Franziska Quadri, President of the Medical Cannabis Association Switzerland (MEDCAN), tells MCN about MEDCAN’s advocacy work and the need for legislative change.
Switzerland’s Medical Cannabis Association (MEDCAN) was founded in 2014 with the aim of giving medical cannabis patients a base to connect with each other and a voice to exert political and social pressure.
In addition to providing support for patients and caregivers and campaigning for less severe cannabis policies in Switzerland, MEDCAN offers educational resources for the general public and for clinicians interested in prescribing medical cannabis.
Franziska Quadri, President of MEDCAN, tells Medical Cannabis Network about MEDCAN’s advocacy work and the need for legislative change.
What is the current legal and medical status of cannabis in Switzerland?
As attitudes towards cannabis are changing worldwide, many people today feel that it is no longer a problem to use cannabis for medical purposes. But this is not the case in Switzerland. Since 2011, doctors have been allowed to prescribe cannabis drugs for medical purposes under certain conditions. According to the Federal Office of Public Health (FOPH), more than 100,000 people in Switzerland use medical cannabis, but only a few thousand have a corresponding licence from the FOPH.
The conditions to legally obtain cannabis are still complicated and the legally available products are lowdosed and very expensive. Today’s legal regulations actually make it impossible to get proper treatment with cannabis for serious illnesses or diseases. The resulting costs are enormous when high doses are used.
Cannabis products and cannabis flowers with less than 1% THC and a high proportion of CBD are allowed in Switzerland and can be legally purchased in shops and on the internet.
Recreational consumption is prohibited. Both the possession and the use of cannabis fall under the narcotics law and are therefore illegal. However, according to Art. 19b2, anyone who ‘prepares’ or carries up to 10g for her own use is exempt from punishment. This law came into force in October 2013.
What are the main challenges facing patients trying to access medical cannabis?
Priceless and uncontrolled cannabis products
Swiss cannabis drugs are expensive. The prices of legal products are several times higher than on the black market. These horrendous prices are incomprehensible. Patients need affordable drugs, because health insurance companies will not have to pay for them in the near future. The cost of the drugs must not exceed the black market prices. This would only mean that many people would continue to have to stock up illegally because they cannot pay the costs. Many of our members have a special permit from the FOPH.
However, the majority of them are forced, for financial reasons or because no doctor can help them, to grow cannabis for medical use themselves or to buy it on the black market. The disadvantage is that those concerned have no control over the quality and ingredients of their cannabis medicine.
Lack of knowledge in the medical profession
Cannabis may only be used medically on a doctor’s prescription. It is very difficult to find doctors who are familiar with the medical use of cannabis. The problem starts with medical school: there is still nothing taught about the endocannabinoid system and the medical use of cannabis. However, this knowledge is absolutely necessary to be able to advise and treat patients correctly.
Ambivalent medical behaviour
Our experience shows that although many doctors know that cannabis can help with many diseases, it is not always easy to find a cure. Unfortunately, however, they usually lack practical experience in the medical use of cannabis. As a result, they often meet patients with uncertainty or rejection. Without medical support, those affected do not get access to cannabis. It is therefore not surprising that the most frequently asked question to our association is: ‘How do I find a doctor who will prescribe cannabis for me?’
Cannabis is not only a drug for serious diseases
Today cannabis is only used to treat the symptoms of serious diseases such as MS, paraplegia, cancer or for difficult pain issues. Patients often have to prove that they have exhausted all other pharmaceutical means. However, especially in the application of cannabis in pain management, it has been shown that many complaints can be alleviated even before the use of addictive opiates or other drugs. Cannabinoids are not harmful to the internal organs in the long term and it is now known that they can be used for a wide range of therapeutic effects. However, it is often argued that there are no studies to prove the effect. For many illnesses, there are only reports of the experiences of other people affected.
The cannabis physician Dr Franjo Grotenhermen, who is well-known in the German-speaking world, says that his patients treat 50 different diseases with cannabis. The fact that there are no studies for many complaints does not mean that cannabis does not relieve these symptoms. Cannabis is not a miracle cure and does not help everyone. However, if cannabis-based drugs are effective, they can significantly improve the quality of life of those affected. Our experience as a patient association shows that especially the number of older patients who do not want to take conventional medicines and would rather treat their age-related complaints with cannabis is steadily increasing.
What is MEDCAN doing to support patients and campaign for policy change?
Patient meetings: information and exchange
At the monthly free patient meetings in Bern and Zurich, those affected – but also other interested parties, such as relatives and caregivers – receive valuable information on the medical use and correct dosage of cannabis. Participants also appreciate being able to connect with other affected persons: many patients with chronic ailments or serious diseases have already tried all conventional medical therapies and still suffer. All the more pleasant is the conversation with other affected people – especially those who have been using cannabis for years and can pass on a lot of knowledge.
MEDCAN works on a political level to help people who use cannabis for medical purposes. Since 2018, some political processes have been underway – but the political mills in Switzerland grind very slowly. This is an intolerable situation for those affected, as their illnesses and chronic conditions demand immediate action.
Educating the general public
MEDCAN informs not only interested parties but also the general public through its website, as well as through media work on the medical use of cannabis, in order to refute and invalidate the false arguments of cannabis opponents that have been used for decades.
What changes would you like to see implemented to Swiss cannabis policy?
Proposal 1: legalise cultivation for affected persons
MEDCAN demands that patients are legally allowed to grow cannabis for medical use themselves. As long as the health insurance companies do not pay the costs for legal cannabis drugs from the pharmacy, despite special permission from the FOPH, the drugs will remain too expensive for most of the people concerned. It must therefore be allowable to produce cannabis for medical use as cheaply as possible yourself.
Proposal 2: introduction of cannabis pharmacies or ‘cannabis clubs’
Since March 2017, affected persons in Germany have been able to obtain a prescription for cannabis medication and obtain it from a pharmacy. As a consequence, much like in Switzerland, prices have risen massively. At the same time, it is difficult to find a doctor who prescribes cannabis; and health insurance companies do not cover the cost of medication. Despite all the adversities, the number of patients has risen massively as a result of legalisation, meaning that many pharmacies have supply bottlenecks.
The Medical Cannabis Association calls for specialised cannabis pharmacies (so-called dispensaries) in Switzerland as in California. There a patient can obtain their cannabis medicine with a doctor’s prescription, on presentation of a passport. Another possibility would be the so-called ‘medical cannabis social clubs’ similar to those available in Spain. These clubs enable patients to organise and co-operate to grow and produce medical cannabis themselves.