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Almost three quarters of the people who receive cannabis medicines on prescription in Germany use them to treat pain. Of these patients, 70 percent perceive an improvement in symptoms. This is shown by the interim result of the accompanying cannabis survey of the BfArM (Federal Institute for Drugs and Medical Devices).

What is medical cannabis used for?

With 73%, the lion’s share of all cannabis prescriptions in Germany is issued for the therapy of pain. This is followed at a great distance by the treatment of spasticity (10%), anorexia/wasting (6%) and other indications (10%). Doctors prescribe dronabinol in 65% of the cases, followed by cannabis flowers, Sativex, with an increasing tendency cannabis extracts and in last place nabilone.

Which specialist groups prescribe cannabis?

The largest group of doctors prescribing cannabis are pain physicians (anaesthesiologists) with a share of 49%. This is followed by general medicine (17%), neurology (12%) and internal medicine (10%).

How successful is cannabis therapy?

In the largest group of cannabis patients, those with pain as their primary symptom, 34% felt their pain was significantly improved and 36% felt it was moderately improved. Thus, medical cannabis was able to alleviate the suffering of a total of 70% of pain patients. 28% said their pain was unchanged.

Among people with multiple sclerosis as their main diagnosis, spasticity improved significantly in 41% and moderately in 43%.

35% of the cannabis patients discontinued their therapy within one year. In 25% of the cases, this was due to the side effects and in almost 40% due to insufficient effect of the therapy. In 21% of the cases, the person concerned died ­– this is also counted as a therapy discontinuation in the accompanying survey.

Private prescriptions not recorded

When looking at these results, it must always be kept in mind that the accompanying survey does not cover all patients treated with cannabis medicines in Germany: The data of self-payers, privately insured persons, inpatients and persons treated within the framework of clinical studies are not transmitted. Furthermore, no survey is compiled for persons who receive the finished medicinal products Sativex and Canemes according to the approved indications.

Accompanying cannabis survey – what is it?

In Germany, doctors who prescribe medical cannabis at the expense of the statutory health insurance are obliged to take part in an accompanying survey on the use of these medicinal products. The survey is conducted by the Federal Institute for Drugs and Medical Devices (BfArM). After three years, this institute has drawn up an interim balance with more than 10,000 data sets that were available by the evaluation deadline on 11 May 2020. One year earlier, the BfArM had already published an interim result based on the data evaluated by then.

The objectives of the survey are the monitoring of side effects and the tolerability of cannabis products. In addition, the survey is to show for which indications cannabis is prescribed. The results should serve as a basis for the planning of later clinical studies.



Schmidt-Wolf, G., Cremer-Schaeffer, P. 3 Jahre Cannabis als Medizin – Zwischenergebnisse der Cannabisbegleiterhebung. Bundesgesundheitsbl (2021).


A survey among people with Parkinson’s disease (PD) found that over 8 percent of PD patients use cannabis products. More than half of these people report a positive effect of cannabis treatment. The results are based on a survey from Germany.

Parkinson’s disease and cannabis: interest is high

Interest in the therapeutic use of cannabinoids to alleviate various symptoms is growing steadily – and this is also true for Parkinson’s disease. The survey was conducted among the members of the German Parkinson’s Association (Deutsche Parkinson Vereinigung e.V.).This is the largest association of Parkinson’s patients in German-speaking countries with almost 21,000 members. The researchers aimed to investigate the attitudes of people with Parkinson’s disease towards medicinal cannabis and to evaluate the experiences of patients who already use cannabis products. The research was published in the Journal of Parkinson’s Disease.

For the survey, researchers analysed more than 1,300 responses. These showed that the Parkinson’s community’s interest in medicinal cannabis is high, but knowledge on the subject is limited. At least 28 percent of the respondents knew about the different forms of intake, such as inhalation and oral intake. However, only 9 percent were aware of the difference between the active cannabis ingredients THC and CBD.

How does cannabis help with Parkinson’s disease?

More than 8% of survey participants reported using cannabis products, and more than half of these users (54%) reported a positive clinical effect. The general tolerability was good. More than 40 percent of the respondents said that it helped them with pain and muscle cramps. And more than 20 percent noticed a reduction in stiffness (akinesia), restless legs and tremors, as well as depression and anxiety.

Furthermore, it is interesting that the patients reported that inhaled cannabis products containing THC were more efficient in treating stiffness than oral products containing CBD. On the other hand, THC was slightly less well tolerated.

Cannabinoid treatment for Parkinson’s disease

Parkinson’s patients who used cannabis tended to be younger, lived in large cities and were better informed about the legal and therapeutic aspects of medical cannabis. 65 percent of the respondents who did not use cannabinoids before were interested in using medical cannabis. Lack of knowledge and fear of the side effects were given as the main reasons for not trying it.

“Our data confirm that patients with Parkinson’s disease have a high interest in treatment with medicinal cannabis, but they lack knowledge about how to take it and especially about the differences between the two most important cannabinoids, THC and CBD,” says study leader Prof. Dr. Carsten Buhmann, medical director of neurology at the University Medical Center Hamburg-Eppendorf (UKE). “Doctors should take these aspects into account when advising their patients about treatment with medicinal cannabis. The data reported here can help doctors decide which patients might benefit, which symptoms might be treated, and which type of cannabinoid and route of administration might be appropriate.”

Taking cannabis, Prof. Buhmann admits, could be associated with a placebo effect due to the high expectations of those affected. However, the medical doctor does not assess this negatively, because “even that can be seen as a therapeutic effect.” Nevertheless, he points out that the results of the study are based on subjective reports and that clinically appropriate studies are urgently needed.


Klagenfurt Clinic is currently using the cannabis substance CBD for covid patients – with good results. The anti-inflammatory and immune-strengthening properties of the cannabinoid are particularly interesting here. A study is already in progress, which should provide well-founded findings.

Positive results with CBD in covid patients

As reported by ORF, intensive care physicians at the Klagenfurt Clinic in Austria are achieving positive results with cannabidiol (CBD) in covid therapy. CBD is a highly interesting substance, also in the treatment of covid patients, explains Prof. Rudolf Likar, who is head of the department of intensive care medicine at Klagenfurt Clinic. CBD works in many ways. It has anti-inflammatory properties and can positively influence the immune system. In Klagenfurt, certain patients received CBD over a period of three weeks. Initially in a dosage of 200 mg, which was then increased to 300 mg.

“We saw that the inflammation parameters in the blood decreased and that people left the hospital faster than the comparison group. CBD supports the immune system,” Prof. Likar told ORF.

A study on the use of CBD is currently underway at Klagenfurt Clinic. Prof. Likar is satisfied with the data and results so far. Therefore, he wants to use CBD “probably routinely, just because it has no side effects.” The medical doctor explains that his team has been researching cannabidiol for quite some time. “It’s an interesting substance and Israel is even in the process of approving CBD for covid therapy. So we are not the only ones working with it.“

Cannabidiol (CBD) – a valuable cannabinoid

THC and CBD are the two main active substances of the cannabis plant. A large number of studies on the use of cannabidiol are already available and science has been able to gain many important insights. Since 2013, PubMed, a US medical research database, has indexed more than 1,500 studies on cannabidiol. This is another reason why many researchers consider CBD to be one of the most important cannabinoids discovered so far.

Unlike THC, CBD does not produce a high. When CBD is used in combination with THC, cannabidiol reduces the psychoactive effects and side effects of THC. Experts who have studied the relationship between CBD and the immune system have already outlined the positive effect of CBD in inflammatory and autoimmune diseases. In addition, there are studies that have investigated the effect of cannabidiol for the relief of chronic pain or for the treatment of epilepsy.

Other studies have shown that CBD can relieve pain and have a calming effect on people with cancer. Scientists have also found that cannabidiol can reduce cell growth in breast cancer.


Photo by Martin Sanchez on Unsplash


Cannabinoids enable pain patients to reduce or even completely discontinue opioids. This is the result of an American survey. In addition, cannabinoids can reduce the severity of pain. The vast majority of respondents experienced a higher quality of life and improved functioning thanks to the use of cannabinoids.

40 percent were able to stop all opioids

American researchers from the Society of Cannabis Clinicians in Sebastopol, USA, conducted an online survey of patients from three medical cannabis clinics. Of the total group of over 1,000 respondents, 525 had been taking prescription opioid medications in combination with medical cannabis for at least three months to treat their chronic pain.

Of these 525 people, about 40 percent reported that they had stopped all opioids thanks to taking cannabinoids. About 45 percent were able to reduce the amount of opioids. No changes in their opioid medication were reported by 13 percent and one percent had to take more opioids. About one third of the respondents reported that they were able to maintain the change in their opioid medication for more than one year.

The cannabis patients not only reported positively on the reduction of opioids – the pain intensity also decreased. Almost half (48%) felt 40 to 100 percent less pain. Nine percent did not notice any change in pain, while three percent experienced an increase in pain.

Clear majority gains in quality of life

Another particularly pleasing result of the survey is that the vast majority of respondents – namely 80 percent – felt an improved ability to function. And even 87 percent stated that their quality of life had improved with medical cannabis. Most of the pain patients (62%) did not want to take opioids in the future. While the change in pain intensity was not influenced by age and gender, the younger age group had improved functioning compared to the middle and older age groups.

Cannabis useful for chronic pain

The researchers therefore conclude that “cannabis may be a useful adjunct and substitute for prescription opioids” in the treatment of chronic pain. Furthermore, cannabinoids have the added benefit of improving functioning and quality of life.

According to the researchers, this is one of the largest surveys of its kind. The results show a remarkable percentage of patients reporting both complete discontinuation of opioids and a reduction in opioids with the addition of medical cannabis. The researchers hypothesise that these effects are due to the “synergistic pain relief shown when cannabis is added to opioids”.



Takakuwa K M, Sulak D (December 02, 2020) A Survey on the Effect That Medical Cannabis Has on Prescription Opioid Medication Usage for the Treatment of Chronic Pain at Three Medical Cannabis Practice Sites. Cureus 12(12): e11848. doi:10.7759/cureus.11848

Photo by Christine Sandu on Unsplash


CBD can reduce the symptoms of fibromyalgia, especially pain-related symptoms. This is shown by an online survey with 2,700 participants, mainly from the USA, who suffer from fibromyalgia. The survey also reveals that the use of cannabidiol (CBD) is widespread among people with fibromyalgia.

Many fibromyalgia patients use CBD

The anonymous online survey was conducted by researchers from the Department of Anesthesiology at the University of Michigan Medical School in Ann Arbor, USA. Overall, about 38 percent of respondents reported never using CBD, but 29 percent reported past use of CBD and 32 percent reported current CBD use. Thus, more than 60 percent of respondents have tried or are still using cannabidiol.

The people taking CBD mostly suffer from fibromyalgia symptoms that are not sufficiently relieved by their regular therapy. The patients who do not use CBD gave safety concerns as the main reason.

Two thirds of the interviewed patients who take CBD informed their doctor about it. It is noteworthy that only 33 percent sought medical advice on the use of CBD. Participants used CBD for many fibromyalgia symptoms, most commonly pain. CBD achieved mild to strong improvements in all symptom areas. About half of the respondents reported minor side effects.

Fibromyalgia – what is it?

Fibromyalgia often means severe pain, exhaustion, sleep disturbances and not infrequently psychological suffering. The symptoms of chronic pain syndrome are manifold and vary greatly from person to person. Many sufferers have great difficulty in coping with their daily lives and the level of suffering is very high. Some studies have already shown that the medical use of cannabis can have a beneficial effect on the symptoms.

The disease manifests itself through muscle and connective tissue pain, which is particularly expressed at certain pain points (tender points). The pain can occur all over the body, but usually shows up near the joints. In Germany, 2 percent of the population is affected by the chronic pain syndrome, women six to seven times more often than men.

Die Ursache der Erkrankung ist ungeklärt, medizinische Fachleute gehen aber davon aus, dass eine genetisch bedingte Krankheitsanfälligkeit eine Rolle spielt. Darüber hinaus können Traumata wie beispielsweise Misshandlungen im Kindesalter, aktuelle psychische Belastungen oder chronische psychische Belastungen wie Stress die Entstehung fördern.

The cause of the disease is unknown, but medical experts assume that a genetically determined susceptibility to the disease plays a role. In addition, traumas such as abuse in childhood, current psychological stress or chronic psychological stress such as stress can promote the development.



Boehnke KF, Gagnier JJ, Matallana L, Williams DA. Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey. J Pain. 2021 Jan 2:S1526-5900(20)30117-6. doi: 10.1016/j.jpain.2020.12.001. Epub ahead of print. PMID: 33400996.

Photo by Annie Spratt on Unsplash


Cannabidiol (CBD) can provide relief for Parkinson’s patients. This was shown in a study by the Department of Neurology at the University of Colorado School of Medicine in Aurora (USA). The motor symptoms of the disease were reduced, but also nighttime sleep and emotional disturbances improved significantly. However, liver enzymes elevated in some participants of the study due to the high dosage.

People with Parkinson’s disease can benefit from CBD

In the study, 13 people with PD and substantial rest tremor received herbal, highly purified CBD (Epidiolex; 100 mg/mL). The CBD extract was titrated from 5 to 20-25 mg per kilogram of body weight and maintained for 10 to 15 days. The patients had an average age of 68 years.

All 13 participants in the study reported mild side effects, such as diarrhoea (85%), somnolence (69%), fatigue (62%), weight gain (31%), dizziness (23%), abdominal pain (23%) and headache, weight loss, nausea, anorexia and increased appetite (5% each). Elevated liver enzymes occurred in five people, representing 38.5% of the total group.

Three people dropped out of the study due to intolerances. The remaining ten achieved an improvement in overall and motor scores. Other positive results were that nightly sleep and emotional or behavioural control disorders improved significantly. The researchers therefore conclude that CBD in the form of Epidiolex may be effective in PD. However, the relatively high dose used in this study was also associated with increases in liver enzymes.

Parkinson’s disease

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s disease. In Germany, about one percent of people over 60 are affected by the incurable disease. The medical treatment options are limited. Therapy is primarily aimed at alleviating the symptoms and improving the quality of life of those affected.

At the beginning of the disease, the symptoms are non-specific. These include pain in the shoulder or neck area or in the back, as well as a slowing down and decrease in movement. In addition, there is a rest tremor that begins on one side. In the course of the disease, the gait pattern changes. Those affected bend forward and take only small, short steps.

In addition to motor symptoms, sleep disturbances, pain in muscles and joints and depressive moods may occur. Later, affect lability, apathy, anxiety disorders and dementia may develop. These non-motor symptoms should not be underestimated, as they often severely limit the patient’s quality of life.



Leehey MA, Liu Y, Hart F, Epstein C, Cook M, Sillau S, Klawitter J, Newman H, Sempio C, Forman L, Seeberger L, Klepitskaya O, Baud Z, Bainbridge J. Safety and Tolerability of Cannabidiol in Parkinson Disease: An Open Label, Dose-Escalation Study. Cannabis Cannabinoid Res. 2020;5(4):326-336.

Photo by Hugo Delauney on Unsplash


Washington State University has published the results of an observational study. It states that patients suffering from post-traumatic stress disorder were able to reduce their symptoms such as flashbacks, anxiety and irritability by using medical cannabis.

People who have gone through an extreme situation are at increased risk of developing post-traumatic stress disorder (PTSD). Such extreme situations can include serious accidents, life-threatening illnesses, mistreatment in childhood or adulthood. But also, witnessing wars, captivity or terrorist attacks can be triggers for this mental illness. It does not necessarily occur immediately after the traumatic experience. Even weeks, months or even years later, various symptoms can still appear.

Typical symptoms manifest themselves in the form of intrusions and flashbacks when those affected are overwhelmed by the emerging memories of the trauma. Intrusions and flashbacks are usually triggered by key stimuli. For example, when a war victim hears a loud bang or a burn victim perhaps smells smoke. Other symptoms of PTSD can manifest themselves as follows:

  • Nightmares
  • Wild outbreaks
  • Tachycardia and shortness of breath
  • Swindle
  • Anxiety, irritability and nervousness
  • Depression

Treatment of PTSD

Those affected need above all psychological care and in severe cases also an inpatient stay in a psychiatric clinic. Therapy usually consists of three phases: creation of a safe environment, stabilization and overcoming trauma.

Drug therapy is usually only used if the person concerned suffers from severe sleep disorders, restlessness, anxiety or depression, for example. Various studies have already shown that medical cannabis can be used as a supportive therapy in PTSD to alleviate the symptoms.

Results of the current observational study

404 medical cannabis users with PTSD used an app over a period of 31 months to track changes in their symptoms (flashbacks, intrusions, anxiety, irritability) depending on different cannabis varieties and doses before and after inhalation.

The results show that the symptoms were reduced by more than 50 percent after inhalation of medical cannabis. In the further course of time, a decrease in intrusions and irritability were also observed, especially at higher doses.

Washington State University researchers stated that medical cannabis could be used temporarily to relieve PTSD symptoms. But according to the researchers it may not be suitable as a long-term treatment, because in the observational study, those affected increased the dose steadily. This could indicate the development of tolerance.


The results of an Israeli observational study show that fibromyalgia patients who had self-medicated with cannabis improved their symptoms of pain and were able to reduce the painkiller dose.

Fibromyalgia, a fibre-muscle pain, is a very complex pain syndrome. Those affected suffer from muscle and connective tissue pain in various parts of the body. Pressure pain above certain pain points can also occur. In addition, affected people often report other complaints such as exhaustion, headaches, sleep disorders and gastrointestinal problems.

The cause of fibromyalgia has not yet been fully clarified. It is assumed that various factors play a role in its development. For example, disturbed pain processing or altered nerve fibres in the muscle tissue can be the cause. In addition, various psychological complaints can also promote the disease.

Patients can alleviate symptoms with the help of movement therapy and relaxation techniques and are often prescribed painkillers or antidepressants.

Observational study in Israel

The doctors of the Laniado Hospital in Netanya and the Hospital of Nazareth observed a total of 101 fibromyalgia patients. 73% of the participants were female. The average age was 45 years old. Pure cannabis was smoked by 54% of the participants. Only 18% of the participants vaporized cannabis and just three participants used cannabis oil. The remaining participants medicated themselves with different combinations.

The results show that 47% of the participants did not take any further medication to alleviate symptoms due to self-medication with cannabis. 51% were able to reduce the dose of pain medication. Only one participant stopped medication with cannabis.

In addition, the doctors reported that pain symptoms and sleep improved by about 77% among the participants. The average daily cannabis consumption was relatively low. It was less than 1 gram.

From the results, the doctors concluded that cannabis may be an effective treatment for fibromyalgia.


The active ingredient, haloperidol, is a highly potent antipsychotic (neuroleptic) drug that is approved to treat acute mania, acute chronic schizophrenia and for tic disorders (Tourette’s syndrome). However, consumption of the drug is associated with severe side effects. These include long-term movement disorders and late dyskinesias.

Researchers from Lagos have now been able to show in animal models that the simultaneous administration of haloperidol and cannabidiol (CBD) could prevent these side effects.

How does Haloperidol work?

The nerve cells in the brain communicate via different neurotransmitters (messenger substances). These can be roughly divided into two groups: While some messenger substances such as norepinephrine have an activating, excitatory and stimulating effect, other messenger substances such as serotonin, the “happiness hormone”, trigger calming and attenuating effects.

Haloperidol is prescribed when an excess of the messenger substance, dopamine, is detected in patients. Dopamine is also known as the “happiness hormone”. An excess of this can trigger schizophrenia, psychosis, delusions and loss of reality.

The active substance haloperidol binds to the dopamine receptors and blocks them so that the dopamine signals are not transmitted. As a result, the high levels of dopamine normalise.

In Parkinson’s disease, patients show a lack of dopamine so that the body’s movement patterns are disturbed. Since haloperidol blocks the dopamine signals, movement disorders may also occur. These are known as extrapyramidal motor disorders and can manifest themselves in the form of an urge to move, restlessness and involuntary movements.

Haloperidol in combination with cannabidiol

The researchers investigated the effects of CBD on haloperidol-induced extrapyramidal motor disorders. There were a total of six experimental groups with rats receiving different combinations of oral cannabidiol with 5 mg/kg haloperidol.

The researchers concluded from the results that haloperidol in combination with CBD could alleviate motor impairments and prevent long-term movement disorders such as acute dystonic disorders.


A report by “Medical Xpress” states that roughky 75,000 Australians are suffering from a chronic bowel disease known as Crohn’s disease, or ulcerative colitis. These are caused by inflammation in the gastrointestinal tract. As a result, those affected often suffer from diarrhoea, constipation, pain and weight loss, which has an enormous impact on the quality of their everyday life.

The report also states that recent research by the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney shows a quarter of those affected in Australia use illegal cannabis for treatment. A total of 838 patients were interviewed, 25.3% of whom reported using cannabis to treat their symptoms. Only 1.4% received legal medical cannabis.

The principal researcher and academic director of the Lambert Initiative, Professor Iain McGregor, stated according to the report:

“The survey was inspired by the experiences of the Taylor family from the Blue Mountains: father Steven Taylor was arrested for growing cannabis to alleviate the suffering of his daughters Morgan and Taylor who suffered from severe IBD and found great relief from non-intoxicating cannabis leaf juice preparations”.

McGregor further explained that this case shows that many patients suffering cannot adequately treat their disease with common medication and therefore turn to alternative treatment options.

Survey: Cannabis relieves symptoms

More than 90% of those affected said that cannabis helped improve symptoms such as pain and cramps. The quality of sleep and anxiety symptoms also improved. In contrast, the benefit for other symptoms such as bleeding, stool frequency, consistency and urgency is smaller.

Furthermore, patients receiving medical cannabis therapy were reported to have significantly improved their quality of life. In addition, cannabis clients reported that they were able to reduce the doses of their prescribed medications and needed specialist treatment less frequently.

The patients were also asked about side effects of cannabis use. These were minor and mainly limited to drowsiness and memory disorders.


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