Will European Medical Cannabis Shift From Flowers To Oils?

European medical cannabis will shift from capricious flowers to quality oils as patients seek consistent and reliable medicines.

Some manufacturers looking to supply Europe with competitively-priced medical cannabis are preparing for this shift. And, one Colombian cultivator says such a switch would have major benefits  in the German market – Europe’s premier medical cannabis country.

Oliver Zugel is founder of Colombian cultivator FoliuMed which hopes to have its first medical cannabis oils available for shipment to Europe by the end of the year.

A Process Of Decay

He said: “Producing cannabis medicine from flower is inherently challenging. One plant is different from the other, and cannabinoid concentrations vary from batch to batch even with same genetics. 

“THC content is very sensitive to light, and changes over time; if you store the flower for a few months it has a lower THC content from what it was at the outset, and that’s not easy to fix.

“It’s a process of nature, of decay, so we believe the pharmacies and the medical community, ultimately, when they have the ability, will switch to extracts. Clinicians require precise dosing, extracts allow them to do that, and are, we believe, the way forward.”

He highlighted how in the recreational area the march of oils is unstoppable as the source material for tinctures, gummies, drinks, cosmetics and the like.

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Just Seven Tons Of Imports

FoliuMed’s aim is to deliver competitively-priced medical cannabis into Europe which is predicted to be the world’s leading market. Prohibition Partners estimate that as the continent eases restrictions on medical cannabis it will grow to be worth up to €123 billion by 2028. 

The market is quite small at the moment with Germany – Europe’s largest market – importing just seven tons in 2019, while Canada had an oversupply of 500 tons at the end of last year. 

However producers are preparing for its projected growth with around a dozen Canadian firms achieving the European Union Good Manufacturing Practice (EU-GMP) standards needed to supply Europe. FoliuMed believes its competitive advantage is the ability to grow in a low-cost environment – Colombia – while processing in compliant European facilities.

In order to achieve this it has secured the required standards at its growing facilities, near Bogota, and has has formed a joint venture with a German pharmaceutical firm to process imported extracts.

EU-GMP Secured In Germany

Once in Germany they will undergo further processing to align with EU-GMP regulations in the pharmaceutical company’s labs. EU-GMP is necessary to sell into the European market, but also fairly difficult to achieve.

Mr Zugel said: “EU- GMP is the gold standard for manufacturing pharmaceutical products, and requires lots of time, effort and money. It means that you need an integrated quality management system which delivers precisely the same product according to specifications in every production run, and can deliver a shelf-life suitable for sales through the pharmacy channel. 

Importance of Stocking GMP Products in Your Shop

Low-cost countries haven’t managed yet to produce meaningful volumes of GMP certified product, which paradoxically results in severe supply shortages and high prices in Europe despite the overhang in Canada and other markets… which in turn keeps the black market going. 

“We believe that extracts will be the next wave of medical cannabis products replacing flower, and those are much easier to standardise than flower and comply, therefore, with EU-GMP. 

From Seed To Sale

“But, building a GMP capability on your own is challenging, and more so when you have your grow and extraction in a region of the world where highly-skilled quality management professionals are hard to come by.

“For this reason, we at FoliuMed decided to enter an upstream joint venture with our German partners who have the experience to build and manage the system from seed to sale.” 

Elaborating on the difficulties in growing cannabis medicine, he continued: “Cannabis seeds and flowers are inherently variable, and perfect standardisation in the grow methods and climate control is very hard to achieve. GMP is, as its name says, is related to manufacturing, which only comes into play for the post-harvest drying, processing and packaging steps. 

“However, if your source material is inherently unstable and varies by each harvest, by definition you can’t get a GMP certified flower from it even if your processing complies with the standard.” 

Evolutionary Plant Genetics

Good genetics is the root of all quality products

There are further difficulties for cultivators in evolutionary plant genetics, says Mr Zugel.  He continued: “On top of this is genetic drift; the changes in the composition of plants and their offspring over time. 

“Think about it like some form of accelerated Darwinism – with cloning, you can create over 20 generations from the same plant within a year, which in human terms would equate to a 1,000 year period. Humans, on average, grew by nearly 10% over that period, and more than doubled their life expectancy, and it’s no different with plants.”

Mr Zugel is German-born and his home market – with some 80,000 patients – runs, by far, the most successful medical cannabis program in Europe. However, the delivery process for medical cannabis flower has it own peculiarities with patients either rolling their own joints of ground dry-flower or using a medical vaporizer.

While most medical cannabis patients in the U.S. prefer joints, it has been ruled out of the prescription process elsewhere in Europe.

Pharmacists’ 100% Mark-Up

The second method is through a vaporiser device of the kind made by Storz & Bickel, which was bought by Canadian firm Canopy Growth in 2018. This cumbersome table-top, cone-shaped device costs hundred of Euros and produces a smoke which fills a balloon for inhaling.

He said: “These are not sustainable long-term ways of delivering a medical application. But that’s how its done, right now, and is why the flower as the medical delivery method will ultimately be replaced by oils.”

Whilst oils are currently used in Germany a pharmacist must have some input – garnering a 100% mark-up for their efforts. This hands-on approach permits the cannabis oils to be sold with a doctor’s prescription without needing to go through the lengthy and expensive clinical trials required for other medicines. 

With oils up to five-times more expensive than flowers and the latter out-numbering the former in German usage by 80% to 20%, FoliuMed hopes to turn this on its head – and allow medical cannabis users to ditch their joint-rolling paraphernalia and cumbersome vaping devices.

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Worker’s Comp Claims Down in Medical Marijuana States

For the working-class schlub who, by definition, is considered an above-average cannabis connoisseur, it can sometimes be challenging to find and maintain gainful employment. The great American nine-to-five has, for decades, deemed it unsafe for the country’s stoner sect to report to work looking like a freshly drawn cartoon. Companies have long since thought that people who consume marijuana before or during work suffer a level of impairment that prevents them from being productive, as well as puts the safety of them and their co-workers at risk. It’s one of the main reasons that marijuana is one of the first substances they look for in a drug screen. Capitalistic society, the squares, the man, whoever is at the wheel of this whirling money machine, is simply doing its best to keep the cannabis user down by making it impossible for them to relish in reefer and continue earning a living. Or maybe we’re just being paranoid.

But what if we were to tell you that there is evidence out there suggesting that the legalization of marijuana is contributing to fewer serious workplace injuries? Would that be something of interest to you? Of course, it would — what are you, high? Otherwise, you would have already bailed out of this article and went on to mindlessly scour the World Wide Waste of Time for the latest cat memes. (By the way, feel free to send us the good ones. Some of us get bored at work, too.)

Unlike everything else that keeps showing up on the Internet, it appears that weed might be safe for work. A recent study published in the journal Health and Economics finds that worker’s compensation (WC) claims are down a smidge in states that have legalized marijuana for medicinal purposes. The study, which utilized data from the Annual Social and Economic Supplement to the Current Population Survey, shows workers in states with medical marijuana laws are nearly 7% less likely to file for worker’s compensation than those grinding it out in areas of total prohibition.

It’s a number that might not seem worthy of much fanfare. Still, considering that there are millions of non-fatal accidents occurring on the job site every year, any sliver off the top should be regarded as a victory.

Researchers at Temple University say the slight decrease appears to be happening because more employees with access to cannabis are dealing with minor pain issues with it as opposed to other drugs. “Medical marijuana is plausibly related to [worker’s compensation] claiming by allowing improved symptom management, and thus reduced need for the benefit, among injured or ill workers,” the authors wrote in the study abstract. “Medical marijuana can allow workers to better manage symptoms associated with workplace injuries and illnesses and, in turn, reduce need for WC. However, the reductions in WC claiming post MML are very modest in size.”

There has been a lot of hype over the past few years surrounding marijuana and its pain-relieving powers. But the results have been a cornucopia of praise, disdain, and ultimately confusion. Some studies show the efficacy of cannabis and its pain taming ability is solid enough to swoop in like a smoking superhero and save a downtrodden America from the opioid crisis. In contrast, others show it would be impossible for the herb to become a viable replacement for these drugs — that while medical marijuana might possibly be an acceptable alternative to low-grade pain meds, it is powerless for those people stuck in the land of warm and fuzzy.

In fact, a 30-year-long study published recently in the Canadian Medical Association Journal found that marijuana isn’t really a suitable pain killer and, what’s more, it doesn’t seem able to keep those people with an opioid problem on the mend. “There is limited evidence that cannabis use may reduce opioid use in pain management, and some high-profile organizations have suggested cannabis is an ‘exit drug’ for illicit opioid use, but we found no evidence to suggest cannabis helps patients with opioid use disorder stop using opioids,” said lead researcher and associate professor of psychiatry and behavioral neurosciences, Dr. Zainab Samaan.

Still, there is no denying there is a red-eyed legion of pain sufferers out there benefiting from the effects of marijuana. Or at least there’s a bunch of people curious about it. A survey published last year in the American Society of Anesthesiologists (ASA) found that 75% of the United States population would really like some answers about whether marijuana can actually reduce pain. But the federal government, which still considers weed a Schedule I dangerous drug, has so far refused to give any consideration to the issue of cannabis as a substitute for pain killers.

But from the sound of the latest study, some workers are merely conducting their own research. And, as the study authors pointed out, those numbers could start to increase with the legalization of recreational marijuana in more states. All in all, this could be an unexpected benefit to pot reform. The “legalization of recreational marijuana may lead to more patients using marijuana for medical purposes and experiencing better symptom management, and therefore there may be fewer workers compensation claims,” researcher Catherine Maclean explained to Inverse.

The only problem is workers can still get fired for testing positive for weed, even in states where it is legal. And while some jurisdictions are starting to shy away from pre-employment drug testing for marijuana, their policies do not prevent employers from putting workers in the unemployment line if they test positive for pot at any other time. The threat of getting fired could be stopping more Americans from experimenting with medical marijuana as a way to ease the woes of the workplace. It’s going to take a change in federal law before that aspect starts to die down.

But rest assured, the second the corporate world learns that legal weed might somehow lower their insurance premiums and strengthen their bottom lines, workers all over the country will be allowed to show up stoned to the bone without the smallest threat of being handed a pink slip. 

P.S. Don’t forget those cat memes.

TELL US, have you used cannabis for pain?

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Oklahoma Medical Marijuana Patients to March on State Capitol

Fearing the state’s medical marijuana program is under threat from a spread of new bills, Oklahoma medical marijuana advocates plan to march on the state’s Capitol on Thursday, Feb. 6 to urge lawmakers to stand down.

Right now, Oklahoma medical marijuana patients are living the good life compared to most. Nationally, there are basically three systems states use to distribute licenses for dispensaries: blind lotteries, merit-based scored applications that often include court fights over alleged corruption, and then Oklahoma, where there’s an unlimited amount of licenses and applicants just have to check a box.

That has led to quite the booming medical marijuana economy. In October, officials announced 5% of the state population, 200,000 people, has a medical marijuana card. They also said they’ve added roughly 3,500 patients a week since the program kicked off. This past week, while naming Travis Kirkpatrick as its new director, the Oklahoma Medical Marijuana Authority announced that number of patients had jumped up to 246,000. And Oklahoma has the most dispensaries per-capita in the nation, according to Cherokee Phoenix, with 56 per 100,000 residents.

But now, with a ton of bills lined up that will heavily regulate the industry compared to the current status quo, Oklahoma patients plan on taking their concerns directly to lawmakers in Oklahoma City. In addition to the march, those participating are encouraged to try and schedule an afternoon meeting with their lawmakers to press them on issues like advertising and a proposed 1,000-foot buffer zone around churches (though existing dispensaries would be grandfathered in).

Currently, there are 621 dispensaries in Oklahoma, according to new numbers from the Oklahoma Medical Marijuana Authority, and 79% of Oklahomans identify as Christian. With plenty of churches throughout Oklahoma, that means there could be giant spaces that may become off limits to cannabis providers. What if there are a couple of churches downtown in some rural parts of the state and their buffer zones overlap? Advocates are worried that providers would essentially be forced to the least desirable parts of town.

“There is nothing immoral about medicine or responsible adult cannabis consumption, so church buffers don’t really make much sense, but any onerous zoning restrictions that single out cannabis businesses are unfair, have a disproportionate impact on small businesses, and could make it impossible for some communities to safely access regulated cannabis,” Morgan Fox, the National Cannabis Industry Association’s media relations director, told Cannabis Now.

When it comes to advertising, Fox noted NCIA is against any restrictions that go above and beyond those placed on alcohol, “though we do generally support measures to limit exposure to minors.”

LeafLink, who tracks 19,000 products across dispensaries in 10 states, has a new pricing report showing Oklahoma providers have it pretty rough on margins despite the boom in patients as the market is still maturing. The most competitive categories of the market currently are edibles and ingestibles. If you’re making prerolls, you’re in good shape since it’s the least competitive sector of the market. Flowers and concentrates are the fourth most expensive of all the markets LeakLink tracks. Flowers have the lowest profit margin of any product in the market. Currently, a pound of marijuana in Oklahoma wholesales for an average of $2,786.

In their letter to lawmakers in preparation for the lobby day element of the march, advocates say the passage of the state’s medical marijuana law, State Question 788, has allowed hundreds of thousands of Sooners to have a choice in how they treat their illnesses.

“This choice has been especially remarkable for patients who were previously stuck in a cycle of using prescription medication and opiates to treat chronic pain,” the letter read. It also pointed to the sheer volume of Oklahomans taking part in the program as evidence of its need.

“Despite the push back, Oklahoma’s medical marijuana program is the shining example upon the hill compared to many states, and it is imperative that it be protected and allowed to grow. Oklahoma’s unique opportunity to create and harvest green gold should be protected and encouraged just as we do our oil and natural gas markets,” the letter read. “This kind of economic windfall for the people of this state should be supported not oppressed.”

The march will commence at 10 a.m. on Thursday, Feb. 6 at the Oklahoma State Capitol, 2300 North Lincoln Boulevard in Oklahoma City.

TELL US, have you protested for cannabis before?

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Only A ‘Dozen’ Domestic Canadian LP Facilities Have Secured EU-GMP Compliance

The European medical cannabis market is a tough nut to crack for Canadian cannabis firms who face a more stringent regulatory regime than at home.

Aphria’s shares rose by more than 10% after it became the latest Canadian Licensed Producer (LP) to secure European Union Good Manufacturing Practice (EU-GMP) clearance for two of its domestic production facilities.

However, fellow Canadian LP Vancouver-based Zenabis saw its shares plummet after sustaining an EU-GMP setback, last month. The success of Aphria brings the total number of Canadian facilities with EU-GMP approval to a little over a dozen – which isn’t many, alongside its hundreds of domestic cultivation facilities.

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$11 Billion German Market

Aphria says the approval opens up a medical cannabis market with a potential worth of billions of dollars. It will initially turn its focus to the German medical cannabis market which is currently worth around $100 million and set to be worth $11 billion by 2028.

Across all industries manufacturers aim to attain various internationally recognised standards, such as ISO and IEC. These help re-assure regulators and customers, and this is also the case in pharmaceutical space.

The U.S. drugs industry operates under Current Good Manufacturing Process (CGMP) regime which is based on five Ps; people, premises, processes, products and procedures. In their home market the Canadian LPs must comply with Health Canada’s Good Production Practices (GPP) standard.

However, these are both considered a lower level of quality assurance than EU-GMP, with its quantum focus on record keeping, operational standardisation and repetitive checking.

Supply Chain Traceability

It is similar in many ways to CGMP but ratchets-up with more robust measures around contamination control and supply chain traceability, amongst others. With its forensic rigor, EU-GMP is widely recognized as the Gold Standard of all ‘good manufacturing’ processes and securing the European standard is the equivalent to securing a global exporting passport.

Businesses looking to secure EU-GMP will initially need a gap assessment to determine what has to change to deliver alignment. Many undertake mock inspections before calling in the EU assessors for the final approval process.

Your Complete Guide to EU GMP-Certified CBD Isolate and Distillate (European Market)

Zenabis ‘Critical’ Failure

The difficulties in achieving EU-GMP were outlined in a no-hold-barred report by the Maltese authorities on an application from Zenabis for an EU-GMP. In November, last year, the Maltese regulators published a synopsis of their work assessing an application by Zenabis for EU-GMP compliance at facility in Delta, British Columbia.

The report says it found the absence of a ‘correctly implemented pharmaceutical quality system’, which was described as ‘critical ‘and  29 other findings, nine of which were ‘major’. While the company said it would initiate all the ‘corrective and preventive actions’ this has failed materialise, reports BNN Bloomberg.

This rejection will impact on the bottom line as Zenabis had announced plans to supply medical cannabis to a chain of 15 Maltese pharmacies, and up to 6,000 kilograms of dried cannabis annually to a second European business. Zenabis told BNN Bloomberg that is now ‘focused’ on achieving an EU-GMP certification for a second operation in New Brunswick, where it is licenced to produce over 46,000 kilograms of cannabis.

Euro-wide Free Trade

Only a handful of Canadian cannabis companies have secured EU-GMP. They include; Tilray, Cronos Group, Canopy Growth and Aurora Cannabis. Alberta-based Aurora says it intends to seek and achieve such certification for all its sites.

Most Canadian companies are pursuing EU-GMP ‘as it’s already been established for medicinal products’, says Karina Lahnakoski, vice president of quality and regulatory at Toronto consultancy Cannabis Compliance.

Any cannabis producer wishing to expand globally is looking at securing GMP certification.

The EU-GMP is run under the auspices of the European Medicines Agency and sets the standard for all medicines in the 28 member states. Once an EU-GMP is secured in one country the rules of the Single Market mean product from that facility can be freely traded across all member states.

For non-European manufactures looking to enter the EU they need to secure approval from the regulators in the country to which their imports are destined. Hence, the inspection of the Zenabis Canadian facility by regulators from Malta, where the company has a foothold with plans for an extraction facility.

Non-Compliance Concerns

However, the EU has mutual recognition agreements with many countries and, in such a case, the assessment can be undertaken by the manufacturers’ domestic regulators.

After inspecting a manufacturing site authorities either issue an EU-GMP certificate or a non-compliance statement. These are entered on to the EudraGMP database, which is a publicly accessible platform containing manufacturing and import authorizations, GMP certificates and non-compliance statements.

The EU-GMP authorization process was outlined in a recent press release by German-based business AMP German Cannabis Group which trades on Canadian Securities Exchange. Its business model is to source EU-GMP medical cannabis from Canadian LPs to supply the German market.

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£58 Billion Euro Market

It says that in order to achieve EU-GMP each Canadian LP it identifies as being a potential partner will need to undergo an ‘EU-GMP gap analysis and audit by its German consultants’.

Once the Canadian LP passes an audit, AMP Germany says it will arrange for an EU-GMP inspection and certification by German authorities. The attraction of the European market is there for all to see. 

The European cannabis Report from Prohibition Partners says that the first-world continent with over 742 million people, and a total healthcare spend of €2.3 trillion, will be the largest global medical cannabis market. 

Over €500m has been invested in European cannabis businesses over the last year and by 2028 the medical cannabis market will be worth £58 billion, says the report. 

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Illinois: More People Apply for Medical Marijuana To Avoid Paying High Taxes

Think about the tax revenue we could generate from the legalization of marijuana. That’s the spiel the cannabis advocacy community has been selling for decades to get a square nation to embrace greener times. But now that lawmakers are starting to listen to the cries — moving to legalize the leaf in their respective neck of the woods — the tax thing has sort of stuck in their craw. In Illinois, which just went legal at the beginning of the year, customers are seeing some of the highest tax rates in the nation on marijuana sales. It’s given them a bit of sticker shock, too. Some of them are even threatening to stay put in the underground market until the legal stuff is more affordable. But others have come up with a better plan to avoid paying the state’s high pot taxes. They are looking to get in on the state’s medical marijuana program. There’s a much lower tax there.

Somewhere around 2,600 people have applied for medical marijuana cards since the start of January, reports the Chicago Tribune. That might not sound like a lot, but it represents a 34% increase over what the state saw in the first two weeks of last December. This uptick, the report suggests, can be attributed to people wanting to take part in the legal cannabis system. Only many are averse to the ridiculously high tax rate in the recreational sector, so they are hoping to join the medicinal side instead. And why not? All of the cannabis products sold in both sectors are the same. And when the weed is labeled “medicine,” customers don’t have to wait in long lines.

In Illinois, the tax scheme on marijuana is like paying a vig to a sports bookie. The state taxes growers to the tune of 7% while imposing a series of excise taxes depending on the type of products. Customers must be prepared to shell out an extra 10% for bud, 20% for edibles and 25% on any pot products that contain 35% THC or more. Of course, there is also state and local sales tax on all purchases. In some cases, customers can expect to pay a 41% tax overall. It’s a situation that has turned many off the legal system and in the illicit market. After all, we’ve seen the underground only getting stronger in times of post-legalization.

But to participate in the state’s medical marijuana program, all a person has to do is get a doctor to sign off on a form that says they have one of some 50 health conditions. A lot of them are serious diseases, like Alzheimer’s and cancer. But recent tweaks in the law has opened the program up to those with pain issues, so virtually anyone can get in on the mix if they really want to. From there, a patient just has to cough up a $100 to $250 application fee, which entitles them to start buying medical marijuana immediately on the receipt while they wait for their card to arrive. And to top it off, all of those purchases are taxed at a rate of only 1%. It is making sense to a lot more people to go this route.

“We predicted that there would be a bump in patient load for cannabis certification but not the extent we are seeing,” Dr. Rahul Khare, who certifies patients for medical cannabis at Innovative Wellness, told the news source.

The trick at this point is not finding ways to sidestep the insanely high taxes on recreational marijuana, but it is finding a dispensary that has any pot to sell.

Since the initial phase of the market rollout only allows the state’s medical marijuana dispensaries to get in on the action, the supply that was there for the state’s 100,000 patients has all but dried up.

“It has been reported that many dispensaries are experiencing a shortage of cannabis products, including products for medical cannabis patients,” according to an email sent to dispensary owners by Cannabis Control Section in the Illinois Department of Financial and Professional Regulation.

“The Department takes seriously the availability of product for medical patients and dispensaries are required by law to prioritize providing products to medical cannabis patients,” it added.

Even with the state warning the cannabis industry to keep enough products on the shelves to service medical marijuana patients, the stock is still dwindling fast. Some of the latest figures show that people spent $11 million in Illinois on legal weed during the first week, which caused some operations to shut down temporarily. Of course, this weed shortage will start to work itself out eventually. But it could take a couple of years before there is enough legal product around to support both sectors.

The state could find itself in a position, however, of needing to reconsider its high tax rate if more people start getting medical marijuana cards. Just ask California how its tax plan is working out, and it is plain to see that cannabis customers will always find a way to avoid being taxed to death.

TELL US, have you ever been a medical marijuana patient?

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Newest Cannabinoid Powerhouse – CBC – What Can It Do for You?

The ever-increasing cannabinoid family has new members coming in every day, and there’s reason to be excited as new research comes out about CBC.

In the last couple of years, CBD (cannabidiol) – a cannabis cannabinoid, has risen to prominence as an effective treatment for many suffering from medical issues like insomnia, anxiety, pain, depression, seizures, high blood sugars, pathogenic diseases, ADHD etc., and a possible answer to many other issues that still require more research like: different forms of cancer, neurodegenerative diseases, and even prion diseases. It seems like every day a new breakthrough is coming out about the use of CBD as a treatment.

It’s easy to forget that CBD, along with THC (Tetrahydrocannabinol) – the main cannabinoid of cannabis plants – are just two of the possibly hundreds of cannabinoids that are present in cannabis plants. In fact, by now, well over 100 cannabinoids have been identified, and each one – though sometimes only appearing in extremely small concentrations – has its own medicinal benefits. One of these lesser known cannabinoids that is starting to make it into the mainstream is CBC, or Cannabichromene.

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What is CBC?

Cannabichromene, which also goes by the names cannabichrome, pentylcannabichromene, cannabinochromene, and cannanbichromene is a phytocannabinoid that is structurally similar to other cannabinoids like THC, CBD and CBN, and the second most prevalent cannabinoid in cannabis.

Much like other cannabinoids, CBC does not actually start out as CBC, but rather as cannabichromenic acid, and is produced over time through decarboxylation. CBC is non-psychoactive, and interacts with the endocannabinoid system differently than both THC and CBD in that it only poorly binds to the CB1 and CB2 receptors in the brain.

In 2019, a study was done looking into the often misunderstood mechanisms of action of CBC, which found that CBC acts as a selective CB2 receptor agonist. As of yet it has not undergone scheduling by the Convention on Psychotropic Substances meaning it is legal to use as of now.

What does the research say about CBC?

The isolation of new cannabinoids means all new
avenues of medical research to go down. The studies on CBC, in fact, go back as
far as a 1981 study that tested the anti-inflammatory, antibacterial, and
antifungal properties of CBC in rats. According to the research, CBC showed anti-inflammatory
effects superior to phenylbutazone,
an NSAID anti-inflammatory/pain medication. It also showed to be a strong antibacterial
agent and a mild to moderate antifungal.

Then, in a 2006, study into the anti-tumor effects of cannabidiol, cannabigerol, cannabichromene, cannabidiol acid and THC acid, it was found that while CBD had a more expected effect on the inhibition of certain tumor growth in rats, the other cannabinoids tested, including CBC, did as well, leading investigators to point in the direction of further testing of cannabinoids for cancer treatment.

$2 Million Going To Cannabis Cancer Research Led By Professor Mechoulam

In 2010 there was a study investigating how CBD and CBC effect activity of the descending pathway of antinociception in anesthetized rats. It was found that both cannabinoids produce an antinociceptive response by interacting with various targets involved in pain control. A less complicated way of saying this is that both CBD and CBC were found to help alleviate pain caused by nerve damage by the ability to block the detection of pain by sensory neuron cells.

It was looked at again in 2012 as an inhibitor of
inflammation induced hyper motility in rats. The investigators were looking at
CBC as a way to control, or inhibit, the overactive digestive tracts in rats
that was caused as a result of inflammation. The results showed a positive correlation between CBC and the normalization of
intestinal motility.

In the 2013 study, The effect of cannabichromene on adult neural stem/progenitor cells, three different phytocannabinoids were looked at in reference to adult neural stem progenitor cells in rats. These cells are similar to stem cells, but more specified, and play a large role in brain function and overall pathology, making them very important. CBC was found to have a positive effect when looking at the viability of adult neural stem progenitor cells in vitro, indicating neural protective qualities.

An interesting systematic review from 2017 investigated the use of cannabinoids including CBC for the treatment of several different pathogenic diseases. The conclusion was important in that though it showed the use of cannabinoids and the elicitation of the endocannabinoid system to be useful in treating many issues, it also pointed to the idea that simply making the assumption that cannabinoids can help with all issues related to a problem, is quite insufficient.

‘This review was able to point to incidences in research where the application of cannabinoids and the elicitation of the endocannabinoid system was not beneficial, and possibly harmful. While this does not in any way undo, or take away from, the possible positive benefits, it does act as a reminder that it’s important to do thorough investigations that do, indeed, look at everything, and to remember that medications – whether plant-based or pharmaceutical – are often specific to a particular problem, and often times cannot be generalized past that.

CBC
shows similar properties to other cannabinoids in its anti-inflammatory, pain
management, neuroprotectant, pathogenic disease fighting, anti-tumor, and
stomach settling properties. Much like CBD and THC, the research into this
compound is ongoing, with new applications coming out all the time. CBC has
been shown in studies to both work alone as a standalone treatment, and in
conjunction with other cannabinoids.

Cannabichromene and the Entourage Effect

Cannabinoids effect us therapeutically by interacting with the CB receptors in our bodies.

While CBD, and cannabis in general, have risen to mainstream medicine, they are different than standard pharmaceuticals because they fall into the category of plant-based medicine. When dealing with plant-based medicine it is often preferable to take just one part of a plant – for example, a cannabinoid like CBC – isolate it, and magnify it for its specific medicinal properties.

This can often be beneficial when a particular property of a plant has been found to treat a precise ailment. Sometimes that’s the best answer. Sometimes it’s not. When dealing with plant-based medicine, the entourage effect can be a powerful force. When looking up the entourage effect online these days, you’re likely to only see articles about cannabis, when in reality this idea is relevant to all plant medicine.

Plants are complicated structures made up of different substances. These substances can provide benefit on their own, or combine with other substances within to create an even more powerful response, we call this the entourage effect, but what it really is, is a full plant effect. Instead of focusing on one isolated part of the plant, it focuses on the combination of parts and the added benefit that these combinations can bring.

When dealing with cannabinoids like CBC, CBD, CBN, THC, etc., the idea of what they can do in concert is often more appealing than what they can accomplish in isolated form. In this 2019 systematic review, researchers took a look at years of research into cannabinoid isolation versus a cannabinoid entourage effect, and the many different applications of both.

They found when reviewing this research that often times the entourage effect far exceeds the effects of a single compound. In this review are examples of cannabis applications for microbial diseases, cancer treatments, anti-inflammatory treatments, anticonvulsant properties, and so on.

CBC Products

CBC
has yet to gain the overall popularity of THC or CBD. As medical research
continues to uncover useful benefits, more products and flowers are sure to
make it to the marketplace. As of right now, CBC can be found in hemp capsules
from different retailers, as an isolate, in oils, and in hemp flowers.

One of
the more well-known high-CBC flower strains is Three Kings: a sativa dominant
hybrid mixing Headband, OG Kush, and Sour Diesel. It has bright green flowers
with tons of trichomes, and an earthy taste of pine and citrus when smoked or
vaped.

Be sure to search for the newest CBC products on the market. We’ll be sure to hook you up with the best new products as they emerge, while keeping you updated on all groundbreaking CBC news.

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The post Newest Cannabinoid Powerhouse – CBC – What Can It Do for You? appeared first on CBD Testers.

The Feds Request Info on Cannabis & Migraines

The federal Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) is putting out a call for research on marijuana’s impact on migraines.

The request comes as part of a wider call from the AHRQ seeking scientific information submissions from the public for review on treatments for Acute Episodic Migraines. The review is currently in progress and being conducted by the AHRQ’s Evidence-based Practice Centers (EPC) Program. The agency said any scientific materials, published or not, that could inform the review are welcome.

A big part of what the AHRQ is trying to do is compare the effectiveness of opioid therapy versus an array of non-opioid pharmacologic therapies. In addition to marijuana, they’ll look at more traditional pharmaceutical options for migraine relief like acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, muscle relaxants and anti-nausea medications, among others. So needless to say, cannabis sounds the most user-friendly of the bunch for sure.

The AHRQ will also be comparing non-pharmacologic therapy options, like exercise or acupuncture, and their impacts on migraines.

For all the treatment options, they’ll be looking for results and info related to things like starting pain, how the person is able to function during treatment, how satisfied the patients are with the pain relief and how their general quality of life is with the treatment. They’ll also look at potential to abuse treatment and overdoses. We imagine cannabis will score well against other treatments in this category, but we can’t imagine anyone has ever overdosed from acupuncture either.

Looking at how effective cannabis is as a treatment for migraines is certainly not a new idea. In 1998, the International Association for the Study of Pain accepted a paper from the long-time cannabis researcher and neurologist Ethan Russo on the subject.

“Cannabis, or marijuana, has been used for centuries for both symptomatic and prophylactic treatment of migraine,” Russo wrote. “It was highly esteemed as a headache remedy by the most prominent physicians of the age between 1874 and 1942, remaining part of the Western pharmacopeia for this indication even into the mid-twentieth century.”

Russo noted that anecdotal evidence suggests that cannabis is still an effective treatment for migraines, and said that he “believes that controlled clinical trials of cannabis in acute migraine treatment are warranted.”

Russo went on to note it’s hard for physicians to simply wrap their heads around how prominent cannabis was as medicine before prohibition. Russo said that research from before 1974 examined five case studies of patients who voluntarily experimented with the substance to treat painful conditions. Three of the people taking part had chronic headaches and found relief by smoking cannabis “that was comparable, or superior to ergotamine tartrate and aspirin.”

In recent times, there is still plenty riding on the quest to understand why people with migraines get relief from cannabis, so much so here we are talking about the federal government trying to figure it out.

Last month, we noted why migraines are such a big deal — not only for women who are two to three times more likely to suffer from migraines than men, but for all people suffering. Research published by Washington State University in November showed that in the 20,000 cannabis use sessions they tracked where people were trying to get relief for a headache, they were successful 90% of the time. Sounds like it’s worth a shot before diving down the rabbit hole of Big Pharma.

TELL US, do you use cannabis to treat any of your medical problems?

The post The Feds Request Info on Cannabis & Migraines appeared first on Cannabis Now.

CBG May Be A Leading Defense Against Drug-Resistant Superbugs

Preliminary research suggests that cannabigerol (CBG) may be the best cannabinoid to utilize in the fight against antibiotic-resistant superbugs like MRSA.

Microbiologists from Hamilton, Ontario’s McMaster University compared CBG against THC (tetrahydrocannabinol) and CBD (cannabidiol) to see which compound was most capable of killing bacteria such as MRSA (methicillin-resistant Staphylococcus aureus). As it turns out, CBG won by a landslide.

Not only did CBG kill the MRSA microbes, but also the remaining “biofilm” that often form on patients’ skin and medical implants. The scientists in this study even went so far as to say CBG was on par with vancomycin, an antiobiotic that so far has the best results in treating drug-resistant bacteria. The study is currently under peer review by the ACS Infectious Diseases journal, but has yet to be certified or published.

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Mark Blaskovich, who studies antibiotic
cannabis compounds at the University of Queensland and is reviewing the study, is
optimistic about this new discovery. He noted that cannabis plants are
particularly rich in antimicrobial compounds when compared to other botanicals
such as tea tree, garlic, and turmeric.

“These are likely made as a defense mechanism to protect the plant from bacterial and fungal infections, but to date have not been very useful for human infections as they really only work outside the body,” he said. “That’s what makes this new report potentially exciting – evidence that cannabigerol is able to treat a systemic infection in mice.”

Using Cannabigerol (CBG) To Destroy Tumors

However promising the results are though, it’s
important to remember that we’re only the beginning stages of research. Lead study author Eric Brown
noted that while cannabinoids are “clearly great drug-like compounds, far more
research is necessary before the results can be tested on human patients or
applied in medical settings.”

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The post CBG May Be A Leading Defense Against Drug-Resistant Superbugs appeared first on CBD Testers.

Cannabis Use in Hospitals Is Still Prohibited, Despite State Medical Pot Programs

Every day, patients around America use cannabis to treat everything from glaucoma to chronic pain to nausea from chemotherapy treatments. Yet even in places like California, which pioneered legal medical marijuana in 1996 and passed adult-use cannabis in 2016, hospital policy has not caught up with the law and cannabis remains officially barred from hospital premises across the country. The reason why should sound familiar: federal prohibition.

Hospitals in the United States are subject to federal regulations, and could stand to lose funding and the ability to serve patients if they break the federal law, even with something like a state-legal medication.

This conflict between state and federal law on cannabis use in hospitals has very real consequences. One woman, Jessica Assaf, wrote on Healthcare in America in January 2018 about the experience of watching her partner’s father die of colon cancer at Memorial Sloan Kettering Cancer Center in New York City.

“After two years of failed chemotherapy and radiation, this prominent New York City lawyer weighed 130 pounds and could no longer talk nor move,” she wrote. “Though this patient had a medical recommendation for cannabis use in New York and vaporized THC and CBD daily to manage his pain, he could not use his medicine while he was stuck in the hospital. Instead, he was administered fentanyl.”

The medical marijuana movement, in fact, has a history of pushing for cannabis use in hospitals. The legendary activist known as Brownie Mary brought the issue into the international spotlight after she was arrested for bringing pot brownies to people dying of HIV/AIDS in San Francisco’s hospitals in the 1980s. Forty years later, it might be legal for millions to purchase medical marijuana — but using it in hospitals remains as prohibited as ever.

California Pioneering the Fight for Cannabis Use in Hospitals

The first sign of progress in allowing cannabis use in hospitals came in September 2016, just north of San Francisco. In a 2-0 vote, with three members abstaining, the board of California’s Marin Healthcare District voted in favor of  a resolution to study allowing patient cannabis use at Marin General Hospital, in the town of Greenbrae. A series of public forums were to be held to discuss the proposal.

However, in the three years since, the study has not been conducted and has effectively stalled.

The resolution was originally introduced by retired emergency room physician Dr. Larry Bedard, who had served on the California Medical Association cannabis task force that led to the association recommending legalization in 2011.

“We ought to be on the cutting edge for our patients, allowing them to openly and appropriately use medicinal cannabis,” Bedard told San Francisco’s KPIX at the time of the Marin resolution.

Speaking at the board meeting in support of the resolution was Lynnette Shaw, who opened the first licensed medical marijuana dispensary in Marin County back in 1997. She told KPIX she had been sneaking pot brownies into Marin General for 20 years, and that most doctors there were perfectly aware of the practice.  

“This is something they know about,” said Shaw. “I think it’s time for Marin General to step up, because this is a revolution for better health… For goodness sake, help the patients! Save lives!”

However, Shaw’s comments apparently didn’t get through. In the three years since the Marin Healthcare District voted to study the issue, little has come of it. Reached for comment in Marin County by Cannabis Now, Bedard says the resolution has seen no progress.

“The hospital administrators basically said ‘C’mon Larry, it’s a Schedule I drug, the Trump administration would take away our Medicare provider number and we’d have to close,” Bedard tells us.

He points out that any hospital that handles Medicare patients — predominantly people with the federal health insurance for those over 65 — must be certified by the federal Department of Health & Human Services. And while there is a small push to get Medicare to cover medical marijuana, there are few prospects for this happening under the current White House administration. 

(Lynnette Shaw PHOTO Gracie Malley for Cannabis Now)

An attempted remedy at the state level in California has also failed. Last year, Senate Bill 305, the “Compassionate Access to Medical Cannabis Act,” unanimously passed both chambers of California’s Legislature. It would have prohibited healthcare facilities from interfering with a terminally ill patient’s use of medical cannabis. It was also dubbed “Ryan’s Law,” after Ryan James Bartell, a San Diego native who had died of pancreatic cancer in April 2018. But in October, it was “begrudgingly” vetoed by Gov. Gavin Newsom.

“This bill would create significant conflicts between federal and state laws that cannot be taken lightly,” Newsom wrote in a veto statement, noting that “health facilities certified to receive payment from the from the federal Center for Medicare and Medicaid Services must comply with all federal laws.” 

But his statement also took aim at those federal laws. “It is inconceivable that the federal government continues to regard cannabis as having no medicinal value,” Newsom wrote, adding that this “ludicrous stance puts patients and those who care for them in an unconscionable position.” 

Doctors Weigh In

Clearly, the stakes in this question are high due to the illegality of cannabis at the federal level. While 11 states have legalized adult-use cannabis and 33 states have legalized medicinal marijuana, the feds still hold significant sway over hospital policy. 

First, as already noted, hospitals must be accredited through the federal Center for Medicare & Medicaid Services and “could be found to be in violation, lose federal funding, and face penalties” if they allow even state-legal cannabis use, according to a 2017 article in the peer-reviewed journal Hospital Pharmacy.

Second, clinicians are also prohibited from prescribing or providing cannabis in a hospital because it is not approved by the U.S. Food and Drug Administration.

“Yet, hospitals in more states are asked to create cannabis policies as voters decriminalize cannabis for medical use,” the authors Laura Borgelt and Kari Franson wrote in that same article. “There is no recognized supplier of medicinal cannabis, so hospitals are often asked to allow patients to bring in their own supply for their own use.” 

But in a Kafkaesque twist, hospitals then risk running afoul of a guideline established by the Joint Commission, the national body that sets standards for medical facilities. Joint Commission Standard MM.03.01.05 states: “The hospital informs the prescriber and patient if the medication brought into the hospital by patients, their families, or licensed independent practitioners is not permitted.”

Borgelt and Franson note that some hospitals have considered that “cannabis policies that could adequately address this standard” and allow cannabis on its premises if it informs everyone involved that the cannabis is “not permitted.”

“But several questions remain,” the authors write. “For example, how is the product identified, how does the institution verify its integrity, and how is a federally illegal drug ‘permitted’?”

However, some doctors have taken a more laissez-faire approach to the issue of allowing cannabis in hospitals.

“I think there’s a legal question and an ethical question,” Dr. Benjamin Caplan, founder of the CED Clinic and a representative of the group Doctors for Cannabis Regulation, told Patient Safety Monitor Journal in 2019. “In order for doctors to best manage illnesses carefully, and to the best of our abilities, we must know as much as we can [about] what a patient is taking. But it’s very common for patients to sneak cannabis in back rooms or under the radar, which is really unfortunate for everyone. I think the hospital perspective should be embracing what patients find helpful.”

Emphasizing the ethical dimension, Caplan added: “To have cases where patients are having seizures in a hospital and they can’t get the medicine that they want (and find helpful) as an outpatient is a real cultural disconnect for the medical establishment. I think the solution is for people to not sneak around; the solution is for hospitals to open their arms to patients who find a medication helpful.”

Veterans Lack Access to Cannabis in VA Hospitals

The question of whether or not it’s allowed to use cannabis in a hospital is a particular concern for military veterans — many of whom use cannabis to treat PTSD, yet are more directly dependent on the federal government for their healthcare. The U.S. Department of Veterans Affairs has remained largely intransigent on the question of medical cannabis, despite growing pressure.

“Moving to make cannabis available through VA hospitals or other go-to sources of care is difficult,” the VA website notes. “Doctors at VA facilities aren’t just prohibited from prescribing marijuana: The drug is still listed as ‘Schedule I,’ so these health care professionals can’t even speak about it with their patients.”

Needless to say, if the VA won’t allow its doctors to prescribe cannabis, it’s certainly not allowing its patients to use cannabis on the premises of VA hospitals.

The Mayo Clinic & the Potential for Change

The most significant opening for allowing cannabis in hospitals appears to come from the Mayo Clinic, the national network of medical treatment and research facilities. The Mayo Clinic website recognizes that “medical cannabis has possible benefit for several conditions.”

It notes that three states — Arizona, Florida and Minnesota — have adopted some form of the “Right to Try Act,” allowing access to “investigational” treatments, potentially including cannabis, for people with life-threatening conditions who have exhausted approved treatment options.

In one of those states, the Mayo Clinic allows on-premises use: “Minnesota residents with a supply of medical cannabis from the Minnesota Medical Cannabis program may continue use during their Mayo Clinic visit or hospital admission.”

However, the Mayo Clinic is in a unique position as a not-for-profit organization with national renown and standing as a top research institute. While the Mayo Clinic receives a significant amount of federal funding and has a Medicare number, it appears willing to take the risk with the federal government. If other hospitals will follow remains to be seen.

TELL US, do you think patients should be allowed to use cannabis in the hospital?

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Coming clean: Your anesthesiologist needs to know about marijuana use before surgery

Given the increasing prevalence and legalization of marijuana, many patients have come to think that marijuana use is not worth mentioning to their physicians. After all, they reason, I would not necessarily tell my doctor that I had a glass of wine last night, so why should I disclose that I smoked marijuana yesterday? Unfortunately, this reasoning is flawed. Because marijuana has a variety of effects on the body and on anesthesia medicines, it is crucial that anyone undergoing a preoperative evaluation disclose their marijuana use. Don’t worry that your anesthesiologist is judging you. That’s not our job! Our job is to understand your health and body in order to provide you with the safest and most pain-free procedure. This information is part of your confidential medical record, and accurate information is crucial to helping doctors provide good care.

Marijuana can affect the type and amount of anesthesia

The way(s) you use marijuana (smoking, edibles, etc.), how often you use, and how much all can affect how your body responds to anesthesia. Since marijuana and anesthesia both affect the central nervous system, people who use marijuana regularly may need different amounts of anesthesia medicines. In order to know which medicines and how much to use, your doctor needs to know ahead of time how much and how often you use marijuana.

Regular users of marijuana generally need larger doses of anesthesia medicines in order to achieve the same degree of sedation. If you don’t tell your anesthesiologist how much marijuana you smoke, he or she may underestimate how much anesthesia will be needed for you to “go to sleep” and stay asleep during your procedure. For example, compared to nonusers, regular marijuana users (daily to weekly) need over three times as much more propofol to achieve adequate sedation for endoscopies. That is a huge increase in dose that your doctor would want to be prepared to administer.

The higher anesthesia dose required for regular marijuana users can lead to an increased risk of complications, such as decreased blood pressure and delayed awakening from anesthesia.

Marijuana use before surgery can increase the risk of complications

Other side effects of regular marijuana use can lead to serious complications of anesthesia. Inhaled marijuana can affect your lungs and increase phlegm, coughing, wheezing, and the risk of respiratory infections. These lung issues can lead to breathing problems during your anesthetic, such as increased airway sensitivity when the breathing tube is put into or taken out of the airway. This may feel like an asthma attack, with a sensation of difficulty breathing and decreased oxygen getting into the lungs. Regular users of marijuana can also have increased postoperative pain, which leads to higher opioid use during and after surgery. This puts regular marijuana users at risk for opioid use disorder after surgery.

Don’t use marijuana the day of surgery — especially edibles

No matter how worried you are about your procedure, don’t use marijuana to relax — you may end up with your surgery rescheduled or with serious complications. Regardless of how often you usually use marijuana, anesthesiologists agree that you should skip it completely on the day of surgery. You should not smoke or inhale marijuana the day of your surgery, and certainly you should avoid any edible marijuana the day of surgery, since the American Society of Anesthesiologists’ guidelines for preoperative fasting do not allow any solid food for six to eight hours prior to anesthesia, in order to decrease the risk of food getting inhaled into your lungs. This can lead to aspiration pneumonia, a very serious complication that may cause death in some patients.

The physical effects of marijuana can increase the risk of complications, especially if consumed within an hour or two of anesthesia. Marijuana can raise your heart rate and lower your blood pressure. These changes are even more serious in patients with heart disease. In selected patient populations, this combination of decreased blood pressure and increased heart rate can cause ischemia (lack of blood supply) to the heart muscle, commonly known as a heart attack.

There are still many unknowns about marijuana

Your anesthesiologist needs accurate information about your marijuana use in order to plan safe anesthesia, and we know that no one should use marijuana on the day of surgery. Because of marijuana’s classification as a drug of abuse, we cannot do medical research on marijuana without legislation to allow that research, and this includes research about how marijuana affects surgical procedures and aspects of anesthesia. The American Society of Anesthesiologists (ASA) has urged the federal government to allow medical studies and has endorsed bills to expand research in marijuana.

Your anesthesiologist just wants to keep you safe

The ASA has a list of eight things that you should tell your physician and anesthesiologist before surgery, and the use of marijuana is one of them. Please don’t be afraid to disclose your use of marijuana to your physician, as it will not affect what we think of you. You will help us manage and adjust your anesthetic, prevent complications, and keep you as safe and healthy as possible.

The post Coming clean: Your anesthesiologist needs to know about marijuana use before surgery appeared first on Harvard Health Blog.