Step by step guide for Danish patients

If you want to try cannabis for your disorder/disease, there are things to consider and steps to take before handling the product.

Below is a guide to plant-based cannabis for medicinal use for Danish patients.

Tænkende kvinde1. Considerations

There could be many reasons why you want to try out cannabis. Most people have a desire to reduce the side effects of their current medicine or to get a better effect.

Before discussing with your doctor, check as much as possible whether it will help your condition and have a conversation with your relatives about your considerations. Particularly when it comes to severe illnesses, it is important that relatives are involved so that the whole family accepts your decision.

The Danish Medicine Agency (Lægemiddelstyrelsen) has estimated that there is reasonable evidence that cannabis may have beneficial effect in four areas: Painful spasms due to multiple sclerosis, painful spasm due to spinal cord injury, nausea after chemotherapy and neuropathic pain, i.e. pain due to disease of the brain, spinal cord or nerves.

However, it is entirely up to your own doctor or a specialist doctor whether he/she will prescribe cannabis for these or other disorders.

You should also consider what a driving ban may mean to you if you are dependent on driving. Most doctors issue a ban on driving until you have achieved some tolerance. After that, the doctor may suspend a driving ban.

2. Book an appointment with your doctor

When you book an appointment with your doctor, ask for a talk about the possibilities for getting cannabis prescribed. For different reasons, currently, there are not many doctors who want to prescribe cannabis to their own patients, but your doctor may instead refer to a specialist. Therefore, a conversation about cannabis for medicinal use is the first step, whether your doctor decides to prescribe or not.

3. Before the doctor’s appointment

Be sure to prepare your questions for the doctor before the appointment. Bring relevant material with you which can strengthen the achievement of the ordination and maybe a friend or a relative.

Lægebesøg4. At the doctor’s office

If your doctor wants to prescribe cannabis to you, he has the choice of two options: Prescription through the magisterial order or trial program.

The different set-ups are discussed here. Whichever you use, your doctor must have your consent. Therefore, he reviews all the risks associated with cannabis for medicinal use with which you must agree. If your doctor does not have your medical history, it is important that you talk about everything that may affect the prescription and dosage. This could be psychological vulnerability, alcohol intake, family history with mental illness, etc., as the prescription is your doctor’s responsibility.

Even though a cannabis prescription is a matter between you and your doctor, your doctor may ask you to try out all available conventional drugs for your disease before he will prescribe cannabis. Cannabis is often not the first thing a doctor will choose as it is not an approved drug.

5. Prescription approved

If you get a prescription, the doctor will inform you as to which cannabis you receive and what dosage plan you need to follow, follow up, etc. It is important that you as a patient will be monitored closely to avoid unnecessary side effects, interactions and contraindications, and possibly phasing out other medication.

Cannabis for medicinal use is available at your local pharmacy. Right now, there are not many products on the market, but in a few years there will be more comparable products and thus also free price formation, as seen in non-patent-bearing medicines.

Depending on the program, some financial supplements may be available. For instance, supplements for the trial program in 2019 are  retroactive for the entire trial period. For palliative patients, the supplement is 100%.

6. Prescription denied

It may be disappointing to get a ‘no’ from your doctor. If this happens, do not hesitate to get a referral to a specialist. For instance, several pain clinics – including the public ones – are open to a prescription. It is also worthwhile to talk to specialist clinics in the field of sclerosis and spinal cord injury or doctors at the hospitals’ specialized departments. Do not give up, especially if you have the four disorders recommended in the trial program.

If you are a member of Cannabis Danmark, we can help with personal advice.

Jointrulning7. The illegal market

All cannabis-based products are illegal in free trade, whether they contain THC or not. The CBD is considered to be a drug in this country.
If you want to try your luck on the illegal market, you should consider carefully whether it is a good idea. Therefore, here’s a ‘damage control’:

For obvious reasons, the illegal market is not state-controlled and therefore hard to navigate in. You are at the mercy of merchants. Ask them to present an independent third party test for cannabinoid and environmental conditions. An independent test is flanked by the independent laboratory’s company name at the top or as text at the bottom and most often in smaller font, who and what the test is made for. The test must also match the product serial number. If an independent third party test cannot be submitted, you do not know what you get.

You do not know about the cannabinoid and terpene relationship. You do not know if it actually contains what you are told. You do not know how cannabinoids are extracted – for example, with toxic substances and if there are leftovers. You do not know if it’s free from pesticides, heavy metals, molds or bacteria.

Do not use sellers or so-called intermediaries as unauthorized laymen for advice, eg by taking out other medicines, dosage etc. They are not doctors and therefore do not understand your body’s interaction with your cannabis or phasing out other medication. First and foremost, they are business people who are interested in selling their own products.