The global cannabis market is growing rapidly, and more countries are starting to legalize the medicinal and recreational use of the powerful plant. The German government only recently shared their draft bill for a gradual legalization of recreational cannabis use over the coming years. However, medicinal cannabis has already been prescribed by doctors in Germany since 2017. For this article, we have interviewed Dr. Christiane Neubaur on the topic of medicinal cannabis in Germany and the challenges that pharmacists face.
Can you please share some information about yourself and the Association of Cannabis Supplying Pharmacies?
“My name is Dr. Christiane Neubaur. I’m a pharmacist and the managing director of the VCA (Association of Cannabis Supplying Pharmacies). The association takes care of the interests of pharmacies that supply cannabis to patients. Whether they have questions about dispensing or products, we are available to support them with our advice. We try to motivate and support pharmacies that don’t have experiences with cannabis through training opportunities and education efforts. But even pharmacies that are more experienced can expand their knowledge through the training we offer. In addition, we exchange knowledge with the industry and doctors who prescribe medicinal cannabis. Our political activities are aimed at ensuring that cannabis-supplying pharmacies are taken seriously both in the area of medicinal cannabis and in legalization efforts. Through our constant commitment we make sure that local pharmacies gain more visibility.”
Dr. Christiane Neubaur
What is the difference between medicinal cannabis and recreational cannabis and why is this distinction important?
“The qualitative difference between medicinal cannabis and recreational cannabis have not yet been determined. So, I can't say much about this. However, one clear difference between the two is that medicinal cannabis is only available via a prescription.”
What are the benefits of medicinal cannabis compared to more traditional medications?
“Patients that get prescribed medicinal cannabis are patients who have already gone through all commonly utilized therapies without seeing improvements to their condition. Cannabis is usually the last chance to improve their wellbeing and enable them to have a better life. It is often used as co-medication. Painkillers such as opioids can be significantly reduced in concentration or even eliminated during cannabis therapy. This leads to a reduced risk for side effects.”
For which symptoms and illnesses is medical cannabis primarily prescribed?
“The primary area of application is pain relief, followed by multiple sclerosis, oncology, and specialized outpatient palliative care.”
What quality standards does medical cannabis have to meet and how do you test for these in pharmacies?
“The quality standards are specified in the German and the European pharmacopoeia. The microbiological quality is based on European pharmacopoeia 5.1.8 ABC or 5.1.4. There is no independent cannabis monograph yet, but it’s currently being developed. Pharmacies verify their cannabis using identity checks using microscopy. This allows any mold nests to be discovered. The qualitative testing of THC and CBD is carried out using thin layer chromatography, rapid tests or mid-infrared spectroscopy.”
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What are the disadvantages of current testing methods?
“There is no nationwide recognition of rapid tests. Usually only thin layer chromatography is recognized. Here the costs and personnel costs are too high for pharmacies that only have a few cannabis patients. Another option that saves time and conserves human resources is identity verification using mid-infrared spectroscopy. There is also no federal recognition for this testing method and its use is only worthwhile for pharmacies that have enough cannabis patients to justify the purchase.”
Which parameters are particularly relevant for you and why?
”The CBD and THC content, terpenes, and the moisture level are all important parameters because they can be used to assess the quality.”
As a pharmacist, which to-dos do you have to tick off before you can distribute medicinal cannabis to patients?
“Ordering the cannabis, preliminary discussions with patients, cannabis identity and quality checks, preparation of the prescription, labeling and documentation, delivering the cannabis to patients and giving them advice e.g., on dosage, storage and application.”
What is your opinion on the German draft bill for the partial legalization of cannabis?
“Pillar one of the legalization bill only affects us to the extent that cannabis is removed from the BTMG (narcotics law). This makes it easier for doctors to prescribe cannabis.”
Where do you still see challenges for pharmacies when it comes to dispensing medicinal cannabis?
“Unfortunately, a drop in the price of cannabis flowers is negatively affecting business. Here we need reasonable compensation for the work that is involved. There are still not enough pharmacies that supply medicinal cannabis.”
What are your hopes and wishes when it comes to medicinal cannabis? (e.g., in regard to changes in laws and test methods)
“I’m hoping for a simplification of test methods to save us time and enable staff to focus on other tasks. The cost for identity and quality checks should also be much lower.”
We would like to thank Dr. Christiane Neubaur for taking the time to answer our questions and for her dedication to educate pharmacies and the wider population on the benefits of medicinal cannabis.
If you would like to learn how Senorics simplifies cannabis analysis for pharmacies and consumers, check out the following resources or send us an email to firstname.lastname@example.org if you have a more specific question.
- Cannabis analysis with the SenoLab
- Ensuring consumer safety: Cannabis analysis made easy
- FAQ: Senorics at cannabis conferences in Berlin
- Explained Episode #16 - Cannabis analysis made easy