Why European Doctors Need a Cannabinoid Handbook: A Q&A With Dr. Viola Brugnatelli

Navigating the European medical cannabis market can be a challenge for healthcare professionals, but help is on the way.

The soon-to-be-published Principles of Clinical Cannabinology handbook, co-authored by Cannabiscientia SA and Prohibition Partners, aims to support doctors by bringing essential information on cannabis science, European regulations, and available medical products together into a single comprehensive textbook.

In the gear up to the handbook’s launch, handbook author and Cannabiscientia co-founder Dr. Viola Brugnatelli spoke at the Cannabis Europa event in London this month. To learn more about the handbook, why it is needed, and the benefits of improving education on cannabis issues, Analytical Cannabis caught up with Brugnatelli ahead of the conference.

The Principles of Clinical Cannabinology Handbook

“[We are] launching a book that we consider a little bit of a bible for finding all the information that a healthcare professional in Europe requires in order to make an informed prescription in each of the regions,” Brugnatelli told us.

“The main focus [of the handbook] is really on the physiology of the endocannabinoid system, the pharmacology of cannabinoids and other molecules beyond cannabinoids. And then the main core is really on pathologies and the work that I’ve been doing collecting interviews around the world from several doctors that are experienced with this topic.”

It is clear that, to the authors, this handbook is intended to serve as a support that doctors can use to translate the scientific knowledge that exists around cannabis into actionable, practical know-how.

“I’ve been around working in education for a while and one of the things that I noticed working with different types of professionals, medical doctors tend to be the ones that like written paper, the hard copies,” Brugatelli said.

In addition to walking readers through the laws regulating medical cannabis in 11 European nations, including the United Kingdom, the handbook also presents information of particular relevance to healthcare providers, such as requirements for prescribers, routes for patients to access therapy, and the availability of reimbursed medications.

“We’re seeing so much, so many issues, and so many obstacles for the prescriber. So one obvious thing to do is try to break down these obstacles, and I believe that education is one of these tools. And this is one of the reasons that we’re already thinking about localizing to the different languages that are spoken in Europe,” she added. 

Helping healthcare professionals make more informed decisions

The ever-changing landscape of the medicinal cannabis sector is a particular challenge when it comes to authoring an educational work like this.

“Science is going to continue updating itself, so we already lean on a constant mindset of every 12 months, whatever you pushed out needs to be completely reviewed. But even more so in a developing regulatory landscape like that of Europe,” Brugnatelli said.

One of the handbook’s most notable inclusions is a list of all the cannabis-based medicinal products that are available in the countries concerned. Just like legislation, such a list will require frequent review to ensure that it is up to date. But it could be a crucial piece of documentation for prescribers to have access to, nonetheless.

“We are completely product agnostic, we are not supporting or endorsing any product in this publication,” Brugnatelli explained. “But the reason we include the names of the products is that, in many regulations, it’s not just needed the name of the applicant or ingredient, but also the name of the brand. And so the doctor needs to know the brands that are available.”

“Simply, as I always say, if you don't know about something you are not going to do that thing,” she continued. “So that’s why education is important because it’s a tool to empower you to really make a more informed decision as a healthcare professional. So that’s why there is a list of products.”

Cannabis Europa

Cannabis Europa is one of Europe’s headline cannabis industry events. Although its messaging in the past has been more geared towards businesspeople and investors, Brugnatelli believes that scientists and healthcare professionals can also get a lot out of the event.

“Cannabis Europa for me is my favorite B2B event,” Brugnatelli said. “I’ve got to say that, for me, Cannabis Europa is a special place because as always managed to highlight – even though it doesn't cater necessarily to scientists or to doctors – really important topics. For example, it always has very nicely led patient panels that managed to convey important information to companies.”

“At the end of the day it’s a great place for decision makers to be at, and to be able to, for example, express some conversations that perhaps we may think are obvious,” she added.

This final point is key, as proper communication and understanding between scientists and healthcare professionals, pharmaceutical companies, businesses, and brands can help to break down some of the barriers currently being faced by patients. Unlike the American model where medical cannabis patients can access their medicine through dispensaries, the European model requires doctors to take on a more active role in facilitating access for patients.

“From my perspective, it may sound absolutely obvious that the medical doctor is almost the gatekeeper to the market activation in Europe for a medical market, because without their compliance and their support and their initiative, actually, there wouldn’t be cannabis patients,” Brugnatelli said.

“Cannabis companies, for the most part, don’t understand that they want to work in a medical space. They don’t understand the basic logic of what it means to be in pharma, and so they operate as a consumer goods company. And this creates a lot of issues, in my opinion.”

This misunderstanding is illustrated in the medical market, Brugnatelli says, which sells a high suspiciously high amount of high THC products,.

“This is a complaint that I receive a lot from doctors and patients,” Brugnatelli explained. “If you look at the reality of pathologies, patients and what doctors prescribe, there should be a majority of balanced varieties out there. Because that’s the majority of patients you're going to target.”

“[High THC] is going to be difficult in application for young patients, it’s going to be difficult in application for elder patients, it’s going to be difficult in application for chronic [illness] patients. I mean, basically, it's a difficult application for most people. But yet, it's the product that most easily we find out there.”

Cannabis Europa was held from May 2-3, 2023 at the Barbican Centre, London. Analytical Cannabis is a media partner for the event.