A situation analysis from the perspective of Swiss cannabis patients
As attitudes towards cannabis change around the world, many now feel that it is no longer a problem to use cannabis medicinally. But that is not the case in Switzerland. The requirements for legally obtaining the remedy that has been tried and tested for thousands of years are still complicated and the legally available products are in low doses and very expensive. Current legal regulations actually make it impossible to properly treat serious illnesses or illnesses with cannabis. The costs incurred are enormous at high dosages. This special permit was created by the Federal Office of Public Health precisely for seriously ill people.
Now a new regulation for medical delivery is being presented. At this point it should be said that the patients are, first and foremost, just happy that something is changing at all. They have been in an impossible situation for decades and now they finally deserve legitimacy.
Various interest groups such as pharmacists, Swiss farmers and CBD producers are positioning themselves and want to earn money with medical cannabis. Large international companies and the pharmaceutical industry also want to get involved in this new market. A new billion-dollar market is emerging worldwide.
The Federal Office of Public Health estimates that up to 100,000 Swiss patients use cannabis medicinally despite the ban. The interest in our Association shows that there is a much larger target group. This development can also be seen in Germany. The interest in medical cannabis is much greater than expected. It is all the sadder to see that Switzerland is losing touch internationally due to its slow political structures.
Who are these estimated 100,000 cannabis patients?
These people come from all ages and walks of life. They often have a long history of suffering behind them. Many have serious diagnoses or severe pain. In addition to the physical and psychological management of the sometimes complex illnesses of those affected, the procurement and financing of cannabis medication poses another challenge. But there are also those who use cannabis like other herbal medicines to relieve their migraines, age or menstrual problems or other ailments.
Cannabis is the drug of choice for these patients. They have consciously changed their therapy or combined it with conventional medical methods and medications. They are convinced of the effect and consider the side effects to be weaker and more pleasant than is the case with many medications. Many have been treating themselves for years, have a great deal of know-how about the use and production of their medication and, in some cases, have in-depth specialist knowledge.
In recent years, patients around the world have networked via social media and are sharing their experiences. There are patient meetings in various cities in Switzerland.
What do cannabis patients need ?
Cannabis patients need affordable and controlled medication, more understanding and support from doctors, competent advice on use and the legitimacy to use cannabis medically.
What cannabis patients fear from new medical regulation
Cannabis is currently being approved for medical use in many countries. These cannabis medications are often sold in pharmacies. The handling from the producer to the pharmacist increases the prices compared to the black market. If the costs are not paid by the health insurance companies, the patients cannot afford the medication despite a prescription from the doctor.
In addition, the quality of cannabis flowers in Germany, for example, is sometimes poor. The German Hemp Association also criticizes the fact that supply bottlenecks for cannabis flowers have been the norm since cannabis was legalized as medicine. Demand was completely misjudged and only 3 to 6 of 32 approved varieties are available. These delivery bottlenecks are associated with significant disadvantages for patients. The example of Germany shows how difficult it is to introduce a functioning medical tax and how important it is not to be dependent on producers from other countries.
Thanks to the CBD boom that emerged a few years ago, Switzerland has a great deal of knowledge about cultivation and an already functioning infrastructure for production. This advantage should not be lost. CBD producers could switch to medical cannabis overnight.
Patients have mixed feelings about the BAG's proposed solutions. It is to be feared that, as in other countries, it will primarily be the pharmacists and the large, international cannabis companies that will get the chance. This turns cannabis into an expensive drug. But there are also countries with other approaches, such as Spain or Belgium. There, patients have the opportunity to grow a certain number of plants themselves or to organize themselves into Medical Cannabis Social Clubs (MCSC). With the estimated 100,000 patients, some of whom have in-depth knowledge and have been connected for years, this would be a sensible approach for Switzerland.
What cannabis patients need before new medical regulation
The affected patients need immediate, unbureaucratic access to medical cannabis until new medical regulations come into force. The current regulation is not practical. Only a few thousand have a BAG permit. Everyone else is treating themselves illegally and is committing a criminal offense. MEDCAN demands impunity for all Swiss patients.
According to BAG, a new regulation for the medical supply of cannabis will go into consultation in June 2019. It will certainly take more than two years before anything changes in the patients' situation. Those affected have been waiting for a long time and can watch the situation around the world changing almost every day. You need a practical interim solution. Otherwise the patients will be forced to help themselves.
Home cultivation and permission to set up medical cannabis social clubs
Until new medical dispensing regulations are implemented and the costs are paid by health insurance companies, those affected must be able to produce their medication as cheaply as possible. The cannabis products available from pharmacies with a license are far too expensive and can push patients to the limit of their financial possibilities. The only way for those affected to get affordable and clean cannabis medicine is to grow their own cannabis.
Patients suggest Medical Cannabis Social Clubs (MCSC) as a concrete model.
- Any Swiss patient who is prescribed cannabis by a doctor can become a member
- Cultivation, harvesting and further processing of cannabis into medicine is carried out by the Association .
- Cannabis is sold exclusively to members
- Each member receives the medically indicated amount they need for their own needs
- Trading cannabis or supplying it to third parties, especially minors, is illegal and will result in exclusion
MEDCAN advocates and supports scientific monitoring of this Association to gain experience for medical
Suggested solutions from patients for dealing with medical cannabis
As you can see in Germany, the demand for the medical use of cannabis is high. This demand will increase in the coming years. Switzerland should not limit itself to just one distribution option. Doctors will be confronted with very different patient groups. Some people already know exactly what they are doing and others need more advice.
On the one hand, we can imagine specialized cannabis pharmacies (dispensaries) in California, analogous to today's CBD shops, where you can get your medication with a prescription from a doctor and showing ID. However, this assumes that the sellers are allowed to provide information about the medical use of cannabis. Of course, this could also be done by pharmacies. However, there is a legitimate risk here that, as in Germany, the costs will become more expensive. In both cases, sales staff must be trained.
Since a lot of experience in medical use can be found among the patients themselves, our preferred solution is permission to grow our own cannabis and to set up medical cannabis social clubs. Those affected can organize themselves into Association and grow and produce their own medicines. This would be primarily intended for people who have been treating themselves for years. Their experiences should be documented scientifically and learned from them. Not using this knowledge would be a big mistake. Since there are only empirical reports and no studies for many diseases, this is the quickest way to better understand the medical effects of cannabis.
An important requirement for patients is that cannabis flowers are regularly examined for their ingredients in the laboratory. They support the idea of a cannabis label to ensure that the raw material for the medicine is not contaminated with pesticides or heavy metals. This is particularly fatal for sick people.
Adequate cannabis medications
In countries such as the USA, Canada, Spain and Israel, patients are now treated with medical cannabis. You have different options for taking it. This is important for the user because the form of consumption also has an influence on the effect. Swiss patients need cannabis full extracts and cannabis flowers from different types of cannabis, which have a different effect depending on the cannabinoid composition. The medication must indicate what type of cannabis it is and what THC/CBD ratio the plant has. The drug must also be tested for pesticides, fungal spores and heavy metals.
Affordable cannabis medicines
The cannabis medicines that can now be obtained legally in Switzerland with a BAG permit are expensive.
The prices correspond to several times the black market. These horrendous prices are incomprehensible. Patients need affordable medicines that correspond to prices in other countries. The cost of the medication must not exceed black market prices. This would only mean that many people would continue to have to stock up illegally because they cannot pay the costs. In addition, it must be precisely regulated when health insurance companies have to pay for the medication. Training and further education of doctors
Cannabis can only be used medically if prescribed by a doctor. To date, medical students have not taught anything about the endocannabinoid system and the medical use of cannabis. However, this knowledge is absolutely necessary in order to be able to provide proper advice and treatment. That's why it's still difficult to find a medical professional who can support patients if they want to treat themselves with cannabis. Our experience shows that both doctors know that cannabis can help with many indications. Unfortunately, however, they usually have neither specialist knowledge nor practical experience in medical applications and therefore often treat patients with a negative attitude. Without medical support, those affected have no opportunity to try out their preferred medication. The most frequently asked question to the Association is where to find a doctor to prescribe.
Competent advice on sales
It is also important that the future advisory sales staff is well trained and can provide competent information and advice. The cannabis variety plays an important role, especially in medical use. The dosage of the medication can also vary greatly from patient to patient and requires some patience when adjusting. For severe illnesses, high doses and an adjustment period are sometimes required. Advice on taking medical cannabis requires some experience. At the moment, this experience is mainly shared by other affected people with the same diagnoses. They exchange ideas in patient groups.
Cannabis is not just a medication for serious illnesses:
Today, cannabis is only used for serious illnesses such as MS, paraplegia, cancer or for difficult pain issues. Patients often have to prove that they have exhausted all other pharmaceutical remedies. Especially with cannabis as a painkiller, it is clear that many symptoms can be alleviated before the use of addictive opiates or other medications. Cannabinoids are not harmful to the internal organs in the long term and it is now known that they can be used for a wide range of therapeutic effects. Nevertheless, it is often argued that there are no studies that prove the effect. For many illnesses there are only reports from other sufferers. The cannabis doctor Dr. Franjo Grotenhermen says his patients treat 50 different conditions with cannabis. The lack of studies for many ailments does not mean that cannabis does not alleviate these symptoms. Cannabis is not a miracle cure and does not work for everyone. However, when cannabis medications are effective, they can significantly improve the quality of life of those affected. Our experience as a patient association shows that the number of older patients who do not want to take conventional medication and treat their aging problems with cannabis is constantly increasing. This group of patients, especially older women, would sometimes prefer to be allowed to grow their cannabis tea in the garden.