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France is an exceptional place. I felt that the moment I planted my foreign feet on its fertile soil. It’s a proud and mature country that’s been around a lot longer than the United States. France holds long traditions that have led to very particular ways of doing everything.
I observed a status quo there that’s as entrenched as the limestone cathedrals dating back to the 12th century and beyond. As of this writing, medical cannabis containing THC (or any psychoactive cannabis for that matter) has absolutely no place in the tapestry of French culture. It is outlawed and banned.
That may be unfortunate because no matter how proud and exceptional any country may be, its citizens still suffer from cancer, epilepsy, multiple sclerosis, and any number of other serious conditions that medical cannabis containing THC has demonstrated to alleviate. Twenty percent of all adults in France suffer from some form of chronic pain. As the population ages, these conditions may exacerbate. Cannabis has been shown to be a safer alternative to opioids for many chronic pain patients.
The clash between the status quo of prohibition and the needs of patients places France at a cannabis policy crossroads. Why should patients continue to suffer when cannabis medicine is accessible widely across the globe? Why should such an advanced country like France continue to deny citizens access to medical cannabis?
These questions were posed at the first medical cannabis conference in France that I attended a few months ago in Bordeaux. The conference was held at the Cite Du Vin wine museum and auditorium in late October of 2024. The attendees and speakers were doctors, scientists, lawyers, and entrepreneurs from all over Europe.
Dr. Pascal Douek is both a medical doctor and a person with multiple sclerosis who uses a wheelchair to get around. He is one of 3,000 French patients approved to receive medical cannabis containing THC. This trial program started in 2021 and the results so far have been promising. When I asked Dr. Douek if the medical cannabis helped his symptoms of MS, he said, “Yes, but more trials and clinical data are needed that support the evidence that’s currently anecdotal and less measurable in this first experiment.” Doctors in France are not willing to prescribe without it, according to Dr. Douek.
Another patient on one of the panels was Valérie Vedere, who was diagnosed with HIV in 1992 and then throat cancer in 2012. She was also a participant in the first patient experiment. “It’s taking too long with all the trials,” she said about patient access to cannabis medicine. “And losing the ability to vaporize last March was a big problem for patients like me.”
She went on to explain that the program allowed dried vaporized cannabis flowers until March of 2024 due to concerns the government had regarding this form of cannabis. “They couldn’t distinguish it from underground cannabis so it was eliminated from the experiment and only the THC oils were kept for patients,” said Vedere.
Vedere explained that vaporizing cannabis alleviates her pain more quickly than waiting for the THC oil to digest and adhere to her receptors in the brain, which can take up to an hour or more. Sometimes her pain needs more immediate relief. “Now I will buy the flowers illegally which I don’t like doing.” One thing she was not willing to do is wait.
And yet, waiting seemed to be a theme at the conference. The constraints for medical cannabis in France and Europe came into focus as each panelist illuminated one issue after another. Not unlike America, it’s difficult for European medical cannabis companies to access bank accounts, loans, and anything resembling normal banking. This puts pressure on entrepreneurs doing business in whatever legal supply chain is allowed.
Then there’s the issue of what pathway medical cannabis should take in France and Europe. Some speakers advocated a pharma-heavy approach like Dr. Douek with more studies, clinical trials, and large volumes of data. Doctors want this data to prescribe and until it exists, there may not be many doctors willing to do it. This inhibits access for patients.
Speakers like Dr. Callie Seaman, co-chair of the Cannabis Industry Council, thought such an approach was unrealistic. “Unfortunately within the UK and Europe RCTs (Randomly Controlled Trials) are the gold standard for the licensing of medicines,” said Dr. Seaman. “Cannabis due to its polypharmacology does not fall into this type of data collection method.”
Dr. Seaman implied it would take many years and billions of dollars to meet that standard. “Real-world evidence needs to be accepted when studying cannabis medicine as there is so much out there that is being discarded due to mono pharmacological bias,” she said.
Cannabis is a complex plant with hundreds of active ingredients and is therefore considered “poly” in its pharmacology. It’s a hard plant to turn into single molecule drugs, or “mono” pharmacology. Drugs like opioids are much easier to make into “mono” pharmacological formats and are easier to test in RCTs and scale in production. This makes them cheaper to produce by many multiples.
Another complication for medical cannabis in France is socialized medicine. In France, the government pays for healthcare and medicines. That means there’s a keen interest in keeping costs low for the taxpayer. The cost of medical cannabis in European pharmacies is quite high due to strict manufacturing regulations called, General Manufacturing Principles (GMP).
Growing, extracting, and processing medical cannabis under GMP standards makes the medicine much more expensive than other Big Pharma options. Governments are reluctant to pay for medical cannabis preparations as a result. It was a big bone of contention at the conference.
Sita Shubert, founder and secretary general of the European Medical Cannabis Association, felt that the reimbursement debate was a distraction from creating a united voice for patients. “Unity is the first thing we must do,” said Shubert. Her organization is broad and holistic, with many stakeholders to bring together and form one advocacy voice.
“Don’t stress the financial point because of the reimbursement,” said Shubert. “We need to focus on the patients and the patients’ stories,” if Europe is to accelerate the pace of reform. For Shubert, the reimbursement debate is just another way to delay accessibility for patients.
One of the more hopeful observations at the conference was the presence of female leadership. Groups like EmpowerHer from the UK were invited to lead panels, curate discussions, and provide a collaborative spirit that was refreshing to experience. The cannabis industry in the United States has struggled with diversity, although women leadership has returned to pre-pandemic levels, it’s still less than 40%. In Bordeaux, it appeared to be the opposite. An informative panel I saw was about gender-specific cannabis therapies for women and health issues that affect them, moderated expertly by Heidi Whitman.
“It’s taken time but I’m confident that France has the potential to lead in medical cannabis,” said Kristen Beury, who was the facilitator of the conference. It’s always risky doing the first medical cannabis conference in any conservative country.
Beury and her family plan to pioneer a series of intimate events for patients and doctors this year to build on the momentum of the conference. She also plans to scale the conference up and bring it back to Bordeaux in the fall of 2025. She was brimming with optimism for France and medical cannabis.
“As the largest cannabis-consuming nation in Europe and a country with a strong tradition of scientific research and innovation,” said Beury, “France is well-positioned to shape the future of the industry. The next few years will be pivotal, and events like Science in the City International can help accelerate progress by fostering collaboration and innovation.”
The situation with medical cannabis in France is complex, and the European market has different circumstances and constraints. For elected officials and the elite of French society, taking time is a smart approach to medical marijuana. For patients who need cannabis medicine, every day is difficult to endure. They want access now.
Striking the balance between the two is the current debate in France. Most attendees felt greater access was inevitable even if it takes time. This conference and the impressive lineup of scientific speakers was another sign it may come to pass sooner rather than later. French patients are waiting.
“}]] The first medical marijuana conference in Bordeaux, France, featuring doctors, scientists, and entrepreneurs from the UK and Europe. Read More