Cannabis as medicine

Cannabis as medicine?

You have heard that you can sometimes get cannabis on prescription for serious illnesses? In this information, you will learn what is known about the effectiveness of cannabis medicines and for whom they can be considered. You will also read what risks to expect and what experts recommend.

At a glance

Cannabis can be prescribed for serious diseases. The prerequisite is that other treatments are not available or not possible. In addition, according to medical assessment, there must be a chance that cannabis will improve symptoms. You will usually receive cannabis in addition to your existing medication.

There are indications of efficacy for permanent pain, muscle spasms in multiple sclerosis, nausea and vomiting as a result of chemotherapy or unwanted weight loss, such as in AIDS. The effect was rather small in studies.

More than one in three discontinues treatment with cannabis because of side effects. What is cannabis. How it works?Cannabis is the Latin term for hemp. People have been using this plant for thousands of years: the fibers are used to make ropes, the seeds are used to make oil. The intoxicants hashish and marijuana can be obtained from the dried flowers and leaves. For some time now, more research has been done on the medical effects of cannabis.

The medicinal effects of hemp are mainly due to the ingredients tetrahydrocannabinol (THC) and cannabidiol (CBD). THC has an intoxicating and relaxing effect, it can dampen nausea. CBD has an anti-anxiety effect. Can inhibit inflammation.

What are the rules for prescribing cannabis?

Since 2017, the statutory health insurance companies cover the cost of cannabis medicines in certain cases. Strict requirements apply:

A severe disease is present.

A recognized medical treatment is not available or is not possible according to medical assessment.

There is a not-so-distant prospect of noticeable improvement in the course of disease or severe symptoms.

Your doctor will judge whether these conditions are met. Before the first prescription, you must obtain approval from your health insurance company. Then you get a so-called narcotic prescription in the doctor's office.

When can cannabis be considered?

Cannabis has been studied for the following diseases or conditions, among others:

persistent (chronic) pain

Muscle spasms in multiple sclerosis or paralysis of the legs

Nausea and vomiting, for example as a result of chemotherapy

Unwanted weight loss, for example as a result of AIDS

Whether cannabis is an option for you for these conditions depends on what other treatments might be available and whether the risk of side effects seems acceptable.

Cannabis is usually given in addition to the medication you are already taking, not instead of it. It has been studied only as an additional medicine.

Is cannabis effective?

So far, there are not enough good studies, so it is not possible to judge for sure how effective cannabis is. For persistent pain, muscle cramps, nausea, or weight loss, studies suggest that THC-containing medications can relieve discomfort. However, the observed effect was mostly rather low. Cannabis does not help with sudden discomfort. It takes a while to kick in. Cannabis has not been shown to help with the following conditions: inflammatory bowel disease, Parkinson's disease, movement disorders, tremors, Huntington's disease (a rare hereditary disease) or bladder weakness resulting from multiple sclerosis. Good studies are lacking on other conditions. Cannabidiol is approved for a rare form of epilepsy, but is currently being promoted as a help for many ailments. At present there is no sufficient evidence that it works against it.

What are the side effects?

The most common side effects of cannabis are fatigue and lack of concentration. In addition, the following symptoms may occur: Mood swings, dizziness, dry mouth, dry eye, muscle weakness, increased appetite, palpitations, sudden drop in blood prere, and heart trouble. Life-threatening complications have not yet been reported after medical use of cannabis. Cannabis increases the risk of becoming mentally ill and developing delusions (psychosis). About one in three discontinues long-term treatment with cannabis because of side effects.

Those who use cannabis for long periods of time become desensitized to many of its effects. People talk about tolerance. Those who then suddenly discontinue cannabis may experience withdrawal symptoms.

Do not take cannabis if you are pregnant or have already had psychosis or other severe mental illnesses. Caution is advised in cases of severe cardiovascular disease.

What cannabis remedies are available?

The doctor or physician can prescribe different types of cannabis medicines:

The active ingredients nabilone and nabiximols are available as ready-to-use medications in pharmacies, as capsules, and as oral sprays, respectively.

The active ingredient dronabinol is available in Germany as a so-called prescription drug. So the remedy is prepared for you personally at the pharmacy, usually as oily drops that you take.

Medical hemp is also available in the form of dried flowers or plant extracts. Both must be heated for the ingredients to work. A vaporizer is suitable for this purpose.

Is cannabis as medicine addictive?

The package inserts of cannabis medications list dependence as a possible side effect. Available data do not allow conclusions to be drawn about whether cannabis medications are addictive at the levels that have been studied in trials. So far, such cases are not known. This may also be due to the fact that most studies did not last long enough.

What experts recommend

If cannabis is an option for you for medical reasons, you should receive ready-to-use or prescription medicines. Unlike flowers and extracts do not vary in composition and effectiveness.

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