Finland

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Aulis - a medical cannabis user, but no pothead

Turku man becomes Finland's first legal user of medicinal marijuana

<table class=posttable align=right width=300><tr><td class=postcell><img class=postimg width=300 src=bin/aulis.jpg></td></tr></table>Helsingin Sanomat
By Tommi Nieminen
December 17, 2006

The apartment is nothing like a dingy drug den; no yellowed posters of hemp leaves, the Grateful Dead, or Haile Selassie adorn the walls.

A wall clock just ticks on one of them.

Aulis is an ordinary-looking 53-year-old man who appears almost shy, who lives in an apartment in the centre of Turku. In his refrigerator he has a thermos bottle containing the only legal cannabis in Finland.

Aulis takes some of his medical marijuana mixed in tea. He brews the fat-soluble medical pot in the thermos bottle, adding a dollop of butter and boiling water to it. The drug, under the name Bedrocan, is in an ordinary medicine bottle. It is the same kind of dried plant matter as street cannabis. The label on the bottle reads Cannabis flos - cannabis blooms.

The container bears the seals of the Dutch Ministry of Health, as Bedrocan is produced under state laboratory conditions in The Hague.

Aulis is the only person in Finland entitled to use cannabis as a medicine. He was injured in a traffic accident in 2002. He did not lose his mobility, but he was left with severe chronic pain in his spine and neck.

"A severe toothache is child's play compared to a pain in the spine. At one point there was not a single position that I was able to be in", he says.

At first, his severe pain was treated with strong opium-based drugs, which he used for three years.

"They brought a numb feeling. I don't know if they helped the actual pain. The psychological and physical feeling was terrible."

After that, he was prescribed a new generation inflammation pain medicine. The product was soon taken off the market, because there was evidence that it could cause heart attacks.

He learned about Bedrocan on the Internet in the spring of 2005. The effective component is THC, of which a synthetic version, Dronabinol, is available. The only natural source is cannabis: marijuana.

Cannabis is an old medicinal plant, which was banned in Finland in the 1960s.

Now medical marijuana is making a comeback. It is used as a prescription medicine in Britain, The Netherlands, and Canada for conditions ranging from glaucoma, to multiple sclerosis, as well as asthma, and severe pain.

However, cannabis is a sensitive subject in Finland. Aulis is not the patient's real name, and he will not allow himself to be photographed. "Even my brother called to say ‘your name won't be in the paper, will it?'"

Naturally, it is hard to be a pioneer like Aulis. At first he asked Finnish doctors for a Bedrocan prescription, but nobody would give him one "for fear of being labelled, or penalised". Later he went to The Netherlands three times for official cannabis therapy.

Note: he went to a doctor's office - not to a coffee shop for recreational pot.

"For the first time in three years, the pain was under control. I felt that I had found a medicine that does not have the dangerous side effects that opiates have."

To his aid came the Turku pharmacist Markku Knuutila, who applied for special permission to supply Aulis with medicinal cannabis. The National Agency for Medicines denied permission. The officials were not swayed until the matter was brought before the Turku Administrative Court.

The court ruled in September that the grounds given by the National Agency for Medicines for refusing permission were insufficient.

"The decision-makers had forgotten the actual patient. They started to bounce the matter around, and to air their internal disagreements", Aulis says.

The system of justice sees Aulis as a criminal. He got a drug conviction in 2005 when he brought medicinal cannabis from The Netherlands to Finland. The cannabis was stopped by customs at the airport. He did not receive any punishment, and he has brought a case before the Court of Appeals to have his conviction overturned. "I do not feel that I am a drug criminal", he explains.

One of the fears linked with medical cannabis is that the substance might be diverted to the illegal market. "The price of Bedrocan is so ridiculous that there is no fear of that. Cannabis on the street is much cheaper", says Aulis's lawyer Kai Kuusi.

Aulis pays EUR 12 for a gramme of the medicine, and his daily dose is two grammes. He mixes one and a half grammes with tea, and the rest he smokes either in a pipe or in a hand-rolled cigarette.

He spends EUR 660 a month on his medicinal marijuana, which is a rather large chunk out of the income of a man who lives on a disability pension. He is currently negotiating with his insurance company and the Social Insurance Institution (KELA) on possible compensation for his medicine.

"This process has cost me a hell of a lot - 12,000 euros to be exact. If this medicine did not work, I certainly would not have put all of my savings into it."

Street cannabis for recreational use is not so very uncommon in Finland. According to a fresh report on the drug situation in Finland by the National Research and Development Centre for Welfare and Health (STAKES), 12 per cent of Finns have tried the drug.

Medicinal cannabis is different, however, even though it does have intoxicating effects. Bedrocan is a laboratory medicine produced under official control, in which the pharmacological effects are more pronounced.

"It can give a relaxed feeling; sleep comes easily. The psychological effects are noticeable when smoking it. When consumed as a beverage, the effect is more on the physical side", Aulis says.

Aulis was sold a one-year supply of medical cannabis. The pharmacy administers ten day's worth at a time. "And that is fine".

Aulis steps into the bathroom, where he smokes half a gramme of Bedrocan mixed with tobacco. He has an efficient fan in the bathroom, which blows the smoke away.

After all, it would be embarrassing if the sharp smell of the medicinal herb were to drift to the neighbour's side.

<center><small>Helsingin Sanomat / First published in print 17.12.2006</small></center>

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Guidelines Sought for Medical Use of Cannabis


YLE News
Published 17.12.2007, 09.23 (updated 17.12.2007, 09.33)

New guidelines are to be drawn up for the medical use of cannabis. The Ministry of Social Affairs and Health wants to clarify legislation so that prescribing cannabis to sufferers of chronic pain would no longer be automatically illegal.

In Finland cannabis has been used for medicinal purposes only in isolated cases, partly because of complicated legal issues and the sensitivity of the subject.

Just over a year ago the National Agency for Medicines granted its first special permission for medical cannabis for a man suffering from chronic pain stemming from a back injury.

The Agency had initially rejected the application for the use of medical cannabis prescribed by a Dutch doctor because its interpretation of the law was that prescribing cannabis was absolutely illegal in Finland. The patient appealed the case to his regional Administrative Court, which overturned the decision.

The patient's condition has improved significantly during the past year, says Turku pharmacist Markku Knuuttila, who dealt with the application process.

The special permission, which was initially granted for one year, has now been extended for another year.

The court decision has forced the Ministry for Social Affairs and Health to clarify legislation. A few months from now changes are to be enacted to allow marijuana by prescription.

Under the plan, even after the changes, medical cannabis prescriptions will require the permission of the National Agency for Medicines.

Cannabis is not expected to be used as extensively as opiates, but in certain cases it has been found to provide relief for the muscle spasms of Multiple Sclerosis, chronic pain, and glaucoma.