Cannabis as a drug

"Darling, I'm so strange ...", breathed in the seventies, the Austrian singer Georg Danzer into the microphone. And immediately suspected hashish in the chocolate egg. What was in the 70s not only in the chocolate egg, but also in biscuits and tea, is still in great demand today. According to a report by the United Nations Narcotic Drugs Control Council, cannabis is also the number one illicit drug in Germany.

Concentration increased strongly

In addition to the sharp increase in cannabis Kosum, addiction experts are worried about the concentration of the addictive substance. While the concentration of the intoxicant tretrahydrocannabinol (THC) in the seventies was 2 percent, today it is 25 percent. Cannabis is by no means a harmless drug. However, more and more Westerners are illegally breeding hemp to meet their drug needs.

In Germany, the use of cannabis for self-medication or for pleasure purposes is prohibited. Since 1983, nabilone, a synthetic THC derivative, since 1998 the cannabis drug dronabinol (THC) may be prescribed by doctors under the Narcotics Act.

While the pros and cons of legalizing cannabis are being discussed among politicians, social scientists and health experts, the Cologne Administrative Court has now ruled against the request of five patients suffering from diseases such as AIDS, multiple sclerosis or Crohn's disease. They wanted to obtain a special permit for the cultivation of cannabis in court by the Federal Institute for Drugs and Medical Devices.

This institute usually decides on the cultivation or acquisition of cannabis for scientific or other public purposes. However, according to the Court, that condition does not exist in the case of the chronically ill concerned. This means that even critically ill patients are still not allowed to grow or buy cannabis for their own therapeutic purposes.

Wide range of applications possible

Medical knowledge of the various uses of cannabis is very mixed. For nausea and vomiting in cancer chemotherapy, loss of appetite and emaciation in HIV / AIDS as well as spasticity in multiple sclerosis and cross-sectional diseases are assured knowledge. In other diseases such as epilepsy, movement disorders and depression, however, the evidence is relatively poor.

However, there is no lack of experience reports from illegal users - scientific studies with a comprehensible study design, however, are available only for a few cases with low study participant numbers. It investigates the mode of action of individual cannabinoids, ie synthetic derivatives, as well as much less the effect of the so-called whole plant preparations, ie smoked marijuana or capsulated cannabis extract.

By chance, when investigating the appetite-enhancing effect of THC in Alzheimer's disease patients in 1997, it was not only increased appetite and weight, but also decreased confused behavior. The appetite-boosting effect was also demonstrated in a long-term study of 94 patients over six weeks. In addition, patients were able to maintain their weight for 7 months or more. Equally coincidental was the discovery that certain dosages of cannabis reduce the intraocular pressure, which is suitable for glaucoma patients.

Master nausea and vomiting

In addition to the desired effects, treatment with the main cannabis active THC must always take into account the undesirable side effects. This experience was made in the 1980s, when cannabis was widely used and scientifically studied to alleviate the side effects of cancer therapy. THC was relatively high dose, so that many patients suffered from psychological side effects.

In the United States, it was approved as early as 1985 as an anti-emetic agent by the Food and Drug Administration (FDA). It also helps in individual cases even if other remedies for vomiting fail or their side effects are intolerable.

Positive effect on convulsions and spasms

In patients with paraplegia and multiple sclerosis, smaller studies have found that cannabis products have a positive effect on convulsions and spasms. In addition, cannabis administration was beneficial for symptoms such as pain, discomfort, and tremors. However, despite occasional positive individual reports, this effect could not yet be confirmed for Parkinson's patients.

Studies on the effect of cannabis in patients with Tourette syndrome are promising. While most patients show little improvement, some patients have remarkably good and sometimes complete symptom control.

In epilepsy patients, cannabis has been historically proven as a cure. The anti-epileptic effect of some cannabis products has been demonstrated in animal experiments as well as the fact that the corresponding effect of existing drugs has been enhanced by THC.

Difficulty with the dosage

Cannabis must be dosed individually and very differently depending on the particular disease. Physicians and scientists therefore recommend a "creeping" dosage, so the slow increase in the dose. In the Netherlands, the expectations associated with the release of cannabis have not been met. There, the government was the first country to license cannabis for health purposes.

However, the Dutch coffee shops selling cannabis are proving to be a strong competitor to pharmacies. Here are the prices for 5 grams of cannabis at around 10 €, while the substance in the pharmacy costs 44 to 50 euros. The Dutch authorities warn against shopping in the coffee shops, because the quality offered there does not meet the medical requirements.

Cannabis & Co. in the Narcotics Act

German laws distinguish five groups of substances in terms of medical use. Three groups are governed by the Narcotics Act and are regulated in Annexes I to III. These include THC (dronabinol) and cannabis.

  • Substances that are part of Appendix I of the Narcotics Act are illegal. They are "non-prescription" and "non-marketable" such as heroin, psilocybin, cannabis and LSD. An exception to this general prohibition "may only exceptionally be issued by the Federal Institute for Drugs and Medical Devices for scientific or other purposes of public interest."
  • Substances of Annex II are not prescriptive but are marketable. This means that pharmacies may produce and purchase substances of Annex II, but may not deliver to patients. Many of the substances of Annex II are precursors of substances of Annex III such as isomethadone and dihydromorphone.
  • Substances that are included in Annex III may only be dispensed on a special prescription, a so-called narcotic prescription. These drugs include morphine, cocaine, opium, pethidine, methadone, etc. Since 1983, the synthetic dronabinol derivative nabilone is in Appendix III. Dronabinol (THC) has been prescribable on a narcotic formula since 1998. Narcotics may be prescribed by any doctor.

Two other groups of medications are not regulated by the Narcotics Act. There are the prescription drugs and the non-prescription drugs. The prescription drugs, such as sleeping pills, must be prescribed by a doctor on a regular prescription. The non-prescription drugs can be bought without prescription at a pharmacy. In addition, some medications are not prescription, but pharmacy-only: they may only be obtained from a pharmacy.

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