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Germany Indications for Medical Marijuana patients – from Cannabis as Medicine group

The government has, at the request of the LEFT in the Bundestag, published the diagnoses of people with an exemption for the purchase of cannabis flowers from the pharmacy. After the system exception approval is now past, these figures are likely to be the “final result” for 10 years of “exceptional medicine” cannabis via §3 paragraph 2 BtMG.

In print 18/11701 of 27.03.2017 the government writes:

The medical conditions underlying the exemptions pursuant to § 3 paragraph 2 BtMG are varied according to the information in the application documents. Some patients perform self-therapy with cannabis because of multiple diagnoses.
The main diagnosis groups and the corresponding percentages of the patients are presently as follows (duplications are
possible):

indication Percentage share
pain approximately 57 percent
ADHD approximately 14 percent
Spasticity (different genesis) approximately 10 percent
depression approximately 7 percent
Anorexia / cachexia approximately 5 percent
Tourette syndrome about 4 percent
bowel disease about 3 percent
epilepsy about 2 percent
Other psychiatry about 2 percent
Posted in Cannabis as a medicine .

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Volatility In Cannabis Land (Germany) – How will it affect prices for consumers? – by Marguerite Arnold

The debate about the price of cannabis as well as its imminent “collapse” or price hikes has been around since there has been a legal market.
In general, the conventional wisdom is a bit off the mark. For the most part, even when it is accurate, it is highly regional and at best temporal, subject to uncertain if short-lived winds. Why? Every cannabis market these days is a different animal thanks to regulations. Further, the American state focussed industry is very different from any other country right now. Canada, Germany, Israel and Australia are more alike to each other than any similarities they share with the U.S. state industry. In any state.

Then there are new wrinkles that so far have not been priced into any of these predictions. If anything, the price of cannabis is going to increase, dramatically, globally over the next 18 months.

U.S. State Markets Are Different
There is a body of evidence that shows that the price of cannabis, to the consumer, has dramatically fallen in places like Colorado. This is understandable for very easy to grasp economic concepts. Supply and demand. The market in Colorado has normalized. There is risk, but there is less of it and all of it is in-state. This all goes into cannabis pricing that is absolutely felt by the consumer. Not to mention all the way along the line until it gets to retail. There is also evidence that the California state cannabis market is going through a similar transition, along with Washington State.

In turn, this along with other pressures are pushing growers to cut costs. But those pressures include major issues, like water, land and energy conservation. None of the investment in such initiatives is tax deductible, either. In other words, this is a rich man’s game of high equity and razor thin margins that those who are well capitalized enough are now playing. Everyone else is being marginalized.

Further, the temporary ups and downs of state markets in the U.S. is by definition, limited to those state markets. It is illegal to transport anything cannabinoid over state lines. And while CBD may be the first to fall on this front, for now, what happens in Boulder, stays in Colorado.

Canadian Markets Will Be Stressed Next Year
There is ample evidence already, just based on the domestic situation in Canada, that there well might be a global medical marijuana shortage until 2020. This has a great to do with how the international as well as domestic Canadian markets are shaping up.

Right now, domestic licensed producers in Canada are expanding. They have great access to global equity markets. They are entering foreign territories. Plus they have large stockpiles of cannabis. The medical patient population is also growing at about 10% a month. In other words, it could double right at the time recreational takes off.

And there is already a rec market in Canada that is easily large enough to compete with even domestic patients.

On top of that, the entire German medical market could be sourced from Canada for the next 18 months to two years. Patient populations, even as estimated by the government (and they are conservative) will put a significant dent in Canadian supplies also.

Even though two new developments may in fact serve to help alleviate the supply of medical grade cannabis, that is already a huge demand that well may drive prices up even if over “just” the next two years.

And while Australia and Israel have just jumped into the cannabis export game, the former via its apparent intent to source most domestic cannabis from Tasmania, this is unlikely to have much of an effect. Yes, Tasmania supplies 40% of the world’s legal heroin. Medical cannabis, however, is a fish of an entirely different flavour.

There is zero chance that any national government at this point, will source the majority of their medical crops or even medication from down under. It is just too expensive. Importing cannabis into Australia (primarily from Canada) also just got very controversial.

For that very reason, all the pricing indicators and market pressures point to at minimum, ongoing upward price trends on the raw plant from growers all the way through to consumers.

German Patients Are In Trouble
If there is one place in the legalizing world right now where price has gone through the roof, it is Germany right now. In an effort to kill the home grow market, the German government passed a new law at the beginning of the year. It will be revolutionary, once they get the kinks out. For now, however, insurers are having to be widely sued to begin covering the drug. Doctors are reluctant to prescribe it. And patients are facing uncompensated costs at pharmacies that have risen dramatically even this year for reasons that have nothing to do with production or distribution, but a locally imposed “pharmacists processing fee.” A month’s supply to a German patient right now, is around $2,400.

It is the German situation, in fact, which dramatically underscores all of the discussions about price volatility and supply.The legal cannabis world is under licensed and way too small to even meet existing demand.

State markets in the U.S. are their own animal for right now. Outside of this very differently refracted local lens, however, the cannabis commodity market has a global footprint that is fairly easy to track, predict and understand when seen from this perspective.

[Featured image credit: commons.wikimedia.org]

Marguerite Arnold | September 11, 2017 at 5:29 am | Tags: Cannabis, cannabis prices, consumer cannabis proce, German cannabis, Israel cannabis, Medical Cannabis | Categories: Business, Opinion, Regulations | URL: http://wp.me/p8nEcz-Mg


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The chairman of the German Association for Cannabis as Medicine Dr. Franjo Grotenherman, has entered an “indefinite” hunger strike until Germany “decriminalize all citizens who need cannabis to treat their serious diseases.”

On August 17, 2017, I entered an indefinite hunger strike. The objective of refusing to accept any food is to decriminalize all citizens who need cannabis to treat their serious diseases.

On March 10, 2017, a much-debated law on cannabis as a medicine went into effect in Germany. It was the declared aim of the legislature to allow all patients who need a therapy with cannabis medicines to do so. The law, however, proves itself in practice as bureaucratic. Therefore, a treatment with cannabis and cannabinoids is unattractive for doctors who in principle support such therapy. Many patients do not find a doctor who allows them legal access to the needed treatment.

The legislator has taken a great step into the right direction. However, many patients are still dependent on a still as illegal regarded treatment. They face criminal sanctions. This is no longer acceptable. Therefore a basic clarification in the narcotics law must be established. The prosecution of patients to whom a doctor has certified the need for a therapy with cannabis must end.

Already today, the German Narcotics Law allows prosecutors to stop a criminal case in the case of a „minor debt“. This possibility is mainly applied in cases of possession of small amounts of cannabis. I urge that criminal proceedings should in principle also be stopped if accused citizens need cannabis for medical reasons. The need for a cannabis therapy should not be judged by the judiciary, a government agency or a health insurance company, but, as with other medical treatments, also by a doctor.

I also strongly support the uncomplicated access of patients to standardized preparations from the pharmacy. In this respect, it is necessary to improve the existing law. However, the prosecution of the remaining losers of the legal situation must also be ended. I am not aware of a convincing argument by which patients‘ prosecution can be maintained. A corresponding amendment to the Narcotics Act is, therefore, logical and unavoidable.

Franjo Grotenhermen, born in 1957, studied medicine in Cologne. Medical practice in Rüthen (NRW) with a focus on therapy with cannabis and cannabinoids. Grotenhermen is the chairman of the German Association for Cannabis as Medicine (ACM), Executive Director of the International Association for Cannabinoid Medicines (IACM) and Chairman of the Medical Cannabis Declaration (MCD), as well as author of the IACM-Bulletin, which is available in several languages ​​on the website of the IACM. Grotenhermen is an associate of the Cologne nova-Institut in the department of renewable resources and author of numerous articles and books on the therapeutic potential of cannabis and cannabinoids, their pharmaco logy and toxicology. Among others, since 2008 he has been an expert on debates in the Health Committee of the German Bundestag on the medical use of cannabis products, most recently in September 2016.

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“It’s California in 1995 All Over Again, Man” – Opportunities and Problems Piling Up in the European Cannabis Market – from Cannabis Business Executive magazine / Philip J. Cenedella IV

“It’s California in 1995 all over again, man.”

That was a comment I overhead during a conversation between an American and a German entrepreneur at the Mary Jane Berlin event held in Berlin in the second week of June, 2017.

Indeed, there may not be a better way to sum up the current state of the state here in Europe’s most populous country. Having been on the frontlines of the grassroots efforts in San Diego last century, it is fun to see how our industry is now growing in Germany and throughout Europe.  And like California back then, or now, the struggle is not always easy.

Here’s another interesting quote of the month:

“European markets are increasingly important to the cannabis sector. Each has a well-funded medical system, residents who seek natural and complementary therapies, and a government-supported mandate to stop the rising tide of opiate addiction related to chronic pain treatment.”

-Benjamin Ward, CEO, Maricann Group, Inc.

As of August, 2017 starts, the medical marijuana patients in Germany are experiencing “sold out” conditions nationwide, and the two exclusive importing countries (Canada and the Netherlands) are anticipating further bottlenecks as their in-country supply needs change. This is a significant problem – but also an opportunity for GMP-certified growers to fill the gap. If, and how, the German government opens up alternative supply to support their medical patients will be the top story in Germany this year.

From the patients perspective, there are two bad things about the current state of affairs: Little to no choice in their required medicine and their insurance companies are now refusing to cover the costs for the medicine as stipulated in the federal law.

Of course, lawyers are now getting involved and insurance companies are starting to be forced into approving valid claims from their policy-paying customers. But it is a silly, slow process to say the least.

The solution the German government is pursuing is to award 10 grow licenses to companies that will then produce 200 lbs. cannabis ​each within the country. The first bud from those plants are not scheduled to be picked until sometime in 2019, which is simply too long for patients to wait.

Some of the companies that have been publicly mentioned as potential winners of a grow license are Spektrum Cannabis, which is the Canopy Growth company formerly known as MedCann; Maricann GmbH, which is the new German subsidiary of its Canadian parent, Bedrocan, that has been a leader in the industry but recently run into a dispute with their Canadian licensee, Bedrocan International; Aurora Cannabis from Canada, which recently acquired the German firm Pedianos adding an EU-wide, medical marijuana distribution capability; and ABCann of Canada, which touts the “Father of THC” Dr. Raphael Mechoulam as a key member of their board of directors.

Homegrow options in Germany are currently not permitted, and existing indoor/outdoor farm operations are not yet able to be registered, licensed and taxed.

The black market continues to win, and patients continue to lose.  Cannabis business executives worldwide need to effectively work with the German government to develop the solutions we all know exist.  Three organizations that are key to this effort are the BfArM (www.bfarm.de )  the DHV (www.hanfverband.de )  and the GTAI ( www.gtai.de )

My personal comment is the government, politicians and regulators here in Germany need to listen to their constituents who support our industry by over 60 percent nationwide, according to a recent poll. The total quantity of flower to be delivered by the 10 licensees is probably less than what my buddy Butch has in his building back in California to handle his patients which live within five miles of the office.

Yes I am joking, Butch usually has less, but the point is – ​it simply is not enough for a population twice the size of California.

With all the talk about Germany, it is also important to remember that it is one of 18 countries within Europe that currently allow for some form of medical marijuana.  Besides Germany, there are provisions for the distribution and use of medical products in Austria, Belgium, Czech Republic, Denmark, Finland, France, Greece, Israel, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and, the most recent addition, Poland.

This is an interesting list that, again, shows these are historic times here in Europe.

Sadly missing from the list above is the United Kingdom, and that has affected people we know. Our friend Vera Twomey, and her entire family had to leave the U.K. last month just to take care of their young daughter with Dravet’s Syndrome. In the U.K. their daughter suffered from up to 30 grand mal seizures a day while taking a regimen of pharmaceutical drugs.

Think about that for a moment – 30 grand mal ​seizures a day.

Now living as “medical refugees” from their homeland, the Twomey’s and their daughter are now dealing with zero grand mal seizures a day thanks to her medical marijuana.

30 grand mal seizures a day, now zero a day – everyday for the past 3-4 weeks.

The United Kingdom calls medical marijuana illegal. Patients and advocates call that thinking arcane, unjust, and possibly criminal itself. They are now petitioning the Human Rights Commission of the European Union in Brussels for help. I am positive their efforts will be successful – it is just a matter of time.

Vera and her family hope it comes within her daughter’s lifetime. That is all for now. Have a successful rest of the summer, rest up and get ready because I believe that Q-4 of 2017 is going to be a busy one for our industry and your company.

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PATIENT UPDATE: The patients in the study had used opioid-based pain medication within the past six months: 97 percent were able to decrease their opiate intake with cannabis, 92 percent said that cannabis possessed fewer adverse side-effects than opioids, 80 percent said that the use of medical cannabis alone provided greater symptom management than did their use of opioids.

Berkeley, CA: Pain patients report successfully substituting cannabis for opioids and other analgesics, according to data published online in the journal Cannabis and Cannabinoid Research.

Researchers from the University of California, Berkeley and Kent State University in Ohio assessed survey data from a cohort of 2,897 self-identified medical cannabis patients.

Among those who acknowledged having used opioid-based pain medication within the past six months, 97 percent agreed that they were able to decrease their opiate intake with cannabis. Moreover, 92 percent of respondents said that cannabis possessed fewer adverse side-effects than opioids. Eighty percent of respondents said that the use of medical cannabis alone provided greater symptom management than did their use of opioids.

Among those respondents who acknowledged having recently taken nonopioid-based pain medications, 96 percent said that having access to cannabis reduced their conventional drug intake. Ninety-two percent of these respondents opined that medical cannabis was more effective at treating their condition than traditional analgesics.

The study’s conclusions are similar to those of several others, such as these herehereherehere, and here, finding reduced prescription drug use and spending by those with access to cannabis. Separate studies report an association between cannabis access and lower rates of opioid-related abuse, hospitalizations, traffic fatalities, and overdose deaths.

For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Cannabis as substitute for opioid-based pain medication: patient self-report,” appears in Cannabis and Cannabinoid Research.norml


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Commentary about Western Europe – by Ben Ward CEO of Maricann – on CNBC

Forget the US. Here’s where medical marijuana is really taking off

  • There is a global shift in cannabis towards Western Europe.
  • That’s where the action in medical marijuana is really heating up.
  • Investor’s focused solely on the U.S. are missing the huge potential overseas.
Benjamin Ward, CEO of Maricann Group Inc.
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David McNew | Getty Images

There’s a groundswell of support for cannabis legalisation in the United States, with 29 states, as well as Washington D.C. approved for medicinal cannabis, and eight for lifestyle use.

Things are farther ahead in Canada. Regulations for production and sales have been in place for over three years, and the federal government has introduced a timeline to full federal legalisation for lifestyle use in July 2018. Capacity in Canada for lifestyle alone is projected to reach “5 billion dollars per year to start,” according to a recent report from Deloitte.

Yet, while many investors focus on opportunities stemming from Canada’s upcoming legalization – plus the longer-term investment potential in what will likely be a growing number of American states – they are missing the global shift in cannabis towards Western Europe. That’s where the action is really heating up.

The population of the United States is approximately 325 million. There are 35 million living in Canada. But compare that to the European Union’s population of 510 million. Germany, with more than 80 million people alone, legalized medicinal cannabis in January of this year. Add that to Italy’s nascent existing medicinal cannabis program.

“European markets are increasingly important to the cannabis sector. Each has a well-funded medical system, residents who seek natural and complementary therapies, and a government-supported mandate to stop the rising tide of opiate addiction related to chronic pain treatment.”

These European markets are increasingly important to the cannabis sector. Each has a well-funded medical system, residents who seek natural and complementary therapies, and a government-supported mandate to stop the rising tide of opiate addiction related to chronic pain treatment.

Taken together, these and other European examples show that we’re seeing traditionally conservative attitudes shift as medicinal cannabis is legalized.

That also means investors in cannabis who focus solely on North America are missing the huge potential found across the Atlantic.

Those investors restricting their cannabis investments to this side of the ocean – and in the United States in particular – are left navigating an array of legislation on a state-by-state basis, prohibitive out-of-state investment regulations, and a prohibitive tax code. These investors miss the boat as they churn through such choppy water.

In Germany, cannabis will be produced by licenced producers and distributed to pharmacies like any other medication, with each prescription eligible for full reimbursement from health insurance.

In their patient-driven markets, Germans, Italians and other Europeans are demanding the alternative of cannabis over opiates.

In our view, people who think opiates are the only answer to pain relief have a similar mis-perception as people who still think medicinal cannabis is nothing more than smoking up with their doctor’s permission.

They are both wrong.

In short, medical cannabis is about personalized and effective medicine. It’s not about getting high.

The Europeans know that, as we do in North America.

As Germany moves smartly down this path of medicinal cannabis, the rest of Europe will soon follow. And to ignore 500 million people in a stable economy is a mistake.

We’re at the start of the global revolution. We all need to be looking to Europe next.

Commentary by Benjamin Ward, CEO of Maricann Group Inc., a vertically-integrated greenhouse producer and distributor of medical cannabis. Toronto, Canada-based Maricann is now building global teams in rapidly expanding European markets as well.

For more insight from CNBC contributors, follow @CNBCopinion on Twitter.


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The State of Cannabusiness in Germany

The State of Cannabusiness in Germany

As a cannabis business executive, you undoubtedly have been following some of the significant events happening in Europe and you have asked yourself: “How does this affect my plans?”

It may be the German government establishing a nationwide medical marijuana program, or news about the Canadian companies buying or merging with their European counterparts that has your attention. But you know the times are a changin’ and you might want to benefit from this historic moment in our Industry.

For those companies that already have a strategic international plan in place, the opportunities are boundless.  Germany, a nation with 2.5 times the population of California, is leading the way with the a national, Federal-government approved, medical marijuana law already in place, and numerous regional efforts to establish recreational use are getting off the ground as I write this column.

Having been an advocate in California during the medical marijuana legalization push of 1990s, and now living here in Germany as they build their own regulated marketplace, it has been fun to be involved. I’d now like to share some of the organizations that may be able to help you and your company, if Europe is indeed on your radar.

Das Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) is the German federal government’s  Institute for Drugs and Medical Devices and is lead by Professor Dr. Karl Broich. Their website is www.bfarm.de and they are basically the cannabis bureau of Germany, charged with implementing the medical marijuana law.  Interestingly, they will also be the sole purchaser of foreign-produced medical marijuana products, and then oversee the distribution exclusively though licensed pharmacies.

So Germans will be going to their local pharmacy to obtain their medicine, which officially should be paid by their insurance company.  Of course, the details are still being worked out, and I know of at least two lawsuits against insurance companies not paying for their clients medicine.

Last month, the BfArM put out a call for bids for the first ten authorized grow licenses in the history of Germany.  Negotiations are underway and the winning bidders should be announced shortly.  We will keep you updated on this, and all important details emanating from Europe, in future columns.

The Deutscher Hanfverband (DHV) is the German Hemp Association in Berlin and a fantastic resource and advocacy organization. They have been instrumental in getting the country to this point and their website is https://hanfverband.de I highly recommend signing up for their newsletter (which can easily be translated.)  Their next big event is the Hanf Parade in Berlin in August which will bring together over 10,000 advocates calling for open access.

For companies that want to get serious about being in Europe, the best organization I know of is the German Trade and Investment office located in Berlin which is part of the German Federal Ministry of Economic Affairs. Their website is www.gtai.de.

Their knowledge is vast, their connections incredible, and there is no charge for their services. They want to make it easy for international companies in our space to help Germany build their regulated marketplace. They provide advanced research, site-selection, tax information. And.. they are just an email or phone call away.

Of course, there are a total of 51 independent states that make up Europe and 28 of those make up the European Union.  To some degree all of these countries are changing the way they treat medical marijuana and CBD products.

If you are looking for some opportunities in this region, I would suggest looking not only at Germany, but also The Netherlands, Spain, United Kingdom, Switzerland, and the Czech Republic. Although Israel is not in the EU region, their expertise, leading edge research, products and capabilities are to be noted.

Before concluding, I need to give a shout out to Mr. Alex Rogers and his team at ICBC Berlin who put together one of the best industry events I have ever attended.  Back in April, in Berlin, almost 1000 attendees and exhibitors from throughout the world gathered to share information, make connections and close business deals.

Congressman Dana Rohrabacher, chairman of the Cannabis Caucus in the U.S. House of Representatives, was the keynote speaker and shared stories on his German ancestry, his first meeting with Ronald Reagan, and why legalizing our plant makes sense in so many ways.

Tommy Chong was also in attendance, was way coherent, and meeting him was definitely one of my personal highlights.  Yes, I admit it, I listened to his albums way back in 1971.

So I wish you a productive, successful and fun month ahead as we collectively take the next steps to “Make Cannabis Great Again” here in Europe, and wherever you are reading this in the world.

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