Tment, A.Li.Sa, 16121 Genova, Italy; [email protected] (C.Tment, A.Li.Sa, 16121 Genova, Italy; [email protected] (C.C.); [email protected] (M.S.R.);

Tment, A.Li.Sa, 16121 Genova, Italy; [email protected] (C.
Tment, A.Li.Sa, 16121 Genova, Italy; [email protected] (C.C.); [email protected] (M.S.R.); [email protected] (B.R.) Correspondence: [email protected]: Russo, E.; Cannas, C.; Rivetti, M.S.; Villa, C.; Rebesco, B. Innovative Clinical-Organizational Model to make sure Appropriateness and High-quality in the Management of Medical Cannabis: An Italian Regional Case. Healthcare 2021, 9, 1425. https://doi.org/10.3390/ healthcare9111425 Academic Editor: Jose M. Moran Received: 14 September 2021 Accepted: 20 October 2021 Published: 22 PX-478 manufacturer OctoberAbstract: This perform focuses around the clinical-organizational model implemented in an Italian area (Liguria) to streamline the access procedures to galenic cannabis preparations. The competent nearby overall health care authority that takes care of tracing a virtuous path to acquire popular, uniform and shared protocols and make certain higher requirements of care is often a.Li.Sa. (Azienda Ligure Sanitaria), a public organization with the function of coordination, path and governance of your overall health care in the regional hospitals and health facilities. To this objective, distinctive operating groups along with a board meeting have been set up together with the main function to define and develop technical standards to become applied for the prescription, preparation and dispensing of pharmaceutical forms based on therapeutic cannabis. In unique, the galenic preparations supplied by the Italian Ministry of Well being, described in detail within the regional normal operating protocols, are described and discussed. Moreover, probably the most significant data monitored from 2018 to 2020 and collected by hospitals and also the evaluation of these derived from regional pharmacies and health facilities are presented, discussed and compared in regards to their adherence and coherence with all the Italian Institute of Overall health (ISS) information. Keywords: medical cannabis; galenic preparations; regular operating protocols; monitoring data1. Introduction At the starting of your 1900s, the Usa was the very first country starting a actual prohibition of narcotic drugs. In 1912, the “International Opium Convention” was signed in the Hague [1] and in 1914, the Harrison Narcotics Act [2] restricted the sale of opiates and cocaine. Cannabis was removed from US Pharmacopoeia in 1942. In 1923, the US Treasury Department’s Narcotics Division banned the sale of all legal narcotics, including cannabis. In reality, in 1937 via the “Marihuana Tax Act” [3], the cultivation, trade and use of Indian hemp was banned. A medical interest in cannabis therapeutics arose in the 1940s when the American chemist Roger Adams chemically identified and synthesized cannabidiol (CBD), cannabinol (CBN) and various other molecules related to tetrahydrocannabinol (THC), obtaining in 1942 a patent in the CBD isolation system [4,5]. In 1963, the Israeli chemist Raphael Mechoulam totally elucidated the properties and structure of THC, recalling and Fmoc-Gly-Gly-OH Purity & Documentation confirming Adams’ discovery [6]. Beginning from the discovery of phytocannabinoids, the analysis turned toward the identification of the molecular pathways and receptor proteins involved within the signal transduction responsible for the many cannabis effects [7]. The discovery of cannabinoid receptors CB1 [8] and CB2 [9] dates to the 1990s when the receptor proteins, to which both exogenous and endogenous compounds were in a position to bind, were identified. At first, CB1 receptors had been identified inside the brain, with the highest concentrations demonstrate.