Cannabis as medicine

Michael F. is seriously ill. For more than 20 years, the craftsman from the western German city of Mannheim has suffered from multiple sclerosis. He has difficulty speaking, often suffers from convulsions and says cannabis gives him relief.

Legal and affordable

The medical effect of cannabis is widely accepted, but for many people like Michael F. a legal and affordable cannabis treatment is difficult in Germany. That could change following a recent ruling, which has not yet gone into effect, by the Federal Administrative Court in Münster.

Under strict conditions, severely ill people in Germany may now be allowed to grow cannabis at home. Those for whom no other therapies are available or effective but may receive a medical benefit from cannabis can apply to the Federal Institute for Drugs and Medical Devices (BfArM) for permission to treat themselves with their home-grown cannabis, when its use is monitored by their doctor.

"If an affordable treatment option is missing, a license for personal cultivation of cannabis has to be taken into consideration - at the discretion of the BfArM," the court ruled.

Previously, all requests for personal cultivation had been rejected by the Federal Ministry of Health.

Dronabinol as an alternative

However, the court also ruled that patients should not be allowed to grow cannabis if their health insurance covers the cost of treatment with cannabis-based medications such as dronabinol.

And therein lies a problem for Michael F. who is now growing cannabis in his bathroom. He said he cannot afford cannabis products from the pharmacy.

Before the Münster court issued its ruling, which policymakers have yet to put into law, Michael F.'s health insurance had declined to pick up the tab for dronabinol. Shortly after the court decision, the insurance company, the AOK, approved payment for the cannabis alternative.

Michael F. and his attorney, Oliver Tolmein, who represents a number of people who want to grow cannabis for medical purposes, claim dronabinol as a cannabis alternative is insufficient.

"Dronabinol acts only as a supplement," said Tolmein, adding that people who use it require less cannabis to achieve the same effect.

'Milestone' ruling

Franjo Grotenhermen, chairman of the Association for Cannabis as Medicine, called the court's ruling "a milestone" in efforts to supply cannabis to German citizens as an alternative therapy.

"Cannabis products from the pharmacy are unaffordable for most patients," he said. "Legal growing of the plant at home opens up for them an affordable alternative for the first time."

Recreational use of cannabis is illegal in most parts of the world. But many countries are beginning to embrace or have already introduced varying levels of decriminalization for its medical usage, including Canada, Israel and the Netherlands. In the United States, some states have approved use of certain cannabis parts for medical purposes.