Medical cannabis plantation offers patients new perspectives

Summary

Three Flemish patient organisations have teamed up to offer patients more pain relief options, and to break the taboo on medicinal marijuana

The use of medical marijuana in Belgium is a fact, but some say the new law needs to be better clarified. What do you think?

Grey area

In June, public health minister Maggie De Block signed a royal decree that legalised the sale of cannabis-based medication, or medical marijuana. Though the move has been hailed as a milestone, the only product currently eligible under the new law is one oral spray for patients with multiple sclerosis. And that leaves many patients out in the cold, according to local associations. Three Flemish organisations have now joined forces to offer patients more pain relief options, even if that means operating in a legal grey area.

The Belgian legislation on cannabis use is fairly complex. In 2005, the federal government issued ministerial guidelines that effectively allowed adults to possess a maximum of 3g of cannabis, or one single plant, for personal use only. While such possession was still illegal under the law, prosecution of cannabis users was given the lowest priority.

To make things more confusing, local municipal administrations can change the rules to their liking. This was illustrated two years ago, when the City of Antwerp adopted a “zero-tolerance” policy that allowed police to hand out on-the-spot fines of €75 to users they caught with less than 3g.

At the start of 2014, in the run-up to the elections, the youth divisions of Flemish liberal party Open VLD and socialist party SP.A called for the legalisation of cannabis. But the new government didn’t heed their call. Instead, its coalition agreement emphasised that the use of cannabis in public spaces would not be tolerated.

A personal plant

In June, public health minister De Block did legalise one cannabis-based product, Sativex: a mouth spray made by the British company GW Pharmaceuticals that can be prescribed to people with MS who suffer from stiff muscles and spasms, known as spasticity. De Block has also said she will continue following up on research into cannabis-based medicines with a view to possibly legalising them in the future.

Cannabis will not cure the disease, but it will improve quality of life

- HGC Academy founder Dominique van Gruisen

The news of the sudden legislation change and the gap it left inspired two Flemings to set up non-profit organisations. Pieter Geens from Nossegem, Flemish Brabant, established Medcan to raise awareness about medical marijuana among patients, doctors and lawmakers, while Guy Hofman from Lier founded the Medical Cannabis Club (MCC), which aims to cultivate cannabis plants for medicinal use according to the highest quality and health standards. The associations work closely together.

Geens and Hofman got in touch with Dominique van Gruisen, from Maasmechelen in Limburg. He’s the founder of the Home-Grown Cannabis Academy (HGC), a local consulting company that provides advice on cultivating cannabis. In the past, it has assisted a US pharmaceutical company with its medicinal cannabis production, for example.

The three Flemings teamed up to create a strict system to safely provide more patients with medical cannabis. Patients who wish to obtain medicinal marijuana must first register for free at Medcan, which helps them find a doctor who can give them a prescription. Once they have the prescription, they can make an appointment for an intake interview with Hofman. If their case is approved, their doctor will again be consulted, and if the doctor agrees, the patients can pick up their personal cannabis plant at the MCC plantation.

Patients can already buy marijuana plants in Belgium through non-profit Cannabis Social Clubs – like Trekt Uw Plant in Antwerp – but these don’t focus on offering medical cannabis. As a result, many patients have opted to travel to pharmacies in the Netherlands instead, where the legislation on medicinal cannabis is less strict. Medcan estimates that these trips to the Netherlands cost Flemish patients €360 on average.

“We will provide cannabis that is 65% cheaper,” says van Gruisen. Cannabis from MCC’s plantation costs €6.5 a gram, which means a monthly cost of roughly €157. Since this still represents a high cost for most patients, Medcan and MCC are launching the Adopt a Patient crowdfunding campaign on 15 August. The goal is to collect €100,000, enough to help 100 patients.

Helping patients - and police

The new initiative should keep patients from experimenting with marijuana cultivation themselves or, worse, buying cannabis from local dealers, who could be amateurs or involved in criminal organisations. “By weakening these players, we reduce the nuisance they cause in the streets and help the police,” says van Gruisen.

MCC staff are keeping the location of their plantation secret for fear of becoming the target of criminal organisations. They have informed the police and prosecutor’s office of their project, however.

So far, 28 patients have requested the help of Medcan and MCC. “Most of our patients are suffering from cancer,” says Geens. Others have epilepsy, MS, fibromyalgia, tremors or chronic pain. Research has shown that patients with ALS, Tourette’s syndrome and Aids might also benefit from medicinal cannabis.

“In most cases, cannabis will not cure the disease, but it will improve patients’ quality of life considerably,” says van Gruisen.

Van Gruisen saw the effect of medical cannabis first-hand when his grandfather, who had Parkinson’s, tried it. “He could hold a book without shaking and was able to concentrate again,” says van Gruisen. Cannabis similarly helped reduce the nausea bouts suffered by Geens’ father when he underwent chemotherapy for lung cancer. Geens himself uses medical cannabis to treat pains he developed following a severe motorbike accident five years ago.

Just one drop

Six-year-old Sofie Voncken from Maasmechelen, who has a rare form of epilepsy, is one of the patients Medcan and MCC were able to help. She used to have some 50 “invisible” seizures a day, during which she just stared out blankly as if she was paralysed. 

We know we are operating in a grey area

- Guy Hofman

Thanks to one drop of cannabis oil every day, Sofie now has just a few seizures each week. Her parents say medicinal cannabis is the first product that has successfully treated her seizures. Since only adults can become Medcan members, Sofie’s father was the one to register with the club. The oil comes from a homeopathic doctor in the Netherlands.

“Because she is able to concentrate and read again, Sofie can go back to school,” Hofman says. “We know we are operating in a grey area, but such successes for us confirm that we’re doing the right thing.”

Still, cannabis offers no miracle treatment. It doesn’t work for every patient and doctors have warned about side effects like increased anxiety and deterioration of long-term memory.

“It’s essential to create cannabis with a good balance between the substances THC and CBD,” says van Gruisen. THC is the substance with psychoactive properties that reduces pain and leads to a high when present in elevated quantities. CBD mitigates THC’s psychoactive effects and has anti-inflammatory, anti-tumoral, anti-psychotic and relaxing properties.

“We will adapt the kind of cannabis and the required doses specifically to the needs of patients, in consultation with doctors,” says van Gruisen. “Patients are also advised not to smoke cannabis in joints, but to use special vaporisers that help them consume the cannabis in a very controlled manner. This way, they can slowly increase their doses.”

Not a last resort

Seventeen doctors are currently collaborating with Medcan and MCC to offer patients medicinal marijuana, among them an oncologist and a neurologist. With their strict membership conditions and professional approach, the two founders hope to convince more doctors to participate. “Many are interested but afraid to develop a reputation as ‘cannabis doctor’,” Geens explains.

The two organisations also want to organise a meeting with organisations like the ALS League Belgium, to explain how medical cannabis can help patients, while the Foundation Against Cancer has already reached out to them for more information.

Some of the marijuana plants at the MCC plantation will be used for research purposes. The initiative will also be evaluated by a team of researchers at Ghent University and the University of Leuven. This research project, which is being financed by the Flemish Fund for Scientific Research, is scheduled to start in October and end in 2018. It will also look at how Cannabis Social Clubs work. “This kind of in-depth, expensive research on medical cannabis is long overdue but a big step forward,” says van Gruisen.

The three men behind Medcan, MCC and the HGC Academy are also hoping to meet with public health minister De Block. They say that, on the one hand, they are pleased with her careful, evidence-based policies. “We certainly don’t want cannabis to be abused to treat the slightest pain, like after you hit your toe,” says van Gruisen. “But it shouldn’t be treated as a last resort either, because it works better than many drugs now given at an earlier stage.”

They also want the federal government to take a more progressive stance and to look at good practices abroad. In some 30 countries – among them the Netherlands, Switzerland, Israel, Canada and Germany – it is currently legal to buy several cannabis-based products in pharmacies.

“I believe there is widespread support for medically prescribed cannabis among our population,” van Gruisen says. “Increased and more organised non-profit production of medical cannabis is not just good for patients but for society as a whole, as it can create more employment and reduce costs for the government.”

Photo: A still from a Koppen documentary about medical cannabis use in Flanders that recently aired on VRT
© VRT