Marie

New Bioactive Compounds from Natural Product Chemistry 

An example of cutting-edge basic research comes from Jung et al. (Pharmaceuticals 2025;18(4):521). The authors were the first to isolate two previously unknown cannabinoids – including cannabielsoxa – as well as chlorin-type metabolites from the flowers of Cannabis sativa. While classic cannabinoids demonstrated strong antitumor effects against neuroblastoma cells in cell culture, the chlorin derivatives open up an entirely new therapeutic avenue: their light-activated properties could be used in photodynamic treatments to selectively destroy tumor cells. For cancer patients whose standard therapies have reached their limits, these newly discovered compounds may become a valuable addition in the future. 

Long-Term Real-World Data from Australia 

The QUEST initiative provides impressive real-world evidence. In a prospective cohort of 2,353 patients treated with medical cannabis oil, quality of life and symptoms such as pain and fatigue improved within a few weeks and remained stable over twelve months. Remarkably, 70% of participants who had previously relied on opioids were able to reduce or completely discontinue their opioid dosage. Such practice-oriented observations are essential for demonstrating that medical cannabis should not be reserved as a last resort but integrated as a core part of modern pain therapy. 

Cannabis for Chemotherapy-Induced Nausea 

Grimison et al. investigated in a large Phase II/III study whether THC:CBD capsules could relieve nausea and vomiting in patients experiencing severe symptoms despite standard antiemetic prophylaxis. Participants took 2.5 mg THC plus 2.5 mg CBD or placebo three times daily. The result: With the cannabis extract, the rate of complete response (no vomiting, no rescue medications) rose from 8% to 24% – a statistically significant increase of 16% (95% CI 4–28; p = 0.01). Episodes of significant nausea, daily vomiting occurrences, and quality-of-life scores also improved. Side effects were mostly mild (sedation, dizziness, transient anxiety), with no serious adverse events. Even moderate doses thus proved to be an effective complement to antiemetic therapy. 

Conclusion & Outlook 

The studies presented here are just a snapshot, but they expand our understanding of new therapeutic opportunities – from innovative antitumor approaches to alleviating treatment-related side effects. They also highlight where research priorities should lie: closing the gap between clinical trials and real-world practice so that medical cannabis gains further precision and trustworthiness, and finds more frequent integration into everyday prescribing. 

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Last week, the German Pain and Palliative Care Days 2025 took place in Frankfurt. Among the numerous lectures and workshops, the use of cannabinoids was a recurring theme throughout the event. Approximately 14 million people in Germany suffer from chronic pain – a serious public health issue that severely affects daily life and is often associated with psychological burdens. It is all the more important that the use of cannabinoids in pain medicine continues to gain significance. 

Cannabinoids in Pain Therapy 

Cannabinoids work through the body’s endocannabinoid system by reducing inflammation, dampening nerve irritations, and influencing pain processing in the brain. In palliative care, they also alleviate nausea and improve sleep. 

Cannabinoids exert their effects through two main receptors. CB1 receptors, primarily found in the central nervous system, inhibit neurotransmitter release and reduce the perception of pain. CB2 receptors, primarily located in immune cells, contribute to anti-inflammatory effects by decreasing the release of pro-inflammatory cytokines. 

Cannabinoids as an Alternative or Complement to Opioids 

Studies have shown that cannabinoids can be used both as a complement to and an alternative to opioids. A 2017 patient survey with 2,897 participants reveals impressive results. 78% of respondents reported better pain reduction compared to pure opioid therapy, 88% found the side effect profile more favorable, and 97% were able to reduce their opioid dosage. These numbers highlight the potential of cannabinoids, particularly in minimizing opioid-associated risks like addiction and side effects. 

Regulatory Challenges and Future Outlook 

The motto of the congress was “Individualization instead of Standardization” – a reflection of how urgently we need to bridge the gap between scientific knowledge and the specific needs in pain therapy. Practical reports show that, despite growing acceptance of cannabinoid-based medications, doctors are often faced with strict regulations and complex procedures before they can issue prescriptions covered by statutory health insurance (GKV). 

Therefore, it is crucial to simplify the prescription processes and integrate cannabinoids more strongly into the established pain therapy guidelines. Only through targeted research and reducing regulatory barriers can we ensure that patients receive the best possible support they need. 

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With the first issue of the new year, we spotlight a forward-looking topic: research projects on recreational cannabis. While such studies have been underway in Switzerland for about a year (see the Cansativa Experts’ Dialogue), Germany opened the door for research applications on December 11. Despite positive experiences in Switzerland, this endeavor remains new territory in Germany, leaving many questions unanswered.   

The Role of Research in the Cannabis Act 

The Cannabis Act (CanG), effective since April 2024, provides the legal framework for scientific investigations into recreational cannabis use. The goal is to gather data-driven insights to better understand its impact on consumers, markets, and society. This represents a rather conservative approach designed to ensure evidence-based policymaking before implementing extensive regulatory changes.   

Diversity as the Key to Insight 

No single model can fully capture the complexities of cannabis consumption and markets. This is why research projects focus on diverse approaches and distribution models. Different regions and cities will test measures aimed at protecting youth, safeguarding health, and reducing the illegal market. This diversity is crucial to gaining insights into societal, health, and economic impacts. Particularly, analyzing market potentials and demand structures can shed light on how regulated distribution channels affect the illicit market.   

A Starting Point for Research 

The release of the new Cannabis Research Regulation in mid-December marks the beginning of a new phase (more details in the BMEL press release). Municipalities, scientific institutions, and other stakeholders can now submit their proposals. The responsible authority will determine which projects move forward. Cities such as Hanover, two Berlin districts, and Frankfurt have already expressed interest, highlighting the strong demand for robust data. Cansativa, too, is planning a model project in the Groß-Gerau district, focusing on pharmacy-based distribution (see the press release for more details).   

More Than an Experiment – A Foundation for Future Decisions 

Cannabis research projects are far more than mere experiments. They provide a foundation for regulation that considers both health and societal aspects. By testing and analyzing diverse approaches, reliable data emerges to inform responsible policymaking.   

It is now up to all stakeholders—society, researchers, and policymakers—to seize this opportunity. Together, we can lay the groundwork for informed and forward-looking cannabis regulation.   

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The year 2024 has been a milestone for the cannabis industry in Germany. The removal of medical cannabis from the Narcotics Act and the launch of Pillar I have enabled significant progress. More recently, the release of the decree on cannabis research has opened new perspectives and provided greater planning certainty for scientific endeavors. However, the political landscape ahead of the federal election in February 2025 is causing nervousness within the industry. In this briefing, we look back at the past year and take a glimpse into the future: How will the election shape the future of cannabis regulation? 

What’s at Stake? 

The federal election is a pivotal moment for the industry. The Union party has repeatedly announced plans to roll back the Cannabis Act that has been in effect since April, often without drawing a clear distinction between recreational and medical cannabis. Such a rollback could not only halt legal recreational use but also jeopardize advancements in the medical cannabis sector – such as the simplifications in prescriptions for doctors and patients. 

At the same time, the Union has historically emphasized the need for secure access to medical cannabis. It remains critical to ensure and expand the achievements that have been steadily made since the legalization of medical cannabis in 2017. 

Scenarios for 2025: Progress or Regression? 

A conservative-led government could undo previous progress. This would not only destabilize the industry but also present new challenges for patients and consumers. A clear commitment to stable and reliable regulatory conditions would provide the industry with the planning security it needs. This could lead to increased investment, secure jobs, and Germany’s continued growth as an innovation hub for medical cannabis. 

A Look Abroad 

International developments demonstrate that the acceptance of cannabis as medicine continues to grow, with regulatory frameworks being adjusted in many countries. Denmark, for example, has been running a successful pilot program for medical cannabis since 2018. Initially planned as a temporary project, the Danish government recently decided to make the program permanent. The Czech Republic is also taking a significant step forward: From 2025, general practitioners will be allowed to prescribe medical cannabis for the first time. This decision is part of a broader plan aimed at improving access to medical cannabis and enhancing patient care. This approach could pave the way for broader societal acceptance and expand therapeutic opportunities. 

Germany has the potential to benefit from these international developments. The growing demand for medical cannabis, combined with Germany’s strong position as an exporting nation, offers enormous opportunities. However, long-term and reliable regulatory conditions are essential to strengthen the industry and remain competitive on a global scale. 

A Shared Goal 

The past years have shown how important collaboration and exchange between patients, doctors, pharmacies, and businesses are. Only through united efforts can we ensure that the industry is not set back to pre-April 2024 levels. The federal election will set the course for the future. 

As the year comes to an end, we want to extend our heartfelt thanks to all readers of the Cannabis Briefing. 2024 was a year full of challenges and opportunities, during which we made important strides together as an industry. The upcoming elections will define 2025 – and we all have a role to play in ensuring that the progress of recent years is not lost. It’s up to us to continue advancing the cannabis industry with innovative ideas, strong community spirit, and tireless dedication. 

With this in mind, we wish you and your loved ones a joyful holiday season, a happy New Year, and many bright moments ahead. Let’s approach 2025 with confidence and determination! 

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@cansativa.de. If you are interested in revolutionising the cannabis industry with us, then stay tuned and follow our briefings!

We wish you a good read!

Best wishes from both of us,