The Story About One of Sweden's First Medical Marijuana Patients

Top image: Andreas Thörn. All photos courtesy of Andreas Thörn

This weekend, Sweden's Medical Products Agency made a groundbreaking decision. Two patients will be prescribed medical marijuana for chronic pain for the first time in Swedish history. But the journey to these rulings – which the agency highlights are about individual cases – has been long. For one of the patients, wheelchair-bound Andreas Thörn, it's been four messy years.

Thörn has been paraplegic since he was 15 years old, when his fifth and sixth neck vertebrae were crushed in a motorcycle accident. He's bound to an electric wheelchair and suffers from spasticity and incurable pain in his stomach, midriff, and legs. He describes it as "a burning, cutting pain that can't really be explained. It just hurts like hell."

In 2010, almost 20 years after the accident, Thörn became a dad. Later that year, his condition dramatically deteriorated. Recurring constipation and UTIs accompanied the pain he was already suffering, rendering him almost completely unable to take care of his daughter or to run his business. He was diagnosed with irritable bowel syndrome and a chronically inflamed prostate. He fell into a deep depression – antidepressants and therapy helped, but the excruciating pain remained.

The specialists treating Thörn were running out of options – they had given him every painkiller Swedish law permitted, but nothing worked. As a last resort, he was offered methadone, a strong opioid and effective painkiller commonly administered to detoxify heroin addicts. His previous attempts with opioid treatments had caused horrible side effects. "I'm very sensitive to medication and other [psychoactive] substances," Thörn explained in court. "I've been high on most of the medication I've tried, and that's never been my goal. I just wanted to get rid of the pain. Should I live the rest of my life with all the side effects I've gotten from other opiates?" He declined the methadone treatment.

Out of viable medical options, he turned to the internet. On an American forum, Thörn found other paraplegics who recommended non-psychoactive cannabis, with low levels of tetrahydrocannabinol (THC, the main psychoactive molecule in cannabis) and an equal or higher ratio of Cannabidiol (CBD, a constituent with a range of medical benefits that counteracts negative effects of THC). He had tried smoking pot before and experienced some pain relief, but the anxiety and paranoia triggered by the THC were too heavy to make it worthwhile.

According to the other paraplegics on the forum however, medical marijuana had great potential to alleviate neuropathic pain and wouldn't induce a high. "I had to try something to get a life where I could function, be a part of my family and be able to work." After long talks with his wife, deliberating the risks and implications of breaking the law – fines, possible jail time, retraction of his business permit and the social stigma, to name a few – he decided to give medical marijuana a try.

Thörn began cultivating cannabis plants in a small tent behind the family's washing machine. The flowers were harvested, mixed with coconut oil and water, and boiled into a viscous mass. With a teaspoon of goo in his coffee every morning and evening (about 0.4 grams of cannabis per day), Thörn soon experienced a remarkable decrease in pain, spasticity and anxiety. His sleep patterns normalised and his bowel and prostate complications subsided completely. "My body felt good and relaxed. I was able to work full-time, take care of my family, and had enough energy to exercise," he told the court in 2015.

In January 2015, about two years into the illegal gardening project, two police officers visited Thörn's home. They cut down the cannabis plants and had Thörn drug tested and reported. It's not confirmed how exactly the police found out about Thörn's operation.

At first, the court acquitted Thörn of drug crimes. "It was probably our humanitarian thinking, based on what he told us about his situation," one of the jury members said about the decision. The ruling was ground-breaking in Sweden – no one previously charged with crimes relating to cannabis had been acquitted after referring to medical necessity. However, the prosecutor appealed the decision, and on the 31st of March 2016, Thörn was convicted, fined and sentenced to probation by the court of appeals. He was deemed unfit to serve a prison sentence but ordered to pay 11,700 SEK [€1,220].

The case was widely covered and debated in Sweden. It was all pretty much standard procedure, but in the mess of references to scientific reports – either confirming or denying the medical properties of marijuana – a very important question was raised: Should the government have the right to use the law to prohibit citizens from living decent lives? It seemed cynical to prosecute a self-medicating disabled man when the methods provided by the state itself had proved ineffective. But considering Swedish narco-political tradition, Thörn's sentence wasn't surprising.

Swedish drug policy is based on the conviction that all drugs are extremely dangerous and drug use is a big social problem. That conviction is based on the work of psychiatrist Nils Bejerot, internationally renowned for his advising role during the Norrmalmstorg robbery in 1973, after which he coined the term  Stockholm Syndrome.

In the 1960s, drug addiction was perceived as being the result of society failing its most vulnerable citizens, and drug policy focused on rehabilitation. At the time, Bejerot was fighting a small scale government experiment, where heroin and amphetamines were legally prescribed. He was convinced the government was creating a plague by practically feeding people dangerous drugs, and stressed that non-medical drug use had to be criminalised. Efforts to control drug use and end addiction should focus on street dealers and users, he argued. No consumers, no market.

One reason to why Thörn's medicinal marijuana use wasn't acceptable is because the majority of Swedes still consider marijuana to be dangerous, with insignificant medical properties. It's perceived as a gateway to heavier drug use.

Contemporary pop culture has normalised marijuana to a certain extent, but its illegal status hasn't changed. That's a real pain for people like Thörn, for whom it's an effective remedy. "In recent years we have seen how many countries and states have allowed natural cannabis to be used as medicine," Health Minister Gabriel Wikström wrote to me in an email last year. "The decision to permit it has been taken politically or, in some cases, by courts, without clinical testing. I think that's problematic and not the development I would like to see in Sweden."

"If no other legal alternatives appear, I will supply myself with medical cannabis in one way or another," Thörn told me last year. "Of course I want to medicate with cannabis without breaking the law, but if I'm not given that opportunity, I'll keep my head high and continue to break the law without hesitation or shame."

Thörn stopped the cannabis treatment after his arrest in 2015, after which his health declined almost immediately. After a few weeks, the neuropathic pains were back in full effect – a year later, the prostate inflammation had returned, along with constant anxiety. His work capacity went from 100 to 25 percent.

Thörn is only one of several Swedish cases of medical marijuana use in the past few years. While courts tend to refrain from dishing out prison sentences for this type of drug offence, it can be difficult to understand why these people are prosecuted in the first place. There's no obvious victim and it's unclear what justice is served. "I can't comment on individual cases," Wikström wrote in an email when I asked him about the phenomenon. "But when it comes to pharmaceuticals we have a solid process for approving new drugs in Sweden. This is monitored by the Medical Products Agency. I have confidence in the procedure we have for approving new pharmaceuticals today."

Journalist Magnus Linton has a more straightforward theory. In his book Knark – En svensk historia [Drugs – A Swedish History] he writes, "the point of the [Swedish] drug-free society has never been to penalise drug offence from a standpoint of reasonability in relation to a drug's toxicity or the quantity of possession, but rather, to forcefully punish the betrayal against the common goal [the drug-free society]." The notion follows the Bejerotian logic, which seems feasible. Wikström doesn't reject Linton's affirmation. Instead, he asserts that almost all parliamentary parties support the goal of a drug-free society, but that this can't conflict with the care and treatment needed for drug users and addicts. "The health care policy should enable seriously ill people to live decent lives, I think everyone agrees with that," Wikström wrote to me.

In the end of last week, Thörn's fight to live a decent life finally paid off. After being criminalised by the judicial system for trying to solve his health issues, the Medical Products Agency finally agreed with him. Although the agency emphasises that the decision to prescribe medical marijuana to Thörn and another patient won't change Sweden's stance on cannabis in general, the ruling is previously unheard of – who knows what's next?

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