Live
From Plant to Patient: Why Genetics Must Lead Medical Cannabis Outcomes
Arjan Roskam, Green House Genetics; Dave Auger, Big League Genetics; Adele Hollman, Sanity Group; moderated by Alex Fraser, Grow Group
- Adele Hollman, Medical Affairs Manager at Sanity Group, told the room: ‘Genetics is the first variable we can control to have a predictable outcome for patients. If we get this right, everything else in the process follows.’
- The post-harvest stage was identified as the point at which the industry most consistently fails patients. ‘Nine out of ten producers are cutting corners, drying in six, seven, eight days when everybody knows you need 14,’ Roskam said. ‘Companies under financial pressure are putting product on the market too quickly, and patients are the ones paying for it.’
- Strain mislabelling compounds the problem. Distributors buying genetics and rebranding them under different names means patients who find a product that works cannot reliably access it again.
- The feedback loop between patient outcomes and breeders is almost entirely absent. ‘We rarely ask the patient what effect they received from the end product,’ Hollman said. ‘We don’t have the chance to develop specific products for specific conditions because we don’t track the data and feed it back to the breeder.’
- Roskam is launching a tool called Cannabigator within the month, an app allowing patients to input their conditions and current medications and receive a recommended cannabinoid profile, with a parallel interface for clinicians. ‘The doctors think they always want to prescribe 25% THC, but 25% doesn’t mean it’s always good for you. A sativa at 22 or 23% can be much more beneficial, and people don’t realise that.’
- On the question of clinical language, Hollman proposed a workable middle ground. ‘Strain names are good for cultural knowledge and patient familiarity, but chemo-vars, the exact chemical fingerprint, are the language for doctors. Both can work together.’
- Auger pointed to regulatory fragmentation as a direct barrier to product quality. ‘Fresh cannabis is like fresh bread, it’s just better. When you’ve got different regulatory hurdles in every country, patients end up with something that’s been through the shipping process for six months.’
Telemedicine in Germany: Maturity, Regulation and What Comes Next
Kristine Lütke, 365 Sherpas GmbH; Dirk Heitepriem, German Cannabis Business Association; Sascha Mielcarek, Canify; Niels Lutzhöft, Bird & Bird LLP; moderated by Moritz Förster, Krautinvest
‘The hottest topic in the European cannabis space right now,’ was how moderator Moritz Förster opened this session. Telemedicine has been the engine of Germany’s post-CanG growth, driving patient numbers and the 200-plus tonnes of imports recorded in 2025. Yet while international observers are busy admiring the German model, Germany itself is attempting to restrict it.
The draft law and why it has stalled
- The health ministry’s proposed restrictions centred on two elements: a mandatory in-person consultation at the start of therapy, and a ban on mail-order delivery of cannabis flowers. The draft passed its first parliamentary reading in December 2025. Since then, near silence.
- Sascha Mielcarek, CEO of Canify, was direct about the political reality. ‘It’s a bit of a fake discussion, used to trade positions. Do you want people to go back to an illicit market where they don’t pay taxes, while you’re doing economic reforms to save money and increase taxes? I think that’s the real question.’ He does not expect imminent movement, but warned that the danger remains. ‘It’s an open law. It can be represented to parliament at any time.’
- Kristine Lütke, former member of the Bundestag and one of the architects of the original medical cannabis legislation, was equally unconvinced by the public health rationale. ‘I’m not convinced that restricting telemedicine and flower delivery will have any positive effect on public health. People will go back to the illicit market, or patients will have home-grown cannabis that is not quality-controlled. I don’t see any positive effect.’
- Dirk Heitepriem, President of the German Cannabis Business Association, reached back to first principles. ‘We reminded politicians where we came from — why medical cannabis was legalised in Germany in 2017. It was a court decision: either allow the patient to grow at home, or give them regulated access. They said we don’t want home growing because quality can’t be secured. That’s something they need to remember.’
The legal case against the draft
- Niels Lutzhöft, partner at Bird & Bird, outlined why the draft faces serious legal challenges. It is inconsistent with Germany’s own descheduling of cannabis, now a prescription medicine; it cannot be treated differently from any other medicine without justification. The Federal Constitutional Court has a consistent record of striking down inconsistent legislation.
- Regulating the conduct of doctors located outside Germany also creates EU law problems. ‘If those doctors are located outside Germany, their conduct is being regulated — and that requires proper justification. Now that cannabis is descheduled, arguing it is equivalent to a narcotic becomes very difficult,’ he said. A referral to the Court of Justice of the EU on related advertising restrictions is already in motion.
- A recent Supreme Court ruling prohibiting platforms from advertising cannabis with specific medical indications also drew attention. Mielcarek said compliant platforms were unaffected. He offered a broader point: ‘If you look at those websites posting flower pictures and strain names — that’s what’s drawing the attention. There’s no business case for not adapting to a more medically presented industry. It would help both sides.’
The reimbursement threat and what the industry must do
- A separate proposal to end public health insurance reimbursement for cannabis flowers drew the sharpest response of the session. ‘That is an attack on the really, really ill people,’ Heitepriem said. ‘We are moving from “we don’t like potential recreational users entering the medical market” to “we will take away the reimbursement from people who are genuinely sick.” That is a brutal idea.’ He noted the fiscal argument barely holds up: the cost to statutory insurers is negligible against the wider healthcare budget, making it a political rather than economic decision.
- Heitepriem closed with a direct call to action. ‘The stronger the industry represents itself as one voice, the better. Join your industry associations, work with patient groups, with doctors, and with pharmacies. Build common positions. That is the only way this works.’ He acknowledged self-regulation remains elusive in a market still changing rapidly, but argued that a unified industry message, aligned with patients and clinicians, is the most powerful tool available.
- Mielcarek offered the session’s most succinct defence of the German model. Statistics show there are no more users, people are moving from the illicit market to a formalised, standardised, quality-controlled market. I would call that a success. So I wonder why we are having this discussion at all.’
Can Cannabis Help to Close the Gender Health Gap? From Stigma to Solutions in Women’s Health
Dr Grace Blest-Hopley, Hystelica; Suzanne Mulvehill PhD, Female Orgasm Research Institute; Dr Michelle Nyangereka, Our Mothers’ Gardens; Nabila Chaudhri, Alternaleaf; moderated by Sarah Sinclair, Cannabis Health
- Dr Grace Blest-Hopley, neuropsychopharmacologist and Chief Science Officer at Hystelica, opened with a clear diagnosis of the underlying problem. ‘Western medicine has treated women as little men. We excluded women from research because hormones were seen as too much of a variable to control, and then we wondered why we don’t have answers.’ Endometriosis takes on average eight years to be diagnosed. Funding for endometriosis research is approximately one fifth of that allocated to erectile dysfunction. The majority of chronic pain patients are women, and women wait significantly longer than men to receive prescription painkillers, often because they are simply not believed.
- Dr Michelle Nyangereka, psychologist and founder of Our Mothers’ Gardens, added an intersectional dimension that the industry rarely addresses. Black maternal mortality in the UK is three to four times higher than for white women. ‘What makes the difference is having a Black doctor. It is not a question of physiology, it is a question of whether medicine sees us or doesn’t.’
- The science of how cannabis interacts with the female body remains critically underdeveloped, but what exists is striking. Blest-Hopley explained that oestrogen and progesterone are powerful neuro-steroids that directly modulate the endocannabinoid system, changing how anandamide is broken down and how cannabinoids function in the body. ‘As women lose oestrogen and progesterone in perimenopause, they experience increased anandamide breakdown, increased pain, anxiety, sleep disruption and depression, all areas where cannabinoids have documented potential.’ New research from the University of Maastricht is examining how cannabis response changes across the menstrual cycle. A paper published this week found that fear modulation by THC in women is cyclical, it does not work consistently as it does in men.
- Suzanne Mulvehill, founder of the Female Orgasm Research Institute, outlined her experience attempting to get female orgasmic disorder recognised as a qualifying condition for medical cannabis in US states. Eight states denied the petition; two approved it. Illinois became the first state to legislate gender-specific medical cannabis conditions, adding endometriosis, ovarian cysts, uterine fibroids and female orgasm disorder. ‘When we went specifically for the female orgasm aspect, it was not socially acceptable. Yet the research shows cannabis is statistically significant for female orgasmic function and there are no validated first-line treatments for the majority of women with orgasmic difficulty.’
- Blest-Hopley was direct about the industry’s product problem. ‘The entire medical cannabis industry needs to take a long look in the mirror about whether it wants to be a pharmaceutical industry or a stoner recreational market. The UK market is almost entirely high-THC flower. There are no high-CBD prescription products other than Epidiolex. If you have to take your kids to school, do the laundry and get to a PTA meeting, is high-THC flower really appropriate?’ Suppositories are beginning to emerge as a format better suited to women’s needs, but she noted that many have been designed by men without adequate lived experience, resulting in basic formulation errors.
- On safety, Blest-Hopley was equally unequivocal. ‘Women should not be using cannabis when pregnant or breastfeeding.’ The European Food Safety Authority designated cannabidiol as a reproductive toxin last week. THC is already classified as a reproductive toxin internationally. ‘The endocannabinoid system has an extremely precise role during gestation and adolescence. Introducing a powerful external cannabinoid during those periods carries serious risk, whether prescribed or recreational.’
- Nyangereka offered the panel’s most practical closing argument for male allies. ‘Get the endocannabinoid system into medical textbooks. If you understand the ECS, prescribing cannabinoids becomes a no-brainer. You stop thinking about getting high and start thinking about how to get cannabinoids into the body in a way that serves the patient.’ She invoked the Hawaiian concept of kuleana, privilege and responsibility. ‘With your privilege comes a responsibility. If women aren’t being listened to, talk to each other about it.’
