Medical cannabis: opportunities, risks and the future

It makes perfect sense to hold a conference on medical cannabis in Switzerland because more and more scientists in Switzerland are conducting research on this topic. The topic is of course also of interest to patients and the cannabis industry. The University of Bern is an ideal location because research has been conducted here on the topic for many years.

The idea came from Prof. Rudolf Brenneisen, who has been promoting research on medical cannabis in Bern through conferences for many years and has been emeritus for several years. We intend to promote interdisciplinary research in Bern in the coming years, because the location of the University of Bern is ideal.

For the first time, we are addressing various topics related to cannabis because we are convinced that interdisciplinary collaboration is crucial. The main focus is on cannabis-based medications for pain, sleep disorders, and palliative care, as well as for neurological and neuropsychiatric disorders. In addition, we are also examining the topics of cannabis dependence and the potential risks of medical and non-medical cannabis.

We are fortunate to have world-leading experts at our conference, covering a wide range of specialities in both basic and clinical research. Margaret Haney from Columbia University Medical Center in New York, USA, will talk about the risks of cannabis-based medications, while Kirsten Müller-Vahl from the Hannover Medical School in Germany will give a lecture on cannabis-based medications and sleep disorders.

Current developments in medical cannabis research affect various areas. New findings on the endocannabinoid system and its role in stress, pain and metabolic disorders will be presented. Progress in personalised cannabis therapy, particularly for pain relief, will be discussed. In addition, clinical studies on the use of cannabis in neurodegenerative, psychiatric and addiction-related disorders will be presented. A further focus is on the risks, interactions with other medications and the evidence-based regulation of cannabis therapies worldwide.

Cannabis can be used to treat chronic pain, spasticity (e.g. in multiple sclerosis), nausea and vomiting (e.g. as a side effect of chemotherapy), loss of appetite (e.g. in HIV/AIDS), and certain neurological and psychiatric disorders. Numerous clinical studies on the use of cannabis are currently underway and will show for which patients and illnesses it is more effective than a placebo.

One example is Dravet syndrome, a rare and severe form of childhood epilepsy. Many affected children do not respond to conventional antiepileptic drugs, while the cannabis preparation Epidiolex (pure high-dose cannabidiol, CBD) has been shown in clinical studies to significantly reduce seizure frequency. For some patients, it was the only effective treatment.

Since cannabis treatment is carefully dosed and contains significantly less THC than non-medical applications, the health risks are low. The key challenge is to develop optimal formulations with maximum therapeutic effect.

Clinical trials are crucial to determine which conditions cannabis is effective for and where it offers no advantages. Evidence-based research plays a central role here. In addition, individual differences in effectiveness have been observed, which we need to understand better. It is possible that only certain patients may benefit from cannabis therapy, especially if their endocannabinoid system is deregulated.

However, the biggest problem remains the lack of high-quality clinical data on the effectiveness of the available cannabis medications.

Switzerland lifted its ban on cannabis for medical purposes on 1 August 2022. Since then, doctors have been able to prescribe cannabis-based medicines without special authorisation. Compared to countries like Canada or the Netherlands, which have earlier introduced comprehensive medical cannabis programmes, Switzerland is still in a developmental phase. Scientific evidence on the efficacy of cannabis-based medicines is still being evaluated and compulsory health insurance covers the costs only in exceptional cases.

IMCCB-25 aims to bring leading scientists from around the world to Bern to discuss current developments and findings in cultivation, production and clinical application with doctors, the cannabis industry and patients.

This interview was translated using Deeple.