Beginning of the debate on medical hemp use

The Federal Council has published the message on medicinal cannabis. After 2011, this would be the second step towards normalizing the use of hemp as a medicinal product. But it will remain restrictive: The sick get no rights.

Lengthy discussions have now led to a concrete proposal: The Federal Council published the corresponding dispatch to parliament as planned in mid-year. This business has also been given its own number: 20.060. In essence, the Federal Council's proposal corresponds to the one it had submitted for consultation in 2019 (see Legalize it! No. 85, pages 4 and 5). First, a preliminary remark on medicinal cannabis.

Actually, the hope was that the pharmaceutical industry would develop THC drugs, conduct clinical research, and that these would then be approved by Swissmedic for certain clinical pictures. But this did not happen and still does not seem to happen (there is still only one such approved drug, Sativex, for more severe forms of MS). Therefore, most hemp preparations are extemporaneous preparations (produced by pharmacies, mostly drops) that are exempt from approval.

It is about “the lifting of the traffic ban on narcotics of the effect type cannabis for medical purposes”. That sounds a bit abstract. We must be aware that cannabis with a THC content of 1% or more is still classified in the total prohibition category. Actually, nothing at all should be done with it.

Nevertheless, in 2011 the legal possibility was created to use this totally prohibited plant for medical purposes by way of exception. For this, however, an exceptional permit from the Federal Office of Public Health (FOPH) was and is always necessary. In the meantime, thousands of such temporary exemptions have been granted and the authorities consider this no longer a viable option (because the exceptional character is so slowly lost).

Therefore, this bill wants to limit the total ban to hemp consumed for pleasure (which remains a prohibited narcotic). Medicinally used hemp should then be placed in a different category, among the “controlled narcotics with restricted marketability”. Swissmedic is responsible for this (as it already is for morphine, methadone, cocaine, etc.). Thus, medical use no longer requires an exceptional authorization from the FOPH, but is subject to the normal control regime of Swissmedic.

This gives doctors the basic possibility to treat sick people with cannabis. They no longer need to obtain an exceptional permit, but they should not then simply prescribe hemp to everyone. They must comply with their duty of care and are controlled by the cantons (cantonal doctors).

What is meant by this in detail remains to be seen and would be developed first. The timetable would be roughly as follows: If this NarcA-amendment would be passed, the medical use of hemp from 1% THC would no longer be prohibited in principle. Then various regulations could be adapted, also for seeds/cultivation changes would be needed and the control regime would have to be defined more precisely. Afterwards, doctors could start prescribing medical cannabis without an exemption.

In parallel, data on these medical prescriptions would be collected and evaluated, and the various medical societies (MS, pain, etc.) could develop recommendations. Thus, over the years, perhaps with cantonal differences, an accepted practice for physicians would emerge: Under which circumstances can they prescribe which doses of which preparations for which forms of consumption and for how long (and when not) - a kind of “good practice”.

The law does not exclude the possibility of vaporizable or smokable variants (this has been the subject of repeated controversy). In principle, this is also the competence and responsibility of the physician. But it is precisely such points that should be researched and clarified in the initial phase.

There is now no exemption from tobacco tax, because the Federal Court had ruled that hemp products do not constitute tobacco substitutes and are therefore generally not subject to this tax liability.

Some articles have been added to legitimize the authorities to collect data around cannabis prescriptions (especially when using unauthorized cannabis medicines). These were limited to the first seven years. The Federal Council determines exactly what data should be collected.

So that no one thinks that all dams are now breaking here and soon everyone who wants to can be treated with hemp, a quote from the message: “Cannabis, even for medical purposes, will remain a controlled narcotic whose therapeutic use is subject to restrictive conditions and must be precisely documented.” Sick people will still not be allowed to grow or treat themselves. This remains just as criminal as it is today. This change would be just the second step towards the normalization of hemp as medicine and certainly not a revolutionary leap forward.

The assumption of costs by the health insurance companies is also still a long way off, for this it would need new clinical studies on the effectiveness. According to the authorities, this has still not been proven.

Soon, the parliamentary deliberations will begin (in the two commissions and the two councils), which will probably drag on for a year. The chance that the bill will pass is quite high.

➡ Details on parlament.ch, 20.060