CBD News
Switzerland - FEATURE: "Medical Cannabis in Pharmacy" in the June 2020 issue of the medical magazine "Waiting Room
Switzerland: Cannabis Médical ►
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CBD: Relieving our ailments naturally?
Laura was suffering from insomnia. No doubt stress: she had just launched a start-up. Florence suffered from intense, chronic back pain: probably the weight of the years on her body. For several months now, Laura has been free of dark circles, brimming with energy and enjoying nights full of sleep. Florence, for her part, has seen her pain diminish. She no longer takes the medication that used to cause her morning tremors. Is there an alternative to medication? What if pharmacies started selling medical cannabis?
Laura and Florence have one thing in common: it's CBD that has brought them relief in their daily lives. But what is this product? What are its benefits? To find out, we interviewed Fabien Desgouilles, head of Swiss Medical Cannabis, which specializes in the sale of CBD-based oils. His company is said to be the only one in Switzerland legally authorized to resell CBD (full-spectrum) oils to end-users without a prescription. Survey.
What is CBD? What form does it come in?
CBD is a molecule of the cannabinoid family found in industrial hemp. When we think of hemp or cannabis, we think of THC, the active substance known for its high and psychotropic effects. But CBD is a more interesting molecule, as it has none of these unpleasant effects. What's more, clinical studies suggest that CBD is beneficial to well-being, acting on pain, sleep, appetite and anxiety. Our flagship products are CBD-enriched oils. Inside our vials, you'll find hemp vegetable oil containing a dosage of 10 to 30% CBD. Legislation requires us to recommend the use of this oil for cosmetic purposes, i.e. applied to the skin. In reality, most of our customers tell us that they consume it by swallowing a few drops and adjusting the dosage for their own well-being.
What are the benefits for the body?
According to numerous studies, including a recent WHO report, CBD may have therapeutic effects. It is said to be pain-relieving, antidepressant, antiepileptic and neuroprotective. Another sign of its potential efficacy is the many testimonials from our customers. Many report the benefits of CBD, often for chronic pain and osteoarthritis. Others tell us that the molecule improves their sleep. CBD is also said to act on symptoms of more serious illnesses. The example that touched us most was that of 7-year-old Malo, suffering from a rare disease: West's syndrome, a form of epilepsy. The little boy had up to 10 epileptic seizures a day. His mother assures us that he has been taking CBD since last year. The number of seizures has halved and his quality of life has improved dramatically. This story left a deep impression on us. We even decided to support his association "Pour le sourire de Malo".
What about animals?
Three years of testing by Swiss veterinarians have shown that CBD can improve the well-being of animals. In partnership with Doctor Victoria Unt MRCVS, of the Equilibre veterinary practice, we have developed a complete range of CBD oils for animals.
There are many players in the CBD market. How do you stand out?
Although we can't legally recommend that our customers ingest our oils, we know that the majority do. This is a fact of life. So, to guarantee our customers' safety, we carry out very strict quality control on our products. First of all, there is traceability of batches put on sale on the market. We also analyze the CBD and THC content of our oils. This verification of THC levels enables us to comply with legislation, ensuring that it does not exceed 0.2%. The legal limit is 1%. Then we check the CBD content, to make sure that when we sell an oil at 30%. This level is actually present in the product. We also carry out so-called "dietary" analyses. As we know that our customers ingest our oils, we make sure that there are no pesticides, heavy metals or other pollutants inside. We also make sure that our oils have never been contaminated by bacteria. All these controls guarantee the safety of our consumers and traceability in case of need.
... Cannabis for medical use ...
Therapeutic indications, for whom and how? We take stock.
By Dr Christophe Perruchaud
Cannabis plant material contains over a hundred phytocannabinoids, the main ones being Canna- bidiol (CBD) and Δ9-tetrahydrocannabinol (THC). These compounds have the ability to stimulate the receptors of our endocannabinoid system. These same receptors are activated by endocannabinoids, molecules naturally produced by our bodies. Cannabinoid receptors are present in many tissues, including the nervous system, the gastrointestinal tract and the immune system. Dysregulation of the endocannabinoid system can lead to chronic pain, inflammation, psychiatric disorders and neurodegenerative diseases.
By plant species
THC and CBD concentrations vary significantly: Cannabis Sativa is rich in THC, while Cannabis Indica contains more CBD.
Unlike THC, the main psychoactive compound responsible for the euphoric effects of cannabis. CBD is known to have anxiolytic and antipsychotic effects, as well as neuro-protecting properties. Its toxicity is relatively low, even in high concentrations.
Medical cannabis
For medical use, cannabinoids can be extracted directly from the plant in oil or tincture form (active ingredients dissolved in alcohol) or synthesized in the laboratory. The recommended mode of administration is ingestion or oral spraying.
Prescription
Only one drug is currently authorized and marketed in Switzerland. It is subject to the law on narcotics and requires an exceptional authorization issued by the FOPH if it is prescribed outside its recognized indication, i.e. spasticity in multiple sclerosis. Physicians may, however, prescribe magistral preparations made from plant extracts, available in a very limited number of pharmacies. Preparations containing more than 1% THC are also subject to the law on narcotics.
Therapeutic indications
As the endocannabinoid system is involved in the regulation of numerous physiological processes, the potential therapeutic indications for medical cannabis are extremely varied. New applications are regularly emerging in the medical literature.
Pain
Almost all studies evaluating the efficacy of medical cannabis in several acute pain scenarios (post-operative pain, burns, pain provoked by an irritant) have been negative. On the other hand, medical cannabis has been shown to be effective in several chronic pain indications lasting more than 3 months. However, the effect is considered modest, bordering on clinical significance. Cannabis seems to be more effective in pain of neuropathic origin (secondary to a lesion or disease of the nervous system), notably in cases of multiple sclerosis. Evidence of efficacy is also weak for musculoskeletal pain, such as osteoarthritis or back pain. In a review of the literature published in 2016, the authors were unable to demonstrate the superiority of cannabis over placebo for the management of pain in fibromyalgia.
Chronic pain
Patients suffering from chronic pain frequently present with sleep disorders, generalized fatigue, cognitive impairment, and anxiety or depression. These associated symptoms are likely to respond favorably to cannabis treatment and may justify its prescription. In addition, a number of studies have suggested that the administration of cannabis may reduce the simultaneous use of opiates.
Spasticity
Spasticity, defined as increased muscle tone, is a frequent symptom of multiple sclerosis and stroke. The use of cannabis in this indication is currently the subject of a great deal of research. A summary of the results to date shows an improvement in spasticity of around 30% in a third of patients treated.
Nausea and vomiting
For chemotherapy-induced nausea and vomiting, cannabis has been shown to be superior to placebo and other anti-vomiting agents. It significantly reduces symptoms in around one in two patients. What's more, it has an appetite-stimulating effect that can prove beneficial in cancer patients who are often malnourished.
Side effects, tolerance and withdrawal
Side effects of medical cannabis are frequent and include dizziness, dry mouth, confusion, fatigue, gastrointestinal disorders (nausea, vomiting, diarrhea, etc.), psychosis, palpitations and hypotension. Cannabis can lead to both psychic (addiction) and physical dependence, resulting in a withdrawal syndrome when consumption stops abruptly. Dependence, however, is less severe than with opiates. Moreover, lethal overdose due to cannabis use alone is very rare.
The special case of over-the-counter CBD
Over-the-counter sales of CBD preparations containing less than 1% THC have exploded in recent years. The most common indications are sleep disorders, depression, anxiety, epilepsy and pain. As it is not considered a medicine in the strict sense of the term, very few high-quality studies evaluating its efficacy are available. What's more, there's always a risk, especially when ordering over the Internet, of receiving a product that doesn't conform to its description. That's why we recommend that our patients buy only from certified retailers who carry out quality controls on their products.
Conclusion
Public interest in medical cannabis is booming, with patient requests for prescriptions increasing dramatically during medical consultations. This interest is fuelled by the press and social networks, which often present it as a natural panacea. Both safe and effective for a multitude of pathologies. The opiate crisis and the economic interests of the fast-growing cannabis (cbd) industry are probably contributing to this phenomenon. However, this craze contrasts with the low level of evidence found in the scientific literature. Research into the efficacy and safety of medical cannabis use is still in its infancy, and it is difficult to draw definitive conclusions. This is due to the heterogeneity of the substances and dosages studied, the different durations of treatment and the small number of patients included in the studies.
So...
Medical cannabis still has to prove itself scientifically before it can be considered the aspirin of the 21st century!
