Medical cannabis is used under medical supervision for a range of conditions. Here we explain the key fundamentals – from how it works in the body and the forms of intake to the legal situation, prescription, contraindications and side effects. You can read which fields of application we review medically under Indications.
Forms of intake
The common forms of intake each have their own advantages and disadvantages – we are happy to advise you on these during your consultation:
- Oral intake – tinctures, extracts and capsules.
- Inhalation – vaporising with a vaporiser.
- Suppositories – rectal application.
- Topical application – as an oil or cream on the skin.
The endocannabinoid system
The endocannabinoid system is the body's own neuromodulatory system that helps regulate numerous processes in the body. Among other things, it influences mood and behaviour, muscle tone, appetite and the perception of pain, and it is involved in immune and inflammatory processes.
It is made up of cannabinoid receptors: chiefly on nerve cells in the central and peripheral nervous system (the CB1 receptor) as well as in many other tissues (the CB2 receptor). Much like the hormonal system, the body produces its own messenger substances – the endocannabinoids – which bind to these receptors and trigger specific effects. Because plant-derived cannabinoids from hemp can likewise activate or inhibit these receptors, the system can be put to medical use for various conditions. It was discovered and named in the 1990s.
The entourage effect
The "entourage effect" describes the presumed additional effect that arises from the interplay between the aromatic compounds contained in cannabis (terpenes) and the cannabinoids. This is because cannabis does not contain just a single active substance, but a complex mixture of various cannabinoids, phenols, flavonoids and other compounds. The proportions and ratios of terpenes and cannabinoids differ markedly from one cannabis variety to another.
Cannabinoids: THC and CBD
Cannabinoids are chemically active molecules that bind to specific receptors in the body and activate or inhibit them – such as the body's own endocannabinoids anandamide and 2-AG. The best-known target structures are the cannabinoid receptors CB1 and CB2. Plant-derived forms of these compounds are called phytocannabinoids.
The hemp plant Cannabis sativa contains at least 113 phytocannabinoids. The best-studied and psychoactive cannabinoid is Δ9-tetrahydrocannabinol (THC). Cannabidiol (CBD) is being studied for, among other things, its anti-inflammatory properties; for certain rare forms of epilepsy an antiepileptic effect has been demonstrated in studies and is recognised for an approved CBD medicine. In addition, CBD can attenuate the psychotropic effect of THC.
According to current knowledge, THC binds directly to the CB1 and CB2 receptors. CBD, by contrast, acts hardly at all directly on these receptors, but instead modulates the endocannabinoid system predominantly indirectly and via further target structures.
What THC and CBD are being studied for
In research and the literature, THC and CBD are studied for a range of conditions. Whether their use is an option is always decided by the individual medical assessment of the indication – there is no entitlement to a particular preparation. You will find an overview of possible fields of application under Indications.
THC – studied for, among others: spasticity · chronic pain · nausea, vomiting and loss of appetite · neurological disorders · sleep disorders (at low doses) · itching in skin conditions.
CBD – studied for, among others: early-childhood forms of epilepsy · anxiety disorders and panic attacks · chronic inflammation · tension and tightness · depressive moods · sleep disorders.
Available in Switzerland
In Switzerland, a small number of cannabis medicines are approved as prescription-only preparations. Which preparation – if any at all – is an option is decided following an individual medical evaluation.
The majority of prescriptions are dispensed as a compounded (magistral) formulation. This allows individual concentrations and mixing ratios. The pharmacy usually prepares the medicine for oral intake on a carrier solution (oil or alcohol); capsules, suppositories and other forms are also possible. This requires considerable experience in order to ensure reliable quality. A further form is the inhalation of ground flowers by vaporising. We strongly advise against smoking cannabis flowers for medical purposes.
Legal situation & prescribing
The revised Narcotics Act has been in force since 1 August 2022. Since then, an exceptional authorisation from the Federal Office of Public Health (FOPH) is no longer required to prescribe THC-containing cannabis medicines. Within their freedom of therapy, physicians can prescribe these on a narcotics prescription. Cultivation, processing, manufacture and trade are subject to the authorisation and control system of Swissmedic. For evaluation purposes, the treating physicians report therapy data to the FOPH during the first two years of treatment; this data collection is limited until 2029.
Prescription
To obtain THC-containing preparations, every patient requires a narcotics prescription. Pure CBD preparations (below 1% THC) can be prescribed with an ordinary doctor's prescription; they contain only the smallest residual amounts of THC. In individual cases these may nonetheless be detectable – what is decisive for fitness to drive remains your individual condition (see FAQ).
Contraindications
Treatment is generally not suitable in cases of:
- allergy or hypersensitivity to cannabis, THC, CBD or ingredients of the carrier solution (e.g. peanut or coconut oil)
- pregnancy and breastfeeding
- severe hepatic insufficiency or strongly elevated liver values
In addition, THC is not recommended in cases of:
- serious cardiovascular disease
- severe depression, suicidality or psychiatric disorders
- existing or previous addiction disorder
- children and adolescents under 18 years of age
- operating heavy machinery for work, professional passenger transport or driving vehicles in categories C/D
Possible undesirable effects
Like any effective therapy, treatment with cannabis medicines can have side effects.
THC: tiredness, drowsiness, grogginess, dizziness · dry mouth, reddened eyes · cardiac arrhythmia, low blood pressure · nausea, diarrhoea · headache · increased appetite · psychotropic effects (euphoria, dysphoria), disturbances of thinking or speech, and at high doses psychosis, delusions, depression or anxiety · reversible elevation of liver values.
CBD: tiredness, drowsiness, grogginess · reduced appetite.
Which symptoms are suitable for treatment, and whether it is justifiable in your case, we clarify individually – more on this under Indications and in the Process.
Note: The information on this page is intended for general education and does not replace medical advice. Whether and how a therapy with medical cannabis is an option for you is always determined by the individual medical assessment.