Here you will find frequently asked questions and answers on cannabinoid treatments and the course of therapy at EvoCan.
The private medical practice EvoCan was founded in 2022 in Lower Bavaria by a team of doctors specializing in cannabis-based medicine for the treatment of chronically ill patients. By combining integrative naturopathic medicine and digitalized processes using modern telemedicine, we are able to provide our patients with convenient treatment for their ailments.
We care for patients with a wide variety of conditions and guide them through the entire process to make the treatment as safe and uncomplicated as possible. We would be happy to clarify with you whether cannabinoids could be a therapeutic option in your individual case.
The broad therapeutic spectrum of medical cannabis enables its use in a wide range of clinical conditions and symptoms. Among others, the therapy is used for chronic pain, ADHD, depression, migraine and sleep disorders. By law, there is no list of individual indications. Cannabis buds and extracts can be prescribed for any indication if "a generally recognized therapy corresponding to the medical standard is not available in the individual case" or if this treatment "cannot be used in the individual case according to the justified assessment of the treating contract physician, weighing the expected side effects and taking into account the state of the patient." However, the efficacy (i.e., the indication) must be examined by the treating physician in each individual case and the dose must be determined.
Cannabinoid therapy can be useful in the case of severe physical or psychological complaints that last for a longer period of time. The prerequisite is that these complaints could not be treated successfully so far or the treatment with the previous means was not tolerable, for example, due to side effects. Cannabis therapy can thus be used as an alternative or also in the sense of a supplement to existing medication. Established indications for cannabis-based medications include chronic - especially neuropathic - pain, cluster headache, spasticity and painful muscle tension in MS, loss of appetite, nausea and vomiting. But cannabis is also used for many other inflammatory diseases such as Crohn's disease, ulcerative colitis and some psychiatric disorders.
Cannabis should not be prescribed in the presence of a severe personality disorder, psychosis, or severe heart or kidney disease. The same applies to pregnant women and nursing mothers. In adolescent patients, there is an increased long-term risk of psychosis due to incomplete brain development, which is why cannabis therapy should only be prescribed after careful consideration, education and sustained high levels of distress.
The prescription of medical cannabis has been possible in Germany since March 10, 2017, with the passing of the "Cannabis as Medicine" law. This requires a prescription from a physician who believes cannabis use is appropriate due to a serious, chronic condition. The new legislation makes it easier for physicians to prescribe medical cannabis or accessories such as vaporizers to seriously ill patients, even with reimbursement. A serious illness significantly limits your quality of life permanently (at least 6 months). In addition, treatment with medical cannabis can only be carried out if no other generally recognized medical treatment options are available or side effects do not allow its use. Furthermore, there must be a justified hope that the medical cannabis will alleviate the symptoms.
According to current law, patients are generally allowed to participate in road traffic if their ability to drive is not impaired as a result of the medication, which means they must be able to drive a vehicle safely. The same legal situation applies here as for other medications, such as opioid prescriptions. Your attending physician will explain to you again in a personal consultation what needs to be observed in this regard, especially at the beginning of therapy. However, personal legal advice may only be given to you by a lawyer.
At the beginning of the therapy, you will fill out a medical questionnaire about the treatment. This will be reviewed by us afterwards. This process is completely free of charge for you. As soon as we have all the necessary documents, we will make an appointment with you for a personal initial consultation on site. Thanks to our cooperation with mail-order pharmacies, the prescribed preparation can be conveniently sent to your home by parcel upon request and within the scope of the free choice of pharmacy. After the on-site consultation, further consultations take place in digital format via video consultation, as far as this is medically justifiable.
After your free treatment request, you will receive from us a medical history form and other important documents informing you about the treatment. We need these documents filled out and returned to us. In addition, all medical documents with diagnoses, medication plans and doctor's letters should be sent to us.
Provided we have all the necessary documents, we will carefully review your request. We ask for your understanding that the duration of the processing may vary depending on the workload. We will then inform you immediately about the next steps.
Within the free choice of pharmacy, you can submit the prescription to any pharmacy in Germany. Some of our patients have found that availability and prices there can vary greatly in some cases. However, via specialized mail-order pharmacies, the prescribed preparation can be conveniently sent to your home by parcel upon request. We can therefore recommend mail-order pharmacies specializing in medical cannabis.
You can conveniently attend the medical consultations for the monthly therapy control in the form of video consultations from home via computer, tablet or via your smartphone. For further questions, you are also welcome to contact the attending physician in person.
After the consultation, you will receive a scan of the prescription by email. With this scan, you can inquire about the availability and cost of the preparation at a pharmacy of your choice and order the preparation. The original prescription will be sent directly to the pharmacy of your choice after your feedback. This saves time, as BTM prescriptions are only valid for 7 days from the day they are issued. You will then receive the validated original prescription together with your preparation.
Due to the legal requirements for a Medical establishment (Medical care mandate), specialization with a panel doctor's license is not possible in Germany. Therefore, only private medical treatments can be offered. The costs for a treatment with medical cannabis are always due only per appointment and amount to approximately 90-100€. The billing is done according to the standards of the GOÄ (Gebührenordnung für Ärzte). These costs are partly reimbursed by private health insurances. After your treatment request, we will discuss with you which therapy is the most suitable for you. There are no costs for you for this. This is followed by an initial personal consultation and follow-up appointments every four weeks on average. These are necessary to comply with the legal requirements in terms of therapy control and for issuing prescriptions. There are no other costs for the ongoing treatment. You will receive your invoice by e-mail a few days after your private medical treatment. These are created individually and checked several times for correctness of your data. Please make sure that you can attend all appointments on time. Our consultation hours are closely timed to avoid waiting times, which is why we want to avoid delays at all costs. Please understand that in case of a cancellation 24h or more before the scheduled appointment, we will have to charge you a cancellation fee of 35,00€.
The costs for medical treatment, the preparation from the pharmacy or even fees for medical vaporizers are generally reimbursable by private health insurance companies. Our invoices are prepared according to the standards of the German Medical Fee Schedule (GOÄ). However, we cannot guarantee that your health insurance will cover all or part of the costs. Prerequisite for the overnahem of the fees are a medical prescription, the purchase of the drug through the pharmacy, the medical necessity of this therapy, which is in accordance with the rules of traditional medicine, or lack of traditional medical methods or drugs with prospects of success.
For patients with statutory health insurance, the procedure is unfortunately more complicated. Here, the approval requirement applies. In order for the costs to be covered, an application must be made before the start of therapy. According to current legislation, this application may only be rejected in justified exceptional cases. In reality, however, this percentage is still very high. In addition, the statutory health insurance funds require that no other generally recognised medical service is available for the illness, that the side effects of the therapy make its use inadvisable, or that the generally recognised therapy is out of the question for other individual reasons.
Another prerequisite for reimbursement is participation in a so-called accompanying study. For this purpose, patient data are transmitted anonymously to the Federal Institute for Drugs and Medical Devices (BfArM) in order to collect treatment data on the long-term use of medical cannabis. Due to the fact that the treatment by EvoCan is carried out by private physicians, no reimbursement by a statutory health insurance is possible. An application can only be made by physicians in private practice with a registered office. However, certificates and expert opinions for health insurance companies can be provided for the application for cost coverage, which can be used for the request for cost coverage by a registered physician with a registered office.
Medical cannabis is mainly inhaled or taken orally. The intake depends mainly on the form of the preparation. While extracts are available in drop form, for example, cannabis flowers can be inhaled via a vaporizer. Likewise, oral ingestion through tea is possible, but not recommended due to difficulty reproducing results. Smoking of cannabis flowers is not used in medical therapy due to severe adverse health consequences.
Medical cannabis has a variety of effects on the body and brain, which are mediated via so-called cannabinoid receptors. The effect depends on several factors, such as the form of administration, the cannabis variety or the content of different cannabinoids. Therefore, an individual adaptation of the therapy to alleviate your symptoms has absolute priority. Depending on the preparation, possible effects can be, for example, calming, analgesic, mood-lifting or even anti-inflammatory.
Cannabinoids are generally considered effective, safe and tolerable, and suitable for long-term therapy. Allergic reactions occur extremely rarely. However, at the beginning of an application, the following side effects are possible: rapid heartbeat, dry mouth, dizziness, fatigue, euphoria, increased appetite. In the context of medically supervised treatment with medical cannabis, no development of dependence has been observed so far. This is due to low therapeutic doses, prescribed monthly checks, the experience of our physicians, and general guidelines within the therapy that minimize the risk of developing dependence. However, contraindications to cannabis therapy must be truthfully stated by the patient in advance.
At the beginning of any therapy with medical cannabis, cannabis flowers, extracts or finished medicines are always dosed gradually. The amount of the initial dose depends on the THC content and is slowly increased. The required therapeutically effective dose is highly variable depending on the patient and indication, but is predominantly below the psychoactive dose. Physicians are generally bound by a legal prescription limit (100 g per 30 days).