1) What diseases can be treated with cannabis and physicians who can prescribe it?
Decree no. 236/2015 provides specializations of physicians who can prescribe cannabis to single patients:
• Clinical Oncology
• Radiation Oncology
• Palliative Medicine
• Pain Treatment
• Internal Medicine
For each of the defined medical specializations, a spectrum of indications has been determined for which the concerned medical specialist may prescribe medical cannabis.
Indications for the prescription of medical cannabis:
- Chronic continuing pain (particularly in cancer conditions, pain associated with motor diseases, with systemic and immunopathological conditions, neuropathic pain, glaucoma-related pain)
- Spasticity and related pain in multiple sclerosis or spinal cord traumas, spasticity restricting movement and mobility or the breathing of the patient, involuntary kinesis caused by neurological conditions, and other medical complications arising from underlying neurological conditions or spine trauma with spinal cord damage or brain trauma, neurologic tremor caused by Parkinson’s disease and other neurological problems as per the judgement of the treating doctor
- nausea, vomiting, stimulation of appetite in association with cancer treatment or HIV treatment
- Gilles de la Tourette syndrome
- Surface treatment of dermatoses and mucosal lesions
2) The doctor prescribed me the electronic prescription on medicinal cannabis. Where and how can I pick it up?
The pharmacy with the possibility of issuing drugs on electronic prescription with the limit (hereinafter "eRecept restricted") can sell medicinal cannabis to the patient. We recommend to contact the prescribing physician, who is probably in touch with such pharmacy and which can give his/her contact to the patient.
The patient will be issued the prescribed dose of cannabis in its original form (dried plant), specified on eRecept but in max. dose 180 grams per month. Prescribed amount of cannabis will then be used by the patient (inhaled, orally or topically).
3) How can I transport cannabis home from a pharmacy? Can I carry cannabis with me without any permission (when traveling etc.)?
For the control of the Czech Police, the patient is required to prove his/her identity. He/she should also note that he/she is the user of medicinal cannabis, which his physician prescribed and was issued by the pharmacy. Police officers will then verify this fact in the Registry for Limited Medicine. This could be applied even in those cases where the person is in the role of intermediary (e.g. family member).
4) What are the storage conditions of medical cannabis at home?
Cannabis for medical use should always be stored and kept under these conditions:
• in closed box
• in dry place (moisture up to 60%)
• 2-25° C
5) How to use cannabis to treat?
Specific use must always be determined by the prescribing physician, and with regard to the patient and his health problems.
6) What are the side effects of cannabis (what can be side effects, what to do in case of its occurrence, what to do in the event of a serious adverse effect)
The use of cannabis for medical purposes does not entail great risk and there is no need to worry about addiction. For effective treatment with medical cannabis is enough to follow the parameters of treatment. Especially in cases when it is the start of use, or when the patient is using higher doses of cannabis, it is appropriate to be in contact or under the supervision of a trained person (e.g. a family member) who can be near in case of unpleasant sensations, nausea and even health deterioration, which may occur especially by the first-time users (nausea and vomiting often occur at certain individual levels of THC, but after a relatively short time, the condition normalizes and the experience rarely repeats).
One of the most well-known effects of cannabis is a state of euphoria, relaxation, fast heartbeat, uncontrollable laughter and changes in perception of the environment. These conditions are often accompanied by dry mouth and red eyes. In the event of a serious adverse effect, you must contact your physician immediately.
7) What are the possible contraindications, therefore, in what cases should not be used cannabis?
In rare cases cannabis can trigger psychosis in patients with a genetic predisposition. These are individuals with mental disorders in the family history, in particular schizophrenia or bipolar disorder.
Cannabinoids may have temporary, but strong effect on heart rate and blood pressure. If the patient is treated with heart problems, he/she should inform the prescribing physician.
Pregnancy and breast-feeding
Active substances in cannabis, particulary THC, can have negative effects on fetal development. That’s why cannabis is not recommended during pregnancy. Certain substances contained in cannabis, including THC, are excreted in breast milk. Therefore, cannabis is not recommended during lactation.
The liver is the primary organ that is involved in the chemical processing of cannabinoids after oral cannabis use. In patients who have hepatic functionality restrictions may effects of cannabis significantly vary.
Risk of dependence
The recommended daily dose for the treatment is generally low, the patient is also at all times in contact with the physician. Other rule applies to patients who previously had problems with addictions. In these patients, high doses administered in the longer term, lead to psychological dependence. In rare cases, patients may experience withdrawal symptoms, such as restlessness, irritability, and insomnia.
May occur interactions with other taken medicine?
Patients should always inform his/her physician or pharmacist about all the medicines that are currently using or/and, including OTC drugs and supplements. The reason is the possible interaction and the subsequent formation of adverse reactions and health problems.
How to properly dispose cannabis that patient didn’t consume?
When initiating treatment with cannabis, physicians are advised to prescribe the patient a low dose of cannabis. Physician can determine what dose of cannabis meets the patient’s requirements and prevent that medical cannabis remains unused.
If the patient stops using cannabis, he/she should bring it back to the pharmacy to ensure it’s disposal in accordance with the law. Any other procedure is illegal!
Driving and using machines
If a patient use cannabis, driving vehicles and using heavy machinery is not recommended.