Paul had just sat for his ‘A’ levels when he was diagnosed with ADHD, and was immediately put on conventional medicine. But the 18-year-old suddenly became extremely anxious, felt continuously nauseous and grew emotionally inept.

“I could not sleep at all, and when I tried to socialise, I felt like a robot. The side effects were horrible – my creativity was that of a potato,” he told Times of Malta. “I knew I needed to be weaned off the drugs, and when I was swapped to medicinal cannabis, I could finally manage my ADHD symptoms for the first time in my life,” said Paul, now aged 24.

He went on to earn top marks for his bachelor’s degree thesis, eventually enrolling for a master’s degree.

However, despite the positive impact on his life and a better understanding of the plant’s benefits among his peers, Paul believes that consumption of medicinal cannabis is still laden with stigma. That is why he spoke to Times of Malta on condition of anonymity, together with fellow ADHD patient Mark, aged 30. Neither of their real names are used here.

Video: Karl Andrew Micallef

Peace of mind

For Mark, life before his diagnosis at age 19 was “a nightmare”.

“Growing up was a challenge, and I didn’t do well at school. When I was prescribed conventional medicine for my ADHD, I turned into a shell of my former self. It’s like you’re there, but not really there. I would just hang around in the background whenever I met up with my friends.

When Mark was 26, his psychologist suggested he try out medicinal cannabis and referred him to Andrew Agius, a medical doctor specialised in chronic pain.

“It suddenly felt like my life had started to come together from the mess it was. I went back to school, made it to university and my ‘passes’ turned into ‘distinctions’. I could finally have a proper conversation with my parents and our relationship improved a lot.”

Both Paul and Mark had tried cannabis before its consumption for medical reasons became legal in Malta. Mark recalls that the first time he bought it from a pharmacy he was overwhelmed by the peace of mind that a piece of paper – the doctor’s prescription – had brought him. “It is mind-blowing. I turned from a criminal to a patient overnight. I finally had the peace of mind that no one will come break down my door because I was studying with a joint in hand.”

Expensive treatment

But now that he has graduated, Mark has to work two jobs in order to be able to afford his prescribed cannabis. It costs him €700 a month and it does not cross his mind to procure it off the black market. “I cannot trust the quality of cannabis sold on the streets, and I cannot lose the peace of mind that I have managed to acquire.”

Paul adds that had it not been for the financial support offered by his parents, his treatment, which costs €600 a month, would absorb his whole paycheck. “Despite its legality, the price of medicinal cannabis is drastically higher than that of conventional medicine. I know people who have no other choice but to acquire it off the streets. The authorities should make it accessible to those with a low income, including pensioners.”

The authorities should make it accessible to those with a low income, including pensioners

Agius ‒ Paul and Mark’s doctor ‒ is joining his patients’ appeal to eliminate the stigma surrounding cannabis that is prescribed for conditions about which there are no huge clinical trials. Medicinal cannabis is a relatively new concept in Malta, and the plant has been stigmatised for many years across the world, so research is limited.

“There aren’t huge clinical trials for every medical condition that canna­bis can help with, including allergies, and that is why in some cases medical professionals rely on real-world evidence backed up by scientific research,” he said.

Chronic conditions

“In Malta, medical cannabis can be prescribed for any chronic condition where other medication has not been effective or has had negative side effects, including ADHD.”

Agius explained that cannabis could help regulate a person’s imbalances in the endocannabinoid system and dopamine levels – something commonly found in people with ADHD. In some cases, medical cannabis is relatively safer than conventional drugs and patients do not suffer the adverse symptoms linked with pharmaceuticals.”

Agius urged fellow medical professionals to give their patients a chance to try medical cannabis if they have tried different medications for their chronic conditions – whether ADHD, pain, fatigue, Multiple Sclerosis or Parkinson’s – and have not been able to sufficiently control the symptoms or are suffering adverse side effects.

“This should be done in a supervised manner and patients should be continuously monitored. Medicinal cannabis should be prescribed in controlled doses by a medical professional as it could cause more harm than good if it is procured from the black market.”

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