Kiel, March 21, 2022 – Since the Cannabis Act came into force on March 10, 2017, BARMER health insurance in Schleswig-Holstein has received 778 applications for cannabis-based medications up to the end of last year. Of these, 485 applications (61.5 percent) were approved, and 293 were rejected. The number of applications has declined in the past two years. This is according to a recent analysis by BARMER on the occasion of the fifth anniversary of the Cannabis Act. The analysis shows that there were 189 applications in 2019 and 156 and 155 in the following years. "The initial hype surrounding cannabis seems to be over, and it is being used more selectively. Cannabis can be a useful part of treatment for seriously ill patients within a comprehensive therapeutic approach. However, it is not a panacea and is insufficient as a pain reliever on its own," says Dr. Bernd Hillebrandt, BARMER's regional director in Schleswig-Holstein. Further studies will be needed in the future to better understand the complex mechanisms of action of cannabis and to integrate them into individualized treatment plans. Besides pain, spasticity, for example in multiple sclerosis, as well as nausea and vomiting associated with cancer treatments, are common areas of application for cannabis.

Fewer prescriptions during the coronavirus pandemic.
Besides more targeted use, the coronavirus pandemic has also clearly had an impact on the number of prescriptions for cannabis-based medications, Hillebrandt continued. Between May 2018 and March 2020, there were consistently between nine and ten applications per month in Schleswig-Holstein. Since April 2020, the number has leveled off at around seven to eight applications. "Especially during the peak of the coronavirus pandemic, insured individuals visited their doctors less frequently. This is also reflected in the number of cannabis applications," Hillebrandt said.

use of cannabis flowers requires experience.
According to the analysis, BARMER-insured individuals in Schleswig-Holstein received almost 5,000 prescriptions for cannabis-containing preparations worth approximately €2.2 million between March 2017 and November 2021. This included 721 prescriptions for unprocessed cannabis flowers. "Both the treating physicians and the patients need experience to use cannabis flowers. They are difficult to dose accurately, and the effects are not easily controllable. Furthermore, the common method of inhalation using vaporizers is cumbersome for patients," said BARMER's regional director, Hillebrandt. He advised against using them as a tea, as the transfer of active ingredients into the water is highly variable, especially with improper preparation. The cannabis flowers must be kept simmering for 15 minutes. Liquid cannabis extracts for oral use, a mouth spray, or the isolated cannabis active ingredient dronabinol in the form of capsules or drops for oral use are easier to dose and apply than cannabis flowers.