Therapeutic Cannabis: what there is to know about laws and regulation

Therapeutic Cannabis: what there is to know about laws and regulation

 

In Italy, physicians can prescribe magistral preparations containing active plant substances of medical cannabis, which must be prepared in appointed structures.
The inflorescences of the galenic preparations are produced by the Military Chemical and Pharmaceutical Plant of Florence.

As provided for by the Ministerial Decree of November 9, 2015 the prescription of cannabis “for medical use” in Italy, is limited to its engagement in “chronic pain and pain associated with multiple sclerosis as well as in spinal cord injuries; in nausea and vomit caused by chemotherapy, radiotherapy, HIV therapies; as an appetite stimulant in cachexia, anorexia, loss of appetite in cancer patients or patients affected by AIDS and in anorexia nervosa; for its hypotensive effect in glaucoma; in the reduction of involuntary movements of the body and the face in the Gilles de la Tourette Syndrome.”
 

Which are the main molecules producing a pharmacological effect?

THC and CBD are the two main cannabinoids present in Cannabis.

THC was isolated and synthesized for the first time in the 60s by Raphael Mechoulam, “the Cannabis physician”, Israeli, among the very first scientists to study Cannabis and its potentials.

THC is commonly known as responsible for the psychotropic effect developing itself during the consumption of Cannabis.

THC, in fact, stimulates the brain to release dopamine, which results in an effect of euphoria and wellbeing. In 1985, however,  the “Food and Drugs Administration” recognizes its therapeutic abilities, developing a medical drug, dronabinol, prepared by Unimed Pharmaceuticals, financed by the National Cancer Institute.

CBD  is an active compound of Cannabis Sativa and represents the main phytocannabinoid present in the entire plant complex, which contains hundreds of chemical substances and over a 70 phytocannabinoids, some of which still little examined.

For some years now, we’ve been assisting a renewed interest in CBD by the Scientific and Medical Community, mainly due to the discovery of its antioxidant, anti-inflammatory, analgesic and neuroprotectant activities.

For which pathologies Cannabis is used?

Even though scientific research on the use of cannabis and its extracts is still at the beginning, we already have studies demonstrating the effectiveness of cannabis extracts in some pathologies.

Let’s, for example, talk about Multiple Sclerosis and a study conducted by the University of Catania, in which 1500 patients, coming from different centres dedicated to the treatment of this pathology , were examined.

CBD was given to the patients in the form of a spray. After the first month of treatment, 61,9% of the patients registered an improvement in spasticity, quantified in a percentage superior or equal to a 20%.  After six months of treatment, further improvement in spasticity was registered in 40% of the patients, passing from a 20% to a 30%.

Furthermore, the symptoms associated with spasticity like cramps and nocturnal spasms, improved in the major part of the patients.

The conclusion the researchers reached to was that cannabis and its extracts could represent a therapeutic option in the management of spasticity in treatment-resistant multiple sclerosis, a symptom which was often ignored, but which much affects the quality of life of the patients. 

Is it possible to drive after having consumed medical cannabis?

As provided for by the Ministerial Decree: “moreover, individuals in treatment should be exempted from driving vehicles or carrying out jobs which require mental alertness and physical coordination for at least 24 hours after the last administration of cannabis for medical use.”

As can be observed, there is no explicit and clear prohibition, but it is preferred to present it as a recommendation, as no precise law exists regarding patients consuming medical cannabis.


Can patients bring medical cannabis with them?

Quoting, also in this case, the DM 9/11/2015, from the moment therapeutic cannabis is purchased, the pharmacist is obliged to supply a copy of the stamped medical prescription, with price, date and signature. This is necessary in order to show that one is using cannabis for therapeutic purposes.

 

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