The Challenges and Solutions for Medical Cannabis in the Czech Republic
Author: Ondrej Stovicek
Recently, the Czech media has once again turned its attention to medical cannabis. Despite pharmacies being well-stocked and the electronic prescription system functioning smoothly, the sales of medical cannabis remain disappointingly low. Why is this the case? Here, we offer our perspective on the issue.
Overview of Medical Cannabis in the Czech Republic
Regulatory Background
Medical cannabis has been available in the Czech Republic since 2013 and is currently regulated by Regulation 235/2015 Sb. This regulation outlines the maximum allowable amount of cannabis per person per month (180g), mandates electronic prescriptions (eRecepts), and specifies the conditions under which cannabis can be prescribed and the required specializations of physicians.
Annex 1 of this regulation also sets the permissible levels of active substances in cannabis, with THC content ranging from 0.3% to 21% and CBD content from 0.1% to 19%.
Issues with Current Medical Cannabis Offerings
High THC Content, Low CBD Content
According to a report from the State Agency for Medical Cannabis (SAKL) dated June 22, 2018, medical cannabis available from Elkoplast Slušovice s.r.o. contains 19% THC and only 0.1% CBD. In our opinion, this is far from ideal. The high THC content combined with the low CBD content results in a highly psychoactive product, which can be overwhelming even for experienced users.
Effects of THC and the Role of CBD
THC primarily affects the brain, targeting areas such as the hippocampus, cerebellum, and basal ganglia. It mimics neurotransmitters, activating these centers and leading to psychoactive effects. Common side effects of THC include anxiety, fear, panic, and paranoia. These effects can be particularly intense with high THC concentrations.
CBD, on the other hand, interacts with CB1 and CB2 receptors in the nervous system and tissues, reducing overall stress on the body. Research has shown that CBD can counteract the undesirable effects of THC, such as anxiety and paranoia. Therefore, a balanced ratio of THC and CBD is crucial for the therapeutic effectiveness of medical cannabis.
The Need for a Balanced THC to CBD Ratio
Ideal Ratios and Current Imbalance
Ideally, the ratio of THC to CBD in medical cannabis should be 1:1, such as 10% THC and 10% CBD. However, the currently available medical cannabis in the Czech Republic has an extremely unbalanced ratio of 190:1 (19% THC to 0.1% CBD). This imbalance can lead to strong and undesirable psychotic effects, particularly for patients with no prior experience with cannabis.
Recommendations for Improvement
To mitigate these effects, we recommend supplementing medical cannabis with CBD oil to provide the missing CBD, which can counteract the psychoactive effects of THC. Additionally, future medical cannabis offerings should include products with a more balanced ratio of THC to CBD to enhance therapeutic benefits and reduce side effects.
Conclusion
The current state of medical cannabis in the Czech Republic highlights a significant issue with the imbalance of THC and CBD in available products. To improve patient outcomes and increase the acceptance and effectiveness of medical cannabis, it is crucial to offer products with a balanced THC to CBD ratio. Supplementing with CBD oil is a practical interim solution until more balanced cannabis products become available.
Author: Ing. Ondřej Šťovíček, Managing Director of Cannadorra
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