Cover photo: Left, Bedrocan representatives, right, Government representatives
Eight months after Malta legalised medical cannabis, around 20 doctors who have expressed an interest in medical cannabis were invited to ask frank questions about it at a closed door information session in St Julian’s last night.
At an information session hosted by Pharma.MT, local representatives of Dutch cannabis manufacturers Bedrocan, doctors inquired about the increased burden of responsibility on prescribing doctors, about the different uses and methods of ingestion, and even whether their patients would be losing their driving license if they began to use medical cannabis.
Over half a year after the law changed, Maltese doctors remain uncertain about the drug – not because it has proved ineffective, but because they still don’t know what it is exactly.
‘Medical Cannabis – What Every Prescriber Needs To Know’ brought together curious Maltese doctors, Bedrocan representatives, Medicines Authority representatives, and the Superintendent of Public Health Charmaine Gauci for an open discussion on the drug.
Doctors spoke about the continued stigma surrounding medical cannabis
One doctor explained how many doctors were avoiding the drug due to the stigma surrounding prescribing “ħaxixa” to people, with many doctors, specialists and consultants afraid to make the first move.
“The thing is, as soon as one doctor begins to prescribe it, the doctor’s colleagues get curious and begin to enquire,” said one doctor.
Moreover, everyone from patients to doctors seemed to have a lack of clarity on what medical cannabis can treat, and how to use it or access it.
One doctor spoke of a particular patient who thought that their medical cannabis prescription would be free, paid for by the government, and was legitimately confused to be told that they needed to pay up to €16 per gram for their prescribed medicine.
One particular strain of medical cannabis has already run out in Malta
Contrary to the belief that there were only one or two doctors prescribing across the islands, a number of doctors have taken their first steps and began prescribing medical cannabis to their patients.
There are at least two separate patients with prescriptions of Bedrocan in Gozo alone, with the official number of prescribed patients on the islands reaching around 100 people.
Doctors had the opportunity to express their concerns about the current system of prescribing medical cannabis
Any new medical cannabis patient who is found to be eligible for the medicine must start off with a ten-day trial run, with the doctor needing to write a detailed report about the state of the person after those ten days, and the efficacy of the medicine on the patient.
A debate emerged among doctors regarding whether ten days was too short an amount of time to really see the effects of the medicine, with Dr Charmaine Gauci telling the assembled doctors that their concerns would be taken into account and discussed as the government moved forward.
Another doctor said the current legislation had an “Achilles heel” in that it treated medical cannabis as a ‘last resort’ treatment, forcing doctors to prescribe harmful drugs like opiates before they could prescribe cannabis.
However, Dr Gauci clarified that the law stated that medical cannabis shouldn’t be prescribed as a last resort, but when there was “no viable alternative treatment”. As such, it was at the doctor’s discretion if they felt all other options of treatment had been exhausted.
She also clarified that doctors needed to cite a specific illness or condition when prescribing – citing “pain”, as it were, was not enough, as that is just a symptom, and not an illness in itself.
Alternative forms of ingesting the medicine, such as vaping or making tea, were laid out
A vaporiser was passed around for doctors to see and hold for themselves, with Bedrocan representatives opening the handheld machine to show were the grinded cannabis flower should be placed.
When asked if CBD oil or other oils could be used instead, the Bedrocan representatives explained that the vaporiser was just for the flowers.
Overall, the meeting was an opportunity for doctors interested in prescribing cannabis to get much-needed answers – and allay their fears
After the session, doctors compared the different atmosphere and approach to medical cannabis to the April conference organised by the government soon after legalisation, a conference that was universally seen as a hindrance to the acceptance of medical cannabis in Malta.
As reports of increased pressure on doctors continue, and evident confusion as to the actual use of medical cannabis remains, doctors made it clear they were thirsty for governmental support in understanding the uses of medical cannabis, and it was time for a national education campaign on medical cannabis.
One doctor even asked the Medicines Authority whether they would be offering any educational courses on medical cannabis in the future
The representative replied that courses may be on the table, but that they were afraid of hosting the courses just for no doctors to show up on the day.
The doctor replied that he would be happy to pay for such a course, indicating the extent of interest from Maltese doctors.
As Malta prepares to host the Medical Cannabis World Forum in a few weeks, the Maltese industry seems a bit closer to finding its footing – though it was clear that doctors felt like they were still too ill-informed on the potential advantages and disadvantages of the medicine.
However, their openness to the medicine, alongside the Superintendent’s reassurances that the Government was there to support doctors queries, was a good herald for what may be heading Malta’s way in 2019, and beyond.