The paradox of medical cannabis: in Italy, production is limited and San Marino sniffs the deal
To think that Italy up to seventy years ago was a world leader in the production of cannabis, second only to the Soviet Union. One hundred thousand hectares distributed throughout the Po Valley, with Emilia in the lead for the number of crops. That cannabis did not end up in therapies, it was designed above all for the textile, fiber and paper market. A sector wiped out, not only by industrialization and the introduction of new materials, but also by stigma: Benito Mussolini declared hashish, the recreational derivative of cannabis, enemy of the race and drug of “blacks”. The prohibition of the “war on drugs” of the 1960s did the rest.
The free production of legal Italian hemp has been possible since 2016 but the therapeutic one is limited to the Military Pharmaceutical Chemical Plant of Florence (Scfm), in the amount of about 150 kilograms (only in 2020 it was 250 kilos). According to a report by the International Narcotics Control Board, the Italian requirement for patients is 1,950 kilos per year, other estimates of three tons. Although the Italian law on medical cannabis is fourteen years old, the supply chain is unable to guarantee it for everyone, which is why it has to obtain supplies from elsewhere, mainly from Canada and the Netherlands.
From tomorrow the cousins of nearby San Marino will be the new competitors in the sector. Indeed, on 1 June the Republic unanimously approved a draft law on the trade and use of cannabis-based products, intended exclusively for medicinal or therapeutic use. It took several governments, blockades and resumptions to achieve the result.
One of the main intentions is to insert itself as a reference distributor for our country, with that economic and employment gains, then expanding the earnings to the Continent. Our neighbors also move along this line, first of all Germany which in the meantime has become the largest cannabis market in Europe, with over 70 million dollars in revenues per year. After the 2017 law, it is now aiming for ten tons per year. Greece instead approved a law for cultivation and trade in May, just like San Marino.
«It doesn’t often happen that everyone agrees, given the great political conflict in San Marino. Even parties that by their nature were in different positions found themselves on the pharmacological aspect ”, comments Roberto Ciavatta, Secretary of State for Health of San Marino who has already announced numerous potential investors. «We will be aligned with Italy, our primary commercial partner: Aifa is the regulatory body, which is why we first made contact with the Italian Ministry of Health, the management of the surprising central office and the Florence factory. Our will is to create a direct relationship between San Marino and Italy ». And this is exactly what the latest bilateral agreements in the health field between the two countries, signed by the Minister of Health, Roberto Speranza, are talking about.
The real turning point of the Republic of Titano is the address not only to a single body, but to other subjects: the opening to private individuals, with State authorization and the sole purpose of selling to pharmacies of the health system, and the consequent economic fallout of which in San Marino they are all aware, from right to left.
The small Republic moved well and on time, starting a long learning process with the Florence plant as a reference point: Aifa standards are high and every slightest mistake would mean pounds and pounds of pulped cannabis. The guidelines for quality, inspections and controls must follow the Italian ones. Plants designed for therapeutic purposes have specific requirements, lots are carefully certified and various types of contamination, such as mold or fungus, must be avoided.
“With therapeutic use we also regulate the agricultural aspect: open field cultivation, technological greenhouses, private structures. And then we will give relief and san marine patients, and not only, ”said Gloria Arcangeloni, parliamentarian of the Movimento Rete, the majority party in government in the Republic and at the forefront in approving the law.
There are many varieties of cannabis, quantity to quantity of active components, that is the quantity of active components, or the quantity of these in the plant, their use also varies: “Depending on their composition in cannabinoids, and the quantity of greater or lesser amounts of Thc, different cannabis strains may or may not produce psychotropic effects. Cannabinoids other than Thc also have potential therapeutic properties, without however producing psychotropic effects, it is the composition that determines their use in a pathological condition: against neurological, neuropsychiatric, inflammatory, proliferative, malignant or metabolic diseases “, explains Vincenzo di Marzo, director of research at the Institute of Biomolecular Chemistry of the National Research Council (Icb-Cnr).
«We were guests of the Movimento Rete and we were stupid. We understand very well the economic interest of the San Marino Republic in opening production, however, as Italians, we were struck by the news, because here the administration of cannabis for therapeutic purposes is planned for 2007 “, says Antonella Soldo, coordinator of” Better legal “. The law is there, but not the possibility of cultivation outside the military establishment.
«We are launching the tenders that give the possibility to cultivate also to private and public companies to reach the goal of being self-sufficient from the point of view of production. I trust that in the weeks we can start and increase production in our country ». The words of Andrea Costa, Undersecretary of Health, pronounced on 24 October last, are a first response to the move by San Marino. But over the years, promises like this have been advanced by many.
“In 2017, ten years after the Turkish law that opened to cannabis-based therapy, with an ad hoc provision, the possibility of processing and cultivating additional shares of cannabis for medical use was extended to other entities and companies”, adds Soldo. . “Following this act, Minister Grillo has repeatedly declared the opening of a table with stakeholders for the authorization of individuals. To date, however, nothing has been hinged ».
Meanwhile, thousands of patients struggle to find therapy, remain without it for months, struggle to turn to the black market. Last July, representatives of Italian patients who use cannabis were received at the Ministry of Health. Among other things, they asked for a guarantee of therapeutic continuity, expansion of the available varieties, urgent import where there is a lack. Some patients who try to find a DIY alternative, with the personal cultivation of a few plants, end up in trouble with the justice. Like Walter De Benedetto, 49, suffering from rheumatoid arthritis, which we have talked about in these pages. Investigated, and then acquitted, for cultivation of a narcotic substance, for having grown marijuana plants. “My request for help is an indictment against a country that violates my right to treatment recognized by the Constitution,” said the man in an appeal to the President of the Republic, Sergio Mattarella.
On the other hand, the trial is underway for Cristian Filippo, 24, suffering from fibromyalgia. He lives in one of the three regions, Calabria, which together with Molise and Valle d’Aosta has not yet approved the provision to supply medical cannabis to a load of the regional health service. “My pain therapy doctor gives me a prescription on white paper, for a fee, this means at least 800 euros a month and I can’t afford it,” says Cristian. Cristian learned of the syndrome in 2019, after years of pain and misdiagnosis that cost him fatigue and inconclusive therapies. «I have toured all the Calabrian hospitals, each one would have the possibility of importing, but each province operates in its own way. In mine, Cosenza, they wash their hands. For years they have refused requests, other patients like me tell it, we all know each other ».
Cristian, unable to cure the pain, has grown two seedlings at home, so as not to fatten the coffers of the underworld or risk buying a dangerous product because it reaches into contact with harmful substances. “I remember the day I was searched, I had a drying plant and inflorescences, my only thought was: my therapy is being confiscated and the idea of being without it was terrible”. Cristian was arrested at the beginning of June 2019, forced to house arrest for a month. Assisted as Walter by “Better legal”, he awaits the postponement of the trial to March 2022.
In some cases the patient may fall back on cortisone, but prefer to keep the pains that suffered the side effects of such a powerful medicine: “My quality of life with cannabis is completely different, it is an immediate solution that annihilates the disease instantly : it is unthinkable that I will not be able to access it ».