Abstract
In recent years, the Swiss Federal Office of Public Health (FOPH) granted exceptional licenses for the medical use of cannabinoids, typically for 6 months with possible extensions. A systematic review of cannabinoids for medical use commissioned by the FOPH supports the use of cannabinoids for the treatment of chronic pain and spasticity. However, little is known about the patients treated with cannabinoids. We aimed to study medical uses of cannabinoids as part of the FOPH's programme of exceptional licenses. We examined all requests for medical use of cannabinoids sent to FOPH in 2013 and 2014. A standardised data sheet was developed to extract data from the files of approved requests. We extracted the duration of the licence, the year it was granted, and the payer of the therapy. At the level of the patient we collected the date of birth, sex, region of residence, diagnosis and the indication. Ethical approval was granted by the Ethics Committee of the Canton of Bern. We analysed 1193 patients licenced for cannabinoid treatment in 2013 or 2014. During 2013, 542 patients were treated under the exceptional licencing programme (332 requesting physicians) compared with 825 in 2014 (446 physicians). Over half of patients (685; 57%) were women. The mean age was 57 years (standard deviation 15.0), chronic pain (49%) and spasticity (40%) were the most common symptoms, and co-medication was reported for 39% of patients. Seventy-eight different diagnoses were recorded, including multiple sclerosis (257 patients, 22%), soft tissue disorders (119, 10%), dorsalgia (97, 8.1%), spinal muscular atrophy (65, 5.5%) and paraplegia/tetraplegia (62, 5.2%). Licence extensions were granted to 143 patients (26.4%) in 2013 and 324 patients (39.3%) in 2014. There were substantial regional variations of the rates of patients treated with cannabinoids. On average, eight patients per 100 000 residents received an exceptional licence. Most patients (1083, 91%) paid out of pocket. Exceptional licences for medical use of cannabinoids have increased substantially in Switzerland, with the programme including patients with a wide range of conditions.
Highlights
Cannabinoids have been used to treat chronic pain, spasticity, nausea, and other symptoms since the middle of the 19th century [1, 2]
A systematic review of cannabinoids for medical use commissioned by the Federal Office of Public Health (FOPH) supports the use of cannabinoids for the treatment of chronic pain and spasticity
The endocannabinoid system (ECS) has been associated with an increasing number of functional pathways, both in the central and peripheral nervous systems and in peripheral organs, and the ECS has emerged as a target of pharmacotherapy [5,6,7,8,9,10]
Summary
Cannabinoids have been used to treat chronic pain, spasticity, nausea, and other symptoms since the middle of the 19th century [1, 2]. It became clear that the effects of THC are due to the activation of endogenous cannabinoid receptors within a newly discovered endocannabinoid system (ECS) [4]. In the 1970s, the effect of THC on pain was compared to that of codeine [12], and more recent studies showed that THC is equivalent to conventional analgesics [13]. Cannabinoids have been shown to be effective in neuropathic pain and diseases of the peripheral or central nervous system [17, 18]. The International Drug Control Conventions classify THC as an illegal, schedule I drug (together with opioids, opium derivatives, and hallucinogenic or psychedelic substances) and prohibit all use “except for scientific and very limited medical purposes by duly authorized persons” [19]. In Switzerland, the 2011 revision of the Federal Act on Narcotics and Psychotropic Substances (Narcotics Act) made it possible for the Federal Office of Public Health (FOPH) to issue exceptional licenses for the restricted medical use of some prohibited substances, including THC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
