PHIL420

Patient Advocate since 1977


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“I don’t feel high or stoned, All I know is I feel better when I take this.” – Ruth Brunn, 98

Ruth Brunn finally said yes to marijuana. She is 98.

She pops a green pill filled with cannabis oil into her mouth with a sip of vitamin water. Then Ms. Brunn, who has neuropathy, settles back in her wheelchair and waits for the jabbing pain in her shoulders, arms and hands to ebb.

“I don’t feel high or stoned,” she said. “All I know is I feel better when I take this.”

Ms. Brunn will soon have company. The nursing home in New York City where she lives, the Hebrew Home at Riverdale, is taking the unusual step of helping its residents use medical marijuana under a new program to treat various illnesses with an alternative to prescription drugs. While the staff will not store or administer pot, residents are allowed to buy it from a dispensary, keep it in locked boxes in their rooms and take it on their own.

From retirement communities to nursing homes, older Americans are increasingly turning to marijuana for relief from aches and pains. Many have embraced it as an alternative to powerful drugs like morphine, saying that marijuana is less addictive, with fewer side effects.

For some people, it is a last resort when nothing else helps.

Marijuana, which is banned by federal law, has been approved for medical use in 29 states, including New York, and the District of Columbia. Accumulating scientific evidence has shown its effectiveness in treating certain medical conditions. Among them: neuropathic pain, severe muscle spasms associated with multiple sclerosis, unintentional weight loss, and vomiting and nausea from chemotherapy. There have also been reports that pot has helped people with Alzheimer’s disease and other types of dementia as well as Parkinson’s disease.Across the nation, the number of marijuana users who are in their later years is still relatively limited, but the increase has been significant, especially among those 65 and older, according to recent studies.

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Marcia Dunetz, 80, said that she worried at first about what people would think. “It’s got a stigma,” she said. “People don’t really believe you’re not really getting high if you take it.”CreditPhotographs by Yana Paskova for The New York Times

“It’s a bigger issue than we thought,” said Brian Kaskie, a professor of health policy at the University of Iowa who co-wrote a study published in January, “The Increasing Use of Cannabis Among Older Americans: A Public Health Crisis or Viable Policy Alternative?” “This is an elephant we’re just starting to get our hands on.”

A medical marijuana education and support club started by residents of Rossmoor Walnut Creek, a retirement community east of San Francisco, has grown to 530 members — so many that it has changed meeting rooms three times.

“I would be in a lot worse shape if I wasn’t using cannabis, both physically and mentally,” said Anita Mataraso, 72, a grandmother of six who is the program director and takes marijuana daily for arthritis and nerve pain, among other ailments.

In the state of Washington, at least a dozen assisted living facilities have formal medical marijuana policies in response to demands from their residents, said Robin Dale, the executive director of the Washington Health Care Association. The association, an industry group, has posted a sample medical marijuana policy on its website.

In March, an influential group of medical providers, AMDA — The Society for Post-Acute and Long-Term Care Medicine, will tackle the issue at its annual conference. Cari Levy, the group’s vice president, will offer a “Marijuana 101” lesson on the benefits, the risks and the potential pitfalls for providers.

“People are using it, and we need know how to respond,” she said.

But as older people come to represent an emerging frontier in the use of marijuana for medical purposes, questions are being raised about safety and accessibility. Even in states where medical marijuana is legal, older people who stand to benefit often cannot get it. Most nursing homes do not openly sanction its use, and many doctors are reluctant to endorse pot use, saying not enough is known about the risks in the oldest age groups.

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The president and chief executive of RiverSpring Health, Daniel Reingold. He said he administered marijuana to his father as a painkiller shortly before his death.

CreditYana Paskova for The New York Times

“This is a target demographic that may have their access limited, if not cut off altogether, simply because they reside in a facility,” said Paul Armentano, deputy director of NORML, a group that advocates the legalization of marijuana. “It is a problem that may infringe on their quality of life.”

While there is no shortage of research on marijuana, relatively little of it has focused explicitly on older users even as their numbers grow — and not just in the United States. In Israel, for instance, older people have been treated with medical marijuana for years. And Americans for Safe Access, an advocacy group, helped open a research center in the Czech Republic that is evaluating its impact on older people.

“It’s an area that’s very important to look at,” said Dr. Igor Grant, the director of the Center for Medicinal Cannabis Research at the University of California, San Diego, adding that older people are now one of the center’s research priorities.

“Older people can be more sensitive to medicine,” he said. “It’s possible a dose safe for a 40-year-old may not be in an 80-year-old.”

Dr. Thomas Strouse, a psychiatrist and palliative care doctor at the University of California, Los Angeles, said that just as sleeping and pain medications could harm older people, marijuana could possibly make them confused, dizzy or more likely to fall.

“There is no evidence that it is particularly helpful to older people, and some reason that it could be harmful,” he said.

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Medical marijuana is kept in a safe in Marcia Dunetz’s room at the Hebrew Home at Riverdale. CreditYana Paskova for The New York Times

Most nursing homes have also taken a cautious position, often resorting to a “don’t ask, don’t tell” approach.

“If residents are taking it, they are taking it undercover without the staff knowing so it’s not part of their care plan,” said Dr. Cheryl Phillips, senior vice president for public policy and health services for LeadingAge, an industry group representing more than 2,000 nursing homes. “I think that creates a safety problem.”

Fred Miles, a Colorado lawyer who represents nursing home operators, said nursing homes — unlike assisted living facilities — were regulated by the federal government, and were fearful of jeopardizing their Medicare and Medicaid funding. Staff members who administer marijuana could also theoretically face criminal prosecution under federal law, he said, though he has never heard of that happening.

At the Hebrew Home in the Bronx, the medical marijuana program was years in the making. Daniel Reingold, the president and chief executive of RiverSpring Health, which operates the home, said he saw its powers firsthand when his own father, Jacob, was dying from cancer in 1999. To ease his father’s pain, Mr. Reingold boiled marijuana into a murky brown tea. His father loved it, and was soon laughing and eating again.

“The only relief he got in those last two weeks was the tea,” Mr. Reingold said.

When Mr. Reingold requested approval from the nursing home’s board members, there were no objections or concerns, he said. Instead, they joked that they would have to increase the food budget.

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Hillary Peckham, of the medical marijuana dispensary Etain Health, showing an array of marijuana tincture, capsules and vaporizer cartridges. CreditYana Paskova for The New York Times

Then Dr. Zachary Palace, the medical director, developed a program that seeks to offer marijuana as an option but also comply with federal regulations: Though the nursing home recommends and monitors its use, residents are responsible for buying, storing and administering it themselves.

Last fall, the first three residents started taking marijuana pills. Their families obtain the pills at a dispensary in Yonkers run by Etain, a company licensed by the state to sell medical marijuana to qualifying patients or their designated caregivers, who must live in New York. Dr. Palace said that as the program expanded this month, as many as 50 residents could be using marijuana.

Marcia Dunetz, 80, a retired art teacher who has Parkinson’s, said she worried at first about what people would think. “It’s got a stigma,” she said. “People don’t really believe you’re not really getting high if you take it.”

But she decided to try it anyway. Now, she no longer wakes up with headaches and feels less dizzy and nauseated. Her legs also do not freeze up as often.

For Ms. Brunn, the marijuana pills have worked so well that she has cut back on her other pain medication, morphine.

Her daughter, Faith Holman, 61, said the pills cost $240 a month, which is not covered by health insurance. Ms. Holman, who lives in New Jersey, also has to ask a family friend to go to the Yonkers dispensary.

“Obstacles had to be overcome,” Ms. Holman said. “But I think she was meant to have it because everything has worked out.”


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Here’s Everything You Need to Know About Germany’s New Weed Laws

Germany just passed one of the world’s most progressive medical marijuana plans. The new law will put weed in more pharmacies and require public insurers to cover the costs of cannabis products, as they do other pharmaceutical prescriptions, when cannabis is prescribed for “severe conditions.”

Germany will also start growing its own weed. This will replace the old medical marijuana law, which granted permits for people to grow their own. So recreational growers will not have any excuses for ‘exotic houseplants.’

The drug dealers of Berlin’s infamous open-air marijuana market in Görlitzer Park that spoke to Highsnobiety were surprisingly supportive. “Obviously its not going to be so good for business, but it’s the right thing to do if it can help people,” said Jan*, 24. Like many of the dealers lining in the parks of Berlin, he is an African immigrant, this time from Lagos.

While Germany is standardizing its medical marijuana supply chain, authorities in the capital turn a blind eye to illicit dealers selling dime bags in public spaces. But although it will soon be easier to get free weed from the local pharmacy, most dealers we spoke to were not threatened by the competition.

“We also get people who buy weed from us to treat pain,” said Menis*, 27, a Gambian dealer.  “Some don’t come anymore, but a lot of them still do. You don’t get exactly the same experience from the pharmacy products as you do with the marijuana we sell. They spray it with something different. I didn’t like it as much.”

Currently pharmacy prices for medical marijuana fluctuate from 12 to 20 euro per gram, compared to the roughly 10-euro price in the park.

Who Stands to Lose from Medical Marijuana

If data from the United States’ research on the effects of medical marijuana is an indicator of how things could play out in Germany, there might be a reason drug dealers are so chill about the new law: pharmaceutical companies stand to loose more customers.

There is clear difference between annual drug doses prescribed by physicians in medical marijuana states, and in states where weed is completely illegal, according to a 2015 study. There were 1,826 fewer painkiller doses prescribed, followed by 562 fewer anxiety medications and 541 fewer pharmaceutical nausea treatments prescribed in states where patients could be treated with cannabis.

The U.S. National Bureau of Economic Research also found that legal access to medical marijuana is linked to a significant drop in the number of people abusing and dying from prescription painkillers.

This could catch on in Germany as Germans have already started turning away from traditional pharmaceuticals to more natural products. Over half the population has used some form of homeopathic treatment, with awareness and use of alternative drugs rising steadily since their introduction to pharmacies in 1976.

Germany Is Not California

It is no secret that California’s medical marijuana dispensary program has relatively lax requirements to determine who could benefit from a medical marijuana card, which are often used for recreational smoking rather than strictly for treatment of an illness. More than 91,000 medical marijuana cards have been issued since 2004, according to California’s Department of Public Health.

“Germany has much stricter guidelines than California for prescribing marijuana,” said Goerg Wurth, head of the German Hemp association. “Almost anyone who wants a prescription can get one there. In Germany things are more regulated and bureaucratic. Doctors are checking to make sure medical marijuana is not used for recreational purposes.”

There are roughly 30 illnesses for which the German government recommends cannabis, ranging from chronic pain to attention deficit disorder and epilepsy. But even after getting the green light from a doctor to use marijuana, the German system is more regimented than the dispensary model.

Instead of setting up new businesses that deal exclusively in weed, Germans must go through pharmacies. And while doctors can prescribe cannabis for a broad range of ailments, only those that prove to be “severe” will receive reimbursement from public insurers. Doctors also have more sway over what kind of cannabis you can get.

“Although you can get smoking and edible options, it is more likely doctors will suggest vaporizers or THC drops, which are less harmful and easier to dose,” Wurth said.

Where Does Germany Stand Compared to Its Neighbors?

Germany stands somewhere in the middle when it comes to European weed legislation. While some of its neighbors have yet to broach the subject of medical marijuana in parliament, others such as the Netherlands and Spain have certain cities where recreational consumption is legal.

Although many European states have medical marijuana available, Germany will join the Netherlands, Italy and the Czech Republic as the one of the only countries where weed is produced.

“There is more movement for weed legalization than ever before in the world, and it won’t be long until the first European country fully legalizes it,” Wurth said.

Recreational Smoking Is Still Illegal

Despite creating easy access to medial marijuana, the government has been clear in saying that this law is not to be taken as a step towards legalization of recreational use. The government cites health concerns as the main reason for keeping weed from the general public.

“International studies from the last 10 years show that the use and abuse of cannabis can be associated with a number of serious short-term and long-term risks, particularly among young people,” the German Health Ministry said.  “Psychological and psychosocial disorders (such as schizophrenic psychoses), organ-medical effects (such as cardiovascular diseases) and neuro-cognitive impairments (such as the impairment of learning attention and memory functions) are mentioned.”

Still, those pushing for blanket legalization see the new law as a possible step towards it, looking to countries such as the United States and Canada which progressed to legalization after introduced medical marijuana. Eight states recently legalized marijuana in the U.S., whereas Canada introduced legislation to legalize marijuana throughout the whole country this spring.

“I believe that medical marijuana will relax the attitudes of Germans towards cannabis, especially the older, more conservative generation,” Wurth said. “The decision to legalize it for medical purposes was more or less unanimous, whereas the majority of Germans still don’t think it should be legal for recreational use.”

The latest European Drug Report found that nearly a quarter of Germans have tried marijuana.

Germany may lack the political will for blanket legalization, but there are many initiatives and local governments willing to give it a shot. Groups in Berlin, for example, have expressed an interest in the city being a testing site for possible legalization to see whether a change in law could lead to decreases in crime.

“It will eventually become legal in Germany,” Wurth said. “But for it is good that we are taking care of patients.”

On the topic of legalizing weed, here’s our look at what Portland is like two years after weed was legalized

 

http://www.highsnobiety.com/2017/02/17/germany-marijuana-laws/


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German Government Recognizes Quantum 9’s Cannabis Expertise

German Government Recognizes Quantum 9’s Cannabis Expertise

After engaging Quantum 9, Inc. to learn more about the global cannabis environment, the German Federal Ministry of Health has written a letter of recommendation acknowledging the expertise with which Quantum 9 was able to help their queries. The information received provided guidance on drug policy, in favor of cannabis regulation, allowing the drafting of a bill including a cannabis tax.

Letter of Recommendation_German Government

Quantum 9, Inc. is honored to be considered by the German government for such a project, and has been lucky enough to work with several government entities in similar projects.


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DEA Removes Marijuana Misinformation from Website After Months of Public, Legal Pressure

http://www.safeaccessnow.org/iqa_victory

February 13, 2017 | Anna Zuccaro

Americans for Safe Access Says Not Good Enough, Still in Violation of IQA

WASHINGTON DC — After months of public pressure, the Drug Enforcement Administration (DEA) has removed factually inaccurate information from its website. The change comes after Americans for Safe Access, a national nonprofit dedicated to ensuring safe and legal access to medical cannabis for therapeutic use and research, filed a legal request with the Department of Justice last year demanding that the DEA immediately update and remove factually inaccurate information about cannabis from their website and materials.

Americans for Safe Access argued that the more than 25 false statements on the DEA’s website about cannabis constituted a violation of the Information Quality Act (IQA, aka Data Quality Act) which requires that administrative agencies not provide false information to the public and that they respond to requests for correction of information within 60 days.

One publication, “Dangers and Consequences of Marijuana”, contained 23 of the 25 factual inaccuracies in violation of the Information Quality Act. Such inaccuracies included claims that cannabis was a gateway drug, caused irreversible cognitive decline in adults, and contributed to psychosis and lung cancer.

“The DEA’s removal of these popular myths about cannabis from their website could mean the end of the Washington gridlock” said Steph Sherer, Executive Director of Americans for Safe Access. “This is a victory for medical cannabis patients across the nation, who rely on cannabis to treat serious illnesses. The federal government now admits that cannabis is not a gateway drug, and doesn’t cause long-term brain damage, or psychosis. While the fight to end stigma around cannabis is far from over, this is a big first step.”

But the fight is not over. As of February 13th, the government is one week beyond the required deadline to respond to the Americans for Safe Access’ legal petition and the group claims that the DEA is still spreading false information about cannabis.

“We are pleased that in the face of our request the DEA withdrew some of the damaging misinformation from its website” said Vickie Feeman, of Orrick, Herrington & Sutcliffe. “However, the DEA continues to disseminate many damaging facts about the health risks of medical cannabis and patients across the country face ongoing harm as a result of these alternative facts. We are hopeful the DEA will also remove the remaining statements rather than continue to mislead the public in the face of the scientifically proven benefits of medical cannabis.”

“If the DEA does not take the necessary action to comply with the binding time lines in the IQA, petitioners can always seek an intervention by OMB as the Department of Justice so informed the court in W. Harkonen v. USDOJ or in the courts as demonstrated in Prime Time v. USDA” stated Jim Tozzi, the father of the Information Quality Act and member of ASA’s Patient Focused Certification Reviewboard.

Americans for Safe Access argues that correcting false information about cannabis is especially important now that the Department of Justice is led by newly-confirmed Attorney General Jeff Sessions. Sessions has been a staunch supporter of the DEA and cites their publications and opinions about marijuana to justify his opposition to medical cannabis policy reform. Today, Americans for Safe Access delivered a letter to the DEA explaining:

“It is crucial that the DEA correct it’s inaccurate statements, especially in light of Senator Jeff Sessions’  confirmation as Attorney General of the United States.  Attorney General Sessions has made several statements demonstrating his beliefs that cannabis is a gateway drug and that its psychological effects are permanent.  These beliefs are verifiably false, as confirmed by the DEA in its “Denial of Petition to Initiate Proceedings to Reschedule Marijuana.”[1]  As the top law enforcement official in the nation, Mr. Sessions must have access to accurate information based on current scientific data in order to make informed decisions regarding the enforcement (or non-enforcement) of federal drug laws.  Allowing Mr. Sessions to make law enforcement decisions based on biased, out-of-date information does a tremendous disservice to ASA’s members and the American people at large. Therefore, ASA respectfully requests that the DEA respond to its Request, and/or remove the remaining inaccurate statements from its website.”

For more information, or for interviews with Americans for Safe Access, please contact Anna Zuccaro at anna@unbendablemedia.com, 914-523-9145


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Congressional Cannabis Caucus’ new law for Medical Marijuana patients introduced by California Congressman Rohrabacher

The Respect State Marijuana Laws Act of 2017 Has Been Introduced
By Julia Granowicz on Feb 11, 2017 07:18 am
respect-state-marijuana-laws-act-of-2017-has-been-introduced

About a week ago, a handful of lawmakers who call themselves the “Congressional Cannabis Caucus” announced that they intend to introduce legislation that would help protect the cannabis industry from a Department of Justice run by Attorney General Jeff Sessions. Their announcement was just prior to his confirmation – but they believe that his being Attorney General could actually help push some lawmakers into feeling the same urgency to pass such legislation.

As promised, one of those congressmen  – Dana Rohrabacher of California  – has introduced the Respect State Marijuana Laws Act of 2017. This bill was previously introduced twice before, in 2013 and 2015, and didn’t gain enough support either time to make it very far. This time, however, with the uncertainty surrounding how the federal government is going to move forward in handling the cannabis industry – the bill may find more support.

“This is common sense legislation that is long overdue,” said Robert Capecchi, director of federal policies for the Marijuana Policy Project. “It is time to end marijuana prohibition at the federal level and give states the authority to determine their own policies.

There is hope that more legislators will be more inclined to protect an industry that improves lives for patients in medical marijuana states and has entirely ended prohibition in others. Both types of industries have created countless jobs and brought in millions in tax revenue that would have gone straight into the black market otherwise. If the government isn’t ready to change their minds on prohibition, they should at least protect the states’ rights to enact their own laws.

“States throughout the country are effectively regulating and controlling marijuana for medical or broader adult use,” Capecchi said. “Federal tax dollars should not be wasted on arresting and prosecuting people who are following their state and local laws.”

Basically, the Respect State Marijuana Laws Act would prevent the Department of Justice from pursuing cannabis-related cases in states where marijuana is legal, as long as people are operating within the laws in their respective state. With everything that’s going on, many of us are hoping that this piece of legislation will gain the support it needs to be passed – and that, if it does pass, Trump would be ready and willing to sign it into law.

If that were to happen, states could continue to operate as they have – and others would be able to consider legalization with less worries since there will be something binding in place that says the federal government will keep their opinions to themselves and let the states make their own decisions when it comes to cannabis.


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The ever first study on licensed medical marijuana users in Israel

http://www.breitbart.com/jerusalem/2016/05/26/israel-releases-first-ever-study-medical-marijuana-patients/

The ever first study on licensed medical marijuana users in Israel revealed that 99.6% of patients applied for the drug after conventional medications had no effect, the Jerusalem Post reported.

The study, which was released on Wednesday at the Sixth International Jerusalem Conference on Health Policy, was led by Prof. Pesach Shvartzman of Ben-Gurion University of the Negev’s Health Sciences Faculty.

Shvartzman maintains that even though medical cannabis was legalized in Israel a decade ago and is licensed to more than 20,000 patients, until now “there has been no information about the users themselves.”

The report shows that even though most users benefit immensely from marijuana treatment, the cannabis also causes side effects among an overwhelming majority – 77% – of users.

Over the course of two years, the study examined 399 patients’ socioeconomic characteristics including religion, disease profiles, medical indication for use, dosages, treatment given to the patient prior to cannabis, side effects, response, and effectiveness of treatment.

78 of them were cancer patients. The mean age of the non-cancer patients was 50.1 years and of cancer patients 57.5 years. Less than half of both groups (47% and 40%) were native Israelis.

Forty percent of the non-cancer patients and 49.3% of the cancer patients were employed. Of the non-cancer patients, 30.4% and 47.9% of the cancer patients had an academic education. Of the non-cancer patients, 56.7% were married, compared to 65.3% of the cancer patients, the report said.

42% of all patients had been recommended medical marijuana by their doctors, while only 24% from other sources such as a friend or family member.

56% of patients said they wanted to try cannabis because their previous drugs caused side effects.

21% used cannabis oil or vaporized methods of taking the cannabis and three-quarters said they smoked it.

More than 77% said they experienced side effects from the cannabis. 61% of users complained of dry mouth, another 60% of hunger pangs, and 44% said the drug made them “high.” Another 23% reported sleepiness, 28.6% fatigue, 32% red eyes, and 13% blurred vision.

Still, only 6% stopped taking cannabis either because of side effects or complaints that it was not effective.

In the U.S., the Washington University School of Medicine in St. Louis just released a study that showed that the number of adolescents taking marijuana recreationally has fallen. In addition, problems in adolescents related to the drug’s use has decreased markedly by 24% in the past decade. This is despite the fact that more and more U.S. states are legalizing or decriminalizing marijuana use.


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Federal Council of Germany approves law on the use of medical cannabis…goes into effect in less than 30 days.

DHV – Florian and Georg

A new era has begun for cannabis patients and legalization activists in Germany. On 19 January the Bundestag adopted the new law for cannabis as a medicine. A great success for all those who have been struggling to improve the situation for decades. Now natural cannabis blossoms and extracts in Germany can be used quite normally medically. Here is a summary of the current situation.

Shortly after the law was passed, the Federal Institute for Drugs and Medical Devices (BfArM) had already first information on its website. The German Federal Ministry of Health has now also followed suit. In addition to the actual law, there is already some information that is available. How some things look in practice, however, will only be apparent from March. Then the law shall enter into force.

What were the changes before the last consultation in the Bundestag?

Actually, in recent weeks, the DHV has seen only improvements to the law. The cost of cannabis should no longer be used only in the case of serious, chronic diseases, but in general in the case of serious diseases. Even people who are under medical treatment for less than a year therefore qualify for it. The health insurance companies are only to refuse to accept the costs for cases of serious illnesses only in exceptional cases and doctors can also prescribe cannabis without the person concerned before trying all conceivable drugs, if this is not appropriate from a medical point of view. These changes will increase the number of people who get their cannabis really paid off the cash register.

For which diseases are there cannabis as medicines?

Basically, cannabis can be prescribed for every illness on private recipe. There are no legal restrictions in this regard, although certain guidelines may still be drawn up within the framework of medical guidelines, but these are not mandatory for doctors. (Edit: This article contains a list of diseases for which the BfArM has already granted exemptions.) For those affected, the key problem is still to find a physician who is able to do so Theme. It is likely to be a bit more difficult to obtain a cost from the health insurance.

When does the checkout cost?

The health insurance is to take over the costs of cannabis in case of serious illnesses. It is only in individual cases that health insurance funds are to reimburse the costs if they are a serious illness. The basic condition for this is a prescription from a physician approved by a physician. Again, there is currently no fixed catalog of diseases, for which admission is possible. Unfortunately, the term “serious disease is not clearly defined, so many disputes between patients and health insurance funds are to be expected. Cannabis helps with many different diseases and so it is very welcome that the doctors at this point were granted wide freedoms.

There were slight improvements in the issue of the treatment. The costs can also be borne if the physician does not consider the allocation of other medicines to be useful. Who will end up receiving the costs and who is not, you can only speculate about it at the moment.

What happens with the exemptions?

The old exemptions will be lost in the course of three months. Patients with exception approval must then have an anesthetic remedy issued by their treating physician. The complicated approval procedure at the BfArM is dispensed with, which makes it much easier for doctors to start therapy trials with cannabis. Therefore, it is to be assumed that the number of doctors working with cannabis will increase significantly. It is no longer appropriate to apply for a derogation from now on. New requests are probably not processed anymore.

What happens with the cultivation permits?

The two farm permit approvals granted recently by the BfArM will be no longer valid at the moment, as soon as the health insurance companies of the affected persons have received the payment of their cannabis from the health insurance from the pharmacy. Nevertheless, it still makes sense for patients to apply for cultivation applications to the BfArM. We believe that there will continue to be patients who will help cannabis in the future, but they will not be paid by the cash office. These people still have the opportunity to do so as before, ie to apply for self-cultivation and / or to plead in the event of a criminal complaint due to self-sufficiency in justifiable emergency!

How to find a doctor?

Not every doctor wants to work with medical cannabis. This will remain so even after the law change. The ability to prescribe cannabis flowers to a prescription will make the procedure much easier for doctors. Therefore, the number of doctors will rise massively. We have good reasons to assume that a larger number of doctors will be publicly known at the start of the law in March.

Where does the cannabis come from?

Currently, several companies are importing cannabis flowers from the Netherlands and Canada. Following the introduction of the law, a cannabis agency is established as a subordinate authority to the BfArM, which will start a tendering procedure for licenses. The BfArM has already published corresponding job vacancies in order to increase its staff accordingly. Anyone interested in working in this area should apply now!

Companies wishing to apply for the tender for cultivation need to be patient. Nevertheless, many entrepreneurs are already in contact with the BfArM, in order to develop a better position. It may be useful to make contacts here.

How expensive is the cannabis from the pharmacy?

There are different theories. Some believe that medicinal hemp will become more expensive in the future than the current 12-20 € per gram, others go from falling prices. In the long term, prices are likely to fall, but in the short and medium term, different scenarios are conceivable.

Is the use of cannabis medication prohibited in public?

No. Smoking of cannabis is, of course, prohibited as well as tobacco smoking in public buildings and non-smoking areas. Apart from this, there are no specific restrictions on when and how to take their medicine.

How can you identify yourself as a police officer?

The previous exceptions are not applicable, so only the BTM recipe remains. Possibly the BfArM or the new cannabis agency will also introduce a card, as is usual in many other countries, which can be used for legitimation against police officers.

Can you drive as a cannabis?

Currently, there is a large Grauzone. Many cannabis patients with exception approval have been driving for years and are tolerated by police and driving license. Some also successfully made an MPU under cannabis influence to prove their cruising. Other patients were worse off, and in recent years there have been frequent driving tests and MPU orders after police checks.

The difference is already present in patients who receive Sativex or dronabinol on prescription. They have THC in the blood, but may drive with the consent of their doctor also car. In the past, problems rarely arose in the past. As soon as cannabis blossoms are prescribed for prescription, the doctor can clarify how long after taking the patient should not drive a car. In principle, it is always possible to drive a car with cannabis when the patient has been stably placed on the drug in consultation with the doctor. See info TÜV Süd .

To whom is this success owed?

This law did not arise through the goodwill of the CDU-led government. It was only written to prevent the increasing legalization of self-cultivation for patients by courts. In April 2016, the Federal Administrative Court of Leipzig had obliged the BfArM to grant appropriate permits. Currently two cannabis patients in Germany have an authorization to grow their own cannabis. These are limited in time, until receipt of a cost transfer by the health insurance funds. That the prevention of self-cultivation is one of the objectives of the real purpose of the law, was repeatedly stated by the Federal Government.

The increasing number of exemptions from the pharmacy, as well as many court decisions on patients who were caught in the cultivation and then released for reasons of justifiable necessity or condemned only to minor penalties, increased the pressure on the government massively. Even these first permits for the possession of cannabis had to be legally fought, the same went on.

The thanks for this law must not be due primarily to the government, the CDU and the SPD, but to the many patients who have fought for their right. Michael F., who succeeded and won it up to the Federal Administrative Court , but also to all the other parties concerned, who did not insist, but insisted on their position, either as plaintiffs or defendants.

The work of Dr. Franjo Grotenhermen, the working community of cannabis as medicine as well as the self-help network of cannabis as medicine was decisive for the success of the individual patients. Through their professional support, the path to the exemption or the application for self-cultivation could be explained to many stakeholders. Politicians and journalists find serious contacts and information on the subject of cannabis medicine. Without these two organizations and the personal work of Dr. Grotenhermen this success would have been difficult to conceive.

What has the DHV contributed?

Since its founding, the DHV has also dealt with the topic of cannabis as a medicine. Since the issue of the first exemption for cannabis possession, we are pursuing the development very intensively. After the millionaire vote, we were able to do much more. So one of our cinema commercials concentrated on the subject of cannabis medicine. On YouTube, this spot was the top spot spot among our three videos and it was played hundreds of thousands of times in German cinemas. The Lindenstraße resumed the theme more than a year later with some very similar pictures and sequences.

In 2014, we supported the donation campaign of the Cannabis Consortium as a medicine “impunity for patients” with € 10,000 and massive donation calls via our channels. Thus, a lot of money could be collected to support the criminal proceedings of those affected.

One year later we supported the petition of Dr. Grotenhermen for cannabis as medicine to the German Bundestag. Many activists from DHV localities collected signatures, prize money for signatures were praised, and in the final sprint we even hired paid forces to sign collecting. Over 30,000 signatures were thus submitted to the Bundestag. Not all claims from this petition are met with the new law, but many.

Through our flyer and our booklet on cannabis as medicine, we were able to enlighten tens of thousands of people. Our employee Maximilian Plenert is organizing a self-help group of patients in Berlin. To this day, we have also helped hundreds of patients throughout the federal state on their way to the exemption. In the last few years, we have hardly had a week in which we did not talk about our cannabis channels as a medicine, and in discussions with politicians and the media, we always pointed out the drama of the situation of cannabis users in Germany. The DHV employees were also heard as experts in the Bundestag on the subject.

How is it going now?

In addition to the official procedures at the new cannabis agency, it will now primarily be necessary to support the self-cultivation of patients. There will probably be further legal proceedings in the future. Otherwise, we will focus our policy lobbying on the full legalization of cannabis. Not only, but also in the sense of the patients! For as long as cannabis is not completely legal, patients will also have to reckon with stigmatization and social problems because of their medicine. Conclude with crime. Cannabis normal!

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Here is a list of diseases for which the Federal Institute for Drugs and Medical Devices (BfArM) has granted exceptional permits.
(But beware: this brochure also refers to the current and soon outdated legal situation!)

There may have been other diagnoses since the brochure was written, I just do not have time to check.

Https: //hanfverband.de/sites/hanfverband.de/files/patienten_ratgeber_v10 …

DHV
Cannabis as medicine
A guidebook for patients

Pages 12 and 13

Exemptions
For which diagnoses are exemptions granted?
Approval may in principle be granted for any disease that helps cannabis. Up to now 400 approvals have been granted for 30 different diagnoses, some patients also having several diagnoses. Five diagnoses play the most important role.
More than half of the patients suffer from chronic pain. Approximately every fifth is suffering from multiple sclerosis. One in ten is affected by Tourette’s syndrome, depressive disorders, or ADHD.

There are also exemptions for the following diagnoses known some of which fall “chronic pain” under the diagnosis:
• allergic diathesis
• anxiety disorder
• Anorexia and Cachexia
• Armplexusparese
• Arthritis
• Asthma
• Autism
• Barrett’s esophagus
• Bladder spasms
• Blepharospasm
• borderline personality disorder
• Borreliosis
• Chronic polyarthritis
• Chronic fatigue syndrome
• Pain syndrome after polytrauma
• Chronic spine syndrome
• Cluster headache
• Ulcerative colitis
• Epilepsy
• Failed back surgery syndrome
• Fibromyalgia
• Hereditary motor-sensitive neuropathy with painful states and spasms
• HIV infection
• Cervical spine And LWS syndrome
• Hyperhidrosis
• Headache
• Lumbago
• Lupus erythematosus
• Migraine accompagnée
• Migraine
• Mitochondropathy
• Ankylosing spondylitis
• Crohn’s disease
• Scheuermann ‘s disease • Morbus breastfeeding

Sudeck’s disease
• Neurodermatitis
• Paroxysmal nonkinesiogenic dyskinesis (PNKD)
• Polyneuropathy
• Posner- Castle’s syndrome
• posttraumatic stress disorder
• psoriasis (psoriasis)
• irritable bowel
• rheumatism (rheumatoid arthritis)
• sarcoidosis
• insomnia
• Painful spasticity in syringomyelia
• Systemic scleroderma
• tetraspasticity by cerebral palsy
• Dejerine-Roussy syndrome
• thrombangitis obliterans
• tics
• tinnitus
• trichotillomania
• urticaria unclear Genesis
• Cervicobrachialgia • Consequences of craniocerebral
trauma
• Compulsive disorder