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Nach meiner Kenntnis verkauft bisher nur die Bock-Apotheke in Frankfurt CBD von arzneilicher Qualität. Die Apotheke arbeitet mit dem Unternehmen THC Pharm zusammen, das als erstes Unternehmen 1998 Dronabinol als Rezepturarzneimittel auf den deutschen Markt brachte. Kann CBD Bewirken, Daß Man Beim Drogentest Durchfällt? – Zamnesia CBD ist eine absolut sichere, legale und nicht-psychoaktive Substanz, aber könnte sie bewirken, daß man beim Drogentest durchfällt?

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Wirkung am Menschen noch nicht untersucht. Cannabidiol ist nach Delta-9-Tetrahydrocannabinol der häufigste Bestandteil von Cannabis. Anders als THC wirkt CBD kaum psychoaktiv, es sorgt nicht für

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Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen also been shown to directly inhibit tumor growth and metastases in vitro and in animal tumor models, suggesting the endocannabinoid system may hold promise as a therapeutic target in cancer. Of course, because marijuana has not been put through the U.S. Food and Drug Administration approval process, very few reliable studies demonstrate its efficacy—none of them in children. Furthermore, marijuana is illegal at the federal level and some doctors say it should not be used by adults, let alone children. The American Academy of Pediatrics, for one, has raised questions surrounding the uncertainty of medical marijuana’s effects on children’s still-developing brains and nervous systems. Unfortunately, the dearth of data on marijuana’s safety and effectiveness is not likely to grow anytime soon. The federal government classifies marijuana as a Schedule I drug, which means it cannot be easily studied in humans for medical value. But advocates of the drug argue that it must be compared on a case-by-case basis with the other available options, which in many cases “are much more toxic,” says Sulak. Like marijuana, most of the alternatives currently given to children with cancer, such morphine and oxycontin, and powerful antipsychotic drugs that are used in long-term treatment of childhood mental illnesses have not been studied for either safety or efficacy in children. In fact, fewer than half of all drugs routinely used to treat children have been studied in pediatric trials. And anecdotally, at least, marijuana appears to be relatively safe and welltolerated by children. “The nice things about cannabis is that the negative side effects are much less than most other drugs given to children,” Sulak said. Carter agreed: “I do feel, under almost any circumstance, that medial marijuana is safer than opioids.” Both, however, note that instances in which they have prescribed medical marijuana are extremely rare, as is the case nationwide. Most states where medical marijuana is legal do not keep demographic data on its registrants, but those that do demonstrate medical marijuana usage among children is limited. Colorado, for instance, currently counts 45 children on the state’s medical marijuana registry that have taken medical cannabis, while Montana reports 55. In Nevada, Lauren is the state’s only medical marijuana registrant under the age of 18. “If you look at the numbers, you can see this is not a situation where suddenly you will have thousands upon thousands or even hundreds upon hundreds of children using marijuana,” said Armentano. “It should be available to the small number of children who do need it.” Szendrei, K. (2004) “[A novel analgesics made from Cannabis].” Ideggyogy Szemle 57 (1-2): 36-40. Bayer AG has recently announced that it acquired exclusive rights for the marketing of GW Pharmaceuticals’ new medicine Sativex in Europe and in other regions. Sativex is a sublingual spray on Cannabis extract basis, and is equipped with an electronic tool to facilitate accurate dosing and to prevent misuses. It is standardized for the THC and CBD. The new analgesic is proposed for the treatment of muscle spasticity and pains accompanying multiple sclerosis and as an efficient analgetic for neurogenic pain not

Russo, E.B. (2003) “Future of Cannabis and Cannabinoids in Therapeutics.” Journal of Cannabis Therapeutics 3/4: 163-174. This study reviews human clinical experience to date with several synthetic cannabinoids, including nabilone, levonantradol, ajulemic acid (CT3), Dexanabinol (HU-211), HU-308, and SR141716 (Rimonabant®). Additionally, the concept of “clinical endogenous cannabinoid deficiency” is explored as a possible factor in migraine, idiopathic bowel disease, fibromyalgia and other clinical pain states. The concept of analgesic synergy of cannabinoids and opioids is addressed. A cannabinoid-mediated improvement in night vision at the retinal level is discussed, as well as its potential application to treatment of retinitis pigmentosa and other conditions. Additionally noted is the role of cannabinoid treatment in neuroprotection and its application to closed head injury, cerebrovascular accidents, and CNS degenerative diseases including Alzheimer, Huntington, Parkinson diseases and ALS. Excellent clinical results employing cannabis based medicine extracts (CBME) in spasticity and spasms of MS suggests extension of such treatment to other spasmodic and dystonic conditions. Finally, controversial areas of cannabinoid treatment in obstetrics, gynecology and pediatrics are addressed along with a rationale for such interventions. Russo, E.B. and G.W. Guy (2006) “A tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol.” Medical Hypotheses 66 (2): 234-246. This study examines the current knowledge of physiological and clinical effects of tetrahydrocannabinol (THC) and cannabidiol (CBD) and presents a rationale for their combination in pharmaceutical preparations. Cannabinoid and vanilloid receptor effects as well as non-receptor mechanisms are explored, such as the capability of THC and CBD to act as anti-inflammatory substances independent of cyclo-oxygenase (COX) inhibition. CBD is demonstrated to antagonise some undesirable effects of THC including intoxication, sedation and tachycardia, while contributing analgesic, antiemetic, and anti-carcinogenic properties in its own right. In modern clinical trials, this has permitted the administration of higher doses of THC, providing evidence for clinical efficacy and safety for cannabis based extracts in treatment of spasticity, central pain and lower urinary tract symptoms in multiple sclerosis, as well as sleep disturbances, peripheral neuropathic pain, brachial plexus avulsion symptoms, rheumatoid arthritis and intractable cancer pain. Prospects for future application of whole cannabis extracts in neuroprotection, drug dependency, and neoplastic disorders are further examined. The hypothesis that the combination of THC and CBD increases clinical efficacy while reducing adverse events is supported. Russo, E.B., G.W. Guy and P.J. Robson (2007) “Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.” Chemistry & Biodiversity 4 (8): 1729-1743. Cannabis sativa L. has been utilized for treatment of pain and sleep disorders since ancient times. This review examines modern studies on effects of Δ-9tetrahydrocannabinol (THC) and cannabidiol (CBD) on sleep. It goes on to report new information on the effects on sleep in the context of medical

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen = 91). Homogeneity chi(2) values were non-significant, allowing data combination. Analyses focused on baseline-endpoint score differences. The cannabidiol/THC buccal spray decreased pain 1.7 +/- 0.7 points (p = 0.018), cannabidiol 1.5 +/- 0.7 (p = 0.044), dronabinol 1.5 +/- 0.6 (p = 0.013), and all cannabinoids pooled together 1.6 +/- 0.4 (p /=20% progressed to a 12-week randomized, placebo-controlled phase. Results: Of the 572 subjects enrolled, 272 achieved a >/=20% improvement after 4 weeks of single-blind treatment, and 241 were randomized. The primary end-point was the difference between treatments in the mean spasticity Numeric Rating Scale (NRS) in the randomized, controlled phase of the study. Intention-to-treat (ITT) analysis showed a highly significant difference in favour of nabiximols (P = 0.0002). Secondary end-points of responder analysis, Spasm Frequency Score, Sleep Disturbance NRS Patient,

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen THC Pharm liefert diese Grundsubstanz an rund 100 Apotheken in Deutschland – zu einem Viertel des Preises, den die Importprodukte kosten. Dort erst entsteht das Endprodukt: Kapseln zum Schlucken oder Tropfen zum Inhalieren. “Das Verfahren ist völlig legal, solange die Abgabe-Menge nicht 100 Packungen pro Tag überschreitet”, erläutert THC-Pharm-Chef Christian Steup seine nach eigenen Angaben deutschlandweit einmalige Geschäftsidee. Sie war aus der Not geboren: Ein querschnittsgelähmter Freund bat den studierten Apotheker Steup um Hilfe bei der möglichst legalen CannabisBeschaffung. Seither gehört das Arzneimittelgesetz zu Steups Lieblingslektüre. (2002) “Cannabinoide: Tetrahydrocannabinol zur Therapie chronischer Schmerzen?” Medizinische Monatsschrift für Pharmazeuten 25 (3): 97. Cannabis wurde bereits im 19. Jahrhundert auch zur Therapie der Migräne oder von neuropathischen Schmerzen eingesetzt. In den USA ist schon seit längerem Dronabinol (synthetisch hergestelltes Δ-9-Tetrahydrocannabinol) im Handel, in Deutschland ist es als Rezeptursubstanz verfügbar. Einsatzgebiete sind die Behandlung von Übelkeit und Appetitlosigkeit bei Chemotherapie. (2003) “Synthetisches Cannabis hilft bei Neuropathien.” Deutsche Medizinische Wochenschrift 128 (45): 2350. (2003) “Cannabis-based medicines–GW pharmaceuticals: high CBD, high THC, medicinal cannabis–GW Pharmaceuticals. THC:CBD.” Drugs in R & D 4 (5): 306309. GW Pharmaceuticals is undertaking a major research programme in the UK to develop and market distinct cannabis-based prescription medicines [THC:CBD, High THC, High CBD] in a range of medical conditions. The cannabis for this programme is grown in a secret location in the UK. It is expected that the product will be marketed in the US in late 2003. GW’s cannabis-based products include selected phytocannabinoids from cannabis plants, including Δ-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). The company is investigating their use in three delivery systems, including sublingual spray, sublingual tablet and inhaled (but not smoked) dosage forms. The technology is protected by patent applications. Four different formulations are currently being investigated, including High THC, THC:CBD (narrow ratio), THC:CBD (broad ratio) and High CBD. GW is also developing a specialist security technology that will be incorporated in all its drug delivery systems. This technology allows for the recording and remote monitoring of patient usage to prevent any potential abuse of its cannabis-based medicines. GW plans to enter into agreements with other companies following phase III development, to secure the best commercialisation terms for its cannabisbased medicines. In June 2003, GW announced that exclusive commercialisation rights for the drug in the UK had been licensed to Bayer AG. The drug will be marketed under the Sativex brand name. This agreement also provides Bayer with an option to expand their license to include the European Union and certain world markets. GW was granted a clinical trial exemption certificate by the Medicines Control Agency to conduct clinical studies with cannabis-based medicines in the UK. The exemption includes

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen help people with post-traumatic stress disorder. Experiments in rats show that THC “speeds up the rate at which the animals forget unpleasant experiences,” he says. And a recent study in people with PTSD showed that THC capsules improved sleep and stopped nightmares. Despite these heady beginnings, medical cannabis still faces an uphill climb. Although some states have sanctioned its use, no smoked substance has ever been formally approved as a medicine by U.S. regulatory agencies. Smoking cannabis can lead to chronic coughing and bronchitis, and smoking renders a drug off-limits for children, Mechoulam notes. THC pills don’t have these downsides, but the drugs have received only lukewarm acceptance. Despite smoking’s drawbacks, “it is seen as better because you can regulate the amount of THC you’re getting by not puffing as much,” says pharmacologist Daniele Piomelli of the University of California, Irvine. Capsules can cause dizziness and make it hard to focus. “Patients suffering from neuropathic pain or depression don’t want to be stoned — they want relief,” he says. Controlled, randomized trials that seek to clarify whether smoked cannabis delivers on its medical promise — with acceptable side effects — have been hard to come by. But scientists in California have recently concluded several studies in which patients with severe pain received actual cannabis cigarettes or cannabis cigarettes with the cannabinoids removed. In one trial, researchers randomly assigned 27 HIV patients to get the real thing and 28 to get fake joints. All the patients had neuropathic pain, in which neurons can overreact to even mild stimuli. About half of the people getting real cannabis experienced a pain reduction of 30 percent or greater, a standard benchmark in pain measurement. Only one-quarter of volunteers getting the placebo reported such a reduction. “That’s about as good [a reduction] as other drugs provide,” says Igor Grant, a neuropsychiatrist at the University of California, San Diego, who is among the scientists overseeing the trials. While such studies provide evidence that smoked marijuana has medical benefits, future trials are more likely to explore the benefits of cannabis derivatives that don’t carry the baggage that smoking does. Ultimately, the fate of medical cannabis and its derivatives will rest on the same make-or-break requirements that every experimental medicine faces — whether it cures a disease or alleviates its symptoms, and whether it’s tolerable. “We have to be careful that marijuana isn’t seen as a panacea that will help everybody,” Grant says. “It probably has a niche.… We can’t ignore the fact that cannabis is a substance of abuse in some people.” Getting cannabis in When most people think of medicinal cannabis, smoking comes to mind. Though smoking works quickly and allows users to regulate their intake, it’s hardly a scientific approach: Cannabis quality is often unknown, and inhaling burned materials is bad for the lungs. These and other drawbacks have spawned new ways to consume medical marijuana. Some people inhale cannabis by using a device that heats the plant without igniting it. This vaporization unleashes many of the same cannabinoid compounds as smoking does, without the combustion by-products, researchers say. Anecdotally, patients report that the effect is prompt, on a par

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen viel zu schwer gemacht. Das Rezepturverfahren von Dronabinol klingt kompliziert. Ist das praktikabel? Müller-Schwefe: Die Anwendung ist durch die Hersteller schon sehr gut vorbereitet. Für den Arzt entsteht da wirklich kein besonderer Aufwand. Es ist ein kleines bisschen umständlicher, weil Cannabinoide eben kein Fertigarzneimittel sind und man zusätzliche Angaben auf dem Rezept braucht. Deshalb kann man das Rezept natürlich nicht einfach aus der Roten Liste abrufen. Das ist aber auch schon alles. Bei welchen Patienten sollte man an den Einsatz von Cannabinoiden denken? Müller-Schwefe: Besonders profitieren Patienten, bei denen die endogene Schmerzkontrolle gestört ist, z. B. durch Poliomyelitis. Der Einsatz beim PostPoliosyndrom ist sehr segensreich. Diese Patienten leiden an einem Ganzkörperschmerz durch die virusbedingte Zerstörung der hemmenden spinalen Interneurone. Gleiches gilt auch für das Fibromyalgiesyndrom. Auch diese Patienten sprechen ausgesprochen gut auf geringe Dosen Dronabinol an, da auch bei Fibromyalgie die endogene Schmerzkontrolle gestört ist. Wie sieht es mit dem Psychoserisiko aus? Gefährdet man die Patienten? Müller-Schwefe: Mir ist kein Fall bekannt, bei dem durch den therapeutischen Einsatz von Cannabinoiden eine Psychose induziert wurde. Der wesentliche Unterschied zum Cannabisabusus besteht in der Applikation und der Dosis. Die therapeutisch eingesetzten Dosen sind viel geringer und sie fluten wesentlich langsamer an. Wenn zum Beispiel Dronabinol einschleichend dosiert wird, sehe ich da überhaupt kein Risiko. (2011) “Neuropathischer Schmerz: Gerauchtes Cannabis bessert Schmerz und Schlaf.” Neuro-Depesche 14 (1/2): 17. Abrams, D.I., Ch. Jay, K. Petersen, S. Shade, H. Vizoso, H. Reda, N. Benowitz, and Rowbotham, (2003) “The effects of smoked cannabis in painful peripheral neuropathy and cancer pain refractory to opiods.” IACM 2nd Conference on Cannabinoids in Medicine, 12-13 September 2003, Cologne. Introduction: There is significant evidence that cannabinoids may be involved in the modulation of pain, especially of neuropathic origin. There is also theoretical rationale to suggest that cannabinoids may provide synergistic analgesia with opioids while possibly reducing opioid-related side effects. No information is available on potential pharmacokinetic interactions between cannabinoids and opioids. Methods: We are currently conducting two clinical trials of smoked marijuana in two populations of patients with pain: HIV patients with painful peripheral neuropathy and cancer patients with persistent pain despite an opioid analgesic. Both studies are designed to begin with a 16 patient open-label pilot proof-of-concept phase. If effectiveness is demonstrated in the pilot, the magnitude of the effect allows us to calculate a follow-on randomized, double-blind controlled trial of smoked marijuana vs smoked placebo. In addition to the effect of smoked marijuana on the subjects’ chronic clinical pain, we are also evaluating the impact on an experimental heat/capsaicin pain model. Here we report experience with the open label phase of the neuropathy study. Results: Sixteen subjects (14 men, 2 women, mean age 43 years) completed the HIV neuropathy pilot trial. Patients had an average of 6 years of neuropathic pain. In 3 cases the pain was felt to be secondary to HIV alone, in 8 secondary to dideoxynucleoside antiretrovirals

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen immer in der Qualitätskontrolle tätig. Juli 2000: Genehmigung und Zulassung Somit stand das Synthese- und QS-Verfahren. Doch ein Antrag auf Erlaubnis zur Herstellung eines Cannabisextraktes wurde 1997 abgelehnt. Anfang 1998 wurde Dronabinol in Deutschland als Betäubungsmittel verschreibungsfähig. Da es Apotheken erlaubt ist, in begrenztem Umfang Arzneimittel selber herzustellen, zog der Pharmazeut und Mediziner Christian Steup mit seinen Apparaturen zu einem befreundeten Apotheker in die Frankfurter BockApotheke, um dort nach seinem Verfahren Dronabinol herzustellen und gegen BTM-Rezept auszugeben. Im Juli 2000 bekam THC Pharm die Genehmigung nach Betäubungsmittelgesetz, den Wirkstoff Dronabinol bundesweit an Apotheken sowie auch an Apotheken in Österreich und in der Schweiz zu vertreiben. Inzwischen besitzt THC Pharm nicht nur eine Genehmigung für die Herstellung eines standardisierten Cannabisextraktes, sondern plant auch die Zulassung eines Fertigarzneimittels auf Cannabis-Basis. Das anfangs geringe Interesse der pharmazeutischen Industrie an der Entwicklung von cannabishaltigen Handelspräparaten hat sich nachhaltig gewandelt. Neben dem Erscheinen von „Me too“-Produkten haben die Wiedereinführung von Cannabispräparaten durch THC Pharm und aktuelle Forschungsergebnisse des Münchner Max-Planck-Instituts zu dem körpereigenen und mit Cannabis verwandten Anandamidsystem eine ganz neue Wirkstoffklasse in den Fokus der Mediziner gerückt. Das pharmakologische Potenzial dieser Wirkstoffklasse ist bei weitem noch nicht abschätzbar. (2005) “THC Pharm GmbH erhält Patent für Dronabinol-Herstellung / Herstellung von synthetischen Cannabinoiden für 2005 geplant.” MedKolleg 2005-03-10. Die THC Pharm GmbH hat den Erhalt des Patentes für die Herstellung von halbsynthetischem Dronabinol, dem medizinischen Hauptwirkstoff der Cannabispflanze, am Rande des Deutschen Schmerztages bekannt gegeben. Damit sichert sich die aus einer Patienteninitiative hervorgegangene Firma ihren Qualitätsvorsprung im Markt. Seit 1998 produziert und vertreibt die in Frankfurt am Main ansässige Firma Dronabinol als Rezeptursubstanz in Deutschland. Eingesetzt werden die vom Apotheker herzustellenden Tropfen und Kapseln als nebenwirkungsarme Alternative zur Bekämpfung von Spastiken, Schmerzen, Übelkeit oder Appetitlosigkeit. Weitere Cannabinoide befinden sich derzeit in der Testphase. Das patentierte Herstellungsverfahren erlaubt nun, Dronabinol aus Faserhanf in bisher einzigartiger Qualität und Reinheit herzustellen. “Im Gegensatz zu den geforderten 95 Prozent Wirkstoffgehalt, können wir nun 99 prozentiges Dronabinol herstellen, ein deutliches Plus an Sicherheit für Ärzte, Apotheker und Patienten”, so Christian Steup, Laborleiter der auch in andere EU Länder exportierenden Firma. Zusätzlich plant die seit 1996 bestehende Firma die Herstellung von vollsynthetischem Dronabinol, um der zu erwartenden Nachfrage besonders aus dem Ausland nachkommen zu können. Noch in diesem Jahr wird die Zulassung von Medikamenten auf Cannabisbasis gegen Multiple Sklerose in Kanada durch einen britischen Mitbewerber erwartet. Dadurch verspricht sich das als Vorreiter der Cannabismedizin geltende Unternehmen auch positive

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen treatment of neuropathic pain and symptoms of multiple sclerosis, employing standardized oromucosal cannabis-based medicines containing primarily THC, CBD, or a 1 : 1 combination of the two (Sativex). Sleep-laboratory results indicate a mild activating effect of CBD, and slight residual sedation with THC-predominant extracts. Experience to date with Sativex in numerous Phase I-III studies in 2000 subjects with 1000 patient years of exposure demonstrate marked improvement in subjective sleep parameters in patients with a wide variety of pain conditions including multiple sclerosis, peripheral neuropathic pain, intractable cancer pain, and rheumatoid arthritis, with an acceptable adverse event profile. No tolerance to the benefit of Sativex on pain or sleep, nor need for dosage increases have been noted in safety extension studies of up to four years, wherein 40-50% of subjects attained good or very good sleep quality, a key source of disability in chronic pain syndromes that may contribute to patients’ quality of life. Russo, E.B. (2007) “History of cannabis and its preparations in saga, science, and sobriquet.” Chemistry & Biodiversity 4 (8): 1614-1648. Cannabis sativa L. is possibly one of the oldest plants cultivated by man, but has remained a source of controversy throughout its history. Whether pariah or panacea, this most versatile botanical has provided a mirror to medicine and has pointed the way in the last two decades toward a host of medical challenges from analgesia to weight loss through the discovery of its myriad biochemical attributes and the endocannabinoid system wherein many of its components operate. This study surveys the history of cannabis, its genetics and preparations. A review of cannabis usage in Ancient Egypt will serve as an archetype, while examining first mentions from various Old World cultures and their pertinence for contemporary scientific investigation. Cannabis historians of the past have provided promising clues to potential treatments for a wide array of currently puzzling medical syndromes including chronic pain, spasticity, cancer, seizure disorders, nausea, anorexia, and infectious disease that remain challenges for 21st century medicine. Information gleaned from the history of cannabis administration in its various forms may provide useful points of departure for research into novel delivery techniques and standardization of cannabis-based medicines that will allow their prescription for treatment of these intractable medical conditions. Russo, E.B., G.W. Guy and P.J. Robson (2007) “Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.” Chemistry & Biodiversity 4 (8): Cannabis sativa L. has been utilized for treatment of pain and sleep disorders since ancient times. This review examines modern studies on effects of Δ-9tetrahydrocannabinol (THC) and cannabidiol (CBD) on sleep. It goes on to report new information on the effects on sleep in the context of medical treatment of neuropathic pain and symptoms of multiple sclerosis, employing standardized oromucosal cannabis-based medicines containing primarily THC, CBD, or a 1 : 1 combination of the two (Sativex). Sleep-laboratory results indicate a mild activating effect of CBD, and slight residual sedation with THC-predominant extracts. Experience to date with Sativex in numerous Phase I-III studies in 2000 subjects with 1000 patient years of exposure demonstrate marked improvement in subjective sleep parameters in patients

Cannabis, Dronabinol und die Behandlung schwerer Erkrankungen wieder Appetit. Auf Cannabinoide würde auch der Präsident des Verbandes Deutscher Ärzte für Algesiologie, Dietrich Jungck aus Hamburg, nicht verzichten. Er kann ebenfalls über beachtliche Behandlungserfolge berichten. Der Nutzen der Cannabinoide, so wurde in Münster deutlich, steht und fällt mit der genauen Abstimmung der Dosis auf den jeweiligen Patienten. Gerade weil es sich um eine derart individuelle, die Kunst des Arztes fordernde Therapie handelt, dürfte sie sich in gewisser Weise der Überprüfung durch eine große Studie entziehen. Denn in solchen Untersuchungen kommt es auf eine möglichst umfassende Standardisierung an, auch was die Homogenität des Patientenkollektivs betrifft. Wie repräsentativ die Ergebnisse dann sind, ist eine andere Frage. Einer Studie mit einer großen Zahl von Patienten stehen auch die hohen Kosten des aufwendig hergestellten Dronabinols entgegen. Der Preis ist zudem einer der Gründe, daß viele Schmerzspezialisten dafür plädieren, Haschisch von definierter Zusammensetzung für den Vertrieb durch Apotheken zuzulassen – zum Vorteil jener Patienten, denen die Krankenkasse das teure Cannabinoid verweigert.