Legislation for Patients in Denmark
There are four ways to obtain medical cannabis legally:
- The magisterial order
- The trial program
- Prescriptions from a doctor in the EU
- Drugs with a dispension license
The magisterial order
Since 2011, Danish physicians have been able to prescribe cannabis through what is known as the magisteral order.
To prescribe magisteral medicine means that a doctor can prescribe pretty much anything that he finds will medically benefit his patient if he takes the responsibility himself.
In 2011, the law on euphoric substances was changed. This change in legislation meant that doctors could now prescribe plant-based cannabis through the magisteral order.
When the doctor prescribes through the magisteral order, he must provide a “recipe” for what the drug should contain and how it should be dosed. The pharmacy then produces the drug and handles it to the patient. There are only two pharmacies in Denmark that manufacture drugs for the magisteral order, and only Glostrup Pharmany handles cannabis.
As a rule, either CBD or THC is extracted and processed from the cannabis plant.
The Trial Program
On 1 January 2018, a four-year trial program came into effect.
The purpose of the trial program is to give patients a legal way to get treatment with medical cannabis if they have not had effect of approved medical drugs. The intent of the trial program is to gain information and a better foundation to be able to evaluate the use of medical cannabis.
This means that all doctors can prescribe medical cannabis from 2018-2022, after which the program will be reevaluated. The program includes both imported cannabis products and Danish cultivated and processed cannabis.
The products are not approved medical products, but they are approved by the Danish Medicine Agency (Lægemiddelstyrelsen) for prescription through the trial program.
The Danish Medicine Agency recommends four areas in which there is reasonable evidence that cannabis works for in some patients.
The areas are:
- Painful spasms due to multiple sclerosis
- Painful spasm due to spinal cord injury
- Nausea after chemotherapy
- Neuropathic pain, i.e. pain due to brain disease, spinal cord or nerves
The law is designed so that prescription is entirely a matter between the patient and the doctor. Manufacturers are fully responsible for the product itself and the doctor for the prescription with the consent of his patient.
Cannabis products are exclusively plant-based with different variants of, among other things, cannabinoids and terpenes. The form can be anything from the raw cannabis flower over oils to spray, but the products that are prescribed are listed below.
Approved products through the trial program
At the moment, there are a few products in Denmark that have been aprroved to prescribe through the trial program:
Sedamen, soft capsules containing the indica dominated “Pink Kush”. 5 mg dronabinol (THC) and max. 0,2 mg cannabidiol (CBD).
Outside the trial program, it is also possible to get the generally approved drug: Sativex, which contains the active cannabinoids THC and CBD in equal proportions, and is mainly prescribed for sclerosis patients. THC and CBD in this product originate from the cannabis plant.
Extent of the trial program
The trial program begun January 1st, 2018 and already three times as many prescriptions have been given. The blue line is the accumulated number of patients who have received a prescription. The green bars are number of new patients per month. In 2019, even more have joined. According to the latest numbers in April, over 2000 patients now have a prescription.
Financial supplement program
From 1/1 2019, a financial supplement program has taken effect retroactively for the entire trial period. That means that if you have had a prescription under the trial program you will automatically be reimbursed 50% up to 10.000 DKK. For terminal patients, the financial supplement is 100%.
Prescription from a doctor within the EU
Due to Denmark’s membership of the EU, it is possible for patients to receive prescription and dispensing of cannabis in another EU country.
Some have used this method before the trial program came into effect, and some use it if they are unable to find a doctor in Denmark who will prescribe cannabis.
If you want to use this method, you will usually find a doctor in, for example, Germany or the Netherlands who will prescribe cannabis. You also have to make sure you have a medical pass/pill pass so that the medicine can be carried across the border. The drug may be used for 30 days.
Drugs with a dispension license
Danish doctors can apply to dispense two products with synthetically manufactured THC. These are the drugs Marinol and Nabilone, which are drugs approved in the United States.