No cannabis in ADHD

LSG Celle: drug is not a legal alternative

Doctors should not prescribe cannabis for ADHD. The benefit is controversial and cannabis anyway intended only for the treatment of serious illnesses, stressed the Landessozialgericht (LSG) Lower Saxony-Bremen in a decision published on Monday, December 10, 2018 (Ref .: L 16 KR 504/18 B ER). The drug is here "no recognized alternative treatment".

Since March 2017, doctors can prescribe cannabis at the expense of the statutory health insurance. The requirement is, according to law, that this at least promises relief for a "serious illness". In addition, there must be no traditional medical alternatives or these may not be reasonable for the patient in the opinion of the doctor, for example because of strong side effects. How far after the scope of cannabis is, is still evaluated differently by the LSGs (on this decision of the Hessian LSG in Darmstadt of October 4, 2017, Az .: L 8 KR 255/17 B ER and others, JurAgentur message from 16. November 2017).

The now 31-year-old plaintiff in the new case has depression, difficulty concentrating and sleeping, and an increased urge to move with partial loss of impulse control. Because of ADHD, he was first treated with the drug Ritalin; but this caused weakness, loss of appetite and powerlessness.

On the order of a controversial physician, the plaintiff already got an exemption in 2015 for the acquisition of medicinal cannabis flowers. The doctor has since lost his license and the exemption was revoked.

In May 2017, a general practitioner prescribed him private prescription cannabis. His application for reimbursement refused the health insurance.

And rightly so, as the LSG Celle first decided in an urgent procedure. A "serious illness" is not found here. There is also considerable doubt about the benefits of cannabis in ADHD; there is no evidence to date. Conversely, the drug could even increase the symptoms and probability of ADHD in adulthood.

In the specific case, moreover, the diagnosis of ADHD is not even guaranteed, according to the LSG in its decision of 27 November 2018. The doctor prescribed the drug only once. He just wanted to continue the treatment he had started to clarify the matter. In the meantime, his practice has decided against further cannabis regulations. The plaintiff is completely fixated on the drug.

According to the LSG Celle, the social courts are increasingly concerned with similar lawsuits. Apparently, the 2017 created prescribing ability of cannabis aroused false ideas. "Cannabis is supposed to relieve severe illness, it is not just any treatment alternative or help for coping with everyday life," said court spokesman Carsten Kreschel. mwo / fle