Cannabis: a legitimate medicine
Long-time cannabis advocate Franjo Grotenhermen is the founder of the International Association for Cannabinoid Medicines and a practicing doctor in the state of North Rhine-Westphalia. He talks about the potential and the pitfalls of the German cannabis market.
Which areas need more research and development in this growth market?
Many people think of cannabis as just pain medication, but that’s not the full picture. Even before the 2017 legislation, it was used to treat 50 different kinds of medical issues. There are several promising areas of research such as psychiatric therapy. We have seen good results in neurodevelopmental disorders like attention deficit hyperactivity disorder (ADHD) and compulsive disorders, as well as in post-traumatic stress disorder (PTSD). This has relieved concerns that cannabis could worsen psychiatric problems. I have over 200 patients with ADHD I’m successfully treating with cannabis, and there are also patients with compulsive disorders who have had success with the cannabinoid tetrahydrocannabinol (THC). That is supported by research done in other countries.
There are other areas such as autoimmune disorders like Crohn’s disease or rheumatic disorders where cannabis can be used as an anti-inflammatory. And certain dermatological conditions like psoriasis have been treated successfully as well. But for many other conditions – from restless legs syndrome to tinnitus – we have very little scientific research so far.
Is there a reason for the lack of R&D?
We have some cannabis companies in Germany that have capital but no apparent desire to do research. You can understand why. If they spend EUR 10 million on research that becomes publicly available, their competitors also profit from it. However, we do need more research. I am always trying to encourage this. In my opinion, it would be great if more companies worked together to support research projects.
At the end of the day, products backed up with research will be prescribed more often by doctors, who prefer to work on a scientific basis. And patients want to know the facts as well – does cannabis help 5 percent of patients with a particular condition, or 50 percent?
Which kinds of cannabis products do you think have the most potential? For example, should Germany be investing in more ready-made medications?
I believe everything has its place. Physicians usually prefer standardized, ready-made medications. They are more familiar with these kind of drugs that are also traditionally more likely to be covered by insurance companies.
On the other hand, the more familiar you become with cannabis the more you understand how the various extracts and strains work. If doctors and patients are more experienced with cannabis, they can more carefully calibrate treatments, for example by using a combination of oral preparations and flowers. The German market certainly needs more information on things like which strain and which active ingredient is good for which condition.