Malta's first cannabis control card has been issued - But there's a catch

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The first batch of cannabis control cards have been issued in Malta, taking patients one step closer to accessing their prescribed medicine. 

However, the first man in Malta to get the control card has already become exasperated with the process after being told the control card is just the first stop in a long process to get his medicine.

"They're making it even harder than it is," says Aaron Pavia, who suffers from chronic pain after a motorcycle crash years back.

"It's taking longer than expected, loads of time being wasted to get the medicine, and it will take me another month or two before I get anything."

After successfully applying for the control card, Aaron now needs to apply for a permit along with his doctor. After that, he'll barely be past the halfway point of getting medicine that is legal in other parts of Europe and the USA.

"My control card was issued six days ago, and I still don't have the medicine, God knows how long it will take," he said. "We didn't know about the permit before, we were told that you need to get your control card and that's it, thats how they explained it to everyone."

The control card is valid for 10 months, and includes a number of notices in red font in the top left corner. But Aaron, who has an ongoing court case, is fearful he might not have his permit approved and get rejected due to the case.

"It's like they are dangling it in front of us and taking the piss out of us at the same time," he said.

Dr Andrew Agius of the Pain Clinic, and one of Malta's foremost pain doctors, has said this longwinded procedure may end up putting people off from getting the medicine in the legal way.

"The procedure is that when the product is available locally, the doctor applies for each and every specific product intended for the patient, and we need to apply with the Superintendent of Health with the reasons for prescribing this medicine, why you want it, and what other medicines you've already tried," said Dr Agius.

Patients would need to get a green prescription every month or two, and would need to take their permit, control card, prescription and ID card when going to the pharmacy to collect their medicine.

Another doctor familiar with the developing medical cannabis industry also expressed his concern about the restrictions related to CBD oil.

"The fact that we are doing this for non-psychoactive CBD oil will make us the laughing stock of the world. For psychoactive medicine with THC it is within reason, but for non-psychoactive CBD oil?" they asked.

Considering how widely available CBD oil has become - you can buy it over the counter at high street shops like Holland & Barrett in the UK - Dr Agius is worried that this long process will just turn sick patients to the black market.

"People aren't going to wait three to four weeks to have their prescription approved when they can go on the internet and buy it online, even when they are not exactly sure what they are buying," he said. 

Another issue is the extra burden put onto Maltese doctors under the new restricted legislation. Unlike most other medicines, doctors must accept responsibility for the way their patient uses the cannabis. 

"It's a big responsibility to put on the doctor, which is probably why many doctors will refuse to prescribe the medicine. If the doctor doesn't know the patient well, he might not feel comfortable," he said.

It is estimated that hundreds of Maltese people make use of grey-market CBD oil to address their pain - let alone the thousands who turn to the black market to access cannabis - but there is no control or proper tracking of them at all.

Nonetheless, Dr Agius is hopeful for the future. 

"I think we are going in the right direction, but it is going to take time for more people to get access to it more easily, especially with CBD oil. The difficult situation will go on for now, and people will always opt for the easiest way out," he ended.

How to access medicinal cannabis in Malta

1. Get a control card from the Health Ministry

This must be signed by the Superintendent of Health.

2. Your doctor must apply for a permit for you

Any prior convictions of ongoing court cases may be flagged at this stage, and your doctor will have to shoulder responsibility for you if he goes ahead with the application. 

Individual permits must be gotten for each separate product. 

3. Get a doctor's prescription 

A doctor may prescribe you medical cannabis in Malta if he/she feels you've tried all other alternatives and there's a good chance medical cannabis can be beneficial.

4. Find a pharmacy that stocks the medicine

With only a handful of companies ready to begin importing medical cannabis, a patient would need to find a pharmacy that is ready to stock the medicine as well.

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