• Patric Bialas, Beate Drescher, Sven Gottschling, Stephanie Juckenhöfel, Dieter Konietzke, Wolfgang Kuntz, Isabell Kühne-Adler, Heidi Merl-Ripplinger, Diether Preisegger, Kathrein Schneider, Manfred Strauß, Patrick Welsch, and Winfried Häuser.
• Schmerzambulanz, Universitätskliniken des Saarlandes, Homburg/Saar, Deutschland.
• Schmerz. 2019 Oct 1; 33 (5): 399-406.

BackgroundThere are uncertainties among physicians with respect to the indications, selection of drugs, effectiveness and safety of cannabis-based medicines for chronic pain.MethodsAll statutory health insurance pain physicians in Saarland were asked to complete a self-developed questionnaire assessing their experiences with cannabis-based medicines, which they prescribed between 10 March 2017 and 30 November 2018 for adult patients with chronic cancer and non-cancer pain.ResultsAll statutory health insurance pain physicians participated in the survey and 13 out of 20 reported having prescribed cannabis-based medicines. The most frequent reasons for prescriptions in 136 patients (1.9% of the patients of the institutions) were failure of established treatment (73%) and desire of the patient (63%). In 35% of patients the type of pain was nociceptive, in 34% neuropathic, in 29% nociceptive and neuropathic and in 13% nociplastic. Dronabinol was prescribed for 95% of the patients and 71% were responders (clinically relevant reduction of pain or of other symptoms). In 29% of patients treatment was terminated due to either a lack of efficacy or adverse events.ConclusionStatutory health insurance pain physicians in Saarland were reluctant to prescribe cannabis-based medicines. Dronabinol was effective and well-tolerated in the majority of the highly selected patients.

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