In this episode of The Cannabis Conversation, host Anuj Desai speaks with Dr Franjo Grotenhermen, medical doctor, cannabis patient, and Chair of the International Association for Cannabinoid Medicines. Franjo reflects on over three decades of clinical, scientific, and political involvement in medical cannabis, offering a grounded perspective on evidence, patient experience, regulation, and the realities of cannabis as a medicine.
Key Highlights and Insights
A personal journey into cannabis medicine
Franjo entered the cannabis field in the early 1990s after becoming chronically ill himself, discovering cannabis medicine at a time when Europe had virtually no expertise, regulation, or clinical frameworks in place.
Founding of global cannabis research institutions
He co-founded both the German Association for Cannabis Medicine and later the International Association for Cannabinoid Medicines, helping to formalise cannabis research and education internationally.
The ‘cannabis dilemma’ for governments
Franjo describes cannabis as presenting a unique policy challenge due to its ease of access as a plant combined with its classification as a narcotic and its exceptionally broad therapeutic potential.
Clinical trials alone cannot capture cannabis’ full value
With more than 50 potential indications, cannabis cannot realistically be validated through traditional pharmaceutical trial models alone, creating tension between evidence-based medicine and patient need.
Real world evidence is unavoidable in cannabis care
Patient feedback plays a central role in clinical decision-making, just as it does with antidepressants or pain medications, and should not be dismissed simply because cannabis lacks large-scale trials.
Whole plant and extracts often outperform single molecules
Many patients report better outcomes and fewer side effects from whole plant cannabis or full spectrum extracts compared to isolated THC.
Patients are experts in their own treatment
Franjo emphasises that long-term cannabis patients develop deep knowledge of how different products affect them, and clinicians must treat this experience as valid expertise.
Cannabis is effective across multiple disease groups
The strongest evidence and clinical experience exist in pain, neurological disorders, nausea and appetite loss, inflammatory diseases, and certain psychiatric conditions.
Cannabis is not a cure-all
In many conditions, only a minority of patients respond positively, and intolerance or symptom worsening can occur, reinforcing the need for careful expectation management.
Risk profile is comparable to many conventional medicines
Cannabis has very few absolute contraindications, and most risks are manageable through proper screening, dose control, and ongoing monitoring.
Regulatory and medical attitudes are evolving
Conditions once considered off-limits, including psychiatric disorders, are now being reconsidered as evidence and clinical experience expand.
Top 10 Quotes from Dr. Franjo Grotenhermen
“Cannabis presents a unique dilemma because it is an easily accessible plant with enormous medical potential, yet governments still treat it primarily as a narcotic.”
“With more than fifty possible medical indications, cannabis cannot be fully evaluated using the traditional pharmaceutical trial model alone.”
“Telling patients to wait twenty years for clinical trials is not acceptable when relief is possible today.”
“Many patients report that whole plant cannabis or full extracts work better and cause fewer side effects than isolated THC.”
“In medical practice, patients using cannabis over time become experts in how it works in their own bodies, and doctors need to listen to that experience.”
“Cannabis is not a miracle medicine, because in many conditions it helps only a minority of patients, while others see no benefit at all.”
“Doctors who try cannabis once or twice and see no effect can wrongly conclude that its medical value is exaggerated.”
“Clinical trials and real-world patient experience both matter, and medicine has to find a balance between the two.”
“The side effect profile of cannabis generally falls within the range we already accept for many conventional medicines.”
“There are very few absolute contraindications for cannabis, which makes it safer than many people still assume.”
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