THE PEOPLE VS. THE ESTONIAN STATE: MEDICAL CANNABIS DIVIDES OPINION IN THE BALTIC STATE

Estonia is starkly juxtaposed with the rest of Europe in the medical cannabis space. On one side, the state are surprisingly keen to implement some form of medical cannabis system but on the other, caution and anxiety pervade mainstream public opinion on cannabis reform.

It’s surprising then, that a country that has leapfrogged so many competitors in its approach to technology has found itself at odds with new medicine. In truth, society has been reeling from worrying levels of alcohol and drug abuse contributing to a stigmatisation of cannabis. If any progress is to be made in Estonian legislation, educational efforts will need to address the schism between hard science and historic myth around medical cannabis.

 

State of Play

Cannabis in Estonia is illegal, but possession of up to 7.5 grams of recreational cannabis is considered an amount for personal use, and is punished only with a fine. The ‘Act on Narcotic Drugs and Psychotropic Substances and Precursors Thereof’ regulates the field of narcotics and psychotropic substances in Estonia and is controlled by the Ministry of Social Affairs.

Medical use of cannabis based drugs has been technically legal since 2005, however, as of 2016, only one patient in the country had been prescribed a cannabinoid-based medication. This was Nabiximols intended for cancer pain.

Despite a conservative mainstream ideology, a cannabis movement prevails in Estonia, led in part by the Estonian Medical Cannabis Association - known locally as MTÜ Ravikanep.

 (MTÜ Ravikanep, Elver Loho

(MTÜ Ravikanep, Elver Loho

The educational group is engaged in collecting and disseminating information on healing and patient custody. At the end of July 2016, the medical cannabis debate began gaining some momentum as two petitions regarding medical cannabis garnered enough signatures to trigger government evaluation.

One of the petitions, initiated by Aleksander Laane of the Estonian Green Party, focused on the medical side of cannabis regulation and demanded five changes:

  1. The creation of guidelines for medical cannabis growth and pharmaceutical distribution of imports.

  2. That herbal cannabis be removed from Schedule I of narcotic drugs to Schedule III.

  3. That the process of prescribing both herbal cannabis and cannabinoid preparations be simplified in a manner similar to how Canada, Germany, the US, Israel and other countries have done it or are planning to do.

  4. That herbal cannabis as well as cannabinoid preparations be made instantly available to patients with relevant prescriptions.

  5. That the state stop penalising people for simple possession and use of cannabis.

The second petition by private citizen Elver Loho went a step forward, consisting of three stand alone proposals. The petition, titled “Suggestions to the Parliament for better regulation of the cannabis market” proposed:

1) That enterprises be allowed export cannabinoid exports

2) That the THC be moved from Schedule I of Narcotic Drugs to Schedule II

3) That the government initiate a pilot study into a heavily controlled and regulated recreational cannabis market.

To date, the Social Affairs Commission has yet to make any definitive decisions regarding medical cannabis in Estonia.

 

The Conservative Marketplace

According to the United Nations’ data on drugs, Estonia is among the top 30 nations for cannabis consumption. Despite the ultra-orthodox public thinking on all kinds of drugs, officially 6% of the country’s population regularly use cannabis. With this number, Estonia is 26th biggest cannabis using nation in the world.

 (Cannabis-Use-Map, Medical Marijuana

(Cannabis-Use-Map, Medical Marijuana

In spite of its popularity, many proponents are pessimistic about Estonia’s chances of cannabis legalisation, claiming it is not a topic which is on any urgent agenda. We spoke to Justin Zehmke, a South-African born journalist and cannabis activist based in Estonia.

On what developments are expected for cannabis legislation in 2018...

None I’m afraid. From what I gather by speaking to proponents of legalisation and activists here, this is simply not something that is really on anyone’s agenda.

On the barriers to legislative change...

Estonia has a somewhat unique situation in that, even though there may be the political will to legalise cannabis for medicinal use, the voting public is largely against it. A poll conducted in 2016 found that an incredible 87% of Estonians were strongly against any form of legalisation. I have spoken to several politicians who claim that proposing legalisation would hit them very hard at the voting booth, even though they feel it is the right thing to do. Estonians are generally reserved and rather socially conservative. There would need to be a huge education drive to change public perception, as they are still very much of the opinion that cannabis is a drug and all drugs are bad. I expect it will be one of the very last countries in the EU to pass positive legislation.

On the chance to develop a strong cannabis industry in the event of legalisation…

Almost certainly. Estonians are highly entrepreneurial, and I’d expect them to make the most of any new business opportunity. The weather would severely hamper large-scale, outdoor growing though.

For now, Estonia have set their sights on the hemp market, cultivating over 3,500 hectares of the plant in 2016, making a gigantic leap from the 900 hectares grown in 2015. The CBD market is growing at an unprecedented rate in Europe, and Estonia, the second largest European producer, is flexing its entrepreneurial muscle via the cannabis cousin.

 

Overcomplicated and Underutilised

Examining the conservative attitudes of Estonia’s vocal majority makes it easy to forget that medical cannabis based drugs are, by definition, legal but only under extreme circumstances. Due to the nature of Estonia’s medical cannabis program, legislators don’t define a set of qualifying conditions for medical cannabis. As a result, physicians may write a prescription if they feel a condition, such as multiple sclerosis (MS) or psoriasis would benefit from medical cannabis, though as we mentioned this is rarely enacted.

All is not entirely lost and though Estonia is estimated to be one of the last countries to legalise a medical cannabis program, the state are now claiming they are willing and able to experiment with pilot schemes and treatments. Commercial and healthcare opportunities in this case would look towards treatment centres for drug addiction and alcohol abuse. With a growing trend of wellness and health centres developed specifically for cannabis treatments in Slovenia, Macedonia, Poland and the rest of Europe, this could be a really viable commercial option for entrepreneurs and investors in Estonia.

In the meantime, advocates and external experts will need to engage with educational and medical bodies before the country can think about any real legislative change.