CBD through medical prescription
How cannabis-derived cannabidiol is capturing the medical industry’s attention
Previously, in Europe, cannabidiol (also known as CBD) had been more commonly known and used as a health supplement for wellness. However, more and more studies have shown that this compound has many medicinal properties. As such, experiments have been launched across Europe to test the validity of cannabis for medical use—which includes the study of THC and CBD and their medicinal properties—as early as 2003 in the Netherlands, and as recently as March 2021 in France.
Find out everything you need to know about cannabis-derived CBD for medical use and prescription below.
Cannabis and CBD: not the same thing
Cannabis and CBD are often confused and the terms used interchangeably. Although closely related, and even used in combination, cannabis and CBD are not the same.
Cannabis is more precisely a botanical genus plant, meaning it groups several plant species from the same Cannabaceae family (Cannabis indica, Cannabis sativa L. and Cannabis ruderalis). Each of these plant species are very similar but differ in some specific properties and compounds, but are all indigenous to Eastern Asia and each have a long history of domestication over centuries, and are referred to under the broader used terms cannabis or hemp.
The cultivation of cannabis is still prohibited in some countries across Europe, including France and England. However, legal cultivation of cannabis, especially cultivation activities registered for medical purposes, can be seen in Canada, USA, Australia and Switzerland.
The legalities of possession, production, distribution and consumption of cannabis for medical purposes are a different story.
CBD: a compound found in cannabis
CBD (cannabidiol) is one of the main compounds found in cannabis. The concentration of CBD found in the plant varies according to the cannabis species, and certain cannabis strains are specially cultivated for their ability to yield high levels of CBD.
THC (tetrahydrocannabinol) is the main psychoactive compound of cannabis and the reason for why cannabis is often recognized as an illegal drug in many countries. Due to the fact that CBD is non psychoactive, it is legal in its pure form in many countries and allowed to be marketed and sold. That said, certain levels of extraction may be needed in order to remove the THC from CBD products to make these legal.
Strictly speaking, CBD (cannabidiol) is not a drug. It is, however, a natural compound proven to show many therapeutic properties, hence why it is used to treat illnesses or symptoms, or used as part of a treatment course.
Chemotherapy is an aggressive type of cancer treatment that can cause intense side effects that can greatly affect a patient’s comfort and quality of life. These can include nausea, diarrhea and/or vomiting. Several clinical studies have confirmed that CBD can help alleviate these side effects and help bring relief to chemotherapy-caused discomfort.
CBD has inflammatory and analgesic properties. As such, CBD is a natural painkiller. The use of CBD has been shown to effectively relieve and reduce pain related to headaches, migraines, sciatica, back pain (including lower back pain), and arthritis (including osteoarthritis).
Scientific studies and clinical trials, along with many patient and health professional reports testimonials, have demonstrated the anxiolytic properties of CBD—meaning, the anxiety relieving properties of the compound. It therefore can effectively help treat, reduce and manage anxiety and chronic anxiety. In relation to this, CBD has also been shown to be effective in the treatment and management of mood disorders often connected with anxiety (including depression) thanks to its positive interactions with dopamine receptors in the brain.
CBD can alleviate the tremors caused by Parkinson's disease, a progressive nervous system disorder that affects movement, and helps to limit the occurrence of seizures caused by epilepsy. CBD has also been linked to slowing down the evolution of multiple sclerosis (MS), as well as having a positive effect on patient treatment and management of other neurological diseases.
Drug withdrawal symptoms caused by major drug addiction and substances of abuse can be extremely challenging, painful and are contributing factors for relapses. Common withdrawal symptoms can include: changes in appetite or mood, congestion, sleep issues and fatigue, irritability, muscle pain, Nausea and vomiting, restlessness, shakes and tremors, cold sweat. Cbd has shown it can help alleviate the severity of such symptoms and subdue the brain’s craving for psychoactive substances, thus showing a lot of potential for substance abuse and drug addiction rehabilitation.
Of its many medical properties, CBD has shown it can help stimulate appetite in patients, which can be a symptom caused by anorexia nervosa, an eating disorder, or even linked to alzeimers. Loss of appetite can lead to serious health problems, including mineral and vitamin deficiencies, and CBD can help avoid such long-term impacts.
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How to obtain CBD for medical use?
Interested in trying cannabidiol to benefit from its medicinal virtues? Here are a few things you should know:
Since CBD is neither considered a psychotropic drug nor a medication, having no side effects of cannabinoid intoxication or addiction, it is legal to consume in its pure form provided there are little to no THC levels in the products. Therefore, CBD products are commonly available for purchase without a prescription online or in specialised shops.
As with anything related to your health, it’s strongly recommended to seek the advice of a health professional, such as a family doctor or licensed specialist, before starting any new therapeutic or medicinal treatment involving cannabidiol. While CBD can be consumed in high doses and an overdose has been shown to be both highly unlikely and low-risk, it is still important to follow an appropriately prescribed dosage for effectiveness and safety.
Consuming medical CBD leverages the extracted compound cannabidiol without (or with very low traces) of THC. Using medical cannabis, however, means consuming whole parts of the plant, which contains both CBD and THC. Since THC is psychotropic, it does have other effects on the brain and body, along with medicinal properties, such as the feeling of being high (intoxication) and is commonly illegal without a prescription.
Only a few pharmaceutical solutions, such as NHS approved Sativex (cannabis-based drug called nabiximols), have been granted a license by MHRA (the Medicines and Healthcare products Regulatory Agency, an executive agency of the Department of Health and Social Care in the United Kingdom). There is also Epidiolex (an oral solution) approved by the FDA (U.S. Food and Drug Administration).
The landmark decree authorising experimentation in France issued last year in 2020 to gain more understanding and information on medical cannabis has fostered hope for better patient access to medical cannabis, not only in the country but also in the context of becoming a model for the rest of Europe.
Unfortunately, the experiment project suffered delays as the launch was postponed due to COVID-19, resuming in March 2021. The projected duration of the experiment period is to be 2 years.
The ongoing medical cannabis experiment in France currently exist solely within the framework of the intended use for patients suffering from:
● Symptoms caused by cancer or cancer treatments (such as chemotherapy);
● Drug-resistance limiting other treatment options;
● Severe epilepsy and seizures;
● Neuropathic pain (often chronic);
● Pain related to central nervous system disorders (such as multiple sclerosis);
● Palliative conditions.
It should be noted, however, that medical cannabis is being experimented on as a complement to already administered medical treatments only.
The medical cannabis experiment mainly considers and prioritizes patients who do not respond to existing pharmaceutical treatments. There must also be evidence that the patient is not at risk for cannabis intolerance.
Through the experiment, patients in France must go through medical structures approved by the ANSM (Agence nationale de sécurité du médicament et des produits de santé) to obtain a medical prescription for cannabis. Patient follow-ups and prescription renewals can then be carried out by any doctor or licensed specialist with appropriate training.
Once a patient has a prescription, they can procure themselves medical cannabis based products in pharmacies. Oftentimes, prescribed products can be in the form of an oil or dried cannabis flowers, which can then be inhaled through vaporisation. Depending on the desired effects and preferred use, the concentrations of CBD and THC in cannabis based products can differ.
Patients must visit their doctor or licensed physician regularly for follow-ups, and they must strictly adhere to the prescribed dosage of cannabis and/or CBD. Driving or operating heavy machinery is not allowed while undergoing treatment. More information on treatment requirements is available by speaking to a doctor.
While the medical use for prescribed cannabis and CBD is already authorised and commonplace in Canada, parts of the USA, and in several European countries, such as Portugal, Switzerland and the UK (NHS), other countries are not so lucky.
The good news is that France has launched a cannabis experiment period in March 2021 for the next 2 years, under the direction of the ANSM, to study, acquire more information, and better understand the use of medical marijuana. Patients can obtain cannabis based products in pharmacies, after obtaining a prescription from an authorised health professional or licensed specialist. They must regularly visit a doctor who has completed appropriate training for follow-ups and renewals.
If proven successful, with enough evidence, this experiment has the potential of creating a model for all of Europe to help shape the future of medical cannabis and granting better access to patients.