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A Focus On German Patients: What Do They Still Face?

Written by Marguerite Arnold on . Posted in Medical.

At an undisclosed location, somewhere in Bavaria, a group of activists met on the first weekend of November. They were drawn there by their friendships and their long-time struggles to gain access to medical cannabis.

All of them were sick. But for all the disabilities, across a range and spectrum of chronic conditions, there was also a very serious commitment at the gathering too.
These were all German cannabis patients, frustrated with the many issues still in the room since the market began to reform and change in 2016.

Most have not been able to find regular doctors. All of them have struggled with insurers and finding regular supplies at their local pharmacies (including in big cities like Berlin), and a lot of them are starting to cultivate cannabis again if they ever stopped.

For all of the “reform” in the room, namely that cannabis is now available by prescription in German pharmacies, there is still a long way to go. What is on the market is too expensive not only for patients, but also insurers, to cover in increasingly large numbers. Changing the compensation that pharmacies must charge (as is now in the offing) is just one small piece of the conundrum.

In Germany currently, legal medical cannabis that patients can buy in pharmacies costs more than twice as much as what can be found on the unregulated market, and on the grey market prices can frequently go as low as 5 euros a gram, if not “free” for those who grow at home illicitly.

Some of the more business and cost-minded patients are estimating their costs too. Even the fairly novice growers understand that they are looking at the same costs per gram as growing say, tomatoes. Unless of course, they get caught.

Many patients now carry their cannabis in the pre-packaged containers that all the big companies provide flower in for the German market. The joke of course, if not the reality in every medical cannabis market in Europe right now, is that it is not what is actually in those plastic jars.

The patients at the deep end of both sick and tired are defending themselves in the only way that they can. As more than one of the meeting attendees said, “What are they going to do? Arrest me? They already have.”

Everyone knows at this point though, that at least a part of the battle has indeed been won. Germans at least know that really sick people can in fact legally obtain and use cannabis. The particulars, at least so far, however, have not moved the needle anywhere fast enough.

For those whose mobility and/or budgets are limited by their condition, the only way to respond in both protest (if not effective challenge) is very simple – grow their own, or be part of a cooperative that includes them for free or for a minimal charge in a circle of people who know this is the only drug that helps them manage their condition so effectively.

To leave them out of the circle of care, would be, at its core, a very un-German thing to do. It is not a message that the “industry” wants to hear, but it is in the room and as a steady drumbeat that will not go away.

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The IACM Pushes The Medical Conversation Globally

Written by Marguerite Arnold on . Posted in Medical.

Dr. Grotenhermen, the charismatic canna doc you might have seen or encountered in the world of ground-breaking medical cannabis science auf Deutschland, was on stage a lot in Berlin last week. He and a group of world-famous scientists, doctors, and medical researchers came together, as they do once every two years, for the bi-annual meeting of the International Association of Cannabinoid Medicines.

The audience was large, international and attentive.

What Is New?

There is clear evidence that cannabis is a wonder drug for a range of neurological conditions – from Parkinson’s’ to Alzheimer’s to epilepsy and traumatic brain damage. That was a big part of the conference discussion.

There are brave doctors who now say, in public, and professional conferences such as this one, that treating seriously ill children with cannabinoids, including small amounts of THC, is also effective.

The opioid-cannabinoid discussion was also in the room, with rather shocking data out of the US proving what activists and advocates have long known – cannabis is a gateway drug off of opioids, not on to it.

One of the coolest things about this conference is that it has stayed true to, since its inception, the inclusion of patients. Everyone in the room knows how hard it is to get trials going, and every serious canna doctor also knows that sometimes their best “research labs” are the unceasing din of patients now demanding the drug.

While the research and the data from both mouse and human trials is important, so are patient experiences and the IACM has never forgotten that.

The IACM is also making a concerted effort to bring diversity to speakers. There is now spoken understanding that women and cannabinoids are the next unexplored frontier.

Perhaps the best panel from the nitty gritty end of the conversation was a frank “how to” for doctors considering treating their first cannabis patient. There are not enough of them. Anywhere. A fact that the IACM is also dedicated to changing.

What Is Not New?

As encouraging as advances are, if not the range of voices now uniting globally calling once and for all for medical change, there of course is much that is not new.

Doctors and researchers talked about frustrated funding efforts, including for trials. Patients as always have stories to share about stymied access and punishment.

There is a deep seated understanding, at least within the ranks of the pro-cannabis medical community, that the pace of change and acceptance is still too slow. As one questioner to the patient panel posited, perhaps the medical community should again take up the mantle of struggle that was first pioneered by gay activists in the struggle against AIDS and dropped during much of the modern legalization movement post 2010 in Canada and the U.S.

We are, as cannabis patients, everywhere. Get used to it.

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Canada: Seniors Are The Age Group Showing The Most Growth In Cannabis Usage

Written by Johnny Green on . Posted in Business.

For decades people were inundated with anti-cannabis propaganda all over the planet. That unfortunate phenomena still exists in many parts of the world, however, an increasing number of countries are choosing to reform their cannabis laws.

Canada is one of those countries, having been home to a large medical cannabis community for a while now and having become the first G-7 nation to legalize cannabis for adult-use last year. Uruguay legalized cannabis for adult use prior to Canada doing so, however, it does not have as robust of a regulated cannabis industry as Canada does.

The stigma is fading in Canada now that people are seeing that the sky hasn’t fallen post-legalization.

Typically the older a person is, the less likely they are to support cannabis reform and/or personally consume cannabis, and while that’s still the case in Canada, seniors are now the fastest-growing cannabis consumer age group according to data recently released by Statistics Canada:

Cannabis use is less common among seniors than it is in other age groups (7%, compared with 10% at ages 45 to 64, 25% at ages 25 to 44, and 26% at ages 15 to 24). However, cannabis consumption among seniors has been accelerating at a much faster pace than it has among other age groups. For example, in 2012, less than 1% of seniors (about 40,000) reported using, contrasting sharply with estimates from 2019 indicating that more than 400,000 seniors have used cannabis in the past three months.

The increasing popularity of cannabis among older adults has also contributed to an increase in the average age of cannabis users, which has risen from 29.4 years in 2004 to 38.1 in 2019.

The data released by Statistics Canada demonstrated that 27% of the consumers in the senior age group were brand new cannabis consumers. The data also demonstrated that seniors were less frequent users compared to younger age groups, that they were more likely to use cannabis for medical reasons compared to other age groups, and that they were much more likely to exclusively make their purchases from legal sources.

Cannabis stigma has been much more prevalent in decades past, which is reflected in this data. Younger consumers were not subjected to as much reefer madness as older generations, and so it’s not a coincidence that younger people are more likely to have consumed cannabis than older citizens.

But as the stigma continues to fade and seniors share their positive cannabis experiences with other seniors, the consumption rates for the senior age group will continue to rise, which is not a bad thing at all.

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Which Conditions Are Receiving The Most Medical Cannabis Reimbursements In Germany?

Written by Johnny Green on . Posted in Medical.

The cannabis plant is one of the most versatile plants on earth. It has the power to feed, the power to clothe, and the power to heal. A growing number of suffering patients are turning to the cannabis plant to help treat their condition, including in Germany.

Since 2017, doctors in Germany have had to report medical cannabis information to the German government. It’s a requirement whenever German doctors prescribe medical cannabis that’s covered by statutory health insurance and thus is eligible for reimbursement.

The requirement to provide data makes it very easy for the German government to publish statistical data since the data is readily available. Germany recently disclosed the health conditions that have received the most reimbursements as of September, a summary of which can be found below along with what percentage the condition represents from the data set:

  • Pain (70.9%)
  • Spasticity (10.8%)
  • Anorexia (6.9%)
  • Epilepsy (1.6%)
  • ADHD (1.5%)
  • Tourette Syndrome (1.0%)

The remaining 7.3% is comprised of ‘other’ non-specified conditions. As you can see from the data, pain is the most likely condition to receive medical cannabis reimbursements in Germany by far, although that doesn’t mean that it’s necessarily the only condition that those patients suffer from.

It could be that using cannabis for pain management is really popular in Germany, but it could also be that pain is an easier condition to qualify for and that pain is a symptom of a number of other health conditions.

Many patients in Germany could very well suffer from multiple health conditions yet chose to only qualify for medical cannabis for pain management reasons. Rather than go into great detail with their doctors and be subjected to a number of tests, they can simply establish that they are suffering from pain and that cannabis helps.

This survey data that was released by BfArM involved 6,538 patients, although that’s not to say that there are only that many medical cannabis patients in Germany. German doctors are required to report the data only after the patient has received reimbursements for a full year or ‘as soon as treatment is interrupted.’

The number of patients involved in the study will increase over time. The requirement to participate in the data survey will continue until March 2022.

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The German Cannabis Market Is Projected To Reach $16B By 2028

Written by Johnny Green on . Posted in Business.

Germany is home to the largest legal cannabis market in Europe, which is not surprising given the fact that Germany has the fourth-largest economy on the planet. Germany’s population is more than twice that of the state of California.

In addition to Germany’s medical cannabis industry expanding, lawmakers in Germany are reportedly exploring the idea of legalizing cannabis for adult-use. Obviously, if that happens Germany’s legal cannabis industry will increase in size dramatically.

How big will Germany’s legal cannabis industry get? A new projection has been released by Prohibition Partners in regards to Germany’s cannabis industry, and it involves an eye-popping figure. Read more about it in our recent article on Cannabis & Tech Today.

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The Cannabis Industry Is Giving Old Security Technology New Life

Written by Johnny Green on . Posted in Business.

Technology is an evolving thing in virtually every industry on the planet, and security technology is no exception. Facilities have become high-tech and have incorporated surveillance and biometric technology that is like something straight out of a James Bond film.

The technology revolution in the security industry, combined with changes in public policy and an increased reliance on the internet, has resulted in many correctional institutions and financial facilities going vacant.

In years past those types of facilities would have been bulldozed and replaced with more modern structures. However, thanks to the cannabis industry those facilities and the basic security features that they possess are being given new life.

Read about how former prisons, banks, and other secure facilities are being put to use by the emerging cannabis industry in our recent article on Cannabis & Tech Today.

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How Reliable Is Cannabis DUII Technology?

Written by Johnny Green on . Posted in Science.

One of the most common talking points for cannabis opponents is the claim that if cannabis laws are reformed there will be mayhem on public roadways.

The ‘stoned driver epidemic’ doomsday prediction is very popular among people and organizations that campaign and lobby against cannabis reform all over the globe.

No country is immune to the phenomenon. If cannabis reform is being explored, cannabis opponents will come from all over the place to parrot this talking point.

With more countries successfully implementing cannabis reform policies, this talking point is becoming less effective since the doomsday predictions are not becoming reality.

However, cannabis is still an intoxicating substance, and driving under the influence is a very serious issue that deserves constructive conversations and solutions that are based on science.

As countries around the world try to adopt sensible ways to prevent cannabis DUIIs, breathalyzer technology is a popular option for international lawmakers. 

Cannabis Breathalyzers – Effective Technology Or Junk Science?

People that are not familiar with cannabis science often make the false assumption that cannabis intoxication can be effectively measured using a breathalyzer device.

It’s easy to understand why people make that false assumption. After all, breathalyzer technology is very effective at determining if a person is too intoxicated from alcohol consumption to safely operate a motor vehicle on a public roadway.

Unfortunately, the same is not true for cannabis consumption.

All cannabis breathalyzers on the market right now can detect the presence of cannabis, yet they cannot determine if the subject of the breathalyzer is intoxicated or not at the time of the test.

Cannabis affects different people in different ways. An infrequent cannabis user can consume an edible with 5 mgs of THC in it and be too impaired to safely operate a motor vehicle.

A user that consumes cannabis on a frequent basis can consume significantly more than 5 mgs of THC and be able to easily operate a motor vehicle in a safe manner.

Cannabis stays in a person’s system for a long time, especially when the person is a frequent cannabis consumer. 

A breathalyzer may detect cannabis use by a person that occurred well before the person operated a motor vehicle. 

Conversely, a breathalyzer may not detect cannabis use by a newbie since the driver consumed such a small amount of THC, even though the driver may be too impaired to drive at the time of the test.

Canadian Researchers Look At Cannabis Impairment And Motor Vehicle Operation

A group of researchers in Canada recently conducted a double-blind, placebo-controlled clinical trial in which cannabis consumers ‘were randomized with a 2:1 allocation ratio to receive active (12.5% THC) or placebo (0.009% THC) cannabis.’ 

Study participants were then split into two groups – low and high THC, as measured by concentrations of THC in their blood at the time of the trial. 

The participants then performed simulated driving tasks and were assessed 30 minutes, 24 hours, and 48 hours after consuming cannabis.

Researchers concluded the following:

Ninety-six participants were randomized, and 91 were included in the final analysis (30 high THC, 31 low THC, 30 placebo). Mean speed (but not lateral control) significantly differed between groups 30 minutes after smoking cannabis (p ≤ 0.02); low and high THC groups decreased their speed compared to placebo. Heart rate, VAS drug effect and drug high increased significantly immediately after smoking cannabis and declined steadily after that. There was little evidence of residual effects in any of the measures.

The lack of residual effects from cannabis consumption on the drivers in the trial is significant from a DUI policy perspective.

If a cannabis breathalyzer only measures the presence of THC, and not how long ago the consumption occurred or if the consumption caused impairment, the breathalyzer results are basically useless.

Proving Impairment Is Vital For Effective Public Policy And Safety

Responsible members of society want their public roadways to be safe, and responsible cannabis consumers are a subset of that group.

A responsible cannabis consumer does not operate a motor vehicle when impaired and does not want to be lumped in with irresponsible cannabis consumers that get behind the wheel when they shouldn’t.

Because of that, responsible cannabis consumers are helping lead the charge when it comes to developing effective ways of detecting cannabis impairment.

Simply detecting whether or not cannabis use has occurred is not enough. The same is true for measuring metabolized THC in a person’s system.

A much more effective approach is conducting field sobriety tests in a way that incorporates effective technology.

An example of such technology is the Canary App which was developed by NORML. The Canary app ‘combines decades of research and experience, specialized mental and physical performance tests, and sophisticated analysis to accurately measure impairment due to alcohol, medication, fatigue and even the subtle impact of marijuana.’

Performance test technology accounts for a person’s cannabis tolerance level and measures cannabis impairment far more accurately than a breathalyzer that merely detects the presence of THC.

Cannabis DUI laws need to be based on science, not political views, and the technology used by enforcement agencies around the world is obviously part of that.

As lawmakers in countries around the globe continue to explore cannabis reform, effective cannabis DUI detection technology needs to be a top priority.

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Paraguay Legalizes Industrial Hemp

Written by Johnny Green on . Posted in Politics.

The global industrial hemp market is currently estimated to be worth nearly five billion dollars (USD). By 2025, it is projected to be worth over $26 billion dollars (USD).

For a number of years, the industrial hemp industry was significantly limited by prohibition policies all over the globe. Fortunately, things have changed in recent years.

A number of countries around the world still prohibit hemp production, however, a growing list of countries are allowing farmers to legally cultivate the versatile plant, with the latest being the nation of Paraguay. Per La Nacion:

On Monday, the Executive Branch announced that President Mario Abdo signed the regulatory decree for the controlled production of industrial hemp or cannabis. It establishes that family farming producers can grow it.

The policy change allows every family in Paraguay to cultivate up to a maximum of two hectares of low-THC industrial hemp. Two hectares equates to slightly under 5 acres.

How Much Money Can A Family In Paraguay Make From Cultivating Hemp?

Each hectare of industrial hemp in Paraguay is valued at roughly 10,000,000 Paraguayan Guarani, which converts to roughly $1,545.00 USD.

If a family in Paraguay can successfully cultivate and harvest 2 industrial hemp crops annually, that’s a significant income boost considering the per capita GDP in Paraguay ($9,826 USD).

Paraguay’s industrial hemp industry model is very interesting in that it is built on a cottage industry model.

Out of a population of roughly 7 million people, it is estimated that as many as 25,000 families will take advantage of the recent policy change.

How Popular Will Hemp Cultivation Be In Paraguay?

How widespread hemp cultivation ultimately proves to be will largely depend on how profitable it is for families.

For families who live in areas with rich soil and a climate that is suitable for proper hemp cultivation, the 2-hectare limit may prove to be too low. For families who live in less ideal areas, reaching the cultivation limit may never be a concern.

The hemp plant will grow just about anywhere, however, to grow in a manner that yields a desirable harvest the hemp plant needs good soil and a mild climate.

Technology can help increase yields and quality, although it may be tough for some families to afford sophisticated cultivation equipment and light deprivation greenhouses in Paraguay.

Demand For Hemp Will Continue To Increase

The hemp plant is one of the most versatile plants on earth, with tens of thousands of products being able to be made from it.

In recent years the popularity of CBD, which the hemp plant is rich in, has exploded all over the planet. 

Demand for CBD products is what is going to drive the hemp industry forward, in Paraguay and beyond. Consumer demand for hemp-derived CBD will definitely increase, including CBD derived from industrial hemp from Paraguay.

However, whether or not families in Paraguay will reap the rewards will have to be seen as time goes along. 

Comparatively, farmers in the United States are making tens of thousands of dollars per hectare from hemp. The estimated value for hemp in Paraguay is considerably less. 

Hopefully Paraguayan families get an equitable share of any profits generated by Paraguay’s hemp industry. If not, Paraguay’s industrial hemp industry will never reach its full potential.

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France Authorizes A Cannabis Experiment

Written by Marguerite Arnold on . Posted in Medical.

On October 25, the French National Assembly finally gave the green light to a national experiment with medical cannabis. This has been in the offing for some time. As of now, the French government is finally willing to give the cannabis discussion a two-year trial. The Medicines Agency has already signed off.

Cannabis will be able to be prescribed for patients with treatment-resistant conditions including epilepsy, nerve pain, side effects of chemotherapy and for diseases of the central nervous system, including uncontrolled muscle contractions.

That said, the French are skipping the idea of “prescription joints” and will make oils and other ingestible basics (including drinkables) available via French doctors and through French pharmacies.

Prescribing doctors will have to complete an online training course, the details of which have not been released.

Will France Challenge Germany As Europe’s Most Lucrative Market?

Comparisons between France and other countries when it comes to cannabis are at this point premature. However, the French are certainly approaching the issue in a way that so far, even Germany has not.

Doctor training and certification, for example, are not centrally managed, administered, or even made available (no matter how many people are trying to set this up). However, Germany will be a producer within the next two years, unlike current plans in France. Unless and until French cultivation happens, French patients will be caught in the same conundrum as everyone else in Europe.

The idea of getting a prescription is very nice, but actually obtaining one, plus the approvals of health insurance to remove the burden of payment, is much, much harder than many people think.

In the short term look for more foreign-based businesses to get established in France, and further to see products entering the country from all points of the globe, starting with Portugal, Spain, Greece, and Poland.

There is a silver lining of course. Now that the two most powerful, economically intact economies in Europe are in the cannabis basket, it will drive other kinds of reform.

The idea of getting patients into an established program and out of the unregulated market is the ultimate goal, of course, however, it is a goal that is so far unreachable in an environment where medical cannabis is still expensive and far too hard to obtain.

So yes, vive la cannabis! But this is hardly the great green wave revolution most in France, if not in other places, have hoped and fought for. This is not the vision of the “industry” that most have sacrificed and worked for.