Parlez-vous Cannabis Médical? The French Begin National Medical Cannabis Trial

France has bowed to the inevitable. After several years of promises about normalizing the discussion and failing to do so, and further in direct contrast to its German, Dutch, Danish, and even Swiss and Spanish neighbours, the country has finally caved in recognizing that medical cannabis has at least theoretical efficacy.

The first trial, delayed for much of 2020, was publicized last fall right as the European Commission decided that CBD was not a narcotic and as the WHO voted to remove cannabis from global Schedule IV status. The timing was not accidental. The country’s ever-savvy political Machiavellian on the topic, President Emmanuel Macron, was there belatedly to cheer it on, just at the finishing line of done and dusted. In late January, the country chose its finalists.

Regardless of the cynicism in the room, it is an important step—and not just for France—but a range of discussions now literally haunting the industry if not the full reform discussion across the EU if not elsewhere.

Why This Trial Is Different

Anyone who expects this all to go smoothly and without major mistakes has clearly not been paying attention to the disasters that have so far ensued, everywhere, when a country or region takes up actual implementation of cannabis reform, and in any form. See the U.S. state market, the Canadian national one, if not the embarrassing faults inherent in both the German medical and more recent Dutch recreational bids.

However, there are indications that the French have in fact been watching.

The first fascinating difference, apart from the inclusion of non-Canadian firms, is that the tender bid mandated that corporate participants also cover all the costs of medicine and devices required. 

The second is that the entire trial will be provisioned from product made elsewhere and imported into the country. This potentially could be an economic boon for nascent cannaproduction in every country across the region from Portugal to Greece. Just as in other places, such forward steps are now not happening in a vacuum. And now, thanks to the Pandemic, the idea of including cannabis reform in a regional Green New Deal has absolutely taken hold, and in multiple countries.

The French experiment, in other words, is well-timed, no matter the intricacies and headaches it is also likely to still cause doctors, patients and even the participating companies themselves, to seed further reform if not cultivation across Europe. That starts with France itself, where the draconian and lingering laws about even medical cannabis have thwarted widespread trials so far. Unless specifically addressed, these regulations are also likely to be a barrier even this time. 

But everyone is watching. Starting with the fact that so many countries as well as companies are actually involved in the supply chain.

What Comes Next?

The next part is likely to go relatively smoothly, as France recruits (remember also in the middle of a global Pandemic and shutdown) for participants. This is also not Europe’s first national cannabis trial (see Denmark, if not Luxembourg of late, if not since 2017). 

The “trial” itself is also completely uncontroversial—see Germany next door where the vast majority of medical prescriptions approved by health insurance are for conditions like chronic pain and muscle spasticity.

Vive La France!?

Don’t expect the country to lead any cannabis revolution on the research it is conducting. Once the medical efficacy of the drug for chronic pain at least, is established in country, it is also likely that the considerable clout of the French pharmaceutical industry will come into the mix (beyond of course the first movers now). 

And that could also spell a range of reforms just in France. Starting with at minimum decriminalization. 

Beyond this, it certainly looks from the European, if not explicitly German, side of the discussion that the French are passing the buck. Yet this trial alone, from one of the Eurozone’s largest economies, will also help tip the needle elsewhere in Europe—and could well change the conversation in other places.

This starts just across the Channel in now Brexited Britain, where NHS guidelines explicitly left chronic pain off the list of conditions cannabis may be prescribed for as of late 2019. 

But that is far from the only place. North America is clearly on everyone’s radar. Starting with the participation of the companies involved in the French trial themselves. 

Why Are Europe’s Medical Trials So Critical For North America?

Despite leading the way on both the idea of medical and recreational reform, the idea that cannabis is a legitimate medicine that should be covered under health insurance is lagging throughout the American hemisphere. Private purchases are what drive the market, even in Canada, with a far more comprehensive medical system than its American neighbours. 

That in and of itself however, presents a terrible dilemma and problem for patients who still must, somehow, find the money to pay for their prescriptions every month. Even in Germany, where the law was changed in 2017 to mandate coverage under statutory health insurance and for a wide range of conditions, about 40% of cannabis prescription applications are being turned down as of 2021. A Gen X woman with a range of disabilities became the first in the country last fall to win her right to a year’s prescription to dronabinol in a ground-breaking court challenge. Everyone else is in a catch-as-you-can situation.

In the United States and Canada, however, so far, the entire discussion has been moot—and for a range of reasons, including the fact that widespread trials are still difficult to get approved in the United States.

With widespread health reform on the docket, certainly in the aftermath of Covid, however, the data from the trial in France, used by its trial companies in the United States and Canada, could also turn the tide in other places. 

And that is something to certainly break out the fromage and champagne about.