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Cannabis in Switzerland – Medical use and legal basis
Cannabis has been used for medicinal purposes for centuries, but it is only in recent years that scientific research has taken a closer look at the actual effectiveness and risks of cannabis-based preparations. The focus is particularly on the two main active ingredients, tetrahydrocannabinol (THC) and cannabidiol (CBD). While THC has an intoxicating effect and can relieve pain in certain conditions, CBD is primarily valued for its calming, anti-inflammatory and anticonvulsant properties – without any psychoactive effects.
The Freiburg University’s Clinic has provided a comprehensive assessment of the current state of research in a report. The picture that emerges is a nuanced one. In some areas, there are good scientific evidence but not yet in many others. The CBD-containing drug Epidiolex has been shown to significantly reduce the number of epileptic seizures, particularly in the treatment of rare forms of childhood epilepsy such as Dravet syndrome and Lennox-Gastaut syndrome. In controlled studies, a reduction in seizure frequency of around 20% was observed compared to the placebo group. At the same time, however, relevant side effects were also observed, such as drowsiness, loss of appetite, diarrhoea and elevated liver enzymes. These side effects occurred particularly frequently in patients who were also taking other liver-damaging medications.
The study results are much more inconsistent when it comes to pain therapy. Although medical cannabis is often used to treat chronic pain, its clinical effectiveness is frequently low. Studies show a certain benefit, particularly for neuropathic or tumour-related pain, but this is often weaker than with other medications. In addition, the side effects – ranging from fatigue and dizziness to psychological impairment – are not insignificant.
For many other conditions such as multiple sclerosis, Alzheimer’s, Parkinson’s, depression or anxiety disorders, there is currently only evidence from preclinical studies, such as animal experiments or laboratory analyses. The transferability of these findings to humans remains questionable, as there is a lack of high-quality clinical studies. There are also interesting theoretical approaches to the anti-inflammatory effects of CBD, but without reliable data, therapeutic use in these areas remains speculative.
In terms of its mechanisms of action, CBD is pharmacologically versatile. Among other things, it affects serotonin receptors, which explains its anxiolytic effects, as well as pain receptors and so-called TRP channels. It also interacts with the endocannabinoid system, which regulates key bodily functions, including mood, pain perception and sleep. Nevertheless, the exact mechanism of action in many areas of application is not yet fully understood.
In summary, it can be said that cannabis preparations have considerable potential in medicine, particularly for specific indications such as treatment-resistant epilepsy or in palliative care. At the same time, current studies clearly show that many of the promised effects have not yet been scientifically proven. The widespread medical use of cannabis products should therefore only be considered after carefully weighing up the benefits against the potential risks. Further high-quality clinical studies are urgently needed to enable a sound medical assessment.
Source:
Freiburg University Hospital – Institute of Forensic Medicine:
‘On the clinical efficacy of preparations made from hemp’
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