
government still plans to penalise recreational and repressed CBD shops that sell leaves and resins since
medicinal use. this summer on the basis of a controversial
interpretation of the law to curb the massive
In the debate around this project, we have seen that movement to open stores that like to call themselves
the main barriers to change are the rigidity of the “coffeeshops”.
government, which is unwilling to let go of outdated
cannabis stigmas. If the situation is complicated on the “wellness”
market, things are really evolving on the medical front.
Medical cannabis could be as valuable a medicine as The French minister of public health declared that
prescription opioids, while from a recreational “legalisation of medical cannabis could happen in
perspective, France already has growing shops, seed France” and created a special committee to work on
shops, and CBD shops. Everything is legal except the this question. The committee will publish its
plant itself. conclusions before the end of 2018. We can assume
that legalisation of medical cannabis would fall in line
There is a great understanding of cannabis cultivation with the current feeling that “France is back” on the
and manufacturing in France. French individuals who economic field, a strong argument of the new
want to work in the cannabis industry currently have to governing party. It could be the great liberal reform
emigrate, to Spain or California for example. True that the French President would politically need in the
regulation would reveal the wealth of underground second half of his term. It could be the reform uniting
knowledge we have here. agricultural farmers as well as economic and
ecological voters.
The European Cannabis Report™ Spain
68
SPAIN
MARKET OVERVIEW
Population (m) 46.6
GDP (€t) 1.11
Ruling
Government PSOE (Socialist)
Party
Open to medical
Party Stance legalisation but not a
on Cannabis priority in the current
government agenda
98.5
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 10 Cannabis consumption and cultivation for recreational
Per Year)
or medical use is decriminalised in Spain, providing it
Prevalence is for personal use and in a private place. Sale,
of Tobacco 29.3 importation, purchase, possession and consumption
Users (%)
of cannabis in a public place is still illegal, however.
Number Spanish law does not distinguish between recreational
of Cannabis
Users (m)
2.8 or medical cannabis, so many patients go to cannabis
clubs to obtain and use their medicine because Spain
Average Price currently prohibits medical cannabis containing THC.
Per Gram 4.3
of Cannabis*
Commercially, there is a culture of cannabis social The Catalonian parliament submitted a bill in July 2017
clubs across Spain, and particularly Barcelona. These calling for the legalisation of the cultivation,
are non-profit private collectives, some of which consumption and distribution of cannabis throughout
operate through a ‘back-door’ illegal market. While the autonomous Spanish region. However, with the
hemp seeds are legal, breeding and growing your own current political climate in Spain, the issue of cannabis
plant is not. Going to a club to consume cannabis is law reform is set to take a back seat for the time being.
allowed, but it is forbidden to transport the minimum Catalonia is the third regional government in Spain to
amount of product on the street, and according to data approve such a law, after the Navarra and Basque
from the National Drug Plan, three out of every ten County regions in the north of the country.
Spaniards has consumed cannabis.
69

Inconsistent.
Inconsistent.
Possession/consump
Possession/consump tion is legal in private
At present, Spain tion is legal in private areas.
has legalised the areas.
sale of Sativex, Public
Epidiolex, Public Legal
possession/consump
Nabilone and possession/consump tion is decriminalised
Dronabinol. tion is decriminalised with amounts up to
up to 70 - 100 grams 70 - 100 grams
(depending on region) (depending on region)
sanctioned by fines sanctioned by fines
(between €300 - (between €300 -
€2,000). €2,000).
Summary that will be presented to the Spanish Parliament in

early 2019. Mr Iglesias commented: “It is no longer a
Spain has legalised all major cannabis pharmaceutical question of whether there is a global debate on the
medicines including Sativex, Epidiolex, Nabilone and regulation of cannabis, this phase has already passed,
Dronabinol. the debate today is about who will be the next to
regulate cannabis.” In his opinion, Spain could greatly
Spain does not have formal medical cannabis benefit, socially, economically and symbolically if it
treatment programmes but has decriminalised were a pioneer in the industry. The debate, which
cultivation for personal use. lasted for three hours, discussed:
On 18 October 2018 at the Congress of Deputies, the 1. International experiences of cannabis regulation
Spanish party Unidos Podemos organised a forum and global paradigm shift.
entitled “Towards the integral regulation of cannabis”, 2. The scientific and health perspective of
led by Pablo Iglesias, who reiterated his cannabis.
pro-legalisation position and said that he considered 3. Potential production models and their economic
the meeting a starting point for the drafting of a law impact.
In terms of the model for regulation, Iglesias was clear have had a rocky past in relation to regulation. They
in his preference for a state-run production model, exist on the back of a liberal narcotics law, which does
with the focus on creating social wealth rather than not mention any penalty for the cultivation and
economic growth, which would also revitalise the consumption for personal use in a private
agricultural sector and rural areas. He emphasised environment. However, the definition of what
that he does not want production to fall into the hands constitutes ‘personal use’ or a ‘private environment’
of large multinationals. remains vague. In 2015, the Spanish Supreme Court
ruled that a cannabis social club with over 300
While Ciudadanos traditionally supports such members could no longer be considered a private
initiatives, it will be less easy to convince Spain’s two environment. After the ruling, five of the
traditional parties, the PSOE (Socialist Party) and the owners/members were found guilty of drug trafficking.
PP (People’s Party), although the latter has agreed to However, this case was recently annulled, which was
the formation of a permanent commission within the seen by many as an important win for the future of 70
Congress to discuss the future of Spanish cannabis. Spain’s cannabis clubs.
Spanish citizens are allowed to cultivate cannabis There have been several failed attempts to implement
plants up to a limit within their private residences for policies and regulations that allow the possession and
personal consumption. consumption of cannabis at a local level. All proposals
were issued by city councils or by regional institutions
With its 17 autonomous communities and two (either local parliaments or regional governments of
autonomous cities, Spain’s medical cannabis laws the autonomous communities), taking advantage of
vary by region. Most of Spain’s regions criminalise their devolved powers regarding health, public safety,
some aspects of recreational and medical cannabis, and regulation of non-profit entities. However, almost
predominantly the use, sale and cultivation of the all initiatives have been ultimately cancelled at the
plant. Many areas of the country, including Andalucia, federal level by the central government.
Catalonia, and the Basque country, have maintained a
stable, if not growing number of cannabis social clubs, The Spanish central government is caught in
though this does not represent a fully regulated complicated structural difficulties arising from the
market. post-dictatorship democratic transition initiated in the
late 1970s. Territorial questions, as evidenced by
Actions that are illegal under the Federal recent events in Catalonia, add complexity to cannabis
Anti-Narcotics Act in Spain include: policies. The common tendency of the central
government has been to allow the autonomous
• Sale of cannabis communities to organise their own local drug policies,
• Cultivation of cannabis for purposes other which govern the health and law enforcement
than personal use response to use, possession, distribution, production
and processing of cannabis. However, the power of
Actions that are legal, but sanctioned by fines under regional reforms is becoming increasingly limited as
the Citizenship Security Act, include: the centralised Spanish government looks to tighten
its control on the governance of regional and
• Possession of recreational or medical municipal institutions.
cannabis
• Cultivation of cannabis plants for personal The hundreds of existing and new cannabis social
use, in spaces viewable to the public clubs maintain an important level of social pressure in
• Public consumption of cannabis the country and feed a number of umbrella
organisations that analyse changing political and
Though cannabis related crimes can lead to fines and public opinions. However, there is unlikely to be any
prison sentences, cannabis social clubs are major change to the cannabis club system in Spain in
widespread across the country. At the time of writing, the near future.
there are 800 active clubs. Spain’s cannabis clubs
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Sativex 71
98.5 24.8 400,000 Epidiolex
Nabilone
Dronabinol
Spain's national healthcare system (SNS) guarantees of these cannabis-based medicines, Spain does not
universal coverage and no upfront expenditure from support any medical cannabis programmes.
patients, apart from paying a proportion of Catalonia’s legislation, however, allows medical
prescription charges. Spain spends about 10% of its patients to purchase an unlimited amount of medical
GDP on healthcare, and consists of both private and cannabis, whereas recreational users have a monthly
public healthcare, with some hospitals and healthcare limit.
centres offering both private and state healthcare
services. Private health insurance is not needed to get By providing patients with the option to tailor their
medical treatment in Spain, but it usually allows faster dosage amounts, Catalonia resolved the challenge
treatment for non-emergency procedures, diagnosis patients face in other countries with weekly or monthly
tests, and specialist consultancies. limits. In these countries, patients with severe
conditions or symptoms may be unable to find relief
In Spain, physicians can prescribe Cesamet (nabilone) due to their restricted dosage. Cannabis social clubs
and Marinol (dronabinol) against nausea and vomiting register as non-profits and charge a ‘membership fee’
in cancer chemotherapy, and Sativex for the treatment to cover the price of the cannabis.
of several diseases. However, despite the availability
Forecast Forecast
2028 (€b) 2028 (€b)
Total 3 5.3 8.3
Spain’s cannabis industry operates in a grey area. This businesses have influenced policy writing through
has given rise to private cannabis clubs and a thriving cooperatives that lobby local government, and it
micro production industry. Historically, these appeared that this might deter international
companies.
However, the partnership between Canadian cannabis established a wide, developed and skilled network of
producer, Canopy Growth, and Spanish morphine stakeholders, including cannabis users’ associations,
producer, Alcaliber, for a reported €200m in March patients support groups, policy reform initiatives,
2018 signals an international interest in the Spanish lawyers and physicians, and industries such as
market. More recently, Canopy Growth reported the grow-shops, and seed banks.
successful transfer of 1,500 cannabis clones to
Alcaliber in Madrid. This is the start of the joint venture There are a number of Madrid companies earning
undertaken by both parties and poses to make millions of euros from the sale of hemp-related
significant contributions to the Spanish cannabis products, despite the lack of legal status. Leaf Life, a
market. company distributing products for cannabis
self-cultivation, closed 2016 with a turnover of €12.7
Spain has also amassed a series of seed companies million, three times its 2012 turnover (€4.1 million).
and a knowledgeable workforce that would be
attractive to both international companies and
Businesses related to cannabis continue to flourish, 72
encouraged by the global climate of legalisation, and
investors. In the last 25 years, the country’s social Spain’s cannabis industry is said to be experiencing its
movement of cannabis users and activists has best year in two decades.
€3b
Spain is set to enjoy slower growth in the
first half of the forecast period with
growth ramping up in the second half
should cannabis be legalised across the
country.
€1m
2018 2028
(est) (proj)
Assuming that medical cannabis becomes fully particularly acute in Spain - by 2050, it is expected to
legalised by 2023, we would expect to see patient become the world’s second oldest population, behind
numbers rise beyond 350,000 by 2028. Japan.
There are more than 150,000 HIV/ AIDS sufferers in The volume of cannabis required for the Spanish
Spain today and 270,000 cancer patients, an market in 2028 could grow significantly should it
estimated 46,000 MS sufferers and more than 93,000 become legalised across the country and made
Parkinson’s sufferers. The Spanish population is available for a wider range of qualifying conditions
forecast to decline marginally from 46.6 million in 2018 than those named above. this would significantly
to 46.3 in 2028 but the number of sufferers of key increase the proportion of the Spanish population who
qualifying conditions is likely to hold steady or even become cannabis patients.
increase. This is due to the ageing population which is
CONSUMPTION
The below graph outlines the reported recreational cannabis use in Spain in 2017.
Cannabis
17.1% 73
11% 23.1%
30
55-60 2% 25
20
45-54 4.7%
15
35-44 8.9%
10
25-34 15% 5
18-24 19.9% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
European Panel Input

Kenzi Riboulet Zemouli, Head of Research,
FAAAT think & do tank (Barcelona)
Although some legal reform initiatives are ongoing, no in May 2018. As the country's knowledge base
amendments to Spain’s legal framework with regard to continues to grow, with patient access and doctor’s
cannabis are expected in 2018. organisations rising in numbers, the regulation of
medical cannabis could come to fruition in the short to
As the country hosts important research centres on mid-term.
medical cannabis including the ICEERS (International
Centre for Ethnobotanical Education, Research and In the national Congress, proposals to regulate access
Service), Fundación Canna and the Spanish and availability of medical cannabis have received
Observatory on Medical Cannabis (OECM, broad endorsements from political parties and opinion
Observatorio Español del Cannabis Medicinal), Spain leaders, and it is likely in the coming years that
can expect the regulation of medical cannabis in the regulations will be eased to help protect patient
near future. access or develop a regulated market for medical
cannabis. The current political stalemate is expected
In addition, Barcelona hosted the first Cannabmed to pass within the next five years, allowing more space
Congress in December 2016 on the use of medical for cannabis law reform on the political agenda.
cannabis with the second Cannabmed Congress held
The European Cannabis Report™ The Netherlands
74
THE NETHERLANDS
MARKET OVERVIEW
Population (m) 17.2
GDP (€b) 702.3

People’s Party
Ruling for Freedom
Government and Democracy
Party and Labour Party
In favour of medical
Party Stance legalisation and
on Cannabis considering trials for full
recreational regulation
71.2
Total Healthcare
Expenditure (€b)
Alcohol Consumption Despite the perceived global image of Amsterdam as a

(Litres Per Capita 8.7 haven for recreational cannabis, the Dutch approach
Per Year)
to the drug, much like the rest of Europe, is not without
Prevalence its rules and restrictions. Since its inception,
of Tobacco 25.8 Amsterdam’s famous coffeeshops have had to rely on
Users (%)
the ‘back door’ black market supply of cannabis.
Number
of Cannabis
Users (m)
0.9 The Dutch government is looking to reform this
approach, experimenting with a series of
Average Price government-controlled licences for domestic
Per Gram 11.0 cannabis cultivation that will supply a set number of
of Cannabis*
coffeeshops. The government will then compare the
models in order to create a long-term supply and retail The Netherlands is also strengthening its position
programme. This appears to be the first step in within the hemp industry. In 2016 the country became
creating a government-controlled recreational market Europe’s third-largest cultivator of hemp-based
worth an estimated €1 billion per year. materials, increasing its output by over 600 hectares
compared to the previous year.
Currently, Bedrocan, a leading producer of medical
cannabis, has a monopoly on the country’s medical It seems inevitable that the decades of experience in
cannabis market and R&D licences and is capitalising cultivation and R&D will place the Dutch in pole
on the emerging markets across Europe through position in Europe, whether that be in genetics or as an
export. As of 2019, the government is looking to license exporter to neighbouring nations as laws are gradually
a second medical cannabis cultivator for R&D and reformed.
domestic consumption, though they are unlikely to
challenge Bedrocan for export licences. 75

Inconsistent.
Legal as a
prescribed Possession of <5 grams
Unknown Legal
medication since is decriminalised for
June 2003 public use and for use in
cannabis ‘coffeeshops’.
Summary
Since medical cannabis is legal and widely available, installing the Bureau for Medicinal Cannabis (BMC). In
no specific pharmaceutical cannabis medicines are 2003, two companies were licensed to produce
known to be available in the market. cannabis for medical and scientific purposes, one of
which, Bedrocan, has become a monopolistic force in
Cannabis flowers are available for medical use Dutch cannabis.
through prescription. Medical cannabis is legal via a
doctor’s prescription in The Netherlands. However, Now, 15 years later, the Hague wants to introduce a
the country’s Bureau of Medical Cannabis has put the second government licence for medical and scientific
expansion of their medical cannabis programme on cannabis cultivation, though the successful applicant
hold while it investigates further. will grow cannabis solely for the BMC, which will
control the destination of the product.
Cannabis use for recreational purposes is illegal but
tolerated. As it stands, recreational use is technically illegal but is
tolerated in small amounts for Dutch citizens;
The Netherlands was the first country in the world to specifically - those carrying a maximum of five grams
legalise medical cannabis, when their pioneering or cultivating no more than five plants. The private sale
Health Minister, Els Borst, advocated its use in 1999. of cannabis is also illegal - although this is tolerated in
But it wasn’t until 2001 that the country began the case of coffeeshops as long as the proprietor
officially producing and administering cannabis, after adheres to certain rules including:
• No selling of ‘hard drugs’ (cocaine, heroin, cannabis, social cannabis clubs with a limited legal
ecstasy etc.) right to dispense cannabis, coffeeshops being held
• No selling to anyone under the age of 18. accountable for growing and distributing cannabis
• Not being a nuisance to the local community. etc.
• Not opening any shops within a 250-metre
radius of a school. All of these alternatives have their merits but none
consider complete cannabis legalisation. So, for the
It has always been illegal for coffeeshop owners to moment, the Dutch cannabis market will continue to
grow the amount of cannabis they need to meet operate under ambiguous laws and limitations.
demand. This results in black market sales, which in
turn perpetuates Amsterdam’s reputation as a global In July 2018 the Dutch government gave the green light
hub for illegal drugs. to a wide-ranging experiment to allow six to ten
Over the past few years, the Dutch government has

municipalities around the country to legally grow
cannabis. Over the next four years, the municipalities
76
been increasingly taking a stricter stance on cannabis will oversee the growth and supply to cannabis cafes
cultivation, which is technically illegal even though or coffeeshops, which will then sell to the public.
coffeeshops selling cannabis are legal in a certain
sense. In 2015, the Dutch police reportedly closed While the sale of small amounts of cannabis (less than
nearly 6,000 cannabis plantations. This is despite the five grams) was decriminalised in 1976 and the law
€400 million tax revenue the Dutch government allows individuals to grow five plants for personal use,
receives from national cannabis sales. the wholesale growing and sale of cannabis have been
illegal, and some 600 authorised owners of the
More recently, a bill was put forward by the coffeeshops have resorted to the black market to
progressive D66 party calling for legal and regulatory meet demand.
reforms in the Netherlands. The bill, if cleared, will
effectively allow the government to regulate the supply Cabinet plans to appoint selected growers, and will
of cannabis to coffeeshops, which will then stifle also ensure that there are a “sufficient number of
dependency on criminal networks. The government cannabis varieties”.
will now look to administer a series of cultivation
licences to small independent producers that will The supply chain will be closed, with no cannabis
supply state-monitored coffeeshops. allowed to enter the illegal circuit, and more
municipalities are likely to be included in the
A number of regulatory models are being considered experiment, with a bill expected to be presented to
and more than eight municipalities are participating in parliament “soon”.
the discussion. Some prominent regulatory models
being discussed include cannabis grown by medical The CBD market exists in a vague and unregulated
cannabis companies and supplied to coffeeshops, legal framework. CBD and all other hemp derivatives
coffeeshops being closed and online as well as are available across the Netherlands.
vending machines being used to dispense recreational
HEALTHCARE ANALYSIS
Total
Total Pharmaceutical Medicinal Cannabis-
Healthcare Spending Cannabis based
Expenditure (€b) Allowance Products
(€b) 2018 (grams)
Cannabis
71.2 7 32,684 flowers
Cannabis Oil
The Dutch healthcare system is managed by the Over the last year, changes to insurance policies have
government and supplemented by private insurers. meant medical cannabis is now more difficult for
While Dutch residents and employees are patients to acquire. This came on the back of a review
automatically insured by the government for long-term by the National Health Institute (Zorginstituut
nursing and care as covered by the Long-term Care Act Nederland) in 2017. This is the body that officially
(Wet langdurige zorg or Wlz), everyone has to take out advises insurers on the impact and financial feasibility
their own basic healthcare insurance (basisverzekering). of different medications. They concluded that there
are no conditions for which medical cannabis can be
Although the country has been a pioneer in the use of considered a suitable treatment, mainly due to a lack
cannabis as a treatment, the Dutch medical cannabis of longitudinal and clinical data. Instead, the institute
industry is still very much in its infancy. The BMC will insure patients for alternative treatments. This
oversees patient access to medical cannabis and, decision led to a number of health insurance
although the office has a list of recommended medical
conditions for patients and physicians, they leave the
companies withdrawing cannabis from their policies
and subsequently leaving patients without affordable
77
question of when to write cannabis prescriptions in the access to their medicines.
hands of doctors. The only requirement is that patients
must have sought other treatment options, leaving Due to the price of medical cannabis, many patients
medical cannabis as a last resort. choose to go to coffeeshops to obtain their supply,
leaving them without a reliable and standardised
More than 2,000 pharmacies nationwide are legally product. Alternatively, they could grow their own
required to stock medical cannabis and must provide cannabis plants. However, the legal limit is five plants.
instructions and advice regarding methods of Yet, in certain cases, the legal limit has been raised. In
consumption. Yet many doctors are still not educated one particular case, it was raised to 17 plants. Also, the
about the therapeutic benefits of cannabis and municipality of Tilburg recent permitted medical
therefore rarely offer it as a prescription. Nevertheless, cannabis patients to grow their own plants at home.
recent estimates suggest that there are more than
50,000 medical cannabis patients in the Netherlands.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 3.1 3.4 6.5
The Netherlands has the local expertise to be the world to experience its famous coffeeshops. This
knowledge leader of the European cannabis industry. culture has become so entwined with the tourism
With a deep understanding of genetics and enviable industry that any reduction in tolerance would have a
crop intellectual property (IP), the Dutch are well significant impact on the city’s economy. In early 2018,
positioned to champion innovation and product Amsterdam introduced laws that would outlaw
development in this space. Existing production and smoking in public places in the city centre. Whether
testing companies are set to significantly benefit from this is indicative of any long-term changes is
the European cannabis boom. unknown, but it may affect coffeeshop sales at least in
the short-term.
Today, Amsterdam is known globally as a haven for
recreational cannabis. People travel from across the In Veendam, Bedrocan has a licence from the BMC to
export cannabis medications to other countries (and process industrial hemp containing less than 0.3%
has done so to Italy, Australia, Germany, Finland, THC. It was thanks to this that Ben Dronkers was able
Canada and the Czech Republic). However, with a to establish his company Hempflax in 1994. Today, the
growing number of countries reforming cannabis laws, company has flourished internationally, with 550
and companies in Canada and Israel ready to export hectares in Germany and 700 in Romania to add to the
globally, the country’s share of the export market is set 450 hectares now under production on Dutch soil.
to reduce, despite the standard legal export limit being
raised from 100 kilos to 350 kilos and then to 700 Another promising sector lies in the seeds themselves.
kilos, specifically for the German market. Even more Thanks to the 40+ years of legal, personal and
recently, the Dutch and German health ministers industrial cultivation, the Dutch have a unique pool of
respectively agreed to raise the export limit to 1,500 data and understanding when it comes to the DNA
kilos. and genetics of the plant. The challenge will be
One potentially lucrative route to market is hemp. In

protecting this IP over the coming years. 78
the Netherlands, it is completely legal to cultivate and
FORECAST MEDICAL CANNABIS MARKET 2018-2028
€3.1b
Mature market, would expect to see a
steady growth curve, flattening out
around 2025
€380m
2018 2028
(est) (proj)
Data from the Dutch Cannabis Bureau highlights that prevail, Prohibition Partners estimates the
data currently shows that cannabis is proven to help Netherlands could have between 200,000 and
with pain and muscle spasms/cramps associated with 350,000 eligible cannabis patients living in the
(MS) or spinal cord damage. In 2018, there were an country by 2028.
estimated 14,500 MS sufferers in the Netherlands.
Cannabis can also be prescribed to help ease nausea, The Dutch Medicines Pricing Act, introduced in 1996,
reduced appetite, weight loss and debilitation safeguards the price of medicines (ensuring that it
associated with cancer and AIDS or nausea and doesn’t exceed the average price of the same medicine
vomiting caused by medication or radiotherapy for in Belgium, Germany, France and Great Britain).
cancer and HIV/AIDS. Data from the UN and the However, this has resulted in a fall in the average price
International Agency for Research on Cancer (IARC) of medicines to between 3% and 4% per year in recent
estimate that there are more than 23,000 HIV/ AIDS years. Prohibition Partners estimates that the Dutch
sufferers and almost 120,000 people battling cancer market for medical cannabis could be worth up to
in the Netherlands. Assuming current prevalence rates €3.1b by 2028.
CONSUMPTION
The below graph outlines the reported recreational cannabis use in the Netherlands in 2017.
Cannabis
17.1% 79
11% 23.1%
55-60 2%
45-54 4.7%
35-44 8.9%
25-34 15%
18-24 19.9%
source: EMCDDA
European Panel Expert

Dr Arno Hazekamp, Founder at Hazekamp Herbal Consulting
In 2019, the cannabis industry is expanding fast, not thus, it is not likely to challenge Bedrocan’s cannabis
only for recreational but for medical and scientific monopoly over the next few years.
purposes. The Netherlands wants to have an
additional international company, a producer, to stay However, the Netherlands is an old market, and it is
in sync with the international developments in the highly prized by international companies, which see it
cannabis industry. As a result, there was a tender as a stepping stone to the rest of Europe. Other groups
published on 28 February 2018, and we expect that may be able to purchase cannabis from the Dutch
100-200 international groups will register their office if there is a plentiful supply but patients’
interest. demands will be the priority.
Though highly contested, the market and opportunity We have had coffeeshops since 1976 and there has
for the successful candidate is not huge. The group always been a discussion about how we can amend
will have one client, which is the BMC, which will the ‘back-door’ policy. Eventually, the coffeeshop
decide the use and destination of the cannabis. For became a tourist attraction that increased the demand
instance, the bureau will decide whether it is for cannabis. Due to the fact that there was no
processed for medical cannabis or tested for scientific state-run cultivation, supply became controlled by
purposes, but importantly, the private company will criminal organisations. As a result, the government is
not have any power to export the cannabis abroad and attempting to reform this system.
A committee, mostly comprised of scientists, are

organising round-table discussions to explore
alternative methods of supplying coffeeshops, rather
than relying on the unregulated black market. The plan
is to provide a series of government-approved licences
to independent producers that can, in turn, supply a
selection of state-monitored coffeeshops over the next
four years. These licenses will likely be awarded to
Dutch farmers in the greenhouse industries rather
than large-scale international medical cannabis
companies. While they are conducting this experiment
the government will monitor the consumption of
state-run cannabis supplies and ‘back-door’ supplies 80
to determine how much cannabis is needed, how many
strains will be required and what is the best way of
distributing the recreational cannabis.
The European Cannabis Report™ UK
81
UK
MARKET OVERVIEW
Population (m) 66.4
GDP (€t) 2.23
Ruling
Government Conservative
Party
Party Stance In favour of medical

on Cannabis cannabis
215
Total Healthcare
Expenditure (€b)
Alcohol Consumption
Medical cannabis products became legal in the UK on
(Litres Per Capita 11.4 1 November 2018, and registered specialist doctors
Per Year) may now prescribe medical cannabis to “some
patients in need”. Access, which is currently
Prevalence
of Tobacco 22.3 restricted, is expected to expand as the number of
Users (%) clinicians listed on the Specialist Register of the
Number General Medical Council increases. There are
of Cannabis
Users (m)
2.5 currently around 80,000 on the list, however, NHS
doctors have little guidance on how to prescribe
Average Price cannabis, and there are fears that many will refrain
Per Gram 7.23 from doing so because there is not enough
of Cannabis* infrastructure to support them should something go
*Prices refer to black market cannabis prices wrong.
Some politicians have also criticised the with a second hearing delayed until 6 July. Pressure
recently-announced National Institute for Health and was mounted on the UK government after the two
Care Excellence (NICE) guidelines, saying that while high-profile campaigns for Billy Caldwell and Alfie
the programme is a step in the right direction, the Dingley stressed the need for urgent reform.
guidelines are overly restrictive. While the legislation
technically allows medical cannabis to be taken for In April 2018, the Dingley family applied for a licence to
any condition, doctors are more likely to follow the use medical cannabis oil to treat the six-year-old’s
guidelines and are therefore not expected to prescribe condition - severe epilepsy. Two months later the
it for conditions other than those listed. Caldwell family attempted to “openly smuggle”
cannabis oil from Canada to the UK to treat Billy, 12,
Sir Mike Penning, the co-chair of the All Party who suffered from the same condition. The two
Parliamentary Group on Medical Cannabis Under incidents mobilised mainstream media support and
Prescription, was quoted as saying “Those responsible
for this botched and cruel outcome should hang their
created public awareness around the urgency for
medical cannabis reform. In response, Home
82
head in shame. Guidance and associated Secretary Sajid Javid announced in the House of
recommendations have effectively shut down the Commons that the Home Office would provide 20-day
policy, crushing the hopes of many thousands of licences to both Billy Caldwell and Alfie Dingley, while
patients and their families.” the ministry considers a more long-term solution. The
decision came after the Home Office and the Ministry
The Royal College of Physicians (RCP) and the British for State and Social Care consulted the patients’
Paediatric Neurology Association (BPNA) have both doctors, who urged them to use their emergency
drafted guidelines indicating that cannabis should powers to license the Schedule 1 drug.
only be prescribed as a last resort.
It is estimated that there are as many as 3.6 million
The UK Home Office began reviewing its legislative active cannabis users in the UK, contributing to an
stance on medical cannabis in June 2018, after two estimated black market value of up to €6b per year. In
patients with childhood epilepsy, Billy Caldwell and addition, our research shows that medical cannabis
Alfie Dingley, were temporarily authorised to use can treat up to 2.9 million patients in the UK. This
medical cannabis on 19 June 2018. demonstrates the volume of the consumer base that
awaits a reform in legislation, indicating that the UK
On 10 October 2017, a new bill calling for the legalisation could still capitalise and flourish within the legal
of cannabis for medical purposes was introduced to cannabis industry.
parliament. The bill was filibustered in February 2018,

Illegal.
Legal as of 1 November CBD oil is now legal in
2018 but difficult to Cannabis is classed as the UK, but products are
Only Sativex and
attain. a Schedule 1, Class B required to contain <
Nabilone.
drug in the UK. 0.2% THC.
Summary “The decision to prescribe is only restricted to a

Epidiolex, the first registered CBD medicine, is still doctor on the Specialist Register of the General
awaiting marketing authorisation from the MHRA. Medical Council where the cannabis-based
Epidiolex, a whole plant extract, refined to deliver 98% product is an unlicensed ‘special’ medicinal
CBD, is GW Pharmaceuticals’ second cannabis-derived product for use by a specific patient. Once a
prescription medicine intended for severe forms of product is licensed by the Medicines and
epilepsy. Healthcare Products Regulatory Agency (MHRA), it
will be available for prescription in the same way as
On 19 June 2018 the government announced it would any other Schedule 2 drug.”
be undertaking a two-part review to examine the
scheduling of cannabis-related medicinal products The government also stated that it had “no
under the Misuse of Drugs Regulations 2001. It also intention of legalising the recreational use of 83
laid down regulations that introduced a definition of cannabis”.
‘cannabis-based product for medicinal use in humans’,
stating that only products meeting this definition would Recreational cannabis use is currently illegal, and one
be moved to schedule 2, with products not satisfying Tory MP recently said that making cannabis available
the definition destined to remain Schedule 1 drugs, on the NHS must not lead to the liberalisation of drugs
available only under a Home Office license. for recreational use. He is expected to call for a law
change that will reclassify synthetic cannabinoids -
To constitute a ‘cannabis-based product for medicinal currently a Class B drug - to the most serious Class A
use in humans’, a product must satisfy three category along with heroin and crack cocaine.
requirements:
The MHRA is responsible for controlling and
1. It needs to be a preparation or product that regulating medicines in the UK. The group has already
contains cannabis, cannabis resin, cannabinol or a classified CBD as a potential medicine but does not
cannabinol derivative acknowledge the medical benefits of THC, mainly as a
2. It is produced for medicinal use in humans, and result of the United Nations standing on THC
3. It is a medicinal product, or a substance or (currently in review, expected later in 2018) and the
preparation for use as an ingredient of, or in the lack of clinical data on medical cannabis treatments in
production of an ingredient of, a medicinal product the UK.
The 2001 Regulations also allow just three access The agency only classifies medicines, based on the
routes for the order, supply and use of the products by following criteria:
patients. These are:
• The advantages must outweigh the
1. A special medicinal product for use in disadvantages of taking the medicine
accordance with a prescription or direction of a • The medicine must do the most good for most
doctor (who has made the decision to prescribe) on people who will be taking it
the Specialist Register of the General Medical • The side effects must be acceptable
Council
2. An investigational medicinal product without The UK has suffered a relatively turbulent road
marketing authorisation for use in a clinical trial towards the current review. The UK drugs minister,
or3. A medicinal product with a marketing Victoria Atkins, had consistently maintained that
authorisation. According to the statement: “This cannabis would not be rescheduled and that it would
brings these products explicitly into the existing remain a Schedule 1 drug, which declares it contains
medicines framework. There are well-established no medical benefits. However, cannabis-based
mechanisms for the supply of unlicensed products have now been moved to Schedule 2, and
medicines to patients with exceptional needs. since 1 November 2018 registered specialist doctors
Unlicensed medicines of this sort are known as have been legally able to prescribe medical cannabis
“specials” and can only be manufactured in or to some patients in need. NHS prescription guidelines
imported into the UK by a manufacturer or remain restrictive, with cannabis products only to be
wholesale dealer that has a licence from the MHRA used as a last resort. Patients with MS and chronic
to do so and are expected to meet standards of pain are unlikely to get prescriptions, with the
good manufacturing practice (GMP).
guidelines actually stating that “very few people in

England are likely to get a prescription for medical
cannabis”.
“It has become clear to me since becoming
The Health Secretary has implied that doctors are Home Secretary that the position we find
being given some flexibility, saying “doctors need to ourselves in is not satisfactory. It is not
use their clinical judgement and having guidance in satisfactory for the parents, it is not
place helps. Ultimately the need to treat an individual satisfactory for the doctors, and it is not
person and the responsibility for that falls on the satisfactory for me. I have now come to the
shoulders of a doctor - that’s what they do.” There is conclusion that it is time to review the
likely to be no direct policy from the government that scheduling of cannabis. Before I go into the
limits the conditions for which medical cannabis can detail of the review, let me be absolutely
be prescribed. clear that this step is in no way the first step 84
in the legalisation of cannabis for
UK company GW Pharmaceuticals is the largest recreational use. This Government have [sic]
exporter of legal medical cannabis in the world,
absolutely no plans to legalise cannabis, and
cultivating medical cannabis for the production of
the penalties for unauthorised supply and
cannabis-based medicines such as Epidiolex and
possession will remain unchanged. “
Sativex. In its recent offering on the US stock
exchange, the company sold almost two million - Sajid Javid, Home Secretary
shares, raising US$345m. The move comes four
months after Epidiolex, an oral solution of purified
cannabidiol (CBD) manufactured by GW
Pharmaceuticals’ subsidiary Greenwich Biosciences, Former Metropolitan police chief Bernard
became the first cannabis-derived medicine approved Hogan-Howe has urged the government to review the
for use in the United States for the treatment of evidence that justifies the ongoing criminalisation of
seizures caused by Lennox-Gastaut and Dravet cannabis use after a host of leading clinical bodies
syndromes – both severe forms of epilepsy. called for changes. While he stopped short of calling
for an immediate law change, he said he had seen
Since the beginning of 2018, there has been some ‘clear evidence’ to warrant a meaningful review of
positive political momentum with the Liberal cannabis prohibition. Hogan-Howe joins a growing list
Democrat party, the Green Party and members of the of prominent figures who have cast doubt on the
Labour and Conservative establishing a cross-party coherence of the UK’s approach to enforcing laws that
panel to discuss medical cannabis reform. UK-based are often ignored with impunity, given that a number of
patient access group, the United Patients Alliance, police forces have publicly said they would not
regional parties, and MPs in Wales and Scotland have prosecute perpetrators of low-level cannabis offences.
also been vocal on their desire for a regulated medical
cannabis system. Former Tory leader William Hague said earlier this year
that cannabis laws were “inappropriate, ineffective
The turning point came in the wake of the long-fought and utterly out of date”. Attitudes among leading
campaigns for Alfie Dingley, a six-year-old epilepsy medical institutions are also beginning to shift. The
patient, and Billy Caldwell, a 12-year-old with the same Royal College of Psychiatrists announced in October
condition. In his statement after the authorisation of 2018 that it would review its opposition to the
the two cannabis licences, the Home Office Secretary, legalisation of cannabis. The college’s position has
Sajid Javid, announced a new review of medical been central to the government’s refusal to publicly
cannabis. consider any further reform since its members advise
ministers on mental health issues and the misuse of
drugs. Other leading organisations such as the British
Medical Journal, the British Medical Association and
the Royal Society for Public Health, have also called
for changes.
On the Channel Islands, there has been much

discussion in the government regarding the
legalisation of medical cannabis. Although medical
cannabis as a regulated industry is yet to materialise, is currently available from the pharmacy at Jersey’s
the Jersey Health Minister Andrew Green remains General Hospital, the change, put forward by Deputy
optimistic about the legalisation of medical cannabis Montfort Tadier, opens the market to many more
on the island. Sativex, has been privately available in pre-approved products, which will soon be available
Guernsey for a while and generated 41 prescriptions from other certified practices.
between 2014 and 2016. The hemp market in
particular, in Guernsey, has displayed a lot of potential CBD oil is now available in the UK, however products
for the island’s economy. are required to contain less than 0.2% THC, and
outlets such as health stores and pharmacies may sell
In early November 2018 politicians in Jersey voted to them only if they are sold as nutritional supplements
allow local doctors to be legally allowed to prescribe rather than medicines.
medicinal cannabis by the end of February 2019.
Although only one cannabis-derived product, Sativex, 85
HEALTHCARE ANALYSIS
Total
Total
Healthcare
Expenditure
(€b)
2018 (grams)
Nabilone
215 26.7 19,762 Sativex
Healthcare in the United Kingdom is a devolved 4. Chronic pain in adults

matter, with England, Northern Ireland, Scotland and
Wales each having their own systems of publicly 5. Appetite and weight loss associated with
funded healthcare, funded by and accountable to HIV/AIDS
separate governments and parliaments, together with
smaller private sector and voluntary provision. Medical cannabis could potentially be used to treat
over 52 conditions, and data from the British Medical
Cannabis-based products have now been moved to Journal shows that over four million people in the UK
Schedule 2 of the 2001 Misuse of Drugs Regulations, suffer from ailments that could be eased with
with doctors and clinicians, in the short term, focusing cannabis therapies (including Crohn’s disease, anxiety
on the five conditions set out in the government’s and depression, spinal cord injuries, Alzheimer's,
review: rheumatoid arthritis and fibromyalgia, among others).
However, only a fraction of patients are expected to
1. Multiple sclerosis (specifically pain or muscle apply for treatments. Sativex and Nabilone are
spasticity) currently the only licensed pharmaceutical cannabis
products in the UK and are used to treat spasticity
2. Chemotherapy-induced nausea and vomiting associated with MS and nausea as a result of
chemotherapy. However, the National Institute for
3. Severe treatment-resistant epilepsy in children Health & Care Excellence (NICE) deemed Sativex
(specifically Dravet Syndrome and insufficiently effective in treating muscle spasticity for
Lennox-Gastaut-Syndrome) its price and is no longer covered by the National
Health Service (NHS). The drug is now only available
privately, at significant cost to patients. towards addressing the issue of physician education.
According to Hon. Professor Mike Barnes, Academy
The Academy of Medical Cannabis (www.taomc.org) is Director of Education and one of Europe’s most
a new online eLearning platform that will go some way respected experts in medical cannabis and related
policy:
"We estimate that at least one million people in the UK have conditions that could benefit
from medical cannabis and, from 1 November we expect a large proportion of them to visit
their GP or specialist and ask about medical cannabis treatments. Our concern is that
healthcare professionals are unprepared for this influx, having received no formal training
about medical cannabis as a treatment option. 86
“Official NICE guidance is not expected until October 2019, which means it's down to The
Academy of Medical Cannabis to deliver a deep and thorough learning platform for all
doctors, ensuring that patient needs are met as quickly and safely as possible, as part of a
functional medical cannabis system.”
Forecast Forecast
2028 (€b) 2028 (€b)
Total 8.8 9.6 18.4
The cannabis investment sector is beginning to gain medicinal claims need to receive a marketing
traction in London. The financial hub of Europe has authorisation from the MHRA, many companies have
seen a growth in investment-related cannabis set up CBD companies categorised as food
companies such as European Cannabis Holdings and supplements. As of January 2018, there were an
Canaccord. In addition, the pharmaceutical and estimated 250,000 users - double the number of users
cosmetic industries have started to embrace and reported in late 2016. In that time, the market value for
capitalise on the myriad applications of cannabis. CBD oil in the UK has gone from almost nothing to
€57m per annum.
There has been a swell in cosmetic companies utilising
low THC, high CBD hemp extracts in recent years. The finance sector in the UK has, over the last year,
British high-street mainstays Body Shop and Holland turned its attention towards the European cannabis
& Barrett both stock hemp-based cosmetic products, industry with many banking groups and private
either imported or grown on British soil. investors looking to finance European partnerships in
Overall, the CBD market has begun thriving in the UK the medical cannabis, CBD, analytics and retail
in recent years. Although all CBD products making spaces. A number of consultancies, along with market
research and cannabis-focused finance groups have sharing, exchanging best practices and supporting the
also established themselves in London. development of the therapeutic cannabis industry in
Europe”. The inaugural Cannabis Europa was held in
Cannabis Europa, which will be held on 8 February London on 22 May and focused on public policy,
2019 in Paris and in London on 24 and 25 June 2019, regulatory frameworks, scientific research and
has been described as a “place of reference for commercialisation of the emerging European medical
meeting visionary leaders, facilitating knowledge cannabis market.

87
€8.8b
The UK would follow an S Curve.
Inaccessibility to legal cannabis will slow
growth in the short term, but once
resolved, growth is expected to be
strong. It could also pick up pace
towards the end of the forecast period if
medicinal cannabis is available to treat a
wider range of conditions.
€0m
2018 2028
(est) (proj)
The move to add cannabis to the UK’s pharmacopoeia for cannabis as a medical therapy which means that
has initially only been with a view to using the drug to not all potential medical cannabis patients are eligible
treat a limited range of medical conditions, most for treatment. However, going forward to 2028, it is
notably CINV, HIV/AIDS, epilepsy, chronic pain and likely that the range of qualifying conditions will
multiple sclerosis (MS). Data from the British Pain expand to include a wider range of neurological
Society estimates that 28 million adults in the UK are conditions such as Alzheimer's and Parkinson’s, and
experiencing pain that has lasted for three months or may even include some mental health issues such as
more. Over half a million people have been diagnosed anxiety and depression. Conservative estimates mean
with epilepsy, there are almost half a million cancer that around 1% of the UK population could become
patients, over 100,000 HIV/ AIDS sufferers (2015), and medical cannabis patients by 2028. If calculated as a
100,000 people living with MS. proportion of patients who are using medication for
conditions that could be treated by cannabis, this
At present, only some physical symptoms are eligible could be substantially higher.
CONSUMPTION
Cannabis
11.3% 88
7.2% 15.5%
30
55-60 1.5% 25
20
45-54 2.3%
15
35-44 4.2%
10
25-34 7.8% 5
18-24 15.8% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
source: EMCDDA
2015
The European Cannabis Report™ Denmark
89
DENMARK
MARKET OVERVIEW
Population (m) 5.8
GDP (€b) 276

Venstre, the Liberal
Ruling Alliance and the
Government Conservative People
Party 's Party
Party Stance In favour

of medical cannabis
on Cannabis use
28.2
Total Healthcare
Expenditure (€b)
Alcohol Consumption Historically, Scandinavian policies on cannabis have

(Litres Per Capita 10.4 been strict and restrictive. In Denmark, however, there
Per Year)
has been a significant change in the approach to
Prevalence cannabis.
of Tobacco 19.1
Users (%)
In 2011, Copenhagen’s local council passed a motion
Number allowing the regulated sale of cannabis within the city.
of Cannabis
Users (m)
0.3 This proposal was then rejected at the national level
nullifying the city’s action.
Average Price
Per Gram 17.3 However, just seven years later, on 1 January 2018,
of Cannabis*
Denmark legalised medical cannabis by a unanimous
vote in parliament. The legislation was quickly in March 2017, Alternative MP Nicolaj Amstrup told a
followed by a national government tender for local radio station that a legal medical cannabis
cultivating medical cannabis open to both domestic industry “would be smart” and could potentially
and international companies. present “a new agricultural opportunity” for the
islands. However, due to a strict application process,
The opening of a medical cannabis market initially existing local agricultural firms are unlikely to enter
appeared as though it would be extremely beneficial the new marketplace, as only cannabis-specific
for Denmark’s 27 small islands (many of which have facilities qualify for consideration.
been suffering economically for several years). Earlier,
REGULATORY ENVIRONMENT 90

Sativex, Marinol and Consumption is legal as CBD and Hemp Oil can
Illegal but tolerated in
Dronabinol are available prescribed by a only be procured in
certain regions
for purchase with a doctor; cultivation is Denmark via a medical
medical prescription. legal under government prescription.
licence.
Summary
Denmark has approved several pharmaceutical Denmark’s medicines authority, Lægemiddelstyrelsen,
cannabis medicines such as Sativex, Marinol and released the details of the application process
Dronabinol. These can only be obtained with a valid following the announcement, with licenses falling
prescription from a medical doctor. under one of two categories:
As with pharmaceutical cannabis medicines and 1. Permission to facilitate and grow cannabis
CBD/hemp oils, medical cannabis is only available to domestically or
patients with a doctor’s prescription. However, the lack 2. Permission to import cannabis and
of cannabis education for medical professionals has cannabis-based products into Denmark
limited medical cannabis being prescribed.
Recreational cannabis is illegal. However, there is a
In November 2017, the Danish Parliament announced small culture of cannabis cultivation for personal use
plans to run a four year trial of medical cannabis among Danish nationals. So, in certain limited regions,
beginning on 1 January 2018. The purpose of the it is tolerated to varying degrees.
programme is to help some of the patients who have
tried every possible treatment without success. The Applicants also had to indicate whether they intend to
government has committed €2.7m to the trial, grow, process or distribute. In total, 12 licenses were
investing in a number of research projects focusing on open to both domestic and international companies,
both clinical effects as well as the quality of life for with all licenses to be submitted in Danish. This is
patients during the course of the programme. Initial similar to the approach adopted by Germany in 2017,
licenses were provided for testing only, with the aim of although this requirement in Denmark is geared
creating a ‘Danish standard’. towards bolstering local enterprise.
To date, considerable progress has been made. By the 2. The analysis methods must be validated and
end of August 628 patients had been prescribed described in detail, as well as system suitability
medical cannabis, and the number of doctors requirements, so that they can be transferred and
prescribing medical cannabis continues to increase - repeated in control analysis carried out at the
up to 186 over the same period. request of the Danish Medicines Agency.
To ensure that the products meet the required For the recreational market, the area known as
standards, they have to meet certain requirements, for Freetown Christiania has increasingly come under
example, production needs to be in accordance with legal scrutiny for the open cannabis trade that has
the European Medicines Agency’s Guidelines for Good gone on there since the 1970s.
Agricultural Practices (GAP) and without the use of
pesticides, and the principles of Good Manufacturing At present, CBD and other hemp-based oils are
Guidelines (GMP) of active drug substances should be controlled substances under the Danish drug laws. 91
followed. In addition: However, they can be obtained with a medical
prescription.
1. The manufacturer must document the quality
determination with information on manufacturing
processes and the analytical methods used and
durability.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Sativex
Marinol
28.2 1.53 135,000 Nabilone
Cannabis
Flowers
The Danish healthcare system is divided into two tax and state medical treatment is available to all
sectors: Danish residents and EU citizens free of charge.
• Primary healthcare, which deals with general Sativex became the first modern cannabis-based drug
health problems and is usually the first point of to be marketed in Denmark when it was approved in
contact for anyone requiring general medical 2011 for the treatment of spasticity caused by multiple
treatment. sclerosis. However, prior to approval, doctors could
prescribe Marinol and Nabilone under a special
• Hospital sector, which is responsible for patients “compassionate use permit”. The Danish Medical
who require more specialised medical treatment, Agency oversees and licenses these applications, and
for example, intensive care or the need for has reportedly approved almost 3,000 permits since
specialist equipment. 2004. Medical cannabis is slowly becoming more
available, although the Danish government is cautious
The Danish health service is financed through income not to promote the smoking of cannabis flowers.
Patients require a doctor’s prescription to access some doctors to prescribe cannabis-based medicines.
medical cannabis. Prescriptions are paid for by A survey published in 2013 by the Centre for Alcohol
patients but there are exceptions for patients with and Drug Research at Aarhus University found that at
chronic illnesses or financial difficulties. least 1,200 Danes grow cannabis at home, with many
doing so for medicinal purposes. The Danish
Physician and patient education on medical cannabis government recently declared that it will be covering
are limited, resulting in an unwillingness amongst the cannabis expenses for terminally ill patients in full.
92
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1.1 0.9 2
The market has seen a number of strategic of partnerships to emerge in Denmark, particularly
partnerships between Canadian and Danish with US and Canadian cannabis companies looking to
companies. A number of domestic producers have utilise the local greenhouse industry to cultivate and
already partnered with overseas companies to enter process medical cannabis for exportation.
the market.
Shares of Danish cannabis firm StenoCare nearly
In total, there were 12 national cannabis cultivation quadrupled on the day of its initial public offering
and extraction licenses available, some of which are (IPO).
still under review. Prohibition Partners expects a series

Sharp growth in the first half of the €1.1b
forecast period, Levelling out and then
accelerating again as more patients join
the market
€10m
2018 2028
(est) (proj)
37
Sativex and Marinol are available on prescription in 1.1% of the total population). There are almost 13,000
Denmark and the first medical trial for bud cannabis MS sufferers living in Denmark who could potentially
has received authorisation. This will enable 1,500 benefit from the availability of Sativex in the country
patients to enter into four-year trials that will run from and with almost 41,000 cancer patients and around
2018-2022. 6,500 living with HIV or AIDS, the demand for Marinol
to help ease chemotherapy-induced nausea and
Unlike some of its European neighbours, the vomiting (CINV) or weight loss associated with
population of Denmark is set to grow in the coming HIV/AIDS will also be considerable.
decade and this will help increase the potential
universe of cannabis patients. Prohibition Partners
projects a strong growth curve in patient numbers, to
reach some 67,000 by 2028, (representing just over
93
CONSUMPTION
Cannabis
17.6%
13.8% 22.5%
30
55-60 1.2% 25
20
45-54 2.3%
15
35-44 3.6%
10
25-34 10.4% 5
18-24 23.9% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Portugal
94
PORTUGAL
MARKET OVERVIEW
Population (m) 10.3
GDP (€b) 184.9
Ruling
Government Socialist Party
Party
Party Stance Discussing

personal cultivation
on Cannabis and legalisation
16.6
Total Healthcare
Expenditure (€b)
Alcohol Consumption Portugal decriminalised cannabis, along with other

(Litres Per Capita 12.3 drugs, in 2001. However, in the years that have
Per Year)
followed, very little progress towards regulation has
Prevalence been made. Even as the rest of Europe shifts towards
of Tobacco 22.7 medical cannabis reform, Portugal maintains its
Users (%)
‘illegal yet tolerated’ stance on cannabis.
Number
of Cannabis
Users (m)
0.2 This stance has resulted in an unregulated, black
market that holds a monopoly on the cultivation and
Average Price distribution of cannabis throughout the country, a
Per Gram 6.2 market estimated to be worth at least €106m per year.
of Cannabis*
Portugal’s influential Doctors’ Association called for Cannabis for therapeutic use was approved in the
the legalisation of cannabis-based medicines in Portuguese parliament on 15 June 2018. All political
January 2018, the same day parliament started to parties voted in favour, except the Popular Party,
debate a draft bill that goes even further in seeking to which abstained. The first draft of the bill had
allow patients to grow cannabis at home. previously been approved by the political health
commission but home-cultivation was later removed
before the amended version was passed.
95
Inconsistent.
Only Sativex is legally Medical cannabis is legal Legal
Although technically
available. as of July 2018
illegal, all drugs were
decriminalised in 2001.
Summary
Historically, Portugal is regarded as a trailblazer in In January 2018, political parties Bloco de Esquerda
drug reform. In 2000, Law 30/2000 was passed, (Left Bloc) and PAN (People, Animals and Nature)
which formally decriminalised the consumption and presented a bill to parliament, advocating the
possession of all illegal drugs for personal use. legalisation of medical cannabis under prescription.
Consumption and use are both still considered to be The bill was postponed due to a lack of cohesive
administrative offences and may be punishable by support across parties. The bill proposed giving
fines or rehabilitation orders, but in practice, many citizens permission to cultivate cannabis on the
cases are suspended. condition that the THC content was minimal. On 15
June 2018 the bill was passed, officially allowing the
The sale and cultivation of cannabis presently remain prescription of medical cannabis.
illegal, with the latter specifically exempted from
reform in 2000. Furthermore, legislation introduced in The government requested extra time to hear from
2003 led to Portugal being one of a very small number doctors, industry experts, pharmaceutical institutions
of European states to make cannabis seeds and any and civil society. As expected by the collaborating
equipment used for personal cultivation illegal. groups, the section allowing personal cultivation was
Despite this, a significant industry of cottage removed, but they still hope to avoid the creation of a
cultivators has developed. state-run monopoly on cultivation.
HEALTHCARE ANALYSIS
Total
Total
Healthcare
Expenditure
(€b)
2018 (grams)
96
16.6 4 1,060 Sativex
Healthcare in Portugal is provided through three regulation of all the public, private and social
coexisting systems: healthcare providers.
1. The National Health Service (SNS) The recent bill legalising cannabis-based medications
2. Special social health insurance schemes for could most likely introduce more such medications
certain professions into the Portuguese market. While the regulatory
3. Voluntary private health insurance process on the patient side is yet to be determined, it
is certain to impact the number of patients who turn to
The Ministry of Health is responsible for developing black market cannabis in Portugal for lack of a better
health policy as well as managing the SNS. The Health alternative.
Regulatory Entity (ERS) is responsible for the
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.5 0.6 1.1
British company GW Pharmaceuticals owns a the Government of Portugal in September 2017 and
cultivation facility in Portugal that produces up to 21 Tilray was permitted to import seeds into the country.
tonnes of cannabis for formulating into Sativex. In The facility cultivates, processes, packages, and
addition, major Canadian producers Tilray are distributes medical cannabis and THC products to
currently investing €25m into a cultivation and R&D medical cannabis patients, pharmacies, and
facility 220 kilometres north of Lisbon for producing researchers throughout the European market.
cannabis solely for export. The licence was granted by
In August 2018 the municipality of Nelas, north of the The head of the Doctor’s Association, Miguel
Portuguese capital Lisbon, leased a plot of land to a Guimaraes, claims that Portugal has an interesting
company planning to invest €5m in the creation of a opportunity to develop clinical trials with the presence
sophisticated industrial unit to produce medicinal of the two cultivation projects. However, the Left Bloc
cannabis oil. The company, which has not been Party has argued that the exportation of legal
named, will commence operations within a year and cannabis is unnatural and hypocritical considering the
would be dedicated to commercialising cannabidiol, country’s patients are unable to access medical
with plans to export it to countries such as the USA, cannabis programmes.
Brazil, Mexico, the UK, and France.
CONSUMPTION 97
Cannabis
5.1%
2.7% 7.5%
30
55-60 0.2% 25
20
45-54 1%
15
35-44 2.3%
10
25-34 4.6% 5
18-24 5.8% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Poland
98
POLAND
MARKET OVERVIEW
Population (m) 37.9
GDP (€b) 445.8
Ruling
Government Law and Justice
Party
Party Stance Opposed to

recreational
on Cannabis legalisation
29.8
Total Healthcare
Expenditure (€b)
Alcohol Consumption In the summer of 2017, Poland’s lower house of

(Litres Per Capita 11.6 parliament voted overwhelmingly in favour of making
Per Year) medical cannabis legal “under certain circumstances”.
Prevalence
The bill, which was backed by the country’s Health
of Tobacco 28 Care Committee, was enacted in the same year and is
Users (%) far less restrictive than its predecessors, allowing
Number doctors to offer prescriptions for any condition that
of Cannabis
Users (m)
1.9 can be treated with cannabis if supported by research.
Average Price The new regulations also allow cannabis from

Per Gram 6.6 imported plants to be processed at Polish pharmacies,
of Cannabis* as long as it has been registered with the country’s
Office for Registration of Medical Products. The Polish Domestic cultivation is illegal, however, meaning that
Pharmaceutical Chamber (PPC) confirmed that (initially, at least) all cannabis-based medicines will
pharmacists were already preparing to make the have to be imported. With this in mind, it’s likely that
drugs, and added that specialist training would be Poland’s European neighbours will benefit from
available if required. increased demand.
It was estimated at the time of the announcement that Hemp, or “Konopie”, is a long-standing traditional crop
as many as 300,000 patients could qualify for medical in Poland, with over 50,000 hectares of hemp fields
cannabis treatment, with permitted ailments under the sown annually in Poland before the 1950s. Although
law including epilepsy, nausea caused by Polish hemp cultivation has been in general decline for
chemotherapy, chronic pain and symptoms of multiple decades, it appears that this trend is about to be
sclerosis. The PPC also said that “According to reversed, as the tide of cannabis law reform continues
experts, one gram of medical cannabis will cost PLN
50-60 [€13.69 – 16.43], while a monthly course of
to sweep through Europe. In 2017, for instance, the
Swiętokrzyskie district increased its hemp production
99
treatment around PLN 2,000.” (by area cultivated) by nearly 40%.

Only Sativex is legal Legal as a prescribed Legal

Illegal.
medication since 2017.
Summary
The legalisation of medical cannabis on 22 June 2017 Kalita staged a demonstration outside parliament and
made Poland the 12th country in Europe to provide also met with the Polish president - both instances
cannabis-based medicine through national played a major part in the drafting of the bill.
pharmacies. The vote saw a landslide 440 votes in
favour, with two opposed and one abstention. The bill was initially put forward in February of 2016 by
rapper-turned-politician Piotr Liroy-Marzec and after a
The tabling of the bill came as a result of public debate few months of swift progress, was signed by Poland’s
which intensified in 2015 following the controversial President, Andrzej Duda.
dismissal of a medical professional. A Warsaw doctor
was fired after it was revealed he had experimentally Prescription of medical cannabis is restricted to
administered cannabis to his young, epileptic patients, conditions supported by research, such as nausea
without the authorisation of his superiors. from chemotherapy, MS and epilepsy.
The debate was then revived in 2016 by Tomasz Kalita, CBD and all other hemp derived consumables are
a policymaker who campaigned for the legalisation of legal in Poland.
medical cannabis throughout his own battle with a
brain tumour - a battle which he lost in January 2017.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Sativex 100
29.8 12.6 70,000 Cannabis
flowers
Healthcare in Poland is delivered through a publicly basis It is possible to receive a full refund from the
funded system called the National Health Fund state for cannabis treatments under the ‘destined
(Narodowy Fundusz Zdrowia), which is free for all the import’ scheme.
citizens of Poland provided they are insured (usually
meaning that they have their health insurance paid for In addition, pharmacists, along with doctors and
by their employer, or are the spouse or child of an judges, were encouraged to educate themselves on all
insured person). However, private healthcare is very things cannabis before the bill was enacted in October
extensive in Poland. 2017.
Domestic cultivation of medical cannabis is illegal. “We sent [a to-do list] to the government to let them
This means that (initially, at least) all cannabis-based know what they need to do to prepare” stated
medicines will be imported. Liroy-Marzec in an interview with Marijuana.com. “The
Polish Institute of Cannabis will be starting right now.
Sativex can be prescribed by a doctor while Bediol and Education on cannabis is what Poland needs”.
Bedrocan must be imported on a patient-by-patient
Forecast Forecast
2028 (€b) 2028 (€b)
Total 2.0 2.2 4.2
The cannabis testing and production industry is businesses look likely to be given preference.
beginning to emerge on the back of a legal medical With 15,000 registered pharmacies in Poland, nearly
market. Licences are selectively allocated and local 90% are authorised to distribute cannabis, and the
Polish Pharmaceutical Chamber anticipates that up to cannabis products in the country.

300,000 patients could qualify for medical cannabis.
Pharmacists estimate that the cost per gram for Under Polish legislation, physicians can prescribe
patients will be €10 to €13, adding up to about €450 medical cannabis products to patients who then
per patient per month, giving rise to a sizeable medical access it through registered pharmacies. In specific
market in the short-term. Recently, The Green Dutch instances, products will be covered under statutory
Organic Dutchman invested nearly €30 million into health insurance, and this will create a new and
HemPoland. potentially lucrative medical market for importing
cannabis producers.
In October 2018 Aurora Cannabis Inc was granted
approval to export medical cannabis to Poland, and Cannabis education will also be a necessity for the
Aurora Deutschland GmbH was scheduled to ship the medical community. Despite the vast legislative
products to a pain treatment centre and hospital in
Warsaw within days. This was not only a significant
progress sweeping Europe, there still exists a gap
between the legislation and practical application of
101
milestone for medical patients in Poland but was also the law. Medical professionals will need to undergo a
believed to be the first time a non-government run series of seminars, courses and training in the use of
business has been granted approval to supply medical medical cannabis.
CONSUMPTION
Cannabis
9.8%
3.7% 15.4%
30
55-60 0.9% 25
20
45-54 0%
15
35-44 2.1%
10
25-34 10.3% 5
18-24 9.6% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
Expert Input
Jacek Kramarz, HemPoland
In Poland, CBD oil is tolerated by the authorities, but it considered a food supplement. In Poland, regulators
is still a relatively grey area as the authorities continue are stricter on this point than other countries in
to interpret the legislation differently. Western Europe.
There are two main issues:
We do not expect to see further reforms in 2019. The
1. THC content. Due to the lack of guidance from medical cannabis bill in 2017 has eased a lot of
the authorities on the acceptable levels for THC in political pressure on the government, despite the fact
all hemp products (including CBD oil and hemp
seed oil) the industry has introduced a
that very few patients have been accepted for medical
cannabis treatment.
102
self-regulation of 0.2% THC content in consumer
products. There is an uncertainty over whether that There are indications that Poland, in the event of
will be accepted by the authorities. recreational legalisation, would represent a strong
cannabis market. There are 40 million people in the
2. EU law considering the classification of the country, the economy is buoyant and there is a large
CBD products. Regulators are uncertain what agricultural community. In addition, Poland could
category CBD will fall into, whether it be a become an expert in the extraction process for
foodstuff, food supplement or medical product. If cannabis and hemp, something it has been doing for
the products are classified as food supplements, years for other big European brands.
the EU Novel Food directive becomes an important
consideration. The hemp industry is likely to grow very fast. The
regulations and legislation on industrial cannabis are
Typically, CBD would be considered a food easy to navigate. There is a strong agricultural culture
supplement, but the laws are opaque regarding the from the 1950s and 60s, where farming and hemp was
limit of psychoactive ingredients. Hemp extracts rich a popular industry and hence, Poland offers both
in CBD may contain traces of THC, and though agricultural and processing opportunities.
negligible, these traces may prevent CBD from being
The European Cannabis Report™ Greece
103
GREECE
MARKET OVERVIEW
Population (m) 10.7
GDP (€b) 170.2
Ruling
Government Syriza Party
Party
Party Stance Supports medical

cannabis
on Cannabis products
14.3
Total Healthcare
Expenditure (€b)
Alcohol Consumption Medical cannabis use was legalised in Greece in June

(Litres Per Capita 10.4 2017. Shortly thereafter, in March 2018, lawmakers
Per Year)
approved a law allowing the farming and processing of
Prevalence medical cannabis in Greece. This decision was the
of Tobacco 43.4 latest in Greece’s recent history of anti-prohibition
Users (%) stances, including the legalisation and reintroduction
Number of hemp in May 2016. The decision to reintroduce
of Cannabis
Users (m)
0.1 hemp was borne out of a desire to reignite the
cultivation industry and create commercial trade in
Average Price natural hemp products.
Per Gram 17.7
of Cannabis*
In the near future, the country will rely on imported
cannabis from nations with an existing, established plans to cultivate cannabis for medical use. The value
cannabis cultivation infrastructure to supply its of the investment plans is estimated to be €1b.
patients. The government, however, is keen to develop
a full process cannabis system in the mid to long-term Multiple companies have claimed to have acquired
in order to support the ailing agriculture industry and cannabis licences in Greece but no cultivators have
help boost the economy. Greece will seek to develop a planted high THC cannabis in the country. The
cultivation, processing and distribution sector. government has put in place a three phase licencing
system and while multiple firms have passed phase
Greece will benefit from a predominantly one, receiving a written commitment from the Greek
export-based cannabis industry. As of March 2018, government, no producers have secured all three
many consortiums have approached the Deputy licences.
Economy Minister, Stergios Pitsiorlas, with investment
104

Legal as a prescribed Illegal.

medication since June Although very small Legal
Legal production 2017. amounts (<0.5 grams or (pending legislation on
No patients have 1 pure/2 impure THC limits in food)
received any prescribed cannabis cigarettes)
medicines yet. are decriminalised
Summary
Since 2017, Greece has legalised certain cannabis Recreational cannabis use and possession remain
products under prescription and a specific procedure illegal in the country for the moment.
to be followed and supervised by the National Drug
Organization (EOF). This means it allows the import of Early in 2018, Greece introduced Law 4523/2018, that
all major cannabis-based pharmaceutical regulates the production of medical cannabis. A few
medications. . However, those patients that have months prior, the plant was rescheduled, allowing the
applied to receive Sativex and Bedrocan have not seen medical use of cannabis under a state-run programme.
their demands being satisfied yet and there are very A joint ministerial decision from four Greek ministries
few doctors who are willing to prescribe cannabis was introduced in May 2018, setting out the
products. requirements for the licensing of the production
Medical cannabis manufacturing is legalised in facilities. A ministerial decision from the Ministry of
Greece following the rescheduling of cannabis. Health sets the conditions for receiving the licence to
produce cannabis medicines and the conditions of
Medical cannabis products were legalised in 2018. their market authorisation. A Ministerial Decision from
Under Greece’s licensing system, medicinal cannabis the Ministry of Health on medical cannabis
products would be available on prescription from registrations, prescriptions, products, conditions and
chemists. It would not be subsidised through state dosage is still pending. According to Andreas Xanthos,
health insurance schemes, Health Minister Andreas the Greek Minister for Health, these conditions will
Xanthos said.
include chronic pain, neuropathic pain, nausea due to authorise hemp/ CBD products, especially from Greek
chemotherapy, and some eating disorders. producers, since there is no legislation for THC limits
in food and supplements (although a recent
CBD is legal in Greece for sale and cultivation since it amendment of law 4139/2013 allows for hemp
is considered a non-psychoactive substance. products to be considered as food).
However, national authorities are reluctant to
HEALTHCARE ANALYSIS
Total 105
(€b) 2018 (grams)
6 Cannabis
14.3 5,000 Flowers
Healthcare in Greece consists of a universal standard of healthcare has not dropped significantly.
healthcare system provided through national health While Greece aims to introduce a domestic cannabis
insurance and private healthcare. Healthcare in cultivation industry, medical cannabis will at first be
Greece is provided by the National Healthcare Service imported. Though the full register of available
(ESY). Healthcare spending took a massive hit during products is unknown, it is rumoured that Sativex,
the Greek financial crisis of 2008 and per capita Epidiolex and medical cannabis will be imported, to
expenditure on healthcare fell by 28%, although the begin with.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.9 1.0 1.9

The impact that medical cannabis could have on Greece has great potential for developing a strong
Greece’s struggling economy could be substantial. If cannabis industry both for medical and industrial
Greece were to benefit from medical cannabis to the applications due to its geomorphology and climate
same extent as other countries that have introduced conditions. However, the licensing system favours
medical cannabis, it could inject up to €2b into the vertically integrated companies, which can complete
economy. the entire cannabis development cycle including
cultivation, production, and processing services. Thus, invest over €50m, initially for the creation of 50,000
the new legislation on medical cannabis may exclude square metres that will gradually expand to 100,000
local farmers from the process. square metres. of cultivation, which will create
between 500 and 1,000 jobs.
On 2 March 2018, the Greek government announced
plans to cultivate cannabis for domestic consumption Golden Greece Cannabis intends to grow cannabis on
and exports. In the immediate aftermath, a number of a one-square-kilometre plot at Naoussa, west of
interested parties had contacted the Ministry of Thessaloniki, and also foresees the construction of a
Economy and Development. Among the interested plant to process and produce pharmaceutical
parties are two of the world’s biggest companies in the products, for a total investment that will start from
sector, both from Canada - Aphria and Canopy €400m and exceed €1b after two years.
Growth. Aphria plans in the next four years to develop Shanghai-based Europacific Medical has a €20m
92,000 square meters of greenhouses with a
production capacity of more than 100 tonnes, creating
investment plan for Greece, as does HAPA Medical
Holdings BV, based in the Netherlands.
106
up to 500 jobs until 2021. Canopy Growth aims to
CONSUMPTION
Drug Use
In young adults (15-34 years)
in the last year
4.5%
3.6% 5.4%
source: EMCDDA
Local Expert Input

Michalis Theodoropoulos, President of the Board,
Kannabio Hemp Cooperative
The main barriers to any further legislative change in Increased public awareness and support for the issue
Greece are due to the rigid and centralised governance are stimulating change, as well as the economic
system, bureaucracy and the fragmentation of success of other regulated cannabis markets. There is
responsibilities among the ministries. Also, the lack of already momentum for small enterprises selling hemp
an independent organisation to manage cannabis products and cannabis paraphernalia in Greece,
policies and the exclusion of experts to government although there is still pending legislation on THC limits
consultation processes play a role. Moreover, there is for food. Hemp processing legislation is insufficient
still strong opposition from conservative parties, such and ambiguous, while novel food considerations
as the New Democracy, the Communist Party, and the perplex the situation of authorization for hemp flower
far right parties, as well as from the Church and the products that are marketed in a grey zone. As a result,
State Drug Rehabilitation Centers (KETHEA, 18ANO). there have been arrests of producers, retailers and
consumers with hemp products, while government

agencies have fragmented responsibilities regarding
the market authorisation of hemp products made in
Greece.
An independent cannabis agency is needed in order to

successfully implement new policies on cannabis
regulation. Cannabis is a traditional crop for Greece,
and during the previous century, the country exported
large quantities across the Mediterranean.
We expect to see a pilot implementation of the new

laws on medical cannabis, most probably followed by
a revision of the policy, since the current institutional
107
framework is fragmented and incomplete. In parallel,
we expect a boom in new businesses related to hemp
product distribution and an increase in hemp acreage
and cultivation. Under the current government, there
is stated political will regarding regulation of adult use.
If the current ruling party remains in power after the
next election, it is possible there may be a revision of
the country’s drug law to decriminalise cannabis use
and possession, personal cultivation and adult use.
The European Cannabis Report™ Macedonia
108
MACEDONIA
MARKET OVERVIEW
Population (m) 2.1
GDP (€b) 9.6
Ruling Social Democratic

Government Union of Macedonia
Party (SDSM)
Party Stance Open to

Total Healthcare
Expenditure (€m) 572
In February 2016, after six months of deliberation,
Alcohol Consumption
8.1
Macedonia passed legislation to legalise the use of
(Litres Per Capita
Per Year) medical cannabis. Macedonia has since set its sights
on European expansion, cultivating a cannabis
Prevalence
36.9
industry of its own, opening doors to investors,
of Tobacco
Users (%) entrepreneurs and multinationals. Macedonia is
joining the ranks of the Balkan states leading cannabis
Number
0.1
reform in south-eastern Europe, however, there still
of Cannabis
Users (m) remains plenty of market and healthcare opportunities
with a small proportion of prospective patients
Average Price
Per Gram 7.2 accessing cannabis treatments in the early stages of
of Cannabis* the programme.
Macedonia has adopted the free market model for the According to a recent poll, published by Balkan Insight,
production of cannabis-based products, rather than seven in ten local residents support the use of medical
setting up production under a state monopoly. cannabis. Just over a third (34%) of poll respondents
Consequently, Macedonia can be a leader in this area, support the use of cannabis for recreational purposes.
as development by private companies rather than a
state monopoly will encourage those in the sector to In 2018, Macedonian Prime Minister, Zoran Zaev,
offer innovative products and price them confirmed that his first cousin grew cannabis, and urged
competitively. “everyone with resources” to invest in cannabis because
“it’s profitable”. He commented:
Medical cannabis products were legalised in
Macedonia by the former coalition of the Internal
Macedonian Revolutionary Organization and the
Democratic Party for Macedonian National Unity “It is permitted by law, not only in 109
(simplified as VMRO-DPMNE) in 2016. Initially, Macedonia but also in a larger number of
Macedonians could acquire cannabis oil with a low countries in the world. It has a beneficial
concentration of THC in pharmacies without a effect, it heals, it is accepted by our
prescription. Specialists have been trained to health care and the World Health
Organization".
prescribe stronger products for patients with more
severe conditions.

Legal for production,

processing, distribution
and consumption. The cultivation, sale,
No known Cannabis cultivators must and possession of
pharmaceutical cannabis obtain permission from the cannabis for Legal
products are available Ministry of Health, with recreational purposes
prior written approval from are illegal in Macedonia.
the Government, prior to
sowing.
Cultivation, supply, and possession of any amount of In February 2016, Macedonia legalised medicinal
cannabis for recreational use is still illegal in cannabis with a law covering the cultivation,
Macedonia, although authorities generally overlook production and distribution of cannabis and
possession of smaller amounts. The majority of cannabis-based medicines in Macedonia. In a similar
cannabis illegally produced within the country today is vein to neighbouring Croatia, Macedonia sought
destined for domestic consumption, with traditional external advice from experts in policy, health and
cultivation occurring in the south-eastern region of science across Europe. After a year of research and
Macedonia. deliberation, medical cannabis was legalised through
amendments to the existing Law on Control of Opioid
Drugs and Psychotropic Substances.
“The need to change this law comes from the requests of patients who want to have
the option to use naturally derived cannabis products, under strict supervision. The
amendments would allow patients to have access to strictly controlled products,
improving on the current situation when some patients use unverified products
without any supervision regarding the dosage”.
Stojanco Stojkovski, State Secretary of the Health Ministry in Macedonia.
HEALTHCARE ANALYSIS 110
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€m) 2018 (grams)
CBD Oil
572 - 500,000 THC Oil
Macedonia has made significant reforms to its and infectious disease specialists. The products are
healthcare system during its transition to a market currently intended to treat cancer, epilepsy, HIV, and
economy and established a mix of private and public Multiple Sclerosis although this list is not exhaustive
providers. In addition, Macedonia's National Health and is likely to be expanded in the future as well. The
2020 Strategy aims to close the health-status gap with amendments also limited the right to prescribe
other EU countries and to reduce accessibility medical cannabis to public health specialists.
inequalities as well as improving the overall quality of Healthcare professionals in private institutions are
care. A pioneering health information system has unable to prescribe medical cannabis.
improved efficiency, reduced waiting times and
improved the coordination of care. Oil with CBD levels of 5%, 7% and 10% are available in
pharmacies in Macedonia, produced by local drug
In contrast to the regulation of other medicines, the company Replek, but the THC quality is not high
amendments stipulate which specialists are allowed enough to be effective for the treatment of cancer
to prescribe cannabis products - namely oncologists patients.
CONSUMPTION
There is currently no official data on drug use among 2008. The study found that 5.5% of students (aged 16)
the general population of Macedonia, however, several had used cannabis at least once in their life (lifetime
surveys have been conducted amongst school prevalence), 4.3% had used it in the previous 12
children. The first European School Survey Project on months and 2.2% had used it in the previous month.
Alcohol and Other Drugs (ESPAD) was undertaken in
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.5 0.4 0.9 111

Macedonia’s free-market model makes it one of the Cultivation facilities are required to have the following:
few countries in the world that can legally cultivate
and export medical cannabis. The free market • Atmospheric protection installed,
approach makes Macedonia an attractive market with • A four-metre-high fence perimeter fence
American, Bulgarian and Slovenian companies already topped by three rows of barbed wire,
entering the country to produce high-grade CBD • 24-hour video surveillance over the entire
products for export. space, and
• Security staff.
Cultivation licence requirements are strict with
regards to the security, human and financial Macedonia has very little interest in imports as it aims
requirements for applicants. Cannabis cultivators to become a major exporter within Europe. Over a year
must obtain permission from the Ministry of Health, after medical cannabis was legalised in the country,
with prior written approval from the Government, Social Democrat Prime Minister Zoran Zaev reported
before commencing cultivation. that the government had granted eight licenses to
cannabis oil producers and was in the process of
The criteria state that applicants must have the granting four or five more. Cannabis companies
capacity to cultivate, process and store cannabis. The currently active in Macedonia include NYSK Holdings,
applicants are also required to employ at least four Replek and Freyherr.
people, including a pharmacist and an agriculturalist
with a degree in agronomy, each with a minimum of
three years’ experience.
The European Cannabis Report™ Ireland
112
IRELAND
MARKET OVERVIEW
Population (m) 4.9
GDP (€b) 284
Ruling
Government Fine Gael
Party
Party Stance Considering

on Cannabis a medical
cannabis bill
Total Healthcare
13.0
Alcohol Consumption Pharmaceutical cannabis has been legal in Ireland
(Litres Per Capita since 2013, but only in the form of Sativex, which can
Per Year)
be prescribed to patients suffering from Multiple
Prevalence Sclerosis (MS). However, due to a lack of agreement
of Tobacco 24.3 on pricing and distribution between Sativex’s
Users (%) manufacturer, GW Pharmaceuticals, and the Irish
Number Department of Health, Ireland is yet to see its first
of Cannabis 0.2 prescription.
Users (m)
Average Price There was an attempt in 2017 to expand Ireland’s
Per Gram 18.6 medical cannabis marketplace, with a bill calling for
of Cannabis*
legislative change. However, it was rejected by the
Oireachtas Health Committee over fears the language Cultivating hemp with a THC level of 0.2% or lower is
in the bill might lead to the decriminalisation of legal in Ireland with the necessary documentation and
recreational cannabis use. A redrafting is currently licences. This allows for a number of small business
underway and the bill is expected to be reviewed in and private cultivators to benefit from the myriad of
early 2019. applications hemp possesses. However, Ireland has
yet to make an impact on the global hemp industry.
Pharmaceutical Medical Recreational 113

Legalisation is expected
in the near future and Bill under
current medical consideration Illegal.
availability is on case by
Legal
in 2019.
case basis - needs a
special circrumstance
licence
Summary
Pharmaceutical cannabis products are only permitted need for robust evidence from clinical trials.
under specific conditions and for specific reasons. As
such, products are not readily available and must be The first bill on cannabis law reform was put forward
imported when required. by Gino Kenny from the People Before Profit Party,
which sought to legalise medical cannabis. Though the
Medical cannabis is only accessible in extenuating bill hit a series of initial roadblocks, the government
circumstances with a small handful of patients announced in November 2017 that it had agreed to
accessing medical cannabis via a lengthy and allow the Private Member’s Bill to proceed to the next
convoluted prescription process. However, the Irish legislative stage.
government is currently considering establishing a
medical cannabis programme for specific conditions. The medical cannabis bill is likely to undergo further
amendments before it is expected to pass. However,
Recreational cannabis is currently illegal in Ireland whilst awaiting further developments on the Irish
though certain political parties have put forth a medical bill, The Green Party has put forward a
pro-legalisation regulated market stance in the Irish proposal to legalise recreational cannabis.
parliament.
According to the Green Party’s proposals, a government
A health report published in February 2017 by Health licence would be required to commercially cultivate
Minister Simon Harris recommended that medical cannabis plants, while personal cultivation would be
cannabis should be made available to people with restricted to "two plants per private residence".
specified medical conditions. ‘The Cannabis for However, given the lack of power held by the Green
Medical Use Report’ made eight recommendations, Party and the lack of medical cannabis available for
compiled by Ireland’s medicines regulator, the Health patients, a shift in the status of recreational cannabis is
Products Authority (HPA), stating that cannabis has not expected in the short-term.
potential therapeutic benefits but citing that there is a
All CBD and hemp-derived products are available for

sale legally in Ireland.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams) 114
3.14 Sativex
20.1 215 Nabilone
Healthcare in Ireland is two-tier, involving both the A third licence was also granted in November 2017,
public and private sectors. The public healthcare with the public announcement that 8-year-old Dravet
system is governed by the Health Act 2004 and run by syndrome sufferer Ava Barry, was licensed to use
the Health Service Executive (HSE), the new national medical cannabis. Further support arrived in April
health service that came into being officially in 2005. after the government announced that they would
In addition to the public sector, there is also a large cover the costly medical expenses endured by the
private healthcare market. In 2010, Ireland spent Twomey-Barry family. The campaign received a high
€2,862 per capita on health, compared to a European amount of media attention and triggered a public
Union per capita average of €2,172. Of this spending, conversation about Irish medical cannabis policy.
approximately 79% was government expenditure.
Simon Harris, Minister for Health, previously said the
Prescription drugs and medical appliances are legal issues involved in developing a reimbursement
available to all for a small fee (medical card holders), process for medical cannabis products were being
reduced cost (Drugs Payment Scheme) or in certain examined. He said officials in his department were
circumstances free (under the Long Term Illness working to establish a reliable and affordable quality
Scheme) to residents of Ireland. controlled medical cannabis product for the Irish
market. Supply problems are being blamed for the
By law, cannabis is approved for the treatment of delay in implementing the medicinal cannabis access
resistant MS, Dravet syndrome, nausea, and vomiting programme, with the government experiencing
associated with chemotherapy and severe epilepsy. problems finding a supplier able to export products to
However to date only three patients have acquired a Ireland.
permit to use medical cannabis.
Aiming to address these issues, health department
In November 2017 the Department of Health approved officials travelled to Denmark in late October/early
a three-month licence for THC for the treatment of November 2018 to meet with government regulatory
severe chronic pain. This was the second time such a bodies and other stakeholders in the medical
licence has been granted. In 2016, a three-year-old cannabis production and supply chain. A Canadian
boy from Cork, Tristan Forde, who has Dravet supplier is also said to be currently holding
Syndrome, a severe form of epilepsy, became the first discussions with an Irish-based distributor to supply
person in Ireland to be legally allowed to use cannabis their products to the Irish market.
for medical purposes. The government imported the
cannabis from the Netherlands.
“The aim of these meetings was to hear about the Danish cannabis access
programme and enquire if a supply of medical cannabis products could be sourced.
Good progress was made on both fronts, but a continuous supply of product may still
be problematical to find in the short term.”
- Department of Health Statement.
COMMERCIAL OPPORTUNITIES 115
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1.1 1.2 2.3
Following Brexit, Ireland will be the only Ireland is a world-leading centre for the manufacture
English-speaking country in the EU, which in itself of pharmaceutical and fine chemical products. There
presents interesting opportunities as a European is a substantial domestic industry of over 100
headquarters for many companies. There are also companies engaged in pharmaceutical and chemical
major opportunities for first movers within the activities, including the development and manufacture
domestic market. A number of companies in the Irish of human and veterinary medical products,
agricultural industry have already turned their development of enabling technologies, drug discovery
attention to hemp production this year. Medical and delivery, and contract services.
legislation is expected in early 2019.
Projected Market Value (€) €1.1b

Slow and steady, ramping up towards
end of forecast period.
€0m
2018 2028
(est) (proj)
In 2018 in Ireland, there were around 12,000 population of almost 100,000 (representing almost
Parkinson’s sufferers, 8,000 MS sufferers, and an 2% of the population) with an annual requirement of
estimated 12-14,000 who suffer from fibromyalgia. some 37 million grams of cannabis medications.
Data from Epilepsy Ireland estimates that there are
more than 40,000 suffering from epilepsy (in 2005, Prohibition Partners estimates that the market for
the prevalence rate was 9 per 1,000 of the population). medical cannabis could be worth up to €1.1 billion by
By 2028, assuming current prevalence rates prevail, 2028.
Ireland could have a potential cannabis patient
CONSUMPTION
116
Cannabis
13.8%
No data No data
30
55-60 1.7% 25
20
45-54 2.3%
15
35-44 4.5%
10
25-34 11.9% 5
18-24 16.2% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Czech Republic
117
CZECH REPUBLIC
MARKET OVERVIEW
Population (m) 10.6
GDP (€b) 183.4
Ruling A coalition/ between the

Government ANO and the Social
Democrats.
Party
Party Stance
on Cannabis -
13.4
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 14.4 When the Czech Republic was founded in 1993, the
Per Year) government implemented a revolutionary set of
progressive drug laws, outlawing the production and
Prevalence
34.3
sale of drugs, but legalising their possession and
of Tobacco
Users (%) consumption. Ultimately, this legislation became too
difficult to police until the law was changed in 1999.
Number
0.8
of Cannabis
Suddenly possession of any amounts larger than
Users (m) ‘small’ became completely illegal.
Average Price
Per Gram 6.8 Since 2010, recreational use of cannabis has been
of Cannabis* decriminalised, with consumption for medical
*Prices refer to black market cannabis prices purposes legally regulated in 2013. However, the
country's medical cannabis market has been blighted cultivation and processing than neighbouring
by supply shortages and a lack of competitive countries. As a result, the Czech Republic is currently
suppliers. a world-leader in cannabis-infused products such as
cosmetics and dietary supplements. Numerous Czech
Since its foundation, the country’s medical cannabis products, such as those from CBDex and Biovita
market has been blighted by supply shortages and a Group, are currently on sale in the UK, Spain,
lack of competitive suppliers. Germany, and many other European markets. The
rising popularity of hemp-based cosmetics is likely to
At present, hemp is regulated as an industrial mean a bright future ahead for the cannabis industry
commodity and therefore has more relaxed limits on in the Czech Republic.

Cannabis consumption
and cultivation are illegal.
Sativex and Legal as a However, possession of CBD and Hemp oil is
Dronabinol are prescribed <15 grams/cultivation of legal and can be
available by medical medication since 1 <5 plants
April 2013. purchased openly.
prescription. is treated as a
misdemeanour.
Summary
Although the Czech Republic is a hub for cannabis Controversy still surrounds the domestic cultivation of
research and business activity, it has a very limited e country’s medical cannabis stock. A company called
availability of cannabis-based pharmaceutical Elkoplast Slušovice previously won the bid to be the
products. Only Sativex and Dronabinol are available sole provider of the state’s tender - cultivating a single
and are also very rarely prescribed. cultivar with nearly 20% THC and very little CBD.
However, the state later scrapped the deal leading to a
The Czech government has established a medical shortage of medical cannabis between February and
cannabis programme in the country but it is far from May 2017, which was filled by imports from the
functionally efficient. There have been ongoing Netherlands.
problems with supply, which state monopolised
cannabis production is trying to address. In June 2018 In August 2017, Elkoplast re-applied for the tender and,
it was reported that Czech medical cannabis was once being the only candidate, won the license for domestic
again available from pharmacies, albeit at a higher cultivation for the second time. Under the new
cost than the imported product. contract, Elkoplast is to deliver 40 kilograms of medical
cannabis at the price of €5 plus VAT per gram within 4
Recreational cannabis use in decriminalised for years. The first delivery was available in Czech
possession less than 15 grams and cultivation for pharmacies from summer 2018.
personal use of fewer than five plants. Upon discovery
of either, the act is treated as a misdemeanour. Prime Minister, Andrej Babiš, of the ANO political
Commercial cultivation and sale of cannabis is still party, proclaimed that patient access to medical
treated as illegal. cannabis would significantly increase in 2018, saying
that if such a development did not materialise, the The Czech Republic is also home to the International
only other option would be to legalise home cultivation Cannabis and Cannabinoids Institute (ICCI).
for patients. Established in 2015, through the collaborative effort of
Americans for Safe Access (ASA) and Dioscorides
There were also expectations that, at some point in Global Holdings under the guidance of the then Czech
2018, there would be a discussion about the export of Health Minister, the institute is dedicated to the
medical cannabis. If parliamentarians can iron out the scientific study on the range of effects of cannabis.
ambiguities in the cannabis laws, the Czech Medical This gives the country a major advantage in cannabis
Cannabis Agency can begin to export cannabis from research and continued scientific study is certain to
the Czech Republic. The Czech Pirate Party has also influence policymakers’ decision in the future.
announced a proposal for the legalisation of
recreational cannabis for 2019. Increased openness to All CBD products and hemp oil that do not contain any
legislation, advocacy from existing medical cannabis
users as well as interest from potential patients will
psychoactive properties can be openly purchased in
the Czech Republic.
119
drive progress in the Czech cannabis industry.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
13.4 4 1,200,000 Cannabis flowers
The Czech healthcare system is based on a The permitted prescription amount is limited to 180
compulsory insurance model, with fee-for-service care grams of dry matter per month and cannabis is
funded by mandatory employment-related insurance available with THC between 0.3% and 21% and CBD
plans since 1992. between 0.1% and 19%.
Medical cannabis was legalised in August 2013. In addition, cannabis is not covered by Czech health
Cannabis can be prescribed for the following insurance and very few doctors are willing to endure
conditions: the long-winded, bureaucratic process that is required
to be able to prescribe it. This red tape makes it
• Chronic unstoppable pain (particularly pain extremely difficult for patients to gain access to
related to cancer, pain related to degenerative medical cannabis. It is also illegal for anyone under 18
diseases of the motor system, system diseases of to receive a medical cannabis prescription.
the ligaments and immunopathological
conditions, neuropathic pain). So far, only 155 Czech patients have collected medical
• Spasms and associated pain resulting from cannabis from their pharmacies. In comparison,
multiple sclerosis or damage to the spinal cord. 800,000 individuals reported the use of cannabis for
• Nausea, vomiting, stimulation of the appetite in medical purposes at least once, according to a 2017
relation to treating cancer or treating HIV disease. study by the Czech National Drugs and Addiction
• Tourette's syndrome. Monitoring Centre.
• Surface treatment of dermatoses and mucosal
lesions.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1.3 1.2 2.4* 120

*may not sum due to rounding
The Czech Republic's pro-business government and have well-understood dosages and compositions, and
favourable land and employment rates make it an these are what the pharmacies and patients want.
attractive investment opportunity. However, the Czech Secondly, the prescribing of cannabis needs to be
Republic has adopted a Dutch cultivation system, made like any other prescription drug. That means
creating a monopoly on the cultivation side of the allowing electronic prescriptions for cannabis. Thirdly,
cannabis industry. A large consumer population and a Czech patients need to have insurance coverage for
wealth of agricultural experience would help create a their costs. It is the only prescription drug in the Czech
strong cultivation industry, should the state look to Republic, and many European countries, where
dismantle the state-run monopoly. patients really have to pay for it themselves and the
people who need it most tend to be on disability, so
The Czech Republic has a number of companies, they cannot afford it.
including industry giants such as MGC Pharma and
Canopy Growth, producing cannabis-based According to World Bank estimates, the population of
pharmaceuticals and cosmetic products. In the event the Czech Republic is forecast to peak in 2022 and
of recreational legalisation, or exportation approval, then decline by almost 1% in the five years between
these companies would be able to supply a 2023 and 2028. As the market matures, we expect to
significantly larger market. see the price per gram decline. As a result, growth
potential for medical cannabis is set to slow in the mid-
The Czech Republic is also a global hub for cannabis to long-term. Nonetheless, as with more mature
testing. Companies such as the International markets, cannabis medications will become more
Cannabis and Cannabinoid Institute and Alpha-Cat accessible and Prohibition Partners forecasts that
Lab operate out of Prague, providing patient research, increased accessibility to the drug for patients will
cannabis testing and quality assurance services. increase the number of cannabis patients as a
percentage of the population. An anticipated rise in
In order for the cannabis industry to develop in the patient numbers will sustain volume demand. By 2028,
Czech Republic, three things need to happen. Firstly, almost 200,000 Czechs could be medical cannabis
there needs to be appropriate dosage forms. That patients with an estimated requirement for 76 million
means not just dried cannabis, but other dosage forms grams of medical cannabis.
such as drops, capsules, and suppositories. These all
CONSUMPTION
Cannabis
18.8%
11.7% 25.6% 121
30
55-60 1.1% 25
20
45-54 4.6%
15
35-44 5.6%
10
25-34 13.6% 5
18-24 27.4% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Expert Input
source: EMCDDA
Hana Gabrielova, ICCI Project Manager

(co-authored by Tomas Zabransky, ICCI Chief Scientist & Pavel Kubu, ICCI
Chief Executive Officer)
We expect that the exportation of domestically grown Uruguay, the Netherlands, and several US states. In
cannabis will be permitted in the next five years, which the Czech Republic, the economic and social success
will decrease the domestic price of cannabis for Czech of the regulated market in Canada has not gone
patients. Additionally, insurance companies are likely unnoticed. This case study will have a great impact on
to cover cannabis medications supplied in debates regarding legalisation. In the wake of a
pharmacies, as we have seen in the vast majority of regulated market, we expect that industry-related
neighbouring European countries. This will lift the services will increase dramatically.
financial restraints that are the cause of low numbers
of official cannabis patients. Additionally, as the However, the biggest barrier to progress is
market grows, the country will become more attractive bureaucracy. The Czech Medical Cannabis Agency
to domestic and foreign companies looking to (CMCA) is under the supervision of the highly
establish their own businesses in the Czech Republic. regulated State Institute for Drug Control which limits
A regulated non-medical market could also be a the autonomy of the CMCA.
realistic ambition, given the experience of Canada,
The European Cannabis Report™ Israel
122
ISRAEL
MARKET OVERVIEW
Population (m) 8.8
GDP (€b) 298
Ruling
Government Likud
Party
Party Stance In support of

on Cannabis legalisation &
regulation.
22.0
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 3.8 Israel has been a pioneer in the research and
Per Year)
development of medical cannabis for decades for
Prevalence several reasons:
of Tobacco 25.2 • A medical cannabis programme was first introduced
Users (%)
to the Israeli people in the early 1990s, initially for the
Number treatment of cancer patients with pain related issues.
of Cannabis
Users (m)
0.5 Today, Israel has over 30,000 patients with medical
cannabis licences, which is one of the highest rates
Average Price
9.9
per capita in the world.
Per Gram
of Cannabis*
• Israel also has the world's highest ratio of cannabis However, the true potential of the Israeli legal
users with 27% of the population, aged 18-65, having cannabis market lies in exportation. Israel’s unique
used cannabis in the last year, according to Israel’s cultivation laws mean the country can legally produce
Anti-Drug Authority. far more medical cannabis than prescriptions issued.
The last 12 months have been marked by a political
• Currently, the cannabis black market in Israel has an tug-of-war over the regulations surrounding exports.
estimated value of €6 billion However, as of December 2018, cannabis exports have
been legalised in Israel.

Legal as a Illegal.
prescribed Amounts of 2 grams or Expected to be
Legal medication since above will lead to a legal soon.
1994. criminal record.
Summary
On 20 April 2018, pharmacies in the country started Reform) by the Israeli Medical Cannabis Unit. The
selling medical cannabis. A few months later, in guidelines detail the standards and requirements for
December 2018, Israel also gave the green light for each link in the supply chain of cannabis products.
cannabis companies to start exporting their products The goal of the Green Book is to define production,
(excluding raw flower) internationally. sale and treatment procedures in medical cannabis
that meet stringent standards, intended to ensure the
As a result of the new legislation, an increase in the product and its use are standardised.
price of medical cannabis is expected, to fall in line
with global standard prices. Currently, a low According to the new guidelines, each link in the
government-mandated price is in place, supply chain of cannabis products must meet the
approximately €80 per person per month, regardless highest level of quality in the new official Medical
of volume. However, this is seen as a temporary Grade standards, such as IMC-GAP (cultivation),
situation, with the costs ultimately expected to be IMC-GMP (production), IMC-GSP (security) IMC-GDP
covered by healthcare insurance. (for distribution) as well as IMC-GCP (for correct
clinical treatment), which are all listed in this manual.
Across 2019, there will be continued implementation
of the ‘Green Book’ (The Official Cannabis Guidelines CBD and all hemp products are expected to be legalised
of the Israeli Ministry of Health for the ‘Medicalisation’ following their recognition as non-psychoactive in nature.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
124
22.0 3 10,661,000 Cannabis
Flowers
Healthcare in Israel is universal and participation in a

medical insurance plan is compulsory. The Israeli Pain and nausea related to cancer.
healthcare system is based on the National Health Inflammatory bowel disease.
Insurance Law of 1995, which mandates that all
citizens resident in the country are to join one of four Colitis.
official health insurance organizations, known as Chronic pain.
Health Maintenance Organisations (HMOs).
AIDS/HIV.
The cannabis healthcare system is well established
Multiple sclerosis.
and well supplied. Cannabis patients generally receive
between 18 and 60 grams of cannabis per month, with Parkinson's disease.
an initial recommended amount of 0.6 grams per day.
Tourette syndrome.
At the beginning of the treatment, patients will receive
only strains from the 10% THC groups – this will be the Adult epilepsy.
“recommended starting amount” (33-66 mg THC per
day). Only if the doctor finds that the treatment is
Paediatric epilepsy.
insufficient will patients receive strains containing Palliative care.
15%, 20%, or 24% THC.
PTSD.
Patients can only receive medical cannabis for one of
eleven conditions. Cannabis is defined as ‘last-line An increase in the number of prescribing physicians,
therapy’, meaning that it will be given only after together with an increase in the approved conditions
conventional treatments have been exhausted. In will increase the number of Israeli patients receiving
2018, a further review of additions to the list of medical cannabis. Currently, there are 81 prescribing
approved conditions is expected. Currently, that list doctors in Israel that can directly prescribe medical
includes: cannabis.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1.3 0.8 2.1 125

Israel is home to some of the world's leading cannabis In August 2017, an Israeli parliamentary committee
experts, who have started to export their knowledge estimated that cannabis export could net Israel as
internationally in the forms of products, research and much as $0.94 billion a year, in the short-term
business development. provided the Israeli government establishes an
exportation system.
A growing number of strategic partnerships have been
established in the past 12 months to take advantage of Companies outside of Israel are taking a keen interest
their research expertise and export capabilities. in the nation’s cannabis industry. Further, with these
business opportunities opening up the international
In 2019, Israel is expected to approve international market is certain to benefit from the tremendous
exports. The country is currently growing significantly research capabilities of the Israel cannabis industry.
more cannabis than its medical market can sustain. In
addition, we expect that Israel will increase the In October Bazelet, Israel’s largest medical cannabis
number of cultivation and processing licences from company, signed a manufacturing and licensing
the eight granted prior to the reform. It is possible that agreement with Israeli medical cannabis pharmaceutical
Israel will increase this number to 40 licences. product developer Alvit LCS Pharma, to manufacture,
market and sell Alvit’s line of pharma grade medical
Israel is also a global leader in cannabis research, cannabis products - including sublingual tablets, oral
cannabis healthcare, product innovation, and sprays, extended release, delayed release and
technology. Cannabis-related Israeli startups have suppositories - in Israel and the EU. Bazelet expects to
raised a total of $65.4 million in equity between begin marketing the products in the first half of 2019.
2013-2017, attracting interest from all over the globe.
Expert Input
Saul Kaye,
Founder, iCAN
Change takes time and can sometimes go backward. Israel has become a global leader for cannabis
Look at the export regulations, for example. The research out of an inherent desire from our PhD
stimuli for change comes from both the domestic researchers and doctors to understand the world
demand from patients, physicians and industry, and around them and the desire to fearlessly heal their
international supply of money and customers. We only patients. Government support for R&D, the “StartUp
expect this change and growth to continue due to the Nation” environment here in Israel, and a federally
removal of government price control and the increase legal framework have laid the groundwork, but it is the
in coverage by Health Maintenance Organisations researchers that have abandoned misguided
(HMOs).
preconceptions to pioneer our understanding of the Physician education will be key. Currently, there is a
endocannabinoid system and how phytocannabinoids lack of clear guidelines with respect to products and
engage with it. dosage, but academia and industry will provide these
solutions. The more funding that is directed to clinical
Medical cannabis in Israel will continue to grow with trials, from both public and private sources, the more
two steps forward, one step back approach over the robust the data and the guidelines will be. Legalisation
next five years as cannabis becomes normalised with of adult use consumption within 3 years is my personal
other industries, such as agriculture, manufacturing, prediction.
BioTech, and FinTech.
126
The European Cannabis Report™ Belgium
127
BELGIUM
MARKET OVERVIEW
Population (m) 11.4
GDP (€b) 419
Ruling
Government Centre-Right Coalition.
Party
Party Stance
on Cannabis N/A
43.9
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 12.1 Belgium has a rather unusual history when it comes to
Per Year)
their national drug policy. Ever since the country’s
Prevalence prohibition of alcohol in the 1920s, all drugs were
of Tobacco 28.2 treated similarly harshly. Until 2003, there was no
Users (%) legal distinction between the various classes of
Number controlled substances, and a cannabis offence would
of Cannabis
Users (m)
0.3 be treated the same as a heroin or cocaine offence.
Average Price A 2003 directive differentiated cannabis from other

Per Gram 8.2 illegal drugs, specifying what would be considered a
of Cannabis* public nuisance and problem drug use. Possession of
*Prices refer to black market cannabis prices cannabis in small quantities was decriminalised for
those older than 18 who was not a problem drug user

or involved in public nuisance.
“There is still a lot of research in the
Following the election of the right-leaning government pipeline for the use of cannabis to combat
of Prime Minister Charles Michel in 2014, Belgium pain. There is a lot of research in the field
announced an “end to the policy of tolerance” as the
of pain relief with cannabis. For MS, there
new government threatened to revoke the permitted
use of cannabis. At the time, the leader of the
are already good indications, but also for
European Coalition for Just and Effective Drug Policies the treatment of severe rheumatoid and
(ENCOD), John Omen, clarified that the Belgian degenerative diseases and muscular
government’s stance was meant to address public diseases, research is in progress.”
cannabis smoking and not outright criminalisation
across all sectors, stating: “No sensible country at the
moment is heading toward prohibition”. In late May 2018, De Block signalled that she was on
128
the verge of legalising cannabis oils for the treatment
A royal decree, signed in 2015, legalised the sale of of childhood epilepsy. The announcement was made
cannabis for pain alleviation. Maggie De Block, during a cannabis march in Limburg organised by Jean
minister for Social Affairs and Public Health explained Pierre Voncken and Ula Milata, a couple that had been
that under the programme: campaigning for three years to allow their epileptic
daughter to legally consume cannabis oil.

Sativex can be prescribed

The use of medical Some legal ambiguity
by Belgian doctors for The use of cannabis
treating specific medical
cannabis is legal exists with regard to
under prescription recreationally is non-psychoactive
conditions like MS. No
other products are in the from a specialist decriminalised for substances such as
Belgian market at the doctor. personal use. CBD/hemp oil.
moment.
Summary
Belgium currently permits the prescription of Recreational cannabis use is decriminalised with certain
medicines with cannabis as an active ingredient, like restrictions. Possession of small amount has also been
Sativex, instead of medical cannabis in dried form. It is decriminalised. However, cultivation, transportation and
often prescribed for certain conditions like multiple sale for any purpose are still considered illegal.
sclerosis to help patients tackle their spasticity.
The 2003 directive (noted above) allowed for
Belgium was one of the first European countries to possession of small amounts of cannabis for personal
recognize the benefits of medical cannabis. However, consumption. Prior to this change, there was no
there is still no well-established medical program for differentiation between ‘classes’ of drugs. In 2005, the
cannabis treatments and doctors rarely prescribe directive was revised and established the legal limit for
them. possession at three grams or one cultivated plant. It
also re-emphasised any fines or punishments prospective patients and helps connect them with
individuals could warrant in case they are found to doctors who are trained and registered to provide
possess quantities in excess of the legal limit and they medical cannabis prescriptions. Once approved,
are reported as a public nuisance. patients are free to pick up their personal cannabis
plant at plantations run by the Medical Cannabis Club.
In Belgium there exists a gap between cannabis
legislation (on paper) and the application of medical Recently, politicians, like the Mayor of Antwerp have
cannabis treatments (by healthcare professionals). become more vocal in opposition to Cannabis Social
This inspired two Flemings to set up non-profit Clubs. As a consequence, the political climate,
organisations. Medcan and the Medical Cannabis especially in the Flemish region, is increasingly in
Club aim to cultivate cannabis plants for medical use favour of “zero tolerance”. In the summer, 20 members
according to the highest quality standards. The of a club were arrested and it has been announced
associations work closely together with a network of
doctors, patients, and lawmakers in order to improve
they are to be prosecuted. 129
access to cannabis treatments. All cannabis products - including hemp-extracted
CBD - are illegal in Belgium, however, a market has
Medcan is responsible for raising awareness of started with many “Cannabis Light” products imported
medical cannabis treatments. The group registers from Switzerland.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
43.9 5.6 610,000 Sativex

Dronabinol
The Belgian healthcare system is split between the In July 2001, Belgium permitted the use of medical
state and the private sector, with fees payable in both, cannabis as a treatment for glaucoma, MS-related
funded by a combination of Belgian social security spasticity, HIV/AIDS and chronic pain by those in
contributions and health insurance funds. With possession of a valid prescription from a registered
mandatory health insurance, patients are free to doctor. The 2001 bill allowed for the sale of small
choose their own medical professionals and places of quantities of medical cannabis in pharmacies, but very
treatment. Patients generally pay up front and are few patients have their prescription filled by a Belgian
reimbursed a proportion of the charges for medical pharmacist. Instead, patients often obtain cannabis
and dental fees, hospital care and treatment, from one of two main social clubs currently operating
maternity costs, and prescriptions through their health in Belgium. Prescriptions are only paid for by the state
insurance fund. if they are for treating severe spasticity for MS.
Belgium was quick to introduce medical cannabis Sativex, the sublingual spray produced by British
treatments for Belgian citizens in the wake of changes company GW Pharmaceuticals, is also licensed for a
taking place in the Netherlands in the 1990s. However, prescription. However, other products that contain
few doctors and specialists are educated on such THC, the primary psychoactive substance in cannabis,
treatments, and despite their legality, doctors rarely are not legal in Belgium.
issue medical cannabis prescriptions.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.7 0.8 1.5

130
As legislative changes sweep neighbouring countries, A wider range of conditions is likely to be served by
a ripple effect has been seen in Belgium in the creation cannabis in the mid-long term by 2028, we would
of social clubs, nonprofits, and lobbying groups. The expect to see patient penetration increase to about
anti-prohibition movement, led by domestic social 222,000 (just shy of 2% of the total population). It
clubs, has had a strong influence on the Belgian could also serve Belgium’s 80,000 cancer patients
cannabis market. (most notably those experiencing negative side effects
of chemotherapy), 21,000 Parkinson’s disease
Belgium has boasted a substantial industrial hemp sufferers and 191,000 Alzheimer’s disease patients.
industry since the 1960s, and Belgian farmers
contributed to European growth operations in the Average cannabis spend per patient is expected to
1990s, supplying cannabis to Dutch coffeeshops. The trend downward into 2028, owing to pricing pressures
rise of the CBD market across Europe has boosted the as the market becomes more competitive. This could
traditional hemp market in Belgium. see the cost-per-gram halve between 2018 and 2028.
Prohibition Partners estimates that Belgium’s market
Sativex has been approved for treating MS in Belgium for medical cannabis could be worth up to €715 million
which currently has around 12,000 MS sufferers. by 2028.
CONSUMPTION
Cannabis
10.1%
7% 13.2%
30
55-60 0.4% 25
20
45-54 1.2%
15
35-44 3.3%
10
25-34 8.4% 5
18-24 12.2% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Austria
131
AUSTRIA
MARKET OVERVIEW
Population (m) 8.8
GDP (€b) 354
Ruling Austrian
Government People’s Party
Party
Party Stance Opposed

on Cannabis to legalisation
36.5
Total Healthcare
Expenditure (€b)
Alcohol Consumption Austria has a history of hemp cultivation and a

(Litres Per Capita 11.6 burgeoning cannabis clone industry from Vienna to
Per Year)
Salzburg. However, the election of right-leaning
Prevalence conservative Sebastian Kurz has introduced an
of Tobacco 29.6 element of uncertainty to the Austrian cannabis
Users (%)
community.
Number
of Cannabis
Users (m)
0.4 Austria has enjoyed liberal drug laws with regards to
personal use. The Austrian Narcotic Drugs Act only
Average Price punishes cannabis cultivation for the purpose of
Per Gram 7.5 commercial profit. New legislation introduced in 2008
of Cannabis*
allows citizens to grow cannabis plants at home and
has decriminalised the use of cannabis products in ÖVP (Austrian people’s Party/conservative) and FPÖ
public. Although it is illegal to grow cannabis with the (Right Wing Liberals/populistic) would have a negative
intention of producing THC, it is legal to purchase impact on the country’s cannabis industry, affecting
cannabis seeds and seedlings. The ambiguous farmers who grow hemp as well as owners of grow
wording of the law means that plants are legal at all shops who re-sell cannabis liner plants and plugs.
points up to flowering, as prior to that, THC levels are Flowery Field, the Austrian market leader in sales of
unlikely to be above the legal limit of 0.3%. hemp plants, has already relocated its operations to
Italy.
In December 2017 it was reported that the newly
elected People’s Party, run by Chancellor Sebastian Mr Kurz, the youngest chancellor in Austrian history,
Kurz, planned to ban the “sale of hemp plants and had originally suggested a contemporary approach to
hemp seeds”. In the recently published government cannabis legislation before the election. The recent
programme, the announcement was hidden among a
broad raft of criminal law reforms. The move by the
bill, however, has shown an intention to favour a
conservative approach, in the short-term at least.
132

Not available in
Sativex, Dronabinol Austria and most CBD and all
and Nabilone are cannabis patients Decriminalised for derivatives are not
available through resort to personal personal use. controlled by Austrian
prescription. cultivation for law.
medication.
Summary
Austria’s criminal code has differentiated between cannabis flowers is forbidden. However, Austrian
personal use and commercial distribution of drugs citizens have been allowed to grow cannabis privately
since 1971, with an emphasis on prioritising treatment provided they have a legitimate medical condition
over criminalisation of users. Consumption of cannabis which can be treated by cannabis use.
is technically non-punishable, but possession,
purchase, and distribution are all illegal. Recreational cannabis in Austria is decriminalised for
cultivation and consumption on personal levels. There
Although the Czech Republic is a hub for cannabis are no actual limits set on how much cannabis can be
research and business activity, it has a very limited produced privately. In the event of being discovered
availability of cannabis-based pharmaceutical growing large amounts of cannabis, growers can face
products. Only Sativex and Dronabilone are available criminal prosecution. However, some such defendants
and are also very rarely prescribed. have made a successful defence.
Despite the fact that Austria is one of the biggest In 2008, legislation was passed which permitted the
cannabis clones market and a prominent cannabis cultivation of cannabis for medicinal and scientific
seeds market in Europe, the commercial cultivation of purposes. However, there are no government
sanctioned treatments for medical cannabis patients. Peter Kolba, a candidate for the Peter Pilz Party and
The 2008 legislation gave exclusive cultivation rights founder of his own pro-legalisation organisation
to a single government department under control of (COBIN), explains that there are many issues with
the Health Ministry, with the products primarily used medicinal cannabis treatments in Austria.
for scientific research.
“The current possibilities are not sufficient. There are the following hurdles for pain patients.
You have to find a doctor who is familiar with cannabis in medicine. The doctor must be ready
to issue a narcotic drug prescription. The costs of dronabinol are unworkable. In my dosage (3
x 10 drops) I would have to spend about 800 euro per month. The health insurance companies 133
accept these costs very hesitantly and only with the presence of clinical studies”.
Austria’s Narcotic Substances Act does not prohibit of cannabis which have a psychotropic effect. As such,
the use of CBD or hemp oil as it does not have any there are no restrictions imposed on CBD or hemp oil
psychoactive properties. The Act only applies to forms and products can be purchased openly.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
36.5 5 50,000 Sativex

Dronabinol
Austria has a two-tier healthcare system in which In order to access cannabis-based treatments,
virtually all individuals receive publicly funded care, patients must acquire a prescription for Sativex or
but they also have the option to purchase Dronabinol from a licensed physician. Dronabinol is
supplementary private health insurance. Some typically imported from Germany and is the most
individuals choose to completely pay for their care commonly prescribed drug, due to its relatively lost
privately. cost.
Austria's health programmes are funded by the Patients can legally grow cannabis plants, but THC
sickness insurance fund, known as the Krankenkasse, extraction is not permitted. Doctors also have the
which in 2013 cost 11.0% of the GDP, well above the EU freedom to prescribe Nabilone, but this is rare. Health
average of 7.8% of GDP. insurance covers the cost of cannabis-based
treatments if the prescription is used to treat AIDS,
cancer, MS and nervous system diseases.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.7 0.8 1.5 134

Production of industrial hemp for the production of legal clone businesses in border regions are very
fibres, hemp seed oil and all other non-psychoactive popular among tourists.
parts of the hemp plant was allowed in 1995, after a
forced hiatus since 1958. The plants have been sold for Whilst access to medical cannabis in Austria is not
decades for the purpose of “aromatherapy and limited to select medical conditions or diseases,
decoration”, but owners are not permitted to let their understanding patient numbers of key conditions that
plants bloom. However, it is well known that most of cannabis can assist, provides some indication of the
the many thousands of clone plants sold in Austria are potential patient population. In 2018 in Austria, there
destined for cannabis production. It is estimated that were around 46,000 cancer patients, almost 16,000
at least 300,000 seedlings are sold each month and have Parkinson’s and 11,500 suffer from MS. By 2028,
many successful hemp businesses have been assuming no medical breakthroughs, the country
established in Vienna and its suburbs. could have a potential cannabis patient population of
almost 170,000 (representing almost 1.8% of the
Since 2006, clone facilities have been operating population).
without interference, creating the single biggest clone
market in Europe in terms of volume, selling 300,000 Notwithstanding product innovation that could help
seedlings a month. Unlike most EU countries, the sale steady the price per gram, our forecast model assumes
of cannabis seeds is illegal in Germany and a significant drop in the price per gram of cannabis as
Switzerland. Consequently, travel to Austria is we believe that competition in the market will dampen
common, as customers can purchase high-quality prices going forward. Austria’s market for medical
clones and cuttings. In Vienna, sales by major vendors cannabis could be worth up to €720m by 2028.
are estimated to be worth millions of euros, and the
CONSUMPTION
Cannabis
14.1%
12.7% 55.5%
135
30
55-60 0.4% 25
20
45-54 2.5%
15
35-44 2.5%
10
25-34 10.2% 5
18-24 18.6% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
Official government data suggests that more than 20% government data estimating that 40% of those
or one million Austrians have used cannabis in the between the ages of 15 and 25 consume cannabis.
course of their lifetimes, and an estimated 12.5% According to official data, cannabis consumption
smoke it regularly or occasionally. Cannabis smoking starts among adolescents at 15 years of age on
is especially prevalent among the young, with available average.
The European Cannabis Report™ Malta
136
MALTA
MARKET OVERVIEW
Population (m) 0.5
GDP (€b) 10.7
Ruling
Government Labour Party
Party
Party Stance Open to

1
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 8.1 Malta decriminalised cannabis in 2015 and legalised
Per Year)
medical cannabis in March 2018.
Prevalence
of Tobacco 25.5 Malta’s Prime Minister, Joseph Muscat, was recently
Users (%)
quoted as saying “the current system favours criminals
Number and it would be far better to have controls over its
of Cannabis
Users (m)
0.02 distribution”. And his party has suggested Malta
should look at the legal models adopted by countries
Average Price
21.3
like Canada. Under the new system, Malta is looking to
Per Gram
of Cannabis* legalise medical cannabis cultivation for domestic
consumption and for international exports.
Consumption is legal Possession of small

137
as prescribed by a amounts of cannabis for
Sativex doctor, cultivation is Legal
personal use is
legal under decriminalised.
government licence.
Summary
Recreational cannabis use is currently illegal in Malta. medical cannabis with a doctor's prescription after a
In 2015, Malta introduced policies decriminalising control card has been approved by the Superintendent of
personal possession of cannabis. This was seen by Public Health. The amendments to the bill came ahead of
many as the first step towards recreational the ‘Production of Cannabis for Medicinal Use Act’, which
legalisation in Malta. In the same year, the Maltese was introduced in April 2018. The Act allows companies
government approved the use of Sativex. However, as to obtain a licence to produce and manufacture medical
of July 2017, no patients had actually been treated with cannabis on Maltese land. Not only will companies be
the drug. allowed to produce medical cannabis in Malta, but
they will also be able to export to other legal European
On 9 March 2018, Malta’s Drug Dependence Act was cannabis markets.
amended, allowing doctors to prescribe medical cannabis
products to patients. Patients are now able to access CBD and Hemp products are legal in Malta.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Sativex
1 0.08 15,001 Cannabis flowers
Malta operates a public healthcare system (the practitioners and pharmacists must register the
government healthcare service), and medical services number of drugs prescribed and dispensed on the
are free at the point of delivery. Like most other control cards).
countries with socialised healthcare, Malta also has a
thriving private healthcare system. There are two key There have been reports that Maltese patients are
points to note about Malta’s new medical cannabis facing considerable obstacles, and there is anecdotal
laws: evidence to suggest that one of the conditions
believed to be eligible for treatment with medical
• They do not detail which specific conditions can cannabis, chronic pain, is no longer eligible on its own.
receive prescriptions Pharmacies attempting to import medical cannabis
• Medical cannabis will not be covered by the are now also finding it harder to do so, and are being
country’s public healthcare system. requested to provide more documentation than earlier
Malta’s new cannabis act allows general practitioners

applicants, and applications are also taking longer
than expected to process.
138
to prescribe medical cannabis to patients, who will be
able to access non-smokable cannabis products at Authorities have also been criticised for failing to
pharmacies with a prescription and a control card educate interested family doctors to the potential
(control cards are used to regulate and track the use of benefits of medical cannabis.
narcotic and psychotropic drugs. Legally, medical
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.01 0.02 0.03
After the ‘Production of Cannabis for Medicinal Use cannabis cultivation facility. Malta’s Economic
Act’ was introduced, Malta has received an influx of Ministry estimates that the five pending projects
investment from foreign firms hoping to cash in on the already approved by Malta Enterprise, and worth a
country’s burgeoning market. Among them is total investment value of €30m, will generate some 175
Australia’s MGC Pharma, who have received a permit jobs.
for approximately 4,000 square metres of land for a
The European Cannabis Report™ Switzerland
139
SWITZERLAND
MARKET OVERVIEW
Population (m) 8.5
GDP (€b) 577.1
Ruling Swiss Federal

Government Council
Party
Party Stance Open to gradually

shifting towards
70.7
Total Healthcare
Expenditure (€b)
Alcohol Consumption In the late 1990s, cannabis activists in Switzerland

(Litres Per Capita 11.5 discovered a loophole in the country’s Narcotics Act.
Per Year) The legal gap made it possible to grow and sell
Prevalence cannabis, both for personal use and on a larger scale
of Tobacco 25.7 because the law did not yet distinguish between
Users (%) cannabis and hemp on the basis of THC content,
Number provided products were cultivated and sold for the
of Cannabis
Users (m)
0.5 explicit use of “aromatherapy”. In Switzerland,
cannabis and hemp products can legally contain up to
Average Price 1% THC, compared to the standard 0.2% seen across
Per Gram 11.1 the rest of the continent.
of Cannabis*
This legal quirk has led to a burgeoning hemp and CBD This does not include the current recreational black
business, most notably of late, exemplified by the market, which has a reported 500,000 users.
introduction of cannabis-infused cigarettes which
launched in 2017. Cannabis is a major contributor to The number of shops stocking low THC cannabis
the Swiss economy, with the annual sales of legal (“cannabis light”) has increased dramatically since the
cannabis and hemp products in Switzerland totalling licensing of a tobacco substitute in 2016, which is now
around €87.9m. stocked in both supermarkets and tobacco shops.
140
Inconsistent.
Legal on a named
patient basis. Possession and
consumption are
Only Sativex can be decriminalised.
Although cannabis Legal.
legally prescribed.
containing <1% THC is
legal. Cannabis containing <1%
THC is legal.
In Switzerland, cannabis is decriminalised. Possession The City of Bern had previously requested a cannabis
of up to 10 grams is not punished in most cantons. pilot project several times. Under the proposed trial,
Public consumption, however, is punishable with a 1,000 people who already use cannabis would be
minor fine, of around 100 Swiss francs (€83) and the allowed to purchase it legally. The pilot project, which
purchase of seeds is a criminal offence. Medical would allow cannabis purchases in pharmacies, would
cannabis is not illegal but is very difficult to obtain and be scientifically evaluated and serve as a basis for
only available as tinctures. Though medical cannabis future cannabis policies. The bill will now need to pass
has been legal since 2008, there is no official system the larger chamber of parliament, the National Council
which focuses on the application and treatment of before the pilot can be enacted.
medical cannabis. As a result, there are only a few
hundred registered medical cannabis patients in the Production of the drug for export has been outlawed
country. as the health department has refused to green-light
the cultivation of high-THC medical cannabis. Now
In March 2018, The Swiss Council of States took a step politicians across the political divide (such as The
further towards a regulated cannabis market. Social Democratic Party, The Liberals and The
Switzerland’s smaller chamber of parliament Christian Democratic People’s Party) are uniting to
unanimously approved a bill allowing cannabis studies convince the Swiss government to approve cultivation
and pilot programmes. The Council called for an for export. More than 50 politicians headed up by
experimental article in the Swiss Federation’s Christa Markwalder, of the centrist Free Democratic
Narcotics Act that would allow for scientific research Party, are calling on the executive to either allow the
projects including trials of a coffeeshop system of cultivation of medical cannabis or change the law if
cannabis distribution similar to that of Amsterdam. the current legal framework is fit for purpose.
Five Swiss cities have already called for such
coffeeshop pilot programmes to be implemented.
While Swiss legislation forbids the cultivation, strength of 5%, in order to produce cannabis tincture
consumption and sale of cannabis with a THC and oil for Swiss patients. The products may not,
strength of over 1%, a Swiss chemist has been given a however, be exported, despite demand from
special permit from the Swiss Federal Health Office to neighbouring Germany.
cultivate a specially selected strain, with a THC
HEALTHCARE ANALYSIS
Total 141
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
70.7 7.6 338,843 Sativex

Cannabis Oil
Healthcare in Switzerland is universal and is regulated To receive medical cannabis, patients must visit their
by the Swiss Federal Law on Health Insurance. There physician, who will determine if this form of
are no free health services provided by the state, but medication is their best treatment option. The doctor
private health insurance is compulsory for all residents must then apply to Switzerland’s Federal Office of
in Switzerland. Health insurance covers the costs of Public Health (FOPH) for a special exemption for their
medical treatment and hospitalisation. However, the patient. The FOPH has approved a few hundred
insured person contributes towards the cost of patients to date. Physicians can also legally prescribe
treatment. Sativex and Dronabinol (as of 2013).
In order to comply with strict European regulation With the recent rise in CBD-rich cannabis products in
around the trade and marketing of medical products, the market, medical professionals have raised
all CBD products currently produced and sold in concerns about their proper use. However, the worries
Switzerland are not labelled as ‘medicine’. regarding carcinogens ingested when consuming
cannabis through smoking have been offset by the
Although Switzerland does not have a high-quality standard and organic growing process of
government-established medical cannabis programme, the majority of high-CBD products. Nevertheless, they
they do allow exemptions for qualified patients. The are still to receive any legal authorisation for making
list of qualifying diseases is limited to: medical or therapeutic claims.
Epilepsy or severe tremors

Cancer
Chronic pain
Spasticity
Nausea
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1.2 1.3 2.4*

142
*may not sum due to rounding
Switzerland is pivotal for the growth of the European Throughout most European countries, the sale of
cannabis industry from an investment and IP non-medical cannabis and hemp products containing
perspective. The country is home to some of the more than 0.2% THC is illegal. In Switzerland, however,
biggest pharmaceutical companies in the world as well the legal limit is 1%, prompting a surge in interest from
as a number of major financial institutions. the cannabis community, not only in Switzerland but
from the rest of Europe and beyond. In addition,
Switzerland is developing an impressive and numerous coffeeshops are already open, legally
competitive hemp market. Coop, the Swiss selling CBD-dominant cannabis flowers.
supermarket chain, now stocks cannabis cigarettes
high in CBD (around 20%). Swiss-brand Heimat, Regardless of what Heimat’s cigarettes might do for
produced by Koch & Gsell AG, launched cannabis the Swiss economy, cannabis is already proving to be
cigarettes in July 2017 to add to their existing range of a major growth area, with the annual sales of legal
hemp-infused products such as iced tea, beer and cannabis and hemp products in Switzerland totalling
food supplement oils. around €87.9m annually (roughly 1.5% of the Swiss
GDP).
Around early May this year, German supermarket
chain Lidl began selling low-THC, high-CBD cannabis With medical cannabis trials ongoing, Switzerland may
products in Switzerland, as alternatives to tobacco. add high-THC cannabis to their roster of legal
The two varieties were priced at €15 for 1.5 grams and medicines sometime in 2019. Considering the
were produced by The Botanicals. This company popularity of high CBD products, particularly for
offers cannabis strains produced in automated health benefits, this could be a major success in
greenhouses and is claimed to be produced through Switzerland amongst health-conscious consumers,
sustainable agriculture as well as completely organic. pharmacists and healthcare professionals.
Meanwhile, another company, KannaSwiss has begun
selling CBD oil for a rather steep price at 150 Swiss Swiss “cannabis light” is now on sale in more than
francs. 1,000 tobacco shops in Switzerland, and in 15 to 20
shops in France. After seeing explosive growth since
Recently, low-THC cannabis has entered the Swiss 2016, Swiss CBD companies are targeting markets in
market in bulk. Just in 2017, over 140 businesses Italy and Austria.
started selling these products and the anticipated
revenue from this was near $25 million on legal sales Wayland, a prominent vertically integrated producer
up to almost $100 million. Wayland Group - one of the and distributor of medical cannabis recently made two
first companies to successfully create a stable range key purchases in Switzerland. The first, Haxxon AG,
of THC distillate in Canada - has begun to export THC was acquired in May 2018 for €5.3m, while Proimaging
distillate to Switzerland. The company also announced AG, was purchased in June 2018 for €3m. The former
in September 2018 that it plans to open a retail owns and operates a 60,000 square feet cannabis
location in Zurich in 2019, to supply the market with growing facility dedicated to cultivating cannabis will
high-quality cannabis products containing a maximum up to 1% THC concentration. The latter is based in
THC content of 1%. The location will also offer an Ebersbach, Germany and owns clean-room
“enhanced experience centre” where people will be production, processing and extraction facilities.
able to sample and test different strains and devices.
CONSUMPTION
Monthly Cannabis Consumption

3.0%
2.5%
2.0% 50+
45-49
143
1.5% 40-44
35-39
1.0%
30-34
25-29
0.5%
20-24
0.0% 15-19
1992 1997 2002 2007 2012
Resident population aged from 15, ranging between 13´000 and 21´0000
The European Cannabis Report™ Luxembourg
144
LUXEMBOURG
MARKET OVERVIEW
Population (m) 0.57
GDP (€b) 53
Democratic Party,
Ruling Luxembourg Socialist
Government Workers' Party and the
Party Greens.
Party Stance Supports medical

and recreational
3.2
Total Healthcare
Expenditure (€b)
Luxembourg, nestled between France, Belgium and
Alcohol Consumption
Germany, has long suffered from the domination of
(Litres Per Capita 13 neighbouring countries. The end result is a proud
Per Year) national motto “Mir wëlle bleiwe wat mir sinn” which
translates directly as “We want to remain what we
Prevalence
of Tobacco 13.8 are”. However, when it comes to cannabis legislation,
Users (%) Luxembourg is following directly in the footsteps of its
Number
northern neighbours, Belgium and Germany.
of Cannabis
Users (m)
0.02
In November 2017, Prime Minister Xavier Bettel
Average Price announced that Health Minister Lydia Mutsch would
Per Gram 12.7 formalise access to medical cannabis, having
of Cannabis* approved the use of Sativex five years prior. Mutsch
*Prices refer to black market cannabis prices explained that research into cannabis and certain
cannabinoids in Europe had shown that THC and CBD (Socialist Workers Party) and Déi Gréng (The Greens)
can have a positive effect in the treatment of certain announced an intention to legalise recreational
conditions such as cancer, neurodegenerative cannabis. The legal market will operate within
diseases or chronic and painful diseases. restrictions, according to Luxembourgish media, but
they have not yet been detailed yet. The legislation is
A year later, in November 2018, three parties of the expected to be passed in the next five years.
coalition, namely DP (Democratic Party), LSAP
Pharmaceutical Medical Recreational CBD/Hemp Oil 145
Cannabis Cannabis Cannabis Legislation
Legislation Legislation Legislation
Medical cannabis Expected to be

is legal and being legalised by 2023
Legal prescribed under Legal
a pilot scheme.
According to the ‘Memorial A’ of the Narcotics Bill, The Minister of Health is also in discussions with the
possession, transportation and consumption of National Health Fund (CNS) for a potential
cannabis is illegal, although personal possession is reimbursement of medical cannabis.
decriminalised. Medical cannabis treatments are now
legal. Both the Green Party (Déi Gréng) and the Left Party
(Déi Lénk) were proactive in supporting the medical
The law legalising the use of medical cannabis in bill, and both parties support a fully regulated
Luxembourg is almost complete. The draft law will cannabis market. The Liberal Party (DP) advocate for a
allow doctors to prescribe cannabis in cases where fully regulated market but oppose the broadening of
conventional treatments fail to relieve patients' pain. the existing medical cannabis bill while the
The Council of State has played an essential role by Conservative Party is supporting the medical bill but
recommending that all doctors in Luxembourg be opposes a fully regulated market while remaining open
authorised to prescribe medical cannabis. for discussions.
HEALTHCARE ANALYSIS
Total
Total Total Estimated Approved
Healthcare Pharmaceutical Medicinal Cannabis-
Expenditure Spending Cannabis based
(€b) (€b) Allowance Products
2018 (grams)
Sativex
3.2 0.4 21,790 Cannabis Flowers
Cannabis Oils Cannabis
Sprays Cannabis
Tinctures
The health system in the country has not changed tinctures will all be made available. The government
substantially over the last decade. However, concerns has estimated that around 80-100 patients could
around fiscal sustainability have triggered awareness benefit from the pilot scheme and would receive
about the efficiency of the health system, and as of around one gram per day as part of their therapy.
2010, Luxembourg introduced a series of
cost-containment policies. The state authorised strains of medical cannabis to
have a very low THC content. One major change to the
Health spending in Luxembourg is one of the highest initial text originally presented by the Health Ministry
among EU countries. In 2015, Luxembourg spent just is that the ability to prescribe will not be reserved for
over €5,000 (€5,090) per head on health care, specialised physicians only. All physicians, including
compared to the EU average of less than €3,000 general practitioners, will be able to prescribe
(€2,797). therapeutic cannabis to patients, provided they follow
Treatments are now allowed for cancer patients

a special training course and are subsequently
approved. After receiving a prescription, the cannabis
146
undergoing chemotherapy, neurological conditions is provided only through pharmacies within hospitals.
such as Alzheimer's and multiple sclerosis, as well as
conditions causing severe muscle spasms, pain, or Prescription costs are covered by statutory health
epilepsy. Herbal cannabis, cannabis oils, sprays and insurance.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.07 0.05 0.1
At present, Kalborn-based Cannad'Our is the only Luxembourg offers an appealing corporate tax rate
cultivator that markets hemp products. The cultivation (21%) and lucrative tax breaks (on the transfer of
of cannabis is permitted in Luxembourg provided that money) to multinational companies, often at the ire of
its THC content does not exceed 0.3%. the wider European community. Luxembourg can
capitalise on the lack of financial systems for cannabis
Cannamedica, a non-profit advocacy group, hopes to companies as has been evidenced in the US and
see an expansion of hemp cultivation on Luxembourg Canadian banking systems. Financial hubs in Europe
land. The group has started lobbying the various will have a chance to create a European standard for
political parties for the parliamentary elections in the finance, banking and lending systems for cannabis
October 2018. companies.
Expert Input
Bob Lessel, Member of Cannamedica
The Ministry of Health and other institutions, movement and the resulting national demand for
researchers and entrepreneurs increasingly medical cannabis we are witnessing. Authorities in
understand the international pro-legalisation Luxembourg have been influenced by the worldwide
momentum and the public pressure they experienced the development of cannabis-related activities in
by patients as well as associations like Cannamedica. Luxembourg, whether in a regulatory, political,
scientific or entrepreneurial direction.
The adoption of the draft law on medical cannabis will
decisively change public opinion and the cannabis The upcoming election of the current government
landscape in general in Luxembourg. As soon as maintains its majority, it is likely that it will amend the
doctors in different parts of the country start to medical cannabis law in order to be prepared for
prescribe medical cannabis, we will see an future challenges and opportunities and, possibly,
unprecedented shift in public acceptance. This will even legalise cannabis for recreational uses by the end
help to open up new regulatory pathways and foster of the term of office.
the development of a more progressive and patient
and entrepreneur-friendly landscape. My suggestion is: “If the current government maintains
Luxembourg is famous for recognizing market niches

its majority in the upcoming election, it is likely that it
will amend the medical cannabis law in order to be
147
in activities related to the financial sector. This will prepared for future challenges and opportunities and,
inspire many citizens to take action and contribute to possibly, even legalise cannabis for recreational uses
by the end of the term of office.
CONSUMPTION
Drug use
in young adults ( 15-34 years)
in the last year.
18.8%
6.6% 14.3%
source: EMCDDA
The European Cannabis Report™ Norway
148
NORWAY
MARKET OVERVIEW
Population (m) 5.3
GDP (€b) 339
Ruling Conservative Party /

Government Progress Party.
Party

on Cannabis legalisation.
35.2
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 7.5
Per Year)
Prevalence Norway has historically held some of the harshest

of Tobacco 20.2 drug policies in Europe. On the whole, policies in the
Users (%) Nordic countries are usually informed by modern
Number science and human rights. Drug policy is, arguably, a
of Cannabis
Users (m)
0.15 notable exception. Failing a drug test or admitting to
previous drug use are punishable offences in the
Average Price country that boasts one of the highest per capita rates
Per Gram 14.7 of criminal charges for drug offences. Drug offences
of Cannabis* are reported to account for more than half of all
*Prices refer to black market cannabis prices non-misdemeanour crime.
Scandinavian drug policy is totally divided between slowly turned away from punitive measures and in
the liberal policies of Denmark at one end and the early 2018 introduced new legislation that focuses on
punitive zero-tolerance approach of Sweden at the treatment rather than punishment. The new legislation
other. Norway is somewhere in between but has slowly decriminalises possession and is aimed at tackling
started to differentiate itself from the Swedish model. addiction and criminality.
For instance, in December 2017, The Health
Committee of the Storting (Norwegian parliament) Medical cannabis has been legal since the beginning
voted in favour of decriminalising drug use. of 2016. While Sativex and Bedrocan can be imported
by private persons given a prescription from a doctor,
In the Nordic countries, the construction of drug policy CBD oil with even a trace of THC is not permitted for
started in earnest as a reaction to the drug wave of the private import, not even with a prescription. Though
1960s. While Denmark and Sweden had a mild initial Norway lacks a proper authoritative listing of
reaction, Norway passed some of the strictest
anti-drug laws in Europe.
qualifying conditions for medical cannabis, it has been
prescribed for the treatment of MS and cancer.
149
At the height of the American drug war, in 1984, Industrial production is prohibited for both cannabis
Norway’s right-wing government implemented the and hemp, with seed distribution also strictly
maximum prison sentence for drug offences, often on prohibited.
a par with murder sentences. However, Norway has
Pharmaceutical Medical Recreational CBD/Hemp Oil

Medical Cannabis is
legal as prescribed Possession and
by a specialist. In consumption are both
Legal under order to obtain a illegal but a law Legal
prescription prescription, decriminalising
Norwegian doctors personal use may
must prove that all come into effect in the
other treatments next 2 to 3 years.
have failed.
Summary
In December 2017, the Norwegian Parliament practical aspects legal framework for
announced the nation would become the first decriminalisation. Sveinung Stensland, deputy
Scandinavian country to decriminalise personal drug chairman of the Storting Health Committee, told
use, including cannabis, providing medical treatment Norwegian publication VG: “It is important to
to users rather than fines and imprisonment. The emphasise that we do not legalise cannabis and other
majority of the Norwegian parliament, the Storting, drugs, but we decriminalise”.
backed the historic shift which was supported by the
Conservatives (Hoyre), Liberals (Venstre), the Labour Though there have been some signs of reform in the
Party (Ap) and the Socialist Left (SV). last two years, a series of organisations have been
pushing for change over the previous three decades,
At present, a government committee is working out the including Normal, the Norwegian chapter of the
cannabis legalisation organisation NORML. shift the centreline of the Norwegian public debate
and influence the programmes of almost all major
Since the beginning of 2016 The Association for Safer political parties, including the party of government.
Drug Policies has become a strong voice in Norwegian
drug policy, and together with the other organisations CBD and all hemp derived non-psychoactive
working for drug policy reform they have been able to products are legal in Norway.
HEALTHCARE ANALYSIS
Total 150
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
35.2 2.4 109,500 -
Norway is one of the top spenders on healthcare which are considered suitable. The medical authorities
among OECD countries in per capita terms but much in Norway follow the guidelines and practices set out
closer to the average when seen as a share of GDP. All by the Danish Medicines Agency and their use of
hospitals are funded by the public as part of the medical cannabis. Approval is not required for
national budget. However, while medical treatment is prescription of medical products containing CBD and
free of charge for any person younger than the age of less than 1% THC. In order to prescribe medical
16, adult residents are required to pay a contribution cannabis, doctors are required to show that other
each year before becoming eligible for free healthcare. treatments have not had a sufficient effect, are
Norway has a relatively young population, high life unsuitable or have had adverse effects.
expectancy and low incidences of smoking, alcohol
consumption and obesity. Norway imports medical cannabis from Bedrocan. The
Dutch company produces medical cannabis products
Since the medical cannabis scheme was piloted in under licence from the Dutch Ministry of Health. When
early 2016, the Norwegian Ministry of Health and the the Norwegian Ministry of Health has granted a right
Norwegian Medicines Agency have begun a of claim and the Danish Medicines Agency has
programme of doctor education in hospitals for granted an approval exemption, a pharmacy can then
prescribing medical cannabis. supply the product to a patient. Norwegian
pharmacies or wholesalers must apply to the Danish
Only hospital specialists can apply to prescribe Medicines Agency for import permission.
medical cannabis, but there is no list of illnesses
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.5 0.3 0.8 151

Historically, hemp has been grown in several places in gradually reduced over time, indicating that the
Norway. Unfortunately, all industrial hemp cultivation production of illegal cannabis is not popular in
and purchase of seeds is illegal in Norway, inhibiting Norway. However, given the social stigma surrounding
any potential commercial opportunity. cannabis in Nordic states, these low consumption
figures should be taken with a pinch of salt. Medically,
Norway has a relatively low consumption level of cannabis is growing in popularity with Norway
cannabis among the adult population suggesting the importing 100 kilograms of medical cannabis in 2018.
popularity of cannabis is still low. In addition, the size
of illegal production sites discovered by police has
CONSUMPTION
Cannabis
14.1%
6.1% 11%
30
55-60 0% 25
20
45-54 2.8%
15
35-44 1.4%
10
25-34 6.8% 5
18-24 10.6% 0
2015
2006
2007
2008
2009
2010
2011
2012
2013
2014
source: EMCDDA
The European Cannabis Report™ Finland
152
FINLAND
MARKET OVERVIEW
Population (m) 5.5
GDP (€b) 214

National Coalition Party,
Ruling Social Democratic Party,
Government Swedish People's Party, and
Party the Christian Democrats.
Party Stance
on Cannabis -
19.7
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 10.7 Finland, like its Swedish neighbour, has developed a
Per Year) history of drug prohibition, beginning in the 1960s. In
2008, Finland reformed its policies which permitted
Prevalence
of Tobacco 20.4 the prescription of medical cannabis, specifically that
Users (%) in the form of Bedrocan herbal cannabis from the
Netherlands. However, only some forms of medical
Number
of Cannabis
Users (m)
0.2 cannabis are legal in Finland, and there is still a long
way to go to fully legalise medical cannabis in the
country. It was a further 9 years (2017) until
Average Price
Per Gram 13.9 neighbouring Sweden granted its first licence to use
of Cannabis* parts of the cannabis plants for the treatment of
*Prices refer to black market cannabis prices chronic pain.
In 2018, Finland was forecasted to import in excess of Hamppusampo has a permit from Evira, Finland’s food
75 kilograms of dried cannabis for research purposes safety agency, to import the seeds it uses for research
from the Netherlands, including Bedrocan, Bediol, and and product development.
Bedica. While it is legal to possess medical cannabis in
Finland, cultivation of cannabis or hemp is forbidden. In a more recent development, Evira announced that
sales of Hamppusampo’s flowering hemp plants were
In summer 2018 Finnish cannabis company illegal and the company was forced to remove them
Hamppusampo began experimenting with methods of from sale. Hamppusampo had assumed that Evira
cultivating a non-intoxicating strain of cannabis, with would interpret the flowering of hemp as a food, and
the aim of developing cannabidiol (CBD or ‘cannabis thus allow the sale of light cannabis to consumers.
light’), products to sell both locally and abroad. Board According to Evira inspector Anna Mizrahi, the agency
member Hannu Hyvonen commented that he “has not legalised the flowering of hemp and has not
expected commercial cultivation of medicinal granted any marketing authorisation to anyone.” This 153
cannabis to commence in Finland “within the next few despite the fact that cannabinoids are considered to
years”. The company is currently cooperating with a belong to the category of ‘novel foods’, which were
number of small-scale growers along the coast, in the lawfully introduced into the market with the
Oulu and Jyvaskyla areas, and in the eastern introduction of novel food supplements.
municipalities of Lieksa and Rautavaara.

Possession, Legal, because not

Legal under strict
At present, only conditions, consumption, sale, psychoactive and not
Sativex is legal. cultivation is cultivation and explicitly listed as a
forbidden. distribution are illegal. banned substance.
Summary
Pharmaceutical cannabis-based medicines are yet to grams of cannabis only merit a disposable
appear openly in Finland. So far, only Sativex is sold in income-based fine.
pharmacies.
The 50th chapter of the Criminal Code criminalises all
Medical cannabis is legal in Finland and can be dealings with illegal drugs, including the production,
purchased upon recommendation by a specialist and import, transport, sale, possession, and use of
after procuring a prescription from a doctor. There are cannabis.
not set conditions for which medical cannabis may be
prescribed. The Finnish government has left this The criminal procedure regarding personal use of
decision to the patients and their doctors. illegal narcotics was reformed in 2001. This was to
relieve the burden of personal use cases from the
Recreational use remains illegal but possession of courts, expedite and standardise enforcement
smaller amounts have been decriminalised. policies. Following the reforms, the police issue
Possession of fewer than 10 grams of hashish and 15 summary fines for most personal offences, and cases
are not brought to court unless the defendant so youth wings of the political parties, who are in broad
desires. In practice, possession of up to 10 grams of agreement about the next steps they want to see for
hashish or 15 grams of cannabis is deemed personal cannabis in Finland.
use and carries a penalty of 10–20 “day fines”, which
are penalties calculated as one half of someone’s daily The youth ranks of the Centre Party, Social
disposable income. Democrats, Green League, and Left Alliance have held
internal discussions on reforming drug policy. The
While there is no legal distinction between cannabis main issue the political party youth groups agree on is
and other drugs, it is widely considered to be less decriminalising possession of cannabis for personal
dangerous and punishments tend to take this into use. Beyond that, other views begin to diverge.
consideration too.
Discussions about drugs policy have been led by the
154
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Sativex
19.7 2.7 75,000 Cannabis flowers
Healthcare in Finland consists of a highly medical cannabis products from one of 27 pharmacies
decentralised three-level publicly-funded healthcare that have a permit to sell it. For Bedrocan, Bediol, and
system, supported by a €21.5b budget. Although the Bedica, patients must have a ‘Special Permission for
Ministry of Social Affairs and Health has the highest Compassionate Use’ permit. The Finnish National
decision-making authority, the municipalities are Health Insurance covers part of the purchase
responsible for providing healthcare to their residents. Bedrocan is usually sold in Finland at €127 for five
In the Finnish medical cannabis system, specialists grams with social insurance and sold at €567 without
must recommend medical cannabis before doctors the social insurance.
can prescribe it. Common conditions that qualify for
medical cannabis in Finland include cancer, According to INCB data, Finland’s requirement for
HIV/AIDS, spinal cord injuries and epilepsy. Finland cannabis in 2018 stood at just 75,000 although current
does not limit which ailments are eligible for medical patient estimates would suggest that this requirement
cannabis. Instead, patients and their physicians is much higher.
determine together if medical cannabis is a suitable
treatment option for their conditions or symptoms.
There were reportedly 223 cannabis patients in the

country in 2014. These patients can purchase their
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1.1 1.2 2.3

155
Finland, with its dark and harsh winters, is an unlikely Finland has a strict history of drug prohibition, tobacco
leader in hemp production, but the country is renowned and alcohol are heavily taxed, and retail sales of
within the hemp industry for the development of hardy alcoholic beverages with an alcohol content of more
hemp varieties such as Finola, the trade name for a than 4.7% are restricted to shops of the state monopoly
resilient, frost-resistant cultivar. Developed in 1995, Alko. Though recreational cannabis will not be likely to
Finola was added to the EU’s list of subsidised crops in occur for some years, when it does, expect it to come as
2003 and has since become one of the most important a state-run monopoly.
hemp strains in the world today.
Finland’s medical cannabis industry is set to grow in
Finland is also one of the leaders in global research on value by hundreds of millions of Euro in the coming
hemp and cannabis. In 2018 Finland produced research decade. By 2028, Prohibition Partners forecasts that
reports that have gained international attention. The there will be more than 71,000 cannabis patients in the
first focused on the link between psychosis and country, accounting for almost 1.3% of the total
cannabis and the latter focused on the relationship population. Unlike other European markets, the Finnish
between cannabis and coffee. In addition, Turku medical cannabis market is less likely to be restricted
University in south-western Finland is one of the global by a limited range of qualifying conditions as patients
leaders on the industrial uses of hemp and hemp are already able to use of medical cannabis for their
research. specific symptoms. Nonetheless, conditions that often
qualify for medical cannabis in Finland include Cancer
The possession and sale of cannabis seeds and the (of which there are more than 33,000 sufferers), HIV/
sale of CBD oil are legal in Finland. Other hemp AIDS (4,030 sufferers), Epilepsy (30,000 sufferers) and
products such as soaps, shampoos, and ropes can be MS (7,000 sufferers). A relatively high proportion of
bought and sold freely. Finland’s patients with spinal cord injuries are also
likely to be prescribed medical cannabis.
CONSUMPTION
Cannabis
13.5%
9% 17.9% 156
30
55-60 0.6% 25
20
45-54 2.2%
15
35-44 4.8%
10
25-34 12.1% 5
18-24 15% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
European Panel
Lauri Louhio, Lawyer and Founder,
Lakiasiaintoimisto Väinämöisen Laki Oy milk
The future of cannabis in Finland is bright. There is a 2017 saw a substantial change in Finnish media and
wide consensus between citizens and most of the cannabis-related news. A reform in the Finnish
politicians that cannabis is a normal plant that is healthcare system is scheduled for 2018-2019, which
simply restricted by international regulations. The will make provinces responsible for organising
Justice Ministry of Finland recognises the changing healthcare. It is combined with a takeover of the
attitudes and is open to dialogue with other groups. political power from the municipalities, and
Officially though, there is no framework or preparation decentralisation from the state to the provinces. It will
for the legalisation of cannabis in Finland not directly affect the legal status of cannabis, but it
may have an impact on the aid that is paid to medical
Finland is a small country, and changes in politics may cannabis users for prescriptions. Bedrocan or other
happen fast. At present, 50% of citizens support cannabis products that can be obtained from Finnish
decriminalisation. pharmacies are very expensive, and social aid is often
needed.
The European Cannabis Report™ Sweden
157
SWEDEN
MARKET OVERVIEW
Population (m) 10.1
GDP (€b) 457.3
Ruling Social Democratic

Government Party
Party

49.9
Total Healthcare
Expenditure (€b)
Sweden’s view on cannabis is the most conservative of

Alcohol Consumption
9.2
the Nordic region, and one of the most conservative in
(Litres Per Capita
Per Year) the whole of Europe. The government believes
cannabis offers little-to-no medical or economic
Prevalence benefit. The only minor exception is the limited
of Tobacco 18.8 availability of Sativex to treat symptoms of multiple
Users (%)
sclerosis, which has been available on import from the
Number UK since 2011 and the treatment of two cannabis
of Cannabis
Users (m)
0.2 patients for chronic pain in 2017. The licences were
granted in February 2017 and by May 2017, there were
Average Price
10.1
a further 10 applications to the country's Medical
Per Gram
of Cannabis* Products Agency (Läkemedelsverket) to use cannabis
for pain relief.
Swedish drug policy was previously based on the cannabis. The party cited the commonly held belief
principle that all drugs are dangerous and drug use is a that the prohibition of cannabis does more harm than
social problem. This is based on the work of the plant itself, due to its connection with organised
internationally renowned psychiatrist Nils Bejerot in crime. However, this held no traction within the
the 1960s, who stressed that non-medical drug use Swedish parliament and no further attempts at reform
had to be criminalised. As a result, Sweden has have surfaced since.
implemented decades of zero-tolerance punitive
policies on drug use, with little differentiation between For decades, the cannabis debate has been regarded
different drugs. The goal of which was to create a by the political majority as a movement fuelled by
drug-free society. In spite of this, in recent years there cannabis consumers and teenagers. However, a
has been an increase in drug consumption in Sweden, recent study revealed that cannabis use among
particularly among young people, although every Swedish citizens is increasing rapidly. The number of
major political party remains in staunch support of cannabis users in Sweden rose from 2.5% in 2013 to 158
zero tolerance drug policies. 3.6% in 2016. This is a substantial increase in number
and since Canada, as well as many other western
In 2013, the Centre Youth Party (Centerpartiets nations, consider the benefits of cannabis regulation,
ungdomsförbund, CUF) became advocates for the Sweden can no longer brand the cannabis debate as a
legalisation of both medical and recreational fringe issue.

Allowed as of 2017
but only two Bans any and all
patients are possession, sale,
reported to be using transport, and
Sativex only. cultivation of Legal.
Bediol. Sativex is
permitted to treat cannabis.
MS.
Summary
Sweden does not recognise medicinal benefits of consumption rates in Europe. Since the turn of the
cannabis but has granted patients of chronic pain century, however, the rate has risen progressively, and
permission to use Bediol imported from the it is still the most common drug in Sweden.
Netherlands.
The first two Swedish licences cannabis-based
Cannabis in Sweden is illegal for recreational purposes medicines to relieve chronic pain were granted in
and only very limited medical use of cannabis or February 2017, and since then there have been ten
cannabis-based drugs is allowed for specific further applications. The licences allow patients to use
conditions. Cannabis flower is a Schedule 1 drug, cannabis in the form of Dutch medical cannabis strain
though extracts of the plant are Schedule 2 drugs. The Bediol, a Bedrocan product produced in the
country has historically had a zero tolerance approach Netherlands. The applications must be written by a
to drug use, with no legal distinction between ‘hard’ doctor, and can only be granted once all other
and ‘soft’ drugs, and one of the lowest cannabis available treatments have been tried and failed.
Though the medical authorities are staunchly against a certain extent, but this has not yet impacted on its
the therapeutic effects of cannabis, research on legality.
cannabinoids is done at the famous Karolinska
Institutet. Much of the output is focused on harms of CBD and all hemp derived products are legal in
cannabis use rather than medical benefits. Sweden.
Contemporary pop culture has normalised cannabis to
HEALTHCARE ANALYSIS
Total 159
(€b) 2018 (grams)
4.6 Sativex
49.9 58,580 Bediol.
Healthcare in Sweden is mainly tax-funded, ensuring spasticity due to multiple sclerosis on 22 December
equal access to healthcare services for everyone. 2011. The treatment, however, is not funded by the
Despite having one of the most highly funded state and patients must pay for the product
healthcare systems in the world, the Swedish system themselves.
is not without its challenges, which include funding,
and quality and efficiency of its healthcare services. Prescription of cannabis in Sweden is a lengthy and
Historically in Sweden, cannabis was not officially complicated process. A doctor has to apply for a
recognised for medical use, and medical use has not special permit from the Medical Products Agency, if
been seen as an extenuating circumstance in legal approved, the patient’s closest pharmacy has to
cases. Conversely, in a case that drew some attention arrange a special import.
in the national press involving a multiple sclerosis
patient, the fact that she stated that cannabis helped As more patients apply for licences to use medical
her treat her condition, was seen as an aggravating cannabis, there is likely to be an increase in
circumstance by the court. The court argued in the applications to the Medical Products Agency for
verdict that she lacked the motivation to stop using approval to market new cannabis-based medical
the drug and therefore gave her an unconditional jail products. Approval falls to the Medical Products
sentence. Agency which is responsible for evaluating the
efficacy of the drug and whether any side effects are
Sativex was approved in Sweden for the treatment of reasonable in relation to the intended effects.
Forecast Forecast
Medicinal Recreational
Cannabis Cannabis Total
Market Value Market Value 2028 (€b)
2028 (€b) 2028 (€b)
Total 0.5 0.6 1.1

Cannabis is an unpopular topic in Sweden, in both traded shares on Nordnet in January, with around
medical and legislative circles, but reports suggest 50,000 investors in Sweden trading in cannabis
that cannabis may be garnering significant attention in shares. While the Swedish cannabis industry is
financial circles. This is primarily due to the number of relatively undeveloped, in relation to its more Southern
cannabis users in the country which has grown European neighbours, Swedish investors are clearly
tremendously from 2.5% in 2013 to 3.6% in 2017 as interested in financing the growing cannabis industry.
mentioned before. In light of this fact, the Swedish LGC Capital recently acquired 30% of a Swiss
government will not be able to ignore the cannabis cannabis company, Virdi, and has begun cultivation
topic for very long. operations through it. Another Swedish CBD oil
manufacturer STU GmbH entered into a distribution
Two Canadian cannabis companies, Aurora Cannabis agreement with Pivot Pharmaceuticals for distribution
and Canopy Growth, were among the top 10 most across the Europe Union.
160
CONSUMPTION
Cannabis
14.1%
6.2% 8.4%
2015
30
55-60 0.3% 25
20
45-54 0.4%
15
35-44 1.7%
10
25-34 6.9% 5
18-24 7.7% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
source: EMCDDA
The European Cannabis Report™ Croatia
147
161
CROATIA
MARKET OVERVIEW
Population (m) 4.1
GDP (€b) 46.6
Ruling Croatian Democratic

Union (HDZ)
Government (Conservative,
Party centre-right).
Support medical cannabis

Party Stance but opposed to
on Cannabis recreational.
3.5
Total Healthcare
Expenditure (€b)
Alcohol Consumption
Per Year)
Cannabis-based products for medical purposes have
Prevalence
of Tobacco 37 been legal for use by patients with illnesses such as
Users (%) childhood epilepsy, cancer, multiple sclerosis, or
AIDS, since October 2015 patients with a doctor’s
Number
of Cannabis
Users (m)
0.2 prescription can legally access cannabis teas,
ointments, and other cannabis extracts. Patients can
obtain up to 7.5 grams of THC per month, but smoking
Average Price
Per Gram 6.8 or vaporising cannabis is prohibited. A range of
of Cannabis* products is legal, although cannabis pills are the only
*Prices refer to black market cannabis prices preparations readily available.
It is notable Croatia managed to pass and enact a There are now no stocks of medicinal cannabis in
functioning medical cannabis programme in less than Croatian pharmacies, the current Health minister has
a year, where many European countries have stopped the work of the country’s Committee for
struggled. Despite this, though, uptake has been low, Medical Cannabis, and there is no indication of
due, in part, to the high price of the medicines, which improvements in the availability of medical cannabis
are not co-financed by the state fund and have to be for Croatian patients who may now have to rely
paid for in-full by patients. Along with the prohibitive entirely on the black market.
cost, doctors are reluctant to prescribe the drugs.
162
Legalised for Possession of

Dronabinol, Nabilone, cannabis is
conditions including
capsules, ointments, MS, cancer, epilepsy decriminalised but Legal
teas. and AIDs. cultivation and
distribution is illegal.
Summary
Croatia became the first Balkan country to legalise has concluded that it is necessary to regulate the
medical cannabis following a review of global research cultivation, processing, transport and regulation of
on the therapeutic effects of cannabis by a team of cannabis for medical purposes, the existing legislation
doctors and medical professionals which recommended should be altered and effective control mechanisms
legislation to government policymakers. undertaken that allow for the use of cannabis for
medical purposes, and prevent misuse”.
In December 2014, the country initiated a project
referred to as The Commission, which created a On The Commission’s recommendation, Croatia passed
committee of medical experts, headed by Chairman legislation regulating cannabis for medical use in
Professor Ognjen Brborović, tasked with examining October 2015, less than a year after the project’s launch.
cannabis laws in other countries and studying medical
cannabis to determine whether cannabis should be Brborović stressed the need for scientific data and
legalised for medical purposes. research as a core pillar to legislative reform.
“During the last ten years, activists and several NGOs

The Commission concluded that previous laws on
have been promoting the use of cannabis as medicine,
preventing the misuse of drugs actually encouraged
making it look a panacea in the eyes of patients. The
illegal use of drugs by patients, for which they risked
anecdotal evidence may be there, but medical
prosecution. Altering the law and rescheduling cannabis professionals need scientific data and research. The
would resolve this issue, reduce costs and increase situation was untenable from a public health point of
availability of cannabis to patients. The report from The view, and the establishment of the committee was the
Commission read: first step in order to answer many important
questions”.
“The Commission, taking into account the latest • Professor Ognjen Brborovic
scientific and medical knowledge, and the fact that
patients in Croatia buy cannabis on the black market, Possession of recreational cannabis has been
decriminalised for ‘small amounts’ but there is no by a sentence of anything from six months to five
quantitative definition of what constitutes a ‘small years imprisonment.
amount’. Cultivation still remains illegal, meaning that
owning one plant for personal use could be punished CBD and hemp derivative products are legal.
HEALTHCARE ANALYSIS
Total
Healthcare Pharmaceutical Medicinal Cannabis- 163
2018 (grams)
Dronabinol,
Nabilone,
3.5 0.8 3,000
Cannabis flowers,
Cannabis teas,
Cannabis ointments,
Cannabis capsules.
Croatia operates a universal healthcare programme. Because there are no cannabis producers in Croatia,
The population has basic health insurance coverage medical cannabis products have to be imported. The
provided by a statute administered by the Croatian country received its first shipment in June 2016 from
Healthcare Fund. An additional insurance option is Tilray. The two Tilray products that have been
also available for a fee. Due to the rising costs of approved for Croatian pharmacies are both orally
healthcare, especially expenditures on drugs, Croatia’s administered capsules, containing both THC and CBD,
healthcare system is characterised by a lack of funds. and made to GMP guidelines.
The Croatian Ministry of Health controls the system However, demand for these products remained low. In
with wide-reaching authority. This entails the March 2018 Croatia’s pharmacies were reported to
management of healthcare legislation and reforms, have run out of cannabis-based medicines. The only
proposing budgetary expenditures, monitoring health shipment of cannabis medicine ever to arrive in Croatia
conditions and the needs of the population and expired in March, and the remnants were destroyed by
education of healthcare workers. July.
Medicines containing THC, Dronabinol or Nabilone, Current Minister of Health Prof. Dr Milan Kujundzic
can be prescribed, on a non-repeatable prescription, has stopped the work of the Committee for Medical
by physicians working in general and family practice, Cannabis, showing no intent to improve availability for
paediatrics and women’s healthcare. These medicines Croatian patients. No further stocks have been
may be prescribed to relieve the symptoms of multiple ordered.
sclerosis, cancer, epilepsy and AIDS.
The Health Ministry only ordered 1,200 bottles in 2016,
As cannabis is mostly therapeutic but not curative, and there were no further imports in 2017. Croatian
cannabis medicines are not placed on the Croatian patients are now solely reliant on the black market for
Health Insurance Fund’s subsidised treatments list, their supplies.
and patients have to pay for them in full.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.3 0.4 0.7

164
As cannabis treatments remain outside the scope of will likely look for joint ventures to bring in foreign
the national insurance providers, which are the main cultivation expertise in the initial phases of a domestic
sources for medical coverage in Croatia, there is an cannabis programme.
opportunity for private insurers of cannabis
treatments. In light of the legislation on medical cannabis, the
Croatian government is currently exploring new
Additionally, Croatia has not yet developed a domestic regulations for domestic hemp farming businesses, to
cultivation industry and currently relies on promote commercial opportunities in the industrial
international imports of medical cannabis. However, cannabis sector. The country’s Social Democrats filed
Croatia plans to create a domestic industry and is a legislative proposal in February 2017 that would allow
currently developing research programmes and domestic cultivation of medical cannabis, regulate the
facilities to cultivate and regulate cannabis. Croatia cultivation of hemp and introduce a certification
process for medical institutions.
CONSUMPTION
Cannabis
16%
10.1% 21.8%
30
55-60 0.9% 25
20
45-54 1.5%
15
35-44 6.4%
10
25-34 12.8% 5
18-24 19.7% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
European Panel Input

Ognjen Brborovic, Croatia's Committee for Medical Cannabis, Chairman
There has been little development in Croatia since There has been a recent boom in the production of
2016, mainly due to political instability, with three hemp and CBD, in separation and extraction, and the
different governments assuming power in two years. growth in the production of hemp-based cosmetics
and food additives in the country. This growth has
Medical cannabis patients now have to rely entirely on been possible due to the loosening of cannabis and
the black market, as stocks of Croatia’s single order of hemp laws which has occurred due to a new
cannabis medicine expired in March 2018. No further governmental interpretation of the legislation
stocks have been ordered. Unofficial estimates permitting the growth of hemp and cannabis, rather
indicate that around 100-200 of 25 ml bottles of than changes to the law. 165
cannabis medication a month were consumed in the
whole of Croatia, with illegal products dominating
medical use.
The European Cannabis Report™ Serbia
166
SERBIA
MARKET OVERVIEW
Population (m) 7
GDP (€b) 35.2
Ruling Serbian
Government Progressive Party.
Party
Party Stance Unknown.

on Cannabis
Total Healthcare
Alcohol Consumption
(Litres Per Capita 11
Per Year)
Serbia’s drug laws are strict. Orthodox Christianity is
Prevalence one of the main pillars of society and heavily
of Tobacco 38.9 influences public and political opinion on socially
Users (%)
liberal issues. There is a strong pro-legalisation
Number movement in the country, led by activists, patients and
of Cannabis
Users (m)
0.07 researchers, as well as an opposing force led by
far-right parties and conservative medical groups who
Average Price reject any calls for cannabis law reform.
Per Gram 11.9
of Cannabis* Cannabis is strictly controlled in the country and the
*Prices refer to black market cannabis prices majority of the public oppose any cannabis law
reforms. This is partly the result of the hardline stance alternative treatments have been exhausted. Attempts
of government and regulators. The Governmental to increase access to medical cannabis are currently
Committee for Controlled Psychoactive Substances blocked by fears about the harms of cannabis among
has regulated cannabis oil, which is available to regulators.
patients from certified physicians, but only after all

Legislation Legislation Legislation Legislation 167
Cannabis oil is
available under Possession, cultivation
exhaustive
- circumstances but all and distribution is strictly Illegal
other medical illegal.
treatments are
outlawed.
Summary
Possession of cannabis is punishable by a fine, or by cannabis. The first legal association advocating
imprisonment of up to three years. The sale and cannabis treatments - the Initiative to Change the
transport of cannabis are punishable by imprisonment Cannabis Legislation (IRKA) - was registered in early
of between three and 12 years and cultivation is 2014.
punishable by imprisonment ranging from six months
to five years. Despite complaints and disruptions from far-right
parties in the country, a proposal was submitted to the
Despite the strict criminalisation of cannabis, Serbia is Ministry of Health to legalise medical cannabis, citing
home to several pro-legalisation movements. The first several hundred cases of successful treatments after
pro-legalisation protest, the ‘Ganja March’, was held IRKA held a series of educational seminars on the
on 7 May 2005 in Belgrade with a second planned for medical use of cannabis. Serbian media, however, is
the Summer of 2007. still strongly against both medical and recreational
cannabis legalisation.
However, two days before the event, the Ministry of
the Interior received a threatening email from a group The Green Party, formed after the elections in 2014,
calling themselves the United Patriots. Given the supports medical cannabis legalisation and formed a
violence experienced over a 2001 gay pride protest, coalition with IRKA, agreeing to include them in their
the authorities cancelled the march. Advocates had to manifesto. In addition, ‘Dosta je bilo’, another new
wait a further eight years to hold the second Cannabis political party, formed around the former Finance
March in Belgrade. Minister Saša Radulović, has declared a similar
position to The Green Party, with a focus on medical
Very little political progress was made until February cannabis legalisation.
2014, when Health Minister Slavica Đukić Dejanović
voiced support for the legalisation of medical CBD hemp oil is currently not legal in Serbia.
HEALTHCARE ANALYSIS
Total
Total
Healthcare
Expenditure
(€b) 2018 (grams)
168
3.3 850m
According to the World Bank, Serbia has struggled generate revenue and reduce healthcare costs.
with corruption in the healthcare industry since its
establishment. Wages are low for doctors and There is currently an application being made by the
unemployment rates amongst healthcare Commission for the Application of Cannabis for
professionals have been as high as 20% in recent Medical Purposes to import cannabis-based
years. medicines to treat multiple sclerosis, Crohn’s disease,
oncological patients with advanced cancer, AIDS and
Serbia began a major healthcare reform in 2017 - rheumatoid arthritis.
allocating €2 billion of the state budget towards the
construction of clinical centres, the renovation of The application would legalise the use of dronabinol
hospitals and the procurement of medical equipment. for the treatment of significant weight loss in HIV /
There is a long-term commitment from the Serbian AIDS patients, and side effects of chemotherapy in
Government to the modernisation of the healthcare oncology patients when other drugs have been found
system with a host of major international financing not to work. Nabilone would be permitted for the
institutions involved in the process. As neighbouring treatment of nausea and vomiting in chemotherapy
countries begin to loosen restrictions on cannabis patients who do not respond to alternatives. Sativex
treatments, international finance partners may put would be permitted for treating spasticity in patients
pressure on Serbia’s government to consider with MS.
legislative reform, especially if reforms stand to
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.3 0.3 0.6
Serbia has one of the highest rates of diabetes in The hemp industry in Serbia is growing, mostly as a
Europe with a reported 12% of the population suffering result of the CBD, cosmetics and building material
from the disease. Treatments cost individuals, on markets, following recent attempts to block it from the
average, €565 per month, an extremely high cost for country's agricultural catalogue. Serbia has partnered
low and middle-income earners. To compound this with a Canadian company, Eviana Healthcare, in order
issue, Serbia’s overall pharmaceutical market is to produce hemp-based healthcare products.
relatively underdeveloped, seeing regular medicine Though legislative progress, which is critical to the
shortages and somewhat long waiting times for development of commercial opportunities, has
patients. stagnated, Serbia has been making small steps
towards reform:
There is a growing body of research, such as studies by
the American Alliance for Medical Cannabis (AAMC), 1. Imports are being considered
which indicates that cannabis can be used to stabilise 2. Hemp is currently being cultivated 169
blood sugars, ease nerve pain and reduce 3. The numbers of pro-cannabis legislators are
inflammation, offering a cost-effective supplementary growing in parliament
treatment for a large proportion of Serbian diabetes
patients.
CONSUMPTION
The first representative national general population 34 years (12.8 %). Cannabis is the most frequently
survey (GPS) in Serbia was conducted in 2014 with a used illicit substance, with around 3.3% of young
sample of 5,385 people aged 18-64 years. The results people reporting its use in the last year, while 1.8% had
indicate that drug use in Serbia is still low compared used it in the last month. Its use is more common
with the majority of European Union Member States. among males: 7.7% of 18- to 34-year-old males had
Around 8% of the adult population in Serbia had used used cannabis in the last year, while only 1.5% of
an illicit substance during their lifetime, with drug use women in the same age group had.
being more common among young people aged 18 to
The European Cannabis Report™ Estonia
170
ESTONIA
MARKET OVERVIEW
Population (m) 1.3
GDP (€b) 22
Ruling Estonian
Government Centre Party.
Party
Party Stance Opposed

on Cannabis to legalisation.
1.5
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 11.6 Estonia’s government has refrained from discussions
Per Year)
on medical cannabis, reportedly in fear of losing a
Prevalence substantial voting base that opposes legalisation.
of Tobacco 31.3 However, advocates of medical cannabis, such as the
Users (%)
Estonian Medical Cannabis Association, claim that
Number the government is behind the times and the tide of
of Cannabis
Users (m)
0.1 public opinion is turning.
Average Price
22.4
Since gaining independence, Estonia has become a
Per Gram
of Cannabis* world leader in technology and IT, holding the record
for most startups per person. Despite their
entrepreneurialism, the majority of the public is Most of the deaths occur due to the high prevalence of
staunchly against any medical cannabis legislation, fentanyl use – a potent and dangerous opiate.
and many proponents are pessimistic about Estonia’s
chances of legalisation. Estonians are largely socially Stigmas still remain around cannabis in areas where
conservative and a survey in 2016, conducted by high drug abuse is common. For the cannabis
market research company Turu-uuringute AS, found community, there is a widespread need to
that 87% of Estonians were strongly against any form disassociate cannabis from years of
of legalisation. It is not a topic which is on any urgent compartmentalisation as a ‘harmful’ drug and for
agenda. cannabis to be seen as an alternative treatment for
opioids.
In October 2017, Estonia boasted the unfortunate
accolade of having the highest proportion of problem The Estonian parliament adopted a legal basis for the
drug users particularly with injectables. It also had the implementation of drug treatment as an alternative
punishment for drug users in 2011. This meant that a
171
highest drug overdose rate in the European Union.
Data published in 2018 from the United Nations Office prison sentence of six months to two years could be
on Drugs and Crime places Estonia in the top ten substituted by treatment if the original offence was
countries for overdoses and drug-related deaths with caused by addiction.
almost 103 overdoses per one million inhabitants.

Possession/Distribution
is illegal, but possession Fully legal as CBD is
At present only Illegal of up to 7.5 grams is not regarded as a
Marinol is legal. considered an amount psychoactive
for personal use and is substance.
punished with a fine.
Summary
Estonia has held medical cannabis as legal since and is punished with a fine. The ‘Act on Narcotic Drugs
2005. However, the country does not have any kind of and Psychotropic Substances and Precursors Thereof
an effective medical cannabis program. Until 2016, controls drugs in Estonia and falls under the remit of
only one patient suffering from cancer was awarded the Ministry of Social Affairs.
Nabiximols for treatment, and accessing medical
cannabis is a complicated and arduous process. Medical use has been technically legal since 2005.
However, as of 2016, only one patient in the country
While cannabis for recreational use cannot be legally had been prescribed a cannabinoid-based medication.
cultivated or sold in Estonia, possessing anything less This was Nabiximols – for cancer pain.
than 7.5 grams is considered for personal use and the
person is let off with a fine. In recent years, the topic of legalisation has received
much public attention, spurred by cannabis law reform
Cannabis in Estonia is illegal, but possession of up to measures in parts of Western Europe.
7.5 grams is considered an amount for personal use
Despite resistance from the authorities and a pervasive The second petition, by private citizen Elver Loho,
conservatism among Estonians, a cannabis movement consisted of three standalone proposals. The petition,
prevails in Estonia, led in part by the Estonian Medical titled “Suggestions to the Parliament for better
Cannabis Association - known locally as MTÜ regulation of the cannabis market” proposed:
Ravikanep. The organisation focuses on educating the regulation allowing Estonian businesses to produce
public about medical cannabis and applying pressure and export medical cannabis products, rescheduling of
for cannabis law reform. THC to facilitate doctor prescriptions, and the
implementation of a pilot study to regulate a
In July 2016, the issue of medical cannabis rose to non-medical cannabis market, with heavy restrictions.
prominence as two petitions regarding medical The Parliamentary Commission on Social Affairs first
cannabis garnered enough signatures to trigger a gathered to discuss the medical cannabis related
government evaluation. proposals of both petitions in February of 2016, which
The first petition, initiated by Aleksander Laane of the

faced fierce opposition Estonian Doctors’ Association.
To date, the Social Affairs Commission has yet to make
172
Estonian Green Party, demanded five changes: any definitive decisions regarding medical cannabis in
developing regulations for cultivation, processing, and Estonia.
sale in pharmacies, rescheduling herbal cannabis to
facilitate medical use, simplification of the prescription CBD and all hemp derived non-medical products are legal
process, expanding patient access, and decriminalisation in Estonia. The drug laws in the country recognize CBD as
of possession. a non-psychoactive substance and so, there are no legal
restrictions imposed on it.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
1.5 0.3 9,500 Marinol
In Estonia, everyone has a constitutional right to ambulance services and public health programmes.
health. After gaining independence, the country has Estonia does not have an official medical cannabis
implemented thorough healthcare reforms, especially programme. Instead, the government permits medical
at the primary care level. Functions are separated in cannabis use on a per-patient basis. This approach
Estonia’s healthcare system, the main actors being the results in an extensive, complicated process that
Ministry of Social Affairs and its agencies, the involves the Ministry of Social Affairs and other
Estonian Health Insurance Fund, and independent departments, in some cases.
provider units operating under the private law
. If you’re approved to use medical cannabis, Estonia’s
The Ministry of Social Affairs and its agencies perform laws only permit the use of cannabis-based drugs,
the main stewardship role for the healthcare system, such as Marinol, which uses a synthetic form of
including the development of national healthcare tetrahydrocannabinol (THC). If you want to use
policies and legislation, data collection, and regulatory cannabis flowers, you must go through an additional
functions. It is also responsible for financing review with the State Agency of Medicines and the
emergency care for the uninsured, as well as International Narcotics Control Board (INCB).
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.3 0.3 0.6

173
Currently, all medical cannabis must be imported into option for entrepreneurs and investors in Estonia.
Estonia. In addition, Estonia does not have an For now, Estonia’s focus is on the hemp market,
appropriate climate to house large outdoor growing cultivating over 3,500 hectares of the plant in 2016, a
operations. In the unlikely event of legislation passing, marked increase from 900 hectares grown in 2015.
Estonia would look to import much of its medical The CBD market is growing at an unprecedented rate
cannabis. in Europe, and Estonia, the second largest European
producer, is flexing its entrepreneurial muscle.
The major economic opportunity would be in
treatment centres for drug addiction and alcohol Interestingly, a south-eastern town called Kanepi in
abuse. With a growing trend of wellness and health Estonia recently put the cannabis leaf on its town flag.
centres developed specifically for cannabis This move indicates the growing acknowledgement of
treatments in Slovenia, Macedonia, Poland and the cannabis’ historical role in the local economy and may
rest of Europe, this could be a viable commercial even indicate a resurgence of the same.
CONSUMPTION
Cannabis
13.6%
9.5% 17.6%
55-60 0%
45-54 0%
35-44 1.1%
25-34 7.6%
18-24 19.4%
source: EMCDDA
The European Cannabis Report™ Turkey
174
TURKEY
MARKET OVERVIEW
Population (m) 81.9
GDP (€b) 723.4
Ruling
Government AK Party
Party

Total Healthcare
Alcohol Consumption
(Litres Per Capita 2
Per Year)
While the vast majority of its European counterparts
Prevalence are edging towards greater cannabis reform, Turkey
of Tobacco 27.2 continues to battle an international drug war that is
Users (%)
inhibiting any progressive cannabis legislation. A
Number crossroads between the drug-producing nations in the
of Cannabis
Users (m)
0.2 Middle East, Turkey is focused on controlling drug
trafficking. As a result, many Turkish politicians and
Average Price the majority of citizens view personal cannabis use as
Per Gram 9.3 a criminal offence.
of Cannabis*
However, in 2016, Turkey began the process of recently, Turkey’s national currency Lira has been
legislating medical cannabis access. In October 2016, sliding downwards against all hard currencies. This is
Turkey’s Ministry of Food, Agriculture and Livestock seen as a result of the long-drawn economic boom the
permitted government-controlled cannabis production country’s president Recep Tayyip Erdoğan had
across 19 provinces for medical and scientific initiated in the country. Naturally, Turkey will need a
purposes. However, this is only for plants with limited way out of the financial hole it is sliding into. As such,
THC content (under 0.2%). cannabis can prove a viable investment for the nation
although, given the increasingly conservative stance of
In February 2017, the Turkish Ministry of Health also Erdogan’s government, legalisation in the short-run
added Sativex to its list of “importable medicines.” A would be unexpected.
doctor’s prescription is required for access. More
175

Possession,
Only Sativex is legally consumption, sale and
Medical use
distribution of cannabis Legal
prescribable of cannabis is legal.
for recreational
purposes is illegal.
Summary
Under the new law, ‘Hemp Cultivation and Control of nations of the Middle East (most notably from
Regulations,’ growers in 19 of the country’s 81 Afghanistan). As a result, Turkey is under pressure
provinces will have the opportunity to obtain from European neighbours and international bodies
permission from the Turkish government to grow (such as Europol and the UN) to combat the trade of
cannabis for a three-year period. Growers interested in illicit drugs.
participating in the programme are required to submit
a background check that proves they have not In Turkey, drug cultivation itself subsided in the 1970s,
previously been involved in the production of illegal when poppy production was effectively licensed for
cannabis or other narcotics. Additionally, international the production of medical opiates. Today, illegal drug
control and quality standards apply to the new production in Turkey is limited to cannabis, cultivated
cannabis crops, which will undergo government mainly for domestic consumption, but drug trafficking
inspection on a monthly basis. These new measures remains a key problem.
allow the government to take some form of control over
domestic drug cultivation. These changes, which give The possession and purchase of recreational cannabis
greater control to the government will make it easier to continue to be illegal and punishable by up to two
develop systems (as well as an incentive) to monitor years in prison. The sale or supply of cannabis is
illegal cannabis trades. punishable by up to ten years, while the unlicensed
production or trafficking of cannabis is punishable
For decades, Turkey has been used by drug cartels as with a minimum term of ten years in prison. CBD and
a gateway route to Europe from the drug producing all hemp-based products are available for sale in
Turkey.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
30.6 - 300
Sativex 176
CBD Oil
In 2003, Turkey implemented substantial healthcare well as CBD oils.

reforms, investing in the hospital sector and
establishing a family physician system. The quality of To get a prescription for cannabis-based medications,
healthcare provision has improved since the patients must visit a Turkish physician authorised to
introduction of the Health Transformation Programme, issue red prescriptions. Red signifies medications that
but not at the same rate as its European neighbours. contain narcotics. The doctor assesses the patient’s
According to OECD data, Turkey had the lowest condition and considers whether medical cannabis is
expenditure on healthcare in Europe in 2015, the the best course of treatment. Usually, it’s only
equivalent of 4.3% of GDP. This compares to an prescribed to those who have not found relief from
average of 9% of GDP across the EU-14. other more conventional forms of medication.
Turkey’s Ministry of Health oversees medical cannabis Once they’re issued a red prescription, patients can
in the country but patients who receive a prescription get cannabis-based sublingual medications like
cannot purchase cannabis flowers. The only Sativex or CBD oils. These are currently being
medication approved within Turkey are oromucosal imported into the country. However, Turkey plans to
sprays that contain the cannabinoids CBD and THC as begin cultivating their own medical cannabis soon.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 1 1.2 2.2
Given Turkey’s optimal climate for outdoor cultivation, monthly basis to check for illegal activity.
a history of cannabis production and a strong
agricultural sector, the region is an attractive CBD oil is legal in Turkey if it contains negligible levels
investment opportunity in the hemp industry. of THC (under 0.2%). However, due to a history of strict
drug policies, many local entrepreneurs are nervous
Production of hemp is now legal in almost a quarter of about investing in anything cannabis-related. Thus,
Turkey’s provinces of Amasya, Antalya, Bartin, Burdur, there may be an opportunity for foreign investors,
orum, ĺzmir, Karabück, Kastamonu, Kayseri, Kütahya, although awareness of the strict regulatory procedures
Malatya, Ordu, Rize, Samsun, Sinop, Tokat, Uşak, in place is vital.
Yozgat and Zonguldak.
Turkey has demonstrated an ability to turn illicit drug
Cannabis can only be cultivated for scientific or production into a legal market before. Turkey
medicinal purposes in Turkey. The 2016 regulations
require authorised growers to dispose of all parts of
successfully navigated a shift from illicit to legal poppy
production in the 1970s. Once used for the production
177
the cannabis plant after harvest to prevent the of opium, poppies are now the raw material for the
production of psychoactive products. The Ministry of lucrative opioid industry, a staple of global
Agriculture officials check cannabis fields on a pharmaceutical markets.
CONSUMPTION
Cannabis
Users entering
treatment
All entrants 653
First-time entrants 416
4% 96%
Trends in number of first-time entrants
26 1000
Mean 800
age at first
treatment 600
18 entry
400
Mean
age at first 200
use
0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Slovenia
178
SLOVENIA
MARKET OVERVIEW
Population (m) 2.1
GDP (€b) 41.5
Ruling Modern Centre

Government Party (SMC)
Party
Considering
Party Stance Medical Cannabis
on Cannabis Legislation
3.3
Total Healthcare While cannabis remains illegal in Slovenia, a country
Expenditure (€b)
with two million inhabitants, the medical cannabis
community has been growing.
Alcohol Consumption
(Litres Per Capita 12.6 Many Slovenes became educated on the therapeutic
Per Year)
benefits on cannabis during the visit of cannabis
Prevalence advocate, Rick Simpson, after the Canadian engineer
of Tobacco 22.5 and cannabis patient spoke to the Slovenian
Users (%)
parliament on the medical effects of cannabis.
Number
of Cannabis
Users (m)
0.1 In recent years, Slovenia has started to develop some
extremely progressive cannabis laws (including
Average Price
3.7
personal-use decriminalisation and the legalisation of
Per Gram
of Cannabis* cannabinoid treatments) with a view to creating a
profitable cultivation industry.

Medical cannabis is
Cannabis in
179
At present, only Sativex illegal, but the use of
Slovenia is illegal Legal
and Marinol are legal certain cannabinoid
but decriminalised.
drugs is permitted
Summary
Cannabis in Slovenia is illegal but possession is In December 2016, the Ministry of Health produced
decriminalised. While medical cannabis is not draft legislation that would allow a regulated medical
allowed, the use of certain cannabinoid drugs is cannabis programme. The initial draft allowed patients
permitted. access to flowers, extracts and synthetic variations
when prescribed by a doctor, but cultivation remained
In 2012, a proposal was drafted to decriminalise illegal.
medical cannabis, but it failed to obtain the necessary
support. A new proposal was drafted in 2013 after a In March 2017, Dean Herenda, Secretary for the
strong public advocacy campaign was coordinated by Ministry of Infrastructure, and one of the most
SKSK (Cannabis Social Club Slovenia). The Slovenian prominent advocates of cannabis legalisation in
media successfully promoted a new petition, which Slovenia advocated for the regulation of a CBD
succeeded in gaining enough public support (2,000+ industry. Herenda states that the cannabis industry
signatures). As a result, the Slovenian government can support medical patients and the declining
reclassified cannabinoids as Class II illegal drugs, agricultural sector, which has declined in employment
which allowed for the medical use of cannabinoid rates and the total number of farm holdings.
drugs but not medical cannabis flowers.
CBD and Hemp Oils are legal in Slovenia.
HEALTHCARE ANALYSIS
Total
(€b) (€m) Allowance Products
2018 (grams)
Sativex
3.3 425 15,000 Marinol
Slovenia has a generally good standard of compulsory enrolled in a limited programme that allows
state-funded healthcare. The National Health consumption of registered pharmaceutical dronabinol.
Insurance Institute (HIIS - Zavod za zdravstveno According to Dean Herenda, there are up to 30,000
zavarovanje Slovenije) oversees the health service in patients self-medicating with cannabis (1 in 70 for the
Slovenia and all citizens legally entitled to equal total population).
access to healthcare.
In reality, however, patient access to medical cannabis
Patients can apply for cannabis via a doctor’s in Slovenia is limited. Products cannot be obtained via
prescription, and the majority who do so are in pharmacies and patients that can afford to, buy their
palliative care. According to data from the Slovenian medicines in Austria.
Ministry of Health, about 160 patients are currently
180
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.1 0.1 0.2
There are many ways Slovenia can harness the announced a partnership with the Slovenian
commercial potential of the global cannabis industry. Ministry of Health. The agency for medical
products and medical devices has granted the
1. The government has partnered with a number of group an interim licence for its European medicinal
international cannabis companies. The joint cannabis production facility. Slovenian authorities
ventures aim to cultivate and process cannabis inspected the facility in January 2018, before
within the state, but without selling their products granting the penultimate approval certificate that
domestically. brings the 18-month application process to the
brink of completion.
2. The United States' southeast European policy
has also earmarked Slovenia with the aim of 4. In mid-July 2018, Canadian cannabis company
reinforcing regional stability and integration. As Kaneh Bosm declared that they had acquired
prohibitionist laws continue to dissolve in the US, Framakem, a Slovenian medical cannabis
Slovenia may be encouraged to follow suit. In the company. Framakem, in turn, has agreements with
event of legalisation, expect Slovenia to create a several other companies in Slovenia, Italy and the
series of joint ventures with US-established Czech Republic for collaborative efforts in the
cannabis companies in the cultivation and medical cannabis field. It is also in negotiations
processing sectors. with other German medical cannabis distributors.
3. In 2017, MGC Pharma, one of the largest

medical cannabis companies in Australia, has
CONSUMPTION
Cannabis
10.3%
7% 13.4% 181
30
55-60 0.2% 25
20
45-54 0.8%
15
35-44 1.7%
10
25-34 6.9% 5
18-24 15% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Romania
182
ROMANIA
MARKET OVERVIEW
Population (m) 19.5
GDP (€b) 180
Ruling
Government Social Democrats
Party (PSD)

8.9
Total Healthcare
Expenditure (€b)
Alcohol Consumption
Per Year)
Though medical and recreational use of cannabis
Prevalence flower itself remains prohibited, cannabis-based
of Tobacco 29.7 medicines can be used to treat certain medical
Users (%)
conditions, such as epilepsy, cancer and multiple
Number sclerosis.
of Cannabis
Users (m)
0.3
The distinction between medical cannabis flowers and
Average Price its derivatives had caused widespread confusion
Per Gram 8.3 among European distributors and healthcare
of Cannabis*
professionals in Romania. This confusion is
compounded by the fact that barely any companies Additionally, foreign groups are permitted to invest in
have requested a licence to sell such drugs. However, the cultivation of medical cannabis, and one US firm
manufacturers are able to apply to the National has just done so. It is unclear whether Romanian
Agency for Medicines to license drugs that contain groups are permitted to establish cannabis cultivation
cannabis by-products like resins or plant fragments. firms.

Cannabis Cannabis Cannabis Legislation 183
Possession, cultivation,
No legal pharmaceutical Medical cannabis is legal sale and consumption
medicines based on but only via of cannabis for Legal
cannabis are recognized pharmaceutical products recreational purposes is
in Romania. using cannabis illegal and treated
derivatives. harshly.
Summary
Cannabis flower in Romania is illegal for recreational any meaningful legislation would be unlikely in the
and medical use, but derivatives and extracts are near future.
permitted for medical use as controlled by The
Narcotic Drug Regulations. Besides industrial “[There are] no plans at the moment even though there
production and processing for medical use, raw are some people active in legalising medical cannabis
cannabis is illegal, and so is any action that connects in Romania…[the] Romanian government is the barrier
to it in any way, such as cultivation, supply and [to legalisation] as well our Minister of Health as he
trafficking. The penalty for anyone caught can be doesn’t recognise the medical benefits of cannabis.”
imprisonment for up to seven years and a fine.
Cannabis Club Romania (established in 2015 to — Cannabis Club Romania
provide information on medical cannabis), predict that
CBD and hemp oil is currently legal in Romania
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
Cannabis-
derived
8.9 - 5 products
(tinctures and
resins)
Healthcare progress most often occurs during one in four Romanians has insufficient access to
politically stable periods. However, the country has essential healthcare.
been characterised by political instability in recent
years after officials were accused of corruption and With regard to medical cannabis treatment, Romania
negligence in 2015. operates a relatively simple, albeit limited, system.
In 2017, Reuters reported that tens of thousands of Romanian patients are required to have a prescription
doctors, nurses, dentists and pharmacists were for cannabis-based medicines but do not need to
moving out of the country to France, Germany and the acquire a medical cannabis card or membership.
UK. Professionals were often lured abroad by higher These medical cannabis medications must contain
pay, modern infrastructure and functional healthcare primarily CBD with no more than 0.2% THC. Medical
systems. As a result, Romania is one of the EU states practices and pharmacies can only prescribe and
with the fewest doctors. Nearly a third of hospital supply medical cannabis with government 184
positions are vacant and the health ministry estimates authorisation.
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.9 1.0 1.9
The commercial opportunities for Romania come in The Minister of Agriculture of Romania has welcomed
two forms: overseas investment and it is reported that 40% of
agricultural land is owned by foreign entities.
1. Industrial cannabis/hemp production
2. Foreign investment in medical cannabis One such entity, PHI Group, a US investment fund that
production. specialises in natural resources and agriculture, plans
to cultivate medical cannabis and other medicinal
Romania was one of the largest hemp producers in herbs in Romania’s Transylvania region. In early 2018,
Europe, prior to 1989, most of which was used for the it also proposed plans to open a wellness centre for
production of high-quality textiles for export. At its those looking for natural and holistic treatments.
peak, the Romanian hemp industry cultivated
56%–70% of the entire European production and was Recent years have seen an increase in the market for
the fourth largest producer in the world with 45,000 cultivation and processing of hemp, with crops farmed
hectares of land cultivated with hemp. The climate in Romania being sought for export and used in
provides the perfect conditions to produce some of various industries including building materials, textiles
the best hemp on the market and international and CBD production. HempFlax, a leading Dutch
companies have taken notice. hemp processing company, invested €5 million in the
Romanian hemp industry in 2015.
CONSUMPTION
Cannabis
3.3%
2.7% 4% 185
30
55-60 0.8% 25
20
45-54 0.7%
15
35-44 0.7%
10
25-34 3.3% 5
18-24 3.4% 0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
source: EMCDDA
The European Cannabis Report™ Latvia
186
LATVIA
MARKET OVERVIEW
Population (m) 1.9
GDP (€b) 25.7
Ruling Coalition
government
Government current being
Party formed
The previous coalition felt that

Party Stance Latvia “was not ready” for the
legalisation of medical cannabis.
on Cannabis No clarification on the 3 leading
parties.
1.6
Total Healthcare
Expenditure (€b)
Alcohol Consumption
(Litres Per Capita 12.9 Latvia has a pretty restrictive drug policy which levies
Per Year) very harsh penalties on users. The country was party to
the 1961 UN SCDN and thus, it has established all its
Prevalence
of Tobacco 37 drug laws in accordance. Even though the country’s
Users (%) USSR regime ended in 1991, the severe penalties for
drug violations remained in effect.
Number
of Cannabis
Users (m)
0.05 However, in recent years, the drug control laws have
changed considerably. The Amendment of the
Average Price
Per Gram 11.6 Regulation on Narcotic Substances, Psychotropic
of Cannabis* Substances and Precursors to be Controlled in Latvia
*Prices refer to black market cannabis prices was passed in 2013. Under this law, the possession of
small amount became punishable by fines while However, since 2012, there has been a growing
possession of larger amount characterising intent to movement in Latvia seeking to decriminalize
distribute is awarded jail time. possession of cannabis within specific limitations.
While this initiative was declined in September 2015
Currently, there are no widespread movements for by the Latvian parliament, the initiative itself marks a
legalising cannabis in any form in Latvia and the liberalising trend in the country.
government’s as well as public opinion is against it.
187
Any form of cannabis,

including medicines Medical cannabis is Recreational cannabis CBD and all hemp
based on cannabis, are illegal in Latvia. is illegal in Latvia. derivatives are illegal in
illegal in Latvia. Latvia.
At present, Latvia does not recognise cannabis in any is liable to face jail time depending upon the actual
form as a legal substance. This includes all aspects volume seized. This jail time can be up to 15 years.
from medical, recreational to industrial. The country
enforces cannabis use laws under the aforementioned Recently, Anda Carka, Latvia’s Health Minister stated
2013 amendment. that Latvians, in general, were not ready for the
legalisation of medical cannabis. Though the Interior
As per the laws, cannabis possession less than one Ministry has said it is open to discussion regarding
gram results in a flat fine of €280. In case the person is medical cannabis limited to tinctures, pills and
caught with cannabis or any related activity within a inhalers but will not entertain any arguments for
year or the first booking, they will be brought up on legalising smoking cannabis or growing cannabis
criminal charges. Also, if the volume of cannabis plants for personal medical use.
exceeds the aforementioned amount, then the person
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
1.6 0.43 1
The Latvian healthcare system is mostly funded by the fewer competent medical professionals and
government through taxes. It covers the healthcare corruption resulting from lower wages. Nevertheless,
needs of all citizens of the country. However, the in recent years, the situation has improved somewhat
country’s healthcare system has been recognized as with a relative decrease in corruption. Yet, a 2015
one of the most inept and corrupt in Europe. The report on the European health consumer index
reason for this ineptitude and corruption has been unofficial payments to doctors were very common.
given as systematic brain drain from Latvia resulting in
188
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.1 1.1 1.2
According to the World Bank Group, Latvia ranks 14th However, at the moment, the country is strictly against
in the Ease of Doing Business Index. This makes it an cannabis legalisation in any form. Even cultivation for
excellent place for doing business and can translate to export is not deemed favoured by the government or
the country becoming a viable cannabis business the public. So, for the moment, it does not look like
investment region. Further, Latvia is well-known for that country will move towards a cannabis-friendly
being a transit hub within the Baltic states. This makes environment.
it ideal for transportation for cannabis across the
Baltic states as well as more Eastern nations.
CONSUMPTION
Cannabis
Drug use in young adults
(15-34 years) in the last
year
10.0%
4.3% 15.3%
Population 1.282.112
(15-64 years)
source: EMCDDA
The European Cannabis Report™ Lithuania
189
LITHUANIA
MARKET OVERVIEW
Population (m) 2.8
GDP (€b) 40.1

Lithuanian Farmers and
Ruling Greens Union, Social
Government Democratic Party of
Party Lithuania
Medical cannabis will be

Party Stance available on prescription
from May 2019.
on Cannabis Recreational use remains
illegal.
Total Healthcare
Alcohol Consumption
Lithuania is a former USSR state, which had
(Litres Per Capita 15 implemented the same harsh anti-drug laws and
Per Year) policies that were seen all across all the Soviet
Republics. After the fall of the USSR in 1991, Lithuania
Prevalence
of Tobacco 28.8 became independent and implemented its own drug
Users (%) policy. The most recent iteration of the policy came in
Number 2010 when the Lithuanian National Programme on
of Cannabis
Users (m)
0.04 Drug Control and Prevention of Drug Addiction
2010-16.
Average Price
Per Gram 10.5 As with other European nations, Lithuania places
of Cannabis* cannabis in the same category as many other hard
drugs. This results in no distinction being made In November 2017, the Lithuanian government
between the penalties for cannabis possession and considered an amendment to its drug laws which
use and the same for other narcotic substances. would allow for legalisation of medicinal cannabis in
However, since 2017, possession of certain the country. Seimas, the Lithuanian government,
substances including cannabis have, when possessed passed the consideration almost unanimously, and in
in small amounts, have been counted as a October 2018 voted to legalise medicines containing
misdemeanour and is punished via community service cannabis. The amendments are due to come into
or house arrest. Larger than the prescribed amount force in May 2019.
can result in incarceration for up to two years.
190
At present, there are no It is legally available on

prescription for patients Cannabis use for CBD and Hemp oil
cannabis medicinal
suffering from multiple recreational purposes is products are currently
pharmaceutical products
sclerosis, cancer and illegal in Lithuania. illegal in Lithuania.
in the Lithuanian market.
autoimmune diseases
In October 2018 Lithuania’s parliament passed a law Cannabis use for recreational purposes is illegal in
that will allow doctors to prescribe cannabis-based Lithuania.Under the current drug laws, there is no
medicine, under strict supervision, to patients suffering distinction made between cannabis and other drugs.
from multiple sclerosis, cancer and autoimmune Though cannabis laws have been relaxed in recent
diseases. The lawmakers voted 90-0 with three years, possession of undefined small amounts are still
abstentions in favour of the legislation that will now go punishable by imprisonment. Further, any cultivation
to President Dalia Grybauskaite to be signed into law of cannabis for personal use, even if for medical
and will come into force in May 2019. reasons, is punishable by up to five years of
imprisonment. However, in actual practice people on
The amendments to the Law on Pharmacy and the Law possession charges are rarely given harsh sentences.
on the Control of Narcotic and Psychotropic Courts mostly resort to fines and other punitive
Substances will allow the medicinal use of the products measures to reprimand offenders.
if their safety and efficacy are proven by scientific
research and if they are registered. The products will be Hemp production for industrial purposes is legal.
strictly regulated to ensure that psychotropic
substances are “not used for entertainment”.
HEALTHCARE ANALYSIS
Lithuania has a compulsory healthcare insurance Medicines Register, which contains a list of all
system for all its citizens. All citizens also receive free prescribable medicines. If medical cannabis is
emergency medical care. Lithuania’s average legalised, then it will be inducted into this register.
expenditure on healthcare is 6.2% of its GDP. The
Lithuanian Ministry of Health maintains a State The Health Minister, Aurėlijus Veryga, has expressed
his willingness to permit medical cannabis in Lithuania. However, he also stated that the program will need to be
strictly regulated in order to prevent abuse at any level.
Total
Total
Healthcare
Expenditure
(€b) 2018 (grams)
2.5 0.72 - -
191
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.1 0.05 0.2

Lithuania has a very robust economy where entertains recreational cannabis legalisation, the
manufacturing and food processing are the biggest country’s market potential could be huge.
contributors to the national income. Lithuania also has
a very strong public healthcare system. This translates In September 2018, Canadian firm Aurora Cannabis
into significant potential for cannabis cultivation as purchased two Lithuanian hemp companies, seed
well as consumption provided the legislation enables contractor and processor Agropro UAB and Borela
doctors to prescribe cannabis medication for relevant UAB, a processor and distributor of hemp-based food
conditions. products. The two Lithuanian companies have 4,000
acres of hemp under contract with the potential to yield
Cannabis is recognised as the most popular substance more than 1,000,000 kilograms of organic hemp.
for recreational use. Unlike other substances, cannabis Aurora has expressed its intention to produce CBD
use is also the most widespread and seen in diverse from hemp biomass the two companies have previously
age group. Provided the Lithuanian government left in the field unused as they focused exclusively on
the production and sale of hemp seed based products.
CONSUMPTION
Source: http://www.emcdda.europa.eu/countries/drug-reports/2018/lithuania_en
Cannabis 6.0%
year
Population
(15-64 years)
2.7% 9.1%
1.916.284
The European Cannabis Report™ Slovakia
192
SLOVAKIA
MARKET OVERVIEW
Population (m) 5.4
GDP (€b) 81.4
Ruling Coalition consisting of

Government Smer-SD, the SNS and
the Most-Hid parties.
Party
Party Stance
on Cannabis -
Total Healthcare
Alcohol Consumption
(Litres Per Capita 11.5 Slovakia has a tenuous history with substances. While
Per Year) it was never under the USSR’s rule, Soviet political
opinion was a major influence in the political life of the
Prevalence
30.1
region. This also impacted the laws against
of Tobacco
Users (%) substances with harsh penalties for violating them.
Number
0.4
of Cannabis
In the years since the collapse of the Soviet Union and
Users (m) the establishment of the Slovak Republic, not much
has changed. Cannabis still remains lumped in with
Average Price
Per Gram 9.6 other hard substances and there is very little political
of Cannabis* movement to remedy the situation.
In 2011, Sativex was allowed for import and for this, Near the end of 2013, the Slovakian government
both major substances in cannabis, THC and CBD, moved to legalise cannabis seeds citing that they did
were rescheduled in Group 2 of the Psychotropic not contain any psychoactive substances. The law
Substances Act. However, this did not lead to any came into effect in March 2014 but not much political
loosening in the law surrounding cannabis. activity has been recorded in a positive direction since
then.
193
Illegal Illegal Illegal Illegal
Slovakia is characterised as one of the strictest from the actual purpose of curtailing drug supplies by
countries in Europe when it comes to any kind of targeting end-users rather than dealers.
narcotic substance. Traditionally, this includes
cannabis. However, a recent move has been made to According to the official documents, if accepted, the
render the harsh laws for cannabis possession more legal change would mean any person possessing
forgiving. cannabis less than one gram would be deemed to be
committing a minor offence provided the person is not
The move comes in light of the fact that the Slovakian caught again within 12 months. Now, not every
government considers people possessing drugs for parliamentary faction in Slovakia is in support of this
personal consumption are not the root cause of the move and there is bound to be some heated debate on
problem. In fact, some have argued that it may detract the matter before any conclusion is reached.
HEALTHCARE ANALYSIS
Total
Total Medicinal
Healthcare Cannabis
Spending based
(€b) Products
(€b) 2018 (grams)
5.7 1.5 - -
Slovakia does not have a particularly impressive As such, establishing a medical cannabis programme,
healthcare system. The country does provide a level of should the country ever reconsider its position, would
basic healthcare to all citizens and residents free of be challenging. Without a state-funded healthcare and
cost. However, other healthcare requirements must be insurance segment, medical cannabis patients may
paid for at least partially by citizens. Though the find it difficult to obtain cannabis medication at
government does subsidise things like dental care etc. convenient and tenable prices.
to a degree, this is usually not enough to cover the
costs.
194
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.4 0.9 1.3
Despite the fact that Slovakia’s cannabis laws are so Although at present, there are no plans for any legal
harsh, the country’s youth seem to favour cannabis changes in Slovakia, if and when the market follows
use over all others. A recent study revealed that a suit with the rest of Europe, it could be very profitable.
growing number of Slovak youth either use cannabis When one considers the popularity of herbal
regularly or have used it infrequently in the past. This healthcare treatments in Slovakia, the possibilities of
popularity seems to be rising rapidly. this market increase even further.
CONSUMPTION
Cannabis
year
9.3%
4% 13.8%
The European Cannabis Report™ Lebanon
195
LEBANON
MARKET OVERVIEW
Population (m) 6.1
GDP (€b) 44.1

May 2018 elections - Free
Ruling Patriotic Movement(FPM)
Government 29 seats / Future
Party Movement 20 seats.
The current government

Party Stance is considering the
on Cannabis legalisation of cannabis
for medicinal use.
3.3
Total Healthcare
Expenditure (€b)
Alcohol Consumption Cannabis has long been one of the most important,
(Litres Per Capita 1.5 albeit, illegal products driving the Lebanese economy.
Per Year)
While the country’s laws deem cannabis cultivation,
Prevalence distribution and use in any form to be illegal, this has
of Tobacco 33.8 not stopped the growth of a powerful cannabis
Users (%) industry in the country. In fact, some sources claim
that powerful cannabis cultivating families in the
Number
of Cannabis
Users (m)
0.1 Bekaa Valley are capable of rivalling the Lebanese
army itself.
Average Price
Per Gram 10.5 This, combined with the ailing economy and need for
of Cannabis*
reinvigoration has prompted Lebanon to reconsider its
position on cannabis. Many politicians and powerful be entertained by the Lebanese government in the
lobbies in the country have also expressed support for future, for now, it is aiming at legalising medical
cannabis legalisation, even if merely in a limited cannabis cultivation and use.
capacity. While recreational legalisation will certainly

Legislation Legislation Legislation 196
Lebanon has no
cannabis pharmaceutical Cannabis for medical Cannabis for recreational
products available purposes is illegal in The Lebanese drug law
although with purposes is illegal in
Lebanon but the does not recognise CBD
legalisation a real Lebanon although
government is evaluating as a product separate
possibility in the near plans for legalisation
future, such products the possibility of from cannabis.
are underway.
could easily enter the legalisation.
Lebanese market.
Cannabis, for all intents and purposes, is still illegal in seem to be moving towards a pro-cannabis direction.
Lebanon and has been for a long time. Yet, Lebanon
has consistently ranked among the top five largest While cannabis and other drugs are indeed illegal,
producers of cannabis in the world. Also, the quality of Lebanese law states that those arrested for drug use
cannabis is considered among the best. All of these are to be referred to the “Addiction Committee” to
factors mean that cannabis cultivation is a de facto help them to break their habit rather than face
cash crop just waiting for legalisation. prosecution. In reality, however, it is thought that just
around 3% of drug cases in the country have actually
Now, with the number of European nations along with been referred to such committees since the law began.
US states and Canada looking to legalise cannabis for Recently Judge Samir Hammoud, Lebanon’s state
many purposes, Lebanon can stand to gain a lot from prosecutor, issued a binding rule instructing all of
legalising it. Recently, a report submitted by McKinsey Lebanon’s prosecutors to no longer prosecute cases
and Co. suggested cannabis legalisation as a means of involving drug use, affecting cannabis users as well as
revitalising the economy of the country. This has been all other drug users. Users will still, however, be
the opinion of some political leaders in the Lebanese detained for an investigation period, and there are
government for quite some time. And now, things likely to be fines and other punishments involved.
HEALTHCARE ANALYSIS
Total
2018 (grams)
2.8 1.9
Cannabis, for all intents and purposes, is still illegal in While cannabis and other drugs are indeed illegal,
Lebanon and has been for a long time. Yet, Lebanon Lebanese law states that those arrested for drug use
has consistently ranked among the top five largest are to be referred to the “Addiction Committee” to help
producers of cannabis in the world. Also, the quality of them to break their habit rather than face prosecution.
cannabis is considered among the best. All of these In reality, however, it is thought that just around 3% of
factors mean that cannabis cultivation is a de facto drug cases in the country have actually been referred
cash crop just waiting for legalisation. to such committees since the law began.
Now, with the number of European nations along with Recently Judge Samir Hammoud, Lebanon’s state
US states and Canada looking to legalise cannabis for prosecutor, issued a binding rule instructing all of
many purposes, Lebanon can stand to gain a lot from Lebanon’s prosecutors to no longer prosecute cases
legalising it. Recently, a report submitted by McKinsey involving drug use, affecting cannabis users as well as
and Co. suggested cannabis legalisation as a means of all other drug users. Users will still, however, be
revitalising the economy of the country. This has been
the opinion of some political leaders in the Lebanese
detained for an investigation period, and there are
likely to be fines and other punishments involved. 197
government for quite some time. And now, things
seem to be moving towards a pro-cannabis direction.
Forecast Forecast
Medicinal Recreational
Cannabis Cannabis Total
Market Value Market Value 2028 (€b)
2028 (€b) 2028 (€b)
Total 0.4 0.4 0.8

A recent estimate of Lebanon’s cannabis market profits. This is compounded by the fact that the
suggests it is worth approximately €3.4b. Now, as the Lebanese cannabis market already has a well-defined
government moves towards legalisation, this would grid of growing sites and distributors. This eliminates
open up tremendous opportunities for cannabis the need for establishing the same. However, the
companies worldwide. Investment in the country’s actual legalisation and limit imposed for the same
robust cannabis sector could fetch considerable remain to be seen.
The European Cannabis Report™ Georgia
198
GEORGIA
MARKET OVERVIEW
Population (m) 3.7
GDP (€b) 12.9
Ruling
Government Georgian Dream
Party
In favour of licensing the
Party Stance cultivation of cannabis for
export, and the legalisation
on Cannabis and regulation of cannabis
consumption
0.95
Total Healthcare
Expenditure (€b)
In terms of cannabis legal reform, Georgia is a model

Alcohol Consumption
(Litres Per Capita 9.8 success story among all European nations. The
country formerly had very tough laws regarding
Per Year)
cannabis. As with several other East European
Prevalence nations, Georgia’s drug laws did not distinguish
of Tobacco 28.8 between cannabis and other ‘harder’ substances.
Users (%)
Number However, a recent (July 2018) ruling by the country’s
of Cannabis
Users (m)
0.07 Constitutional Court has changed the scenario
completely. While a similar ruling a year back had
Average Price defended the Georgian government’s right to impose
Per Gram 6.9 fines on cannabis users, the new ruling has effectively
of Cannabis* legalised cannabis use within private spaces.
Nevertheless, cultivation and sale of cannabis remain In light of this new ruling, it can be expected that the
illegal in the country. country’s cannabis market will open up for companies
to make applications.

199
Georgia currently does not

Currently, there are no legal have any medicinal cannabis As per a new ruling in February
pharmaceutical cannabis-based laws or programmes to 2018 by the Georgian
medications available through support the same for Constitutional court, consuming CBD and all other hemp
the government has shown patients. However, the recent or possessing cannabis in public derivatives are legal in Georgia
willingness to introduce them trend towards cannabis is no longer a criminal offence. owing to their non-psychoactive
since the recent cannabis acceptance is indicative of a However, there are certain status.
possession decriminalisation formal medical cannabis restrictions as to the place
law was passed. market being implemented where it can be smoked.
soon.
As a former part of the Soviet Union, Georgia has This was followed by a December 2016 declaration
traditionally maintained very strict drug laws. that said imprisonment for possession of small
However, since the collapse of the USSR, the country amounts of cannabis for personal consumption was
has been on the road to liberalisation. Nevertheless, it constitutional.
was not until 2015 that the country truly began to
consider decriminalising its cannabis laws. Finally, in July 2018, the Georgian Constitutional Court
ruled in favour of permitting private cannabis
The primary advocacy group in Georgia for cannabis is consumption as well as possession in public. With
White Noise. Because of this group’s growing these legal changes coming through quickly, it would
advocacy and support, the Georgian Constitutional seem logical that cannabis cultivation for all purposes
Court ruled in 2015 that imprisonment for cannabis would soon be legalised in Georgia.
consumption was unconstitutional.
HEALTHCARE ANALYSIS
Total
2018 (grams)
0.95 0.5 1
Since 2013, Georgia has adopted a universal While there are no particular moves being made
healthcare approach. Under this system, the towards introducing medical cannabis to the Georgian
government provides for the healthcare needs of healthcare system, the government has expressed
citizens across the board. With the passing of willingness to do so. However, they did express
cannabis consumption laws, it can be expected that concern over the legalisation of cannabis
medical cannabis products will soon make an entry consumption and possession for personal use and
into the Georgian market. said cannabis should only be legalised for use for
medical reasons.
200
Forecast Forecast
2028 (€b) 2028 (€b)
Total 0.3 1.2 1.5
Agriculture and tourism are two major aspects of the makes it a prime destination for all kinds of
Georgian economy. As such, the country has a cannabis-related trade and commerce.
tremendous potential for cannabis cultivation and
tourism should the government legalise the same. It is Georgia’s ruling party recently proposed a draft law on
estimated that 55% of the nation’s population is the plantation and export of cannabis for cosmetic
engaged in agriculture. If cannabis were to be and pharmaceutical use, with the aim of licensing
legalised for cultivation, whether for medical or production and creating a framework that will regulate
recreational purposes, then the country could turn into where cannabis will be grown. According to Guguli
a premier destination for cannabis tourism as well as Magradze, a Georgian Dream MP: “In some places,
trade in East Europe. This position is also people cultivate corn or beans and in others
compounded by the fact that Georgia is a gateway for marijuana. Production will be licensed and the idea is
trade between Europe and more easterly nations. This to bring as much income into the country, as possible.”
CONSUMPTION
No data is available on drug use among the general interviewed in spring 2009. The study found that
population; no general population survey has ever been cannabis was the most frequently reported drug: 3.2 %
conducted due to lack of funding, nor is one planned of all respondents stated that they had used cannabis
by the national authorities for the foreseeable future. or hashish during the last 30 days. Use of cannabis in
the last 12 months was reported by 10%, and use of
A sample of 384 students aged 15 to 16 and cannabis at least once during the lifetime was
representative of the capital city (Tbilisi) was reported by 17%.
The European Cannabis Report™ Appendix
APPENDIX
GLOSSARY
ACMD Advisory Council on the Misuse of Drugs
ANSM French National Agency for Safety of Medicines and Health Products
ATU Temporary Authorisation for Use 201

BPNA British Paediatric Neurology Association
CAN Swedish Council for Info on Alcohol and Other Drugs
CBD Cannabidiol
CINV Chemotherapy Induced Nausea and Vomiting
CMCA Czech Medical Cannabis Agency
DHSC Department of Health and Social Care
ECDD Expert Committee on Drug Dependence
EMCDDA European Monitoring Centre for Drugs and Drug Addiction
ENCOD European Coalition for Just and Effective Drug Policies
ESPAD European School Survey Project on Alcohol and Other Drugs
EU European Union
FOPH Federal Office of Public Health
GAP Good Agricultural Practices
GDP Gross Domestic Product
GMP Good Manufacturing Practices
HMO Health Maintenance Organisations
HSE Health Service Executive
IARC International Agency for Research on Cancer
ICEERS International Centre for Ethnobotanical Education, Research and Service
IEA Institute of Economic Affairs
The European Cannabis Report™ Appendix
APPENDIX
INCB International Narcotics Control Board
IP Intellectual Property
IRKA Initiative to Change Cannabis Legislation 202

MHRA Medicines and Healthcare Products Regulatory Agency
NICE National Institute for Health and Care Excellence
ODC Office of Drug Control
OECD Organisation for Economic Co-operation and Development
OECM Observatoria Espanol Del Cannabis Medicinal
RCP Royal College of Physicians
SCDN Single Convention on Narcotic Drugs
SKSK Cannabis Social Club Slovenia
SNS Spanish National Healthcare System
THC Tetrahydrocannabinol
TRE Treatment-Resistant Epilepsy
UNODC United Nations Office for Drug Control
WHO World Health Organisation
YOY Year On Year
The European Cannabis Report™ Contributors
With special thanks to
Authors
Eoin Keenan, Stephen Murphy, Alexandra Curley, David Attwood
203
Contributors
Professor Michael Barnes, Newcastle University, Professor of Neurological Rehabilitation

Dr Arno Hazekamp, Hazekamp Herbal Consulting, Founder
Dr Ognjen Brborović, Croatia’s Committee for Medical Cannabis, Chairman
Saul Kaye, iCan, Founder and CEO
Kai-Friedrich Niermann, KFN+, Lawyer
Kenzi Riboulet Zemouli, FAAAT, Head of Research
Farid Ghehioueche, FAAAT, Head of Advocacy
Michalis Theodoropoulos, Kannabio Hemp Cooperative, President of the Board
Marco Perduca, Luca Coscioni Association, International Program Coordinator
Tomáš Zábranský, ICCI, Chief Scientist
Hana Gabrielov. ICCI, Project Manager
Pavel Kubu, ICCI, Chief Executive Officer
David Vergara, Assessor, MBA
Jessica Steinberg, Centre for Socio-Legal Studies, University of Oxford, PhD Student
Renaud Large, PLEAD Agency, Associate Director
Aurélien Bernard, Newsweed France, Founder
Bob Lessel, Cannamedica Luxembourg, Board Member
Marguerite Arnold, MedPayRx, Founder
Jacek Kramarz, HemPoland, Sales Director
Nick Bellamy, IBM, Strategy Associate
Naeem Dungarwalla, Accenture, Management Consultant
Sébastien Béguerie, Alpha-CAT, CEO
Lauri Louhio, Lawyer, Lakiasiaintoimisto V.in.m.isen Laki Oy
Elver Loho, Activist
Hannu Hyvonen, Hamppusampo, Chair of the Board
Serge Schneider, Cannamedica, President
Rita Jonyer, NORMAL Norge, Administrator

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2019年欧洲大麻报告（P209）the European Cannabis Report 4th Edition

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The

Advancing the global cannabis industry

Data Bespoke Research, Polling, Consumer Insight, Pricing, Market Forecasting.

Intelligence Policy & Compliance, Market Analysis, Supply / Demand.

Barcelona Carrer d'Estruc 9, 08002, Barcelona, Spain

LEAD SPONSOR FOREWORD 7

MEDICAL BENEFITS OF CANNABIS 20

EXPERT ANALYSIS: EUROPEAN STRATEGY 41

CZECH REPUBLIC 117

LEAD SPONSOR FOREWORD

per gram has been modelled based on

METHODOLOGY post-legalisation pricing trends from a number of

A fully registered and audited cannabis related fund

Population (m): Total Healthcare Average price 15

Estimated Estimated recreational

Source: Prohibition Partners

The European Cannabis Report™: Edition 4 focuses

There is a good reason to be optimistic about Europe’s Estimated €58b by 2028

products in the future. In addition, the lack of a

Europe’s cultivation capacity and processing

Southern European nations are beginning to develop domestic

MEDICAL BENEFITS OF CANNABIS

We know there are at least two cannabinoid receptors

One clear fact is the whole cannabis plant has medical

Despite such complexities, there are two main

Cannabis medication plays an important role in death

Will cannabis be used in future healthcare systems?

Total Cannabis Usage

41% of the French

In contrast, there are nations like The Netherlands,

Pharmaceutical cannabis Medical cannabis refers to

MEDICAL Conservative Average

The most significant medical cannabis event of 2018

Europe will become a hotbed for market development;

The move towards European medical cannabis has

Cannabis remains part of the wider European ‘war on

The decriminalisation of recreational cannabis use is

The map represents the regulatory approach to

The Process of Legal These bodies play a predominant role in cultivating,

Prior to initiating a bill, act or policy in favour of

Although approaching parliament and legislators is

5th 13th 19th 20th 21st

European Political Analysis

Tier 1: those countries and regional authorities moving forward with

Tier 2: countries and regional authorities with active, ongoing reviews of

Tier 3: countries where historical or unique cultural characteristics

Leading the Way

Not Yet Ready for Change

Countries not belonging

There are several authorities involved in allowing a

It is key for a manufacturer to fully understand the

Sub-segment Commercial Industrial

Production Industrial Transport

Cultivation Medicinal Off line

Testing & Recreational

Source: Prohibition Partners

Legal services are in high demand due to the influx of

European cannabis businesses could create an While seeking guidance on how

Education CSR strategy. More centralised

STORZ & BICKEL is a medical device manufacturer

The VOLCANO MEDIC and the MIGHTY MEDIC

inhalation of cannabinoids available in Canada,

Support Consumers For Smart Legalization

Thanks to our experience in working on cannabis legalization in several US States