Now the facilitations for medical hemp have finally come into force and a new era begins. Doctors and physicians can prescribe THC-containing hemp without having to apply for an exemption permit. In the next few years it will become clearer exactly what this now means in everyday life for sick people.
At present, physicians seem to rarely consider this new possibility. Many refuse to prescribe cannabis in general. As of May 2023
This is the old text, which reflects the situation until summer 2022. A revision will follow by the end of 2023.
Prohibited narcotics
Narcotics Act NarcA, SR 812.121, Article 8, Paragraph 1 (narcotics of the effect type cannabis), in PDF (2023) on page 8
Restricted medical use
Narcotics Act NarcA, SR 812.121, Article 8, Paragraph 5, in PDF (2023) on page 8.
In the medical field, THC-containing preparations are only legal if exemption permits have been issued for the entire process (and are also regularly renewed). Thus, several temporary exemption permits are needed, as well as physicians who assume the entire responsibility.
The crucial thing is to find a doctor who really wants to treat with hemp and knows what it is all about. You must really want to take on the effort. But also with commitment: It takes time and patience. Only a few sick people have made it so far.
Anyone who violates the conditions of the licenses can have their license revoked and be punished. In principle, the distributor always has one foot in the door as a drug dealer, because if a license is not valid, the NarcA applies (misdemeanor, because it is a transfer ).
A doctor must determine that a sick person could be helped with THC therapy and submit a corresponding application to the Federal Office of Public Health FOPH. On the one hand, synthetic products such as dronabinol, also known as Marinol, can be prescribed. On the other hand, products such as Sativex or specially produced tinctures (so-called extemporaneous preparations), which are made from natural cannabis, can also be prescribed. These preparations contain 2.5 to 5 % THC. In addition to the active ingredient content, how the preparation is taken plays a key role. To prevent the products from being misused as stimulants, cannabis flowers or concentrates are not approved.
Dronabinol, for example, is used in Switzerland for the following symptoms, among others: Nausea and vomiting, loss of appetite and emaciation, anorexia and weight loss, spasticity, muscle spasms and muscle stiffness, pain conditions, asthma, glaucoma, epilepsy, sleep disorders and anxiety, and movement disorders. Sick people with these symptoms suffer, for example, from multiple sclerosis, cancer, AIDS, Alzheimer's disease, hepatitis C, anorexia or other serious illnesses. In Switzerland, most exemptions concern cancer, followed by multiple sclerosis.
The whole chain of activities leading to the final product “hemp-based medicine” and having something to do with its distribution to patients is subject to authorization. This includes the cultivation of hemp, the production of medicinal products, the treatment and the trade of cannabis as medicine.
When doctors submit an application to the FOPH for treatment with THC on the basis of their diagnosis, they must do the following:
confirm in writing that they accept responsibility for the consequences of their prescription; provide the name, address, age and written consent of the patient(s); disclose the medication used to date; declare the intended dosage and intended duration of treatment; prepare an interim report on the treatment every six months, as well as a final report for the FOPH; describe the logistics of dispensing the medicine (in doing so, the doctor himself or herself, a pharmacy or a hospital may only dispense the hemp-based medicine directly to patients).
It is positive that one does not have to be out of treatment as in other countries (there is no regular therapy left that could help) to make an exception request.
If the drug is to be dispensed by a pharmacy, it requires an operating license for controlled substances in accordance with Article 11 of the Narcotics Control Ordinance. Such a license is also required if a pharmacy itself wants to produce a medicine from the prohibited cannabis, such as a hemp tincture.
The cultivation of hemp (from 1% THC), which is to be used for the production of medicines, is also regulated by law. Basically, the “grower” needs an operating license or must act on behalf of an authorized company. An application for an operating license must contain the following: sufficient protection against theft; a written contract with an authorized operation; precise information on the type and quantity of cultivation; a guarantee that the entire quantity of cultivation will be delivered to the client.
Due to the low content of active ingredients, the preparations are not suitable for all patients. Thus, some are not spared from supplying themselves on the side on the black market. There is also a strict ban on driving during cannabis therapy, even at low doses, which are intended to prevent a psychoactive effect. The costs are not necessarily covered by health insurance. Thus, not everyone who has a permit can afford this therapy.
The bureaucratic effort deters most potential producers of medical hemp from growing legally. The costs incurred due to the various licensing requirements mean that a drug that has cleared all the hurdles to then be exceptionally approved for treatment is not cheap. The costs can quickly amount to hundreds of francs per month.
From 2012 to 2018, 12,000 exemptions were granted (limited to 6 to 12 months). Soon, an exemption will no longer be necessary, only a doctor's prescription will be required (see box below).
We have summarized the ongoing discussions on changing the legal situation regarding cannabis medicines here.
THC use has multiple effects on the user. If it had no effect, we wouldn't want to use it. There are both positive and negative effects. So there are also undesirable side effects. These two sides exist. The positive side is much stronger than the negative side.
An incomplete collection of links…
Those who want to transport prescribed narcotics in the Schengen area will find some information here.
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