In March 2021, launching the experimentation and inclusion of the 1st patient, an experiment which authorizes doctors registered in the register of specialists to legally prescribe cannabis drugs when they accept that their patients can take advantage of them as a means of treatment.
Infographie-frise-temps-maj2022.pdf
Only 20% of people in France still think that cannabis should be illegal, but despite huge support, medical cannabis is still rarely prescribed.
The current directives indicate that, with the exception of a few conditions, there is a lack of evidence to support the prescription of cannabis -based drugs.
For the majority of people in France, the only way to access cannabis is through an experiment on 3000 patients. To be eligible, a patient must have an eligible condition and must have usually tried two previous prescription drugs or treatments for their condition.
Under what conditions can medical cannabis be prescribed in France?
There are a number of qualifying conditions or symptoms that can be treated with medical cannabis. In any case, symptoms can be either a primary problem or a problem caused by another condition. When it is for a clinic, the specialist will ask you questions about your symptoms to assess whether medical cannabis is appropriate.
The main conditions whose medical cannabis is used are:
- neuropathic pains refractory to accessible therapies (drugs or not);
- Certain forms of severe and pharmaco-resistant epilepsy;
- Certain rebel symptoms in oncology linked to cancer or its treatments;
- palliative situations;
- Painful spasticity of multiple sclerosis or other pathologies of the central nervous system.
Find a structure of medical cannabis in France
It is only carried out by doctors of voluntary reference structures and taking charge of one of the 5 therapeutic indications selected.
The map of voluntary reference structures engaged in the experiment can be viewed below.
Discover the card and lists by regions reference structures (04/04/2022)
Two possibilities: Doctors in these centers can offer some of their patients to participate in the experimentation and/or patients followed within these structures can express their doctor to participate.
Patients who are not followed in one of the reference structures can discuss it with their attending physician so that they address them to one of them.
The doctor must have previously checked if the patient has good in inclusion criteria. The final decision to include or not a patient returns exclusively to the doctor of the voluntary reference structure.
Medical monitoring during the 24 months of the experiment can then be provided in part by a liberal, generalist or specialist doctor, having received and validated the compulsory training made available by the ANSM.
The consent of patients is compulsory when the experimentation is started.
What's going on during the appointment?
When you contact an establishment, it will ask you to access medical files to confirm that you are suffering from a disease that lends itself to prescription.
Map and lists by regions reference structures (04/04/2022)
This generally involves telling the general practitioner that you need a copy of the summary health file and the clinic can help you in this regard.
After that, you will have to attend a consultation - in person. During the appointment, the consultant will carry out an assessment and ask questions such as why the previous treatments have not worked or caused problems, how the symptoms of the treated disease affected your life, your sleep, your mobility, etc. .
The doctor or advisor will also ask you questions about any previous use of cannabis as a means of treatment. If they believe that the prescription of medical cannabis is appropriate, they will discuss the options with you.
Certain structures can first present your case to a multidisciplinary team before deciding if a prescription is appropriate, generally these meetings take place every week, you will therefore may have to wait to know the decision.
Remember that doctors and advisers are there to help you and also to answer your questions or fears. You may find it useful to take notes and you always have the right to request that everything that has been discussed is not included in the clinical file.
Medical cannabis: 1 in 5 French people ready to take it
The views of the use of medical cannabis vary a lot from one country to another. According to surveys of the Consumer Insight of Statista, Germany and Poland are among the countries where the inhabitants are the most open on this subject. As shown in our graph, respectively 39 % and 46 % of German and Polish respondents are inclined to use it as part of a treatment.
In Germany, the subject recently drawn public attention, since the government is currently examining the possibility of authorizing cannabis consumption for adults, including for recreational use. The country plans to develop its project to legalize cannabis by the end of 2023. As a reminder, medical cannabis has been legal in Germany since 2017 for seriously sick patients.
In Canada, where the use of cannabis has been legal since 2018, the inhabitants are also rather interested in this form of treatment: more than a third of respondents are willing to take it. On the other hand, in Spain and France, only 22 % and 23 % of those questioned said they were open to taking medical cannabis to treat themselves. In South Korea, they are even fewer: only 13 %.
What happens when medical cannabis is prescribed?
If your doctor agrees to prescribe medical cannabis, your prescription will be confirmed in writing, then filled with a specialized pharmacy.
It is likely that your establishment recommends a specific pharmacy, but you have the choice.
Medical or therapeutic cannabis will be fully supported for patients benefiting from experimentation during the 24 months.
Then, the reimbursement is not yet decided and its rate will be decided according to various parameters such as the cost and the advantages of the product.
Once you have started to take your medication, the dispensary will request a follow -up consultation, usually within 4 weeks, to discuss how you behave with your medical cannabis and to see if changes must be made. It is important that you assist this consultation to continue to receive repeated prescriptions.
How will I take my medical cannabis?
When consulting, the doctor will ask you questions to find out more about you, your condition and how medical cannabis can help you. We can prescribe you cannabis flower or Cannabis oil, according to your symptoms.
Cannabis flowers
If you are prescribed cannabis flower, the doctor will tell you the initial and maximum daily dose that you must take.
However, the cannabis flower requires a little work to be consumed.
You will need a precise balance at 0.01 g to be able to precisely weigh each dose.
You will need to grind (grinder) cannabis flower, a crusher can help you in this process because it breaks down cannabis into a thinner and more coherent shape.
Cannabis can only be prescribed to be consumed with a dry herbs spray. NO SMOKING. THE dry herbs spray Heat cannabis at a temperature where beneficial components, such as CBD and THC, vaporize. This vapor can be inhaled and constitutes a healthier and more effective method of administration than combustion (smoking).
Cannabis oil
If you are prescribed cannabis oil, the doctor will tell you the initial and maximum daily dose that you should take.
Cannabis oils are generally provided with a dropper with a dose indicator on the pipette.
To consume cannabis oil, you will need to place the end of the drop-in-law under your tongue and press the bulb of the dropper to release the oil. Hold the oil under your tongue for 30 to 60 seconds before swallowing. This will help the absorption of cannabinoids.
The side effects of therapeutic cannabis
The side effects of medical cannabis are known: they are mainly linked to THC, they can cause: drowsiness, anxiety crisis, paranoid state but also for prolonged use a risk of dependence…
Other side effects of cardiovascular type or increase in tension or heart rate ... These side effects will of course depend on the THC level and the person's biochemistry.
The contraindications of medical cannabis
The contraindications are different depending on the composition of the products and the history of patients. When the patient has type health problems cardiovascular or severe cardio or cerebrovascular disorders (heart failure, stroke...),
It is contraindicated to prescribe drugs containing THC. Likewise, THC cannot be prescribed to patients who suffer or have suffered from psychotic disorders (schizophrenia) Or Severe anxiety disorders. Medical cannabis is also contraindicated in the event ofhepatic insufficiency severe or predictive biological damage andSevere renal failure.
Participating patients should not drive during the grip of medical cannabis. Finally, THC or CBD cannabis is contraindicated in pregnant and lactating women.
When will medical cannabis be available for more people?
Currently, only three cannabis drugs are authorized and available for the ANSM.
Sprays Sativex, THC and CBD can be prescribed to treat moderate to severe spasticity in adults with multiple sclerosis.
Epidiolex, a product based on CBD isolate can be prescribed with Clobazam to treat crises associated with Lennox-Gastaut syndrome and Dravet syndrome in children.
THE Nabilone, a synthetic product based on THC, can be used as a extra treatment of nausea and vomiting caused by chemotherapy.
It is currently estimated that around 200,000 people in France use cannabis cultivating at home to deal with medical conditions. While these people are pushed to illegality, the question of better access to medical cannabis continues to be an urgent question and a strongly debated subject.
At this stage, ANSM's recommendations still suggest that cannabis drugs are suitable for a small number of conditions.
FAQ: medical cannabis in France
Q: Can we cultivate cannabis in France for medical purposes?
A: Still not. Even during the experimentation of cannabis for medical use, article R.5132-86 of the public health code applies and maintains a principle of prohibition for the cultivation of cannabis, including for therapeutic purposes, insists the 'Medicines agency.
Q: What are the indications of medical cannabis in France?
A: Medical cannabis is prescribed in five specific indications: neuropathic pains refractory to other therapies, severe and resistant epilepsies of conventional drugs, certain rebellious symptoms in oncology such as pain, nausea, painful spasticity of sclerosis in plates or other pathologies of the central nervous system, as well as palliative situations.
Q: Can a patient ask to participate in the experiment?
A: Yes, by addressing a doctor working in one of the 324 hospital reference centers listed on the ANSM website.
Q: In what form is the treatment available?
A: Medical cannabis is available in the form of dried oil and flowers, and the dosage is inspired by experiences carried out in other countries such as Canada or the Netherlands.
Q: Where do the products come from?
A: The products are imported from Australia, Canada, Portugal or Israel. However, a decree published in February 2021 now authorizes the cultivation of medical cannabis in France.
Q: What is the assessment after two years of experimentation?
A: The national electronic monitoring register (recann) recorded 2,282 undesirable effects including 59 serious cases during the first twenty months of the experiment. Adverse effects are mainly central nervous system disorders, gastrointestinal problems and psychiatric repercussions. The risk of addiction is low.
Q: Is there a risk of drift?A: The sale and consumption of cannabis for recreational purposes remain prohibited in France. Medical cannabis is strictly supervised by the ANSM and can only be prescribed by a doctor working in a hospital reference center.
In summary:
Medical cannabis is still shortly prescribed in France despite increasing support for the population. It is currently only available as part of an experiment which aims to include 3000 eligible patients.
These patients must have an eligible condition and have usually tried two prescription drugs or prescription treatments for this condition. The main conditions for which medical cannabis is used are neuropathic pain, certain forms of severe epilepsy, certain rebel symptoms in oncology, palliative situations and the painful spasticity of sclerosis in plates.
Patients can contact a doctor from voluntary reference structures that take care of one of the 5 therapeutic indications used for experimentation. The consent of patients is compulsory at the start of experimentation and medical monitoring is insured in part by a liberal, generalist or specialist doctor who received compulsory training.
Sources:
Inclusion of the first patient in the experimentation of medical cannabis, ANSM, March 26, 2021
Decree n ° 2020-1230 of October 7, 2020 relating to the experimentation of the medical use of cannabis.
National Assembly. Ordinary session of 2019-2020. Full report. First session of Friday October 25, 2019.
