Since March 2017, any doctor of any specialty in Germany can prescribe medical cannabis under certain conditions. In countries such as China and Egypt, cannabis was used as a remedy for various diseases several thousand years ago. To Europe, the medicinal plant came in the 19th century. Nowadays, the plant with its active ingredients reaps a lot of criticism and often unjustified, because some studies have already been able to prove positive results in the treatment of various symptoms. Thus, cannabis could also win some supporters from the medical field. Critics of the plant, however, also see this as a trivialization of cannabis consumption, after all, the plant, also called grass or marijuana, is known as a drug. However, even among cannabis plants there are different types and not all have the same effect, which favors the negative reputation of the plant.
What is Cannabis?
Cannabis is the Latin term for the hemp plant. It contains more than 60 so-called cannabinoids, which are specific ingredients with pharmacological effects. The main active ingredients of the plant are tetrahydrocannabinol (THC) and cannabidiol (CBD). The amount and composition of cannabinoids can vary significantly depending on the variety of the plant. According to this composition also results the respective effect on the human body.
What is medical cannabis?
Medical cannabis is used to treat or alleviate a complaint, symptom, or disease, not for enjoyment. Any cannabis strain that contains an effective amount of active cannabinoids can be considered as medical cannabis. Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the most extensively researched cannabinoids in the hemp plant.
CBD has an analgesic effect. Thus, CBD can have a positive effect on joint pain, but also headaches (migraine) and menstrual pain. CBD has also been used effectively for epilepsy and arthritis.
THC, on the other hand, is used to treat refractory pain as well as spasticity in multiple sclerosis. It is also effective for chronic or neuropathic pain or for loss of appetite, nausea and vomiting as secondary symptoms of chemotherapy.
THC vs. CBD
The two active ingredients differ particularly in terms of their chemical structure and associated effects. These differences determine the use and legality. The most significant difference is the influence of the cannabinoids on the psyche: THC has a psychoactive effect and can be addictive, whereas CBD does not.
Therefore, it is important to be able to differentiate between the two cannabinoids – because the negative reputation of THC does not apply to CBD. THC is mainly associated with marijuana and the intoxicating states of the hemp plant. It falls under the Controlled Substances Act (CSA) and is illegal. CBD, on the other hand, is known for its therapeutic and supportive potential. It is freely available and is now available in various forms, for example directly as a plant or as an oil.
Research results on medical cannabis
Research on medical cannabis is still very incomplete. Nevertheless, the following results can be noted:
In Bavaria, the positive effects of CBD on tumors were proven. Researchers at Munich University Hospital were able to demonstrate a tumor-fighting effect of high-purity cannabidiol for malignant glioblastomas, the most common form of brain tumor in Germany. The cannabidiol apparently kills the cells of the glioblastomas very effectively by stopping cell growth, thus causing the cells to die over time.
CBD is also used for the treatment of epilepsy. A scientific team from Austria and Italy is currently investigating the basic applicability of cannabidiol in epilepsy. The researchers have found that CBD oil-based solutions counteract a wide range of epilepsy symptoms in adults and children.
The Sackler School of Medicine in Tel Aviv conducted a study on effects of cannabis on symptoms of Crohn's disease. The use of cannabis shows an improvement in the subjective quality of life of the participants. Furthermore, the use of cannabis leads to an improvement in sleep, relief of pain, reduction of abdominal swelling, increased appetite and a general feeling of well-being.
What is the legal situation?
While every doctor is theoretically allowed to prescribe medical cannabis, not every patient can have it prescribed. There are legal regulations that cannot be circumvented:
How to get it?
The law on legalization of medical cannabis does not provide any restriction in terms of diseases so far. Basically, medical cannabis can be prescribed by medical professionals for any disease. However, many doctors hold back and limit themselves to diseases for which a positive effect of cannabis has been proven to date or at least suspected based on studies or research.
Who receives a prescription for it?
There are no legal indicators for the prescription of cannabis. In general, patients must be undergoing medical treatment and have already undergone conventional treatment measures. There must be a diagnosed disease with a certain degree of severity for which previous treatments have not shown a positive effect. If the treatment with cannabis can be meaningfully accompanied, a doctor can prescribe cannabis.
When does the health insurance company cover the costs?
The health insurance company must approve the treatment with cannabis. However, this is medical cannabis with a THC content. Pure CBD is now freely available and can be bought on almost every street corner. The law stipulates that health insurance companies may only refuse an application for treatment in exceptional and justified cases.
Some research results prove a positive effect of CBD on specific symptoms and THC is a good alternative to conventional drugs for many sufferers, especially in the treatment of concomitant symptoms of cancer. However, this alone is not enough to completely get rid of the negative image and gain the trust of medical professionals. Primarily, because critics still see the medicinal plant mainly as a pure drug and there are many other drugs whose effects are better researched. However, advocates agree that more intensive research is needed before cannabis can be used regularly for certain therapies. They mention that based on the data already available and the positive experiences, it is imperative to continue research.