Slovenia has only two million inhabitants, and nestles neatly at the foothills of the Alps boasting a series of rolling hills and alpine lakes. While cannabis remains illegal in the country, the medical cannabis community has been growing.
Many Slovenes consume potent cannabis extracts following the visits of Canadian cannabis advocate Rick Simpson, who toured the country several times during his exile in Europe.
Cannabis is regularly or occasionally used by 15 percent of the Slovenian population and it’s estimated that 30,000 citizens self-medicate using cannabis extracts. However, only 160 patients choose to do so legally – via the registered synthetic imports.
As part of the weekly Country Review, Prohibition Partners seeks to examine why so many Slovenian patients choose to self-medicate and how the state is constraining the cannabis industry in Slovenia.
Healthcare
Slovenia has a generally good standard of compulsory state-funded healthcare. Medical staff are well trained and healthcare in Slovenia is available to all citizens and registered long-term residents.
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Slovenian Cannabis and the healthcare system
However, since the economic crisis of 2008, Slovenia’s healthcare systems has suffered extreme hardship. Like many other nations, rates of health spending decreased in 2010. While health spending has gone up in recent years, the cost of pharmaceuticals continues to scorn the country’s health budget.
In 2009, reforms to control the spending growth on pharmaceuticals were introduced. These reforms included lists of drugs that would be reimbursed by the national health insurance fund, as well as price reductions that was negotiated between both the government and pharmaceutical companies.
The OECD released a policy brief on the Slovenian system in 2015. The report expected an especially large increase in expenditure on long-term care of residents, with costs predicted to rise threefold.
The report recommended that Slovenia focus on improving home-care opportunities alongside efforts to promote risk prevention and healthy ageing, as a means of improving the sustainability of long-term care.
The report held no punches in calling for strategic reform of the health system and may yet open doors to home-grow operations and cannabis treatments for the prevention of deadly diseases.
Legal Status outlaws Cultivation
Officially, cannabis in Slovenia is illegal but decriminalised, similar to the Portuguese system. While medical cannabis is not yet allowed, the use of certain cannabinoid drugs is permitted.
A proposal was drafted in 2013, which succeeded in gaining enough public support. As a result, the Slovenian government re-classified cannabinoids as Class II illegal drugs – from the original Class I – thus allowing for the medical use of cannabinoid drugs but not cannabis flowers.
This is an important distinction. The new classification changed its description from a substance deemed “very dangerous” to human health to one that can be acceptable for “medical usage”.
In December of 2016, the Ministry of Health produced a draft of legislation that would allow a regulated medical cannabis program. The initial draft would allow patients access to doctor prescribed flowers, extracts and synthetic variations but cultivation would remain illegal. Cannabis cannot be cultivated, produced, or possessed – a rather strange stipulation for a law intended to make cannabis more accessible to patients.
Dean Herenda, Secretary for the Ministry of Infrastructure and one of the most prominent advocates of cannabis legalisation in Slovenia, explained in March 2017 that the new laws were damaging to both the cannabis market and the agricultural industry-
“In agriculture, the growth of hemp and its products (high CBD extracts, seeds, hemp oil, teas) are de facto prohibited, because the plant (no matter the amount of THC) is fully transferred to the second category of substances, which is overseen by the Ministry of Health. We believe that the impact of this regulation represents a serious blow to agriculture and the economy.
”As you know, CBD is not a psychoactive cannabinoid and is naturally present in the products of so-called ‘industrial hemp’ […] the private growing is banned and CBD is available only as a medicine – this means mainly of synthetic origin […] The prohibition of CBD is therefore a first dramatic contradiction of a declared ‘more liberal’ approach towards cannabis in Slovenia.
Patient Progress
According to data from the Slovenian Ministry of Health, about 160 patients are currently enrolled in a limited program that allows consumption of synthetic THC. The compound, dispensed as Marinol, a registered pharmaceutical has been used for the treatment of a handful of conditions.
The Institute of Oncology has been helping patients with synthetic drugs for more than two years now. Slavica Lahajnar Čavlovič from the institute admits the treatments are limited and the drugs are used mostly for pain alleviation.
“The majority of patients which receive cannabinoids, prescribed by the Institute of Oncology, are in palliative care.
In these two and a half years, since having the magistral drugs, drops, and combinations of THC and CBD, we have only issued 38 prescription bottles.”
Patient groups and Herenda argue that Slovenia is just skimming the surface for cannabis treatments.
“There are around 30,000 Slovenians treating themselves illegally with cannabis today, which is a huge number for population of 2 million.”
Civil pressure for self-sufficiency
Civil groups are especially critical towards the state politics, which many say have not envisaged the possibility of self-sufficiency. Sativex alone can costs patients upto €700 a month. Janko Pirc, one of the advocates for legalising the cultivation of cannabis for personal use explained that the new regulations don’t help the masses of Slovenians who opt to self-medicate.
“The regulation has not changed anything. It has only made it possible for pharmaceutical companies to be able to sell, while for the others it doesn’t really change anything.”
A New Hope for Slovenian cannabis
Slovenia has many reasons to be hopeful about the potential of a Slovenian cannabis industry.
As of March 2017, The Ministry has mandated a study into the effectiveness of cannabis in the treatment of epilepsy in children.
The government has also partnered with a series of international cannabis companies. The partnerships cultivate and process cannabis within the state but do not yet sell their products domestically.
Lastly, Slovenia is one of the focus countries for the United States’ southeast European policy, aimed at reinforcing regional stability and integration. As prohibitionist laws continue to dissolve in the US, Slovenia may be encouraged to follow suit.
Slovenia is a country that embraces transition and boasts strong public engagement. In a small country where ideas spread quickly, and politicians may actually respond, the possibilities for meaningful change are compelling. As the government continues to study the therapeutic effects of cannabinoids and partner with international cannabis experts, it looks likely that Slovenia will move towards a post-prohibition cannabis industry.
