HEALTHCARE HYPOCRISY IN SWEDEN AS MEDICAL CANNABIS PATIENTS NEGLECTED

In Sweden medical cannabis use has been considered an aggravating circumstance rather than an extenuating circumstance as many patients have suffered at the hands of punitive state laws. However, as two historic cannabis licences have been granted, Sweden may no longer be able to remain an island in the changing global consensus on cannabis.

 

A Brief History of Fear

 

In the 1960s, drug addiction was perceived as being the result of a society failing its most vulnerable citizens and drug policy focused on rehabilitation in Sweden. At that time, psychiatrist Nils Bejerot was fighting a small scale government experiment, where heroin and amphetamines were legally prescribed. He was convinced the government was creating a plague and efforts to control drug use should focus on street dealers and users. As a result of his successive efforts, Sweden endured decades of zero-tolerance punitive policies on drug use, with little differentiation between categories of narcotics.

 (Anti-drug demonstration led by Nils Bejerot, Flickr)

(Anti-drug demonstration led by Nils Bejerot, Flickr)

As author Magnus Linton points out, the goal of these policies has never been to penalise drug offence from a standpoint of reasonability in relation to a drug's toxicity or the quantity of possession, but rather, to forcefully punish the betrayal of the common goal, the drug-free society.

Several decades later, in 2013, there were attempts to advocate for legalisation of both medical and recreational cannabis use by the Centre Youth Party (CUF). The party cited the commonly held belief that the prohibition of cannabis does more harm than the plant itself, due to its connection with organised crime. Sadly, this never made any serious waves within the Swedish parliament but patients have since challenged the government and four years later, an historic change was made...

 

A Time to Change

 

Cannabis in Sweden is illegal for recreational purposes and is considered a schedule 1 drug. However, last year two patients were granted licences to use cannabis for medical purposes three months after a decision was made by the Medical Products Agency (Läkemedelsverket) to allow the first prescriptions of the drug in the country.

The licences allow patients to use cannabis for the treatment of chronic pain in the form of Dutch medical cannabis strain Bediol, a Bedrocan product produced in the Netherlands. Applications must be written by a doctor and need to have shown an exhaustive use of alternative methods.

A prescription for Bediol means that all other medicine and treatments have previously been tried and that they did not give the desired effect
— Läkemedelsverket clinical researcher Karl Mikael Kälkner.

Historically in Sweden, cannabis had no officially recognised therapeutic qualities and medical use was not seen as an extenuating circumstance, rather the opposite. In a case that drew some attention in the national press involving a multiple sclerosis patient, the disease, and the fact that she stated that cannabis helped her, were seen as an aggravated circumstance by the court. The court argued in the verdict that she lacked motivation to stop using the drug and therefore gave her an unconditioned jail sentence.

One of the successful applicants, Andreas Thorn, a Swedish paraplegic, had suffered for years consuming strong painkillers that would often become addictive or render him intoxicated, due to a sensitivity to pharmaceuticals. After researching cannabis online he began growing personal amounts behind his family washing machine. He was soon reported to the police and summoned to the court. At first, the court acquitted Thörn of drug crimes.

 (Andreas Thörn leaves courtroom after negotiations in Svea Hovrätt 2016,  PO Sännås / Aftonbladet / IBL)

(Andreas Thörn leaves courtroom after negotiations in Svea Hovrätt 2016,  PO Sännås / Aftonbladet / IBL)

The ruling was groundbreaking in Sweden as no one previously charged with crimes relating to cannabis had been acquitted after referring to medical necessity. However, the prosecutor appealed the decision and Thorn was ordered to pay 11,700 SEK [€1,220].

Andreas’ story is one of struggle and certainly not a lone case in Sweden, but both his acquittal and his successful application for medical cannabis in 2017 are historic rulings for future victims of the harsh Swedish drug policies.


 

A System in Good Health

 

Health care in Sweden is largely tax-funded, a system that ensures everyone equal access to healthcare services. One of the best funded healthcare systems in the world, Sweden spent €47 billion, 9.9% of their annual GDP, on healthcare in 2017.

In addition, Swedish people are extraordinarily healthy in statistical terms. The average life span is now 81.4 years for women and 80.3 years for men. Due to a range of healthy lifestyles, high levels of exercise and low levels of alcohol and tobacco consumption, Sweden also spends a relatively low proportion of its healthcare budget on pharmaceuticals.

Sweden’s healthcare system benefits from a wealth of riches but the lack of tests and trials produced by the Medical Products Authority (MPA) is perplexing given that ministers have consistently referenced the lack of longitudinal studies as a core reason to avoid further legislative discussion.

 (Karolinska Instituet,  flemingsbergscience.se )

(Karolinska Instituet, flemingsbergscience.se)

To prescribe cannabis in Sweden it is a lengthy and complicated process. The doctor has to apply for a special permit from the Medical Products Agency and if approved the closest pharmacy has to arrange a special import.

 

A Society in Limbo

 

Cannabis is an unpopular topic in Sweden, in both medical and legislative circles, but reports suggest that cannabis may be whipping up a storm in financial circles. Two Canadian cannabis companies, Aurora Cannabis and Canopy Growth, were among the top 10 most traded shares on Nordnet in January.

Out of nowhere, the interest for Canadian cannabis shares has completely exploded in Sweden...

It’s interesting that so many Swedes are prepared to invest in cannabis companies while very few according to polls want to legalise cannabis in Sweden. There doesn’t seem to be a problem in making money from it
— Joakim Bornold, a savings adviser at online broker bank Nordnet

Sweden shifts in tandem between two opposing ideas - continuity and change. The Swedish online forums have grown explosively in recent years and now appear to be completely dominated by young cannabis advocates of change. On the other hand, a number of government-funded information campaigns continue to promote scientific and ideological support for the current policies on the criminalisation of cannabis.

But while investors profit from the global consensus on medical cannabis, patients are still suffering on Swedish shores. 2017 was a momentous year for Swedish cannabis advocates and patients as the historic ruling laid a groundwork for further applications. For decades, the cannabis debate has been swatted by the political majority as a movement fuelled by cannabis smokers and teenagers and as such, represented respectively by narrow-self interest and teenage naivety. However, as Canada and many other western nations consider the medical and holistic benefits of cannabis at a state level, Sweden can no longer brand the cannabis debate as a fringe issue.


If you have any queries regarding the content, please contact the author, Eoin Keenan at eoin@prohibitionpartners.com