10/18/2019 Medical Cannabis - HAPA pharm
Medical Cannabis Holistic Health
Continued Medical Education (CME) About
Medical Cannabis
Phytocannabinoids from medicinal hemp act on the endocannabinoid system of the human body, which is involved in
a diversity of physiological functions, while displaying a very favourable safety profile. Many patients use cannabis as
prescription drugs that have a more unfavourable safety profile. Medicinal cannabis follows strict pharmaceutical qual
regarding active ingredient content, stability and purity and may be prescribed by any medical doctor since March 20
with the costs covered by the statutory health insurance funds.
T he legalisation of cannabis for medicinal purposes has been the subject of controversial discussions for many decades,
even though the therapeutic use of cannabis has already demonstrated positive effects in several countries. As an
example, the consumption, abuse, as well as mortality due to (accidental) overdose of prescription drugs (e.g. opioids) has
verifiably decreased in US states where medicinal cannabis is legally available.1
A 2017 cross-sectional study with 2774 cannabis consumers that was published in the Journal of Pain Research revealed that
46% of those surveyed used cannabis as a replacement for prescription drugs. While these figures only illustrate self-reported
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10/18/2019 Medical Cannabis - HAPA pharm
data, certain tendencies are observable: the most frequently substituted classes of drugs were narcotics/opiates (35.8%),
anxiolytics/benzodiazepines (13.6%) and antidepressants (12.7%).2
Narcotics/Opi ates 886
Anxiolytics/Ben zodia zepines 337
Antidep ressa nts 313
NSAIDs/Non-opioid analgesics 238
Others 209
Sed atives/ Hypnotics 144
Muscle relaxants 94
Antiemetics 70
Anticonvulsants 63
Antimigraine 54
Antipsychotics 50
Protonenpumpenhemmer/PPI 23
0 200 400 600 800 1000
Fig.1: Number of reported prescription drug substitutions with cannabis, by drug category (adapted from Coroon et al., 2017)
The plant cannabinoids contained in cannabis, particularly THC and CBD, modulate the body’s own endocannabinoid system
(ECS), which is involved in the regulation of a wide variety of physiological functions (nervous system, immune system,
cardiovascular system, gastrointestinal system, muscles, bones, skin). This also explains the broad therapeutic potential of the
plant 3. Following a 1961 UN Convention, cannabis has been categorised as an illegal drug , on a par with heroin or
cocaine, which has hindered research regarding its medicinal properties and controlled clinical application in recent
decades. Although cannabis has been used as a medicinal plant for thousands of years 4, which in itself should be
considered a testimony to its efficacy and safety, numerous doctors and pharmacists oppose cannabis as a medicine with
disproportionate scepticism.
According to the World Health Organization (WHO), in 2015 an estimated 183 million adults consumed cannabis world-wide;
it is thus the most commonly consumed illegal substance – it was not possible to erase 10,000 years of co-evolution of
humanity and this cultivated plant within a few decades. The WHO subsequently responded and reevaluated the risk of
(recreational) cannabis consumption in 2018: marihuana is now considered a “relatively safe drug” which, in contrast to
heroin, cocaine but also legal substances such as alcohol, nicotine and various medicines, has never led to fatal overdoses. At
most, they deliver a warning regarding possible acute side effects, including an impaired short-term memory formation,
reduced motor control as well as potential risks for the cognitive development of adolescents.5
In any case, medicinal cannabis and its preparations, in contrast to cannabis
from the black market or home-grown cannabis, follow strict quality standards in
terms of active ingredient content and stability, and guarantee the absence of
pesticides, moulds and thinners. This makes research and specific application of
cannabis-based medication possible in the first place. Furthermore, the supervision of
cannabis therapy by a medical doctor serves to minimise potential harm, which is not
the case in an attempted self-therapy with cannabis (e.g. interaction with other
medication, individual assessment of risks and benefits, intervention options in the
event of undesired side effects…).
Previously, the BfArM (Federal Institute for Phamaceutical Drugs in Germany) had granted certificates of exemption for the
treatment with cannabis according to § 3 (2) of the BtMG (German Narcotics Act) for the following diagnoses7:
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10/18/2019 Medical Cannabis - HAPA pharm
Source: German Bundestag (27/03/2017): Antwort der Bundesregierung auf Anfrage der LINKEN (Answer from the Federal
Government to a request from the leftist party Die Linke)
With the inception of the German “Cannabis Law” in March 2017, cannabis flowers and cannabis preparations at
pharmaceutical quality are now marketable and may be prescribed by any medical doctor – excluding dentists and
veterinarians. The legislator rules that the statutory health insurance funds must bear the treatment costs – as long as the legal
prerequisites have been fulfilled. Only in justified exceptional cases shall rejecting the coverage of costs be possible.
Sources
CANNABIS BECOMES MEDICINE
HAPA Medical is an international company focused on the research, development and distribution of cannabinoid-containing drug formulations. We stand for a controlled
cultivation of cannabis plants in the EU as well as for the own production of prescription medicines according to EU-GMP-guidelines.
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