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Canadian exports of medical marijuana soar as producers seek overseas toehold

(This is the third article of a four-part series examining how Canadian cannabis companies are expanding globally. Part I was published Aug. 9 and Part II on Aug. 10. Part IV will publish Wednesday.)

By Matt Lamers

Canadian medical cannabis exports are surging, driven by licensed producers that are using overseas shipments as a way to establish local partnerships and gain a foothold in foreign markets.

In particular, exports of dried medical marijuana and MMJ oil products from Canada have soared since 2015.

And they are on pace to double this year from 2016 levels, according to data obtained by Marijuana Business Daily. Analysts expect this trend to continue in the near future as more countries legalize medical cannabis.

While exports remain a sliver of overall medical marijuana sales in Canada, licensed producers (LPs) have moved to capitalize on burgeoning overseas MMJ markets such as Germany, Australia and South America.

According to data from Health Canada, the government body responsible for issuing cannabis export permits:

  • Just over 45 kilograms (100.3 pounds) of dried cannabis and 94.7 kilograms of cannabis oil were exported through July 20 of this year.
  • For all of 2016, 44.8 kilograms of dried cannabis and 100.8 kilograms of cannabis oil were shipped overseas.

No medical marijuana was exported in 2015 under the former Conservative government, which did not share the pro-MJ views voiced by current Prime Minister Justin Trudeau.

Cam Battley – a member of the board of directors of Cannabis Canada, the industry association for licensed producers – sees exports as a means to an end.

“We’re going to see exports to multiple new legal medical cannabis markets soar,” he said, “but ultimately the real game is going to be building and owning capacity in new markets.”

How it breaks down

Over the past two years, Canadian LPs have exported cannabis oil to Australia, the Cayman Islands, Chile, Croatia, Cyprus, the Czech Republic and New Zealand. Dried cannabis has been sent to Australia, Brazil, Germany, Israel and the Netherlands, according to Health Canada.

No cannabis export permits were issued in 2015, while 43 were handed out last year and 75 as of July 20 this year.

Of the 75 permits issued this year, 11 were for dried cannabis and 64 for cannabis oil products.

In total, 118 export permits were issued by Health Canada as of July 20 under federal guidelines established between 2013 and 2016.

The data also shows that most export applications were approved.

In 2016, Health Canada received 11 export applications for dried medical cannabis and issued nine permits.

So far this year, Health Canada has approved 11 of 13 export applications submitted for dried MMJ.

Though growing quickly, exports still represent a tiny fraction of overall MMJ sales by the country’s licensed producers.

In the first three months of 2017, slightly less than 6,000 kilograms of dried medical cannabis were sold to 129,876 registered clients across Canada for medical use, meaning exports accounted for less than 1% of all sales.

Examples of Canadian exporters

To give their marijuana sales a shot in the arm, several Canadian licensed producers have turned to the export market:

More export growth anticipated

Looking ahead, analysts expect exports will continue to rise as Canadian LPs service niche markets and establish localized operations abroad.

Khurram Malik, a partner with financial advisory firm Jacob Capital Management, sees exports spiking to certain nations and regions before coming back down once Canadian LPs set up operations in those markets.

“Exports will be larger from where they are today, but I don’t think they will be a large part of the revenue mix (for Canada’s LPs) going forward,” he said, owing to the high costs of growing cannabis in Canada. “Canada won’t be cost competitive with markets overseas for exports.”

Battley, the Cannabis Canada board member, sees exports climbing in response to new markets coming online. Twenty-three countries have active medical cannabis laws, while another 14 countries have pending laws, not counting the United States.

“What we’ve seen thus far is a trickle,” he added. “Germany’s intention, for example, is to have licensed producers from other jurisdictions supply the market until 2019, hoping that by then there will be sufficient domestic capacity. But building and licensing high-quality capacity takes time.”

Matt Lamers can be reached at mattl@mjbizdaily.com

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“It’s California in 1995 All Over Again, Man” – Opportunities and Problems Piling Up in the European Cannabis Market – from Cannabis Business Executive magazine / Philip J. Cenedella IV

“It’s California in 1995 all over again, man.”

That was a comment I overhead during a conversation between an American and a German entrepreneur at the Mary Jane Berlin event held in Berlin in the second week of June, 2017.

Indeed, there may not be a better way to sum up the current state of the state here in Europe’s most populous country. Having been on the frontlines of the grassroots efforts in San Diego last century, it is fun to see how our industry is now growing in Germany and throughout Europe.  And like California back then, or now, the struggle is not always easy.

Here’s another interesting quote of the month:

“European markets are increasingly important to the cannabis sector. Each has a well-funded medical system, residents who seek natural and complementary therapies, and a government-supported mandate to stop the rising tide of opiate addiction related to chronic pain treatment.”

-Benjamin Ward, CEO, Maricann Group, Inc.

As of August, 2017 starts, the medical marijuana patients in Germany are experiencing “sold out” conditions nationwide, and the two exclusive importing countries (Canada and the Netherlands) are anticipating further bottlenecks as their in-country supply needs change. This is a significant problem – but also an opportunity for GMP-certified growers to fill the gap. If, and how, the German government opens up alternative supply to support their medical patients will be the top story in Germany this year.

From the patients perspective, there are two bad things about the current state of affairs: Little to no choice in their required medicine and their insurance companies are now refusing to cover the costs for the medicine as stipulated in the federal law.

Of course, lawyers are now getting involved and insurance companies are starting to be forced into approving valid claims from their policy-paying customers. But it is a silly, slow process to say the least.

The solution the German government is pursuing is to award 10 grow licenses to companies that will then produce 200 lbs. cannabis ​each within the country. The first bud from those plants are not scheduled to be picked until sometime in 2019, which is simply too long for patients to wait.

Some of the companies that have been publicly mentioned as potential winners of a grow license are Spektrum Cannabis, which is the Canopy Growth company formerly known as MedCann; Maricann GmbH, which is the new German subsidiary of its Canadian parent, Bedrocan, that has been a leader in the industry but recently run into a dispute with their Canadian licensee, Bedrocan International; Aurora Cannabis from Canada, which recently acquired the German firm Pedianos adding an EU-wide, medical marijuana distribution capability; and ABCann of Canada, which touts the “Father of THC” Dr. Raphael Mechoulam as a key member of their board of directors.

Homegrow options in Germany are currently not permitted, and existing indoor/outdoor farm operations are not yet able to be registered, licensed and taxed.

The black market continues to win, and patients continue to lose.  Cannabis business executives worldwide need to effectively work with the German government to develop the solutions we all know exist.  Three organizations that are key to this effort are the BfArM (www.bfarm.de )  the DHV (www.hanfverband.de )  and the GTAI ( www.gtai.de )

My personal comment is the government, politicians and regulators here in Germany need to listen to their constituents who support our industry by over 60 percent nationwide, according to a recent poll. The total quantity of flower to be delivered by the 10 licensees is probably less than what my buddy Butch has in his building back in California to handle his patients which live within five miles of the office.

Yes I am joking, Butch usually has less, but the point is – ​it simply is not enough for a population twice the size of California.

With all the talk about Germany, it is also important to remember that it is one of 18 countries within Europe that currently allow for some form of medical marijuana.  Besides Germany, there are provisions for the distribution and use of medical products in Austria, Belgium, Czech Republic, Denmark, Finland, France, Greece, Israel, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and, the most recent addition, Poland.

This is an interesting list that, again, shows these are historic times here in Europe.

Sadly missing from the list above is the United Kingdom, and that has affected people we know. Our friend Vera Twomey, and her entire family had to leave the U.K. last month just to take care of their young daughter with Dravet’s Syndrome. In the U.K. their daughter suffered from up to 30 grand mal seizures a day while taking a regimen of pharmaceutical drugs.

Think about that for a moment – 30 grand mal ​seizures a day.

Now living as “medical refugees” from their homeland, the Twomey’s and their daughter are now dealing with zero grand mal seizures a day thanks to her medical marijuana.

30 grand mal seizures a day, now zero a day – everyday for the past 3-4 weeks.

The United Kingdom calls medical marijuana illegal. Patients and advocates call that thinking arcane, unjust, and possibly criminal itself. They are now petitioning the Human Rights Commission of the European Union in Brussels for help. I am positive their efforts will be successful – it is just a matter of time.

Vera and her family hope it comes within her daughter’s lifetime. That is all for now. Have a successful rest of the summer, rest up and get ready because I believe that Q-4 of 2017 is going to be a busy one for our industry and your company.

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Medical marijuana companies in Canada capitalizing on ‘insane’ growth abroad – by Matt Lamers

https://mjbizdaily.com/canadian-medical-marijuana-companies-tap-insane-growth-overseas/

(This is the first article of a four-part series examining how Canadian cannabis companies are expanding globally. Part II will be published Thursday and Parts III and IV on Aug. 15-16.)

By Matt Lamers

Canadian medical cannabis companies are primed to tap what one industry executive calls “insane” growth overseas.

Flush with capital and largely free from American competition, Canadian licensed producers (LPs) are spreading their wings to gain a first-mover advantage in new markets as more countries legalize marijuana for medical use.

Fueling the overseas push is the vast amount of funding the companies have accumulated: During the first half of 2017, Canadian cannabis companies raised more than 1 billion Canadian dollars ($790 million), up more than 1,700% from the same period last year.

“One of the big advantages that Canadian companies have internationally right now is that we have access to capital that companies in no other country can match,” said Cam Battley, a member of the board of Cannabis Canada, the industry association for licensed cannabis producers.

“In addition to our expertise and the credibility of having operated successfully under rigorous government regulation in Canada, we have access to the level of capital required to make significant investments in equity and also in capital projects.”

The potential is significant. A recent analysis by Toronto-based Eight Capital, a full-service investment dealer, pegs the potential international medical cannabis market at CA$180 billion ($142 billion) over the next 15 years.

“We believe the path to global expansion for the LPs starts by partnering through medical-focused opportunities, and that in the longer term, international medical markets could be major upside opportunities,” the report states.

Germany and Australia have been the early focus for nearly a dozen Canadian MMJ companies tapping international markets through exports of flower and oils, licensing arrangements, distribution deals and acquisitions. Others have accumulated interests in South America.

Europe, where about a dozen countries permit sales of MMJ, is the big prize.

Battley said Canadian companies are going overseas to capitalize on their advantage while it exists.

“There are no significant American competitors right now on the international stage, so the best opportunities are open to well-capitalized Canadian producers,” he said.

Vahan Ajamian, an analyst in Beacon Securities’ Toronto office, said Canadian cannabis firms are driven by opportunity overseas rather than competition at home.

“There are all sorts of opportunities in foreign jurisdictions,” he said. “Germany is a hot one. Other countries in Europe are going medical. Mexico legalized medical cannabis. The world is slowly but surely going that way.”

“These are opportunities you’re looking to exploit, because of your size and capability in Canada,” he added.

The race to Germany

After Germany agreed to greatly expand its medical cannabis program earlier this year, a number of Canadian companies quickly established a foothold in Europe’s largest economy.

Germany became the first country to cover the cost of medical cannabis through its national health insurance system for any therapeutic application approved by a doctor.

The country is conducting an application process to select 10 licensed producers to cultivate 200 kilograms (441 pounds) of medical marijuana annually from 2019 to 2022. The 10 licensees could be announced in September, according to industry officials.

Until domestic producers are operational, imports will be needed to meet German demand.

Among the Canadian companies vying for one of the coveted licenses is Vancouver, British Columbia-based Aurora Cannabis, which lists as ACBon the Toronto Stock Exchange.

In May, the licensed MMJ cultivator acquired Germany-based Pedanios, an importer, exporter and distributor of medical cannabis in the European Union. It’s the largest medical cannabis distributor in Germany.

Pedanios passed the first stage of the application process.

“Demand in Germany is expanding at an insane rate,” said Battley, who also serves as executive vice president of Aurora. “Not only is Germany creating a very well-thought-out medical cannabis system, they’re reimbursing medical cannabis under the national health system.”

“We see Germany as our anchor in Europe, and that’s a market of 500 million people in the EU,” added Battley. He said Aurora is making “very considered and select investments that are anchoring us in markets that we see as very attractive future markets for medical cannabis. The good opportunities that come along are available at attractive prices right now.”

Ottawa, Ontario-based ABcann Global (TSX Venture: ABCN), another licensed producer, also is pursuing opportunities in Germany, and its common shares trade on the Frankfurt Stock Exchange.

CEO Aaron Keay said ABcann Global sees Germany as a gateway to broader European opportunities.

“We’re absolutely at the forefront,” he told Marijuana Business Daily. “We look at Europe as a significant part of our strategic plans for expansion, in addition to what we’re doing domestically.”

Keay confirmed that ABcann expects to acquire a distribution license and start exporting MMJ to Germany in the third quarter. He also said ABcann is “very interested to continue to pursue the cultivation in Germany.”

Canopy Growth (TSE: WEED), a licensed producer based in Smiths Falls, Ontario, established a foothold in the country with exports to Germany and its acquisition of MedCann, a Germany-based pharmaceutical distributor, in late 2016.

“Frankly, it’s growing very, very quickly,” Canopy Growth spokesman Jordan Sinclair said of the German market. “It’s very important.”

“There’s a lot of things that happen in the German market that are going to mirror what happens in Canada. So from a positioning perspective, and with the experience we bring to the table, we think we’re going to excel,” he said.

Other Canadian players in Germany (and nearby) include:

Australia bound

Australia, with a comparable population and demographic makeup to Canada, is receiving considerable interest from international cannabis companies.

The country legalized medical marijuana last year for patients with chronic or painful illnesses.

In May, CanniMed (TSE: CMED) marked its first shipment of commercial cannabis oil to Australia with the sale of 3,600 milliliters of oil to Health House International, a medical cannabis wholesaler in Perth.

A CanniMed spokesperson said the current focus is on the global medical market, rather than the Canadian and U.S. recreational markets, “because the opportunities allow for international expansion faster.”

Canopy Growth wants to use the lessons it learned in its early days in Canada to help AusCann Group Holdings (Australian Securities Exchange: AC8) in Australia. Canopy Growth will offer its expertise to AusCann in exchange for an initial 15% ownership stake in the company. AusCann’s strategic partner has been granted two cannabis licenses from Australia’s Office of Drug Control.

AusCann will import MMJ from Canopy until it’s capable of supplying locally produced medicine.

“Over the past year or so we have been supplying them with some of our intellectual property so they can come out of the gate strong. In exchange for that, they gave us a small stake in the business,” a Canopy spokesperson said. “We’re not exporting actual cannabis to Australia, we’re only exporting intellectual property.”

Aurora Cannabis entered the Australian market by taking a 19.9% stakein Cann Group Limited (Australian Securities Exchange: CAN). Cann is the first Australian company licensed to conduct research on and cultivate medical cannabis.

Aurora will also be exporting its intellectual property under an agreement with Cann.

ABcann Global is also actively looking at opportunities in Australia, CEO Keay told Marijuana Business Daily.

Canadian licensed producers have also done business in ColombiaCroatiaSouth AfricaNew ZealandChileCyprusBrazil, the Cayman Islands, Israel, Spain, Uruguay and the Netherlands.

Matt Lamers can be reached at mattl@mjbizdaily.com.


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How Medical Cannabis Could Treat Parkinson’s Disease – by Julie Godard

Over the past two decades, medical cannabis has become an alternative treatment option for many medical patients across the globe.

While medical studies in this area are by no means complete, there have been many promising findings both in the medical lab and outside of it, which may be indicators of future treatments that could be based on medical cannabis. A disease called Parkinson’s disease has recently moved to the forefront of medical investigation involving medical cannabis treatments.

What is Parkinson’s Disease?

Parkinson’s disease is a neurodegenerative brain disorder that occurs when there is a slow reduction in the amount of dopamine produced in the human brain’s nerve cells. Dopamine is the brain chemical that allows coordinated and smooth muscle movements in the body.

Because the disease affects a person’s movements and begins gradually, and because there is no laboratory test for the disease, it can be difficult to spot early on. Through a thorough examination of a patient’s medical history and repeated neurological exams, most cases can be diagnosed. Parkinson’s disease is not generally diagnosed in younger people; age 60 is the age when it usually begins to affect a patient. For the disease to affect a patient noticeably, 60-80 percent of a patient’s nerve cells must be affected. Early warning signs of Parkinson’s disease include:

  • Tremors or shaking
  • Small handwriting
  • Loss of sense of smell
  • Difficulty sleeping
  • Moving or walking issues
  • Constipation
  • Soft or low voice
  • Masked face
  • Dizziness/fainting
  • Stooping

While Parkinson’s disease is not fatal, complications from it can be, and there is no cure. The goal of treatment is to provide the most high-quality life possible once the disease has been diagnosed.

ADHD Cannabis

What are the Symptoms of Parkinson’s Disease?

There are four main stages of Parkinson’s disease, all accompanied by their own symptoms. Stage one involves mild symptoms that do not interfere with normal, everyday activities of patients – tremor and other movement symptoms occur, but only on one side of the body. Changes in posture, walking, and facial expressions may become apparent to friends or family at this stage.

In stage two, tremors and rigidity may appear on both sides of the body, and walking and posture issues are obvious. Daily tasks may become more difficult or take longer, but the patient should still be self-sufficient. Stage three often includes loss of balance and slower movements, possibly with frequent falls. Independence is still possible, but dressing and eating may become more and more difficult at this stage.

In stage four, symptoms of Parkinson’s disease may require help from a walker and help with daily tasks – this usually results in a loss of independence. Help from family, a friend, or a nurse that either visits daily or lives with the patient may now be required. In stage five, leg stiffness may prevent the patient from walking, and require 24-hour nursing care. Although most symptoms of Parkinson’s disease are commonly associated with physical issues, the following non-motor symptoms are also common, particularly in stage five:

  • Depression and anxiety
  • Issues with focused attention, planning, slow thoughts, language and memory
  • Personality changes
  • Dementia, hallucinations, or delusions
  • Orthostatic hypotension
  • Sleep disorders
  • Constipation
  • Lack of appetite
  • Pain and fatigue
  • Vision problems
  • Excessive sweating
  • Sexual issues
  • Weight loss or gain
  • Impulsive control disorders

What Medical Treatments are Available for Parkinson’s Disease?

Among the types of medical treatment that have been shown to decrease symptoms of Parkinson’s disease are surgery, deep brain stimulation (DBS), and various prescribed medications (most common are carbidopa/levodopa, Sinemet, Azilect, Mirapex, ropinirole, and Requip). In DBS, surgically implanted electrodes in the brain block electrical pulses from nerve cells that cause unwanted movements, stopping tremors and other Parkinson’s disease symptoms.

A doctor may use magnetic resonance imaging (MRI) or computed tomography (CT) scans to identify parts of the brain producing unwanted movements prior to surgery. DBS uses surgical insertion of a neurostimulator (similar in size to a stopwatch or heart pacemaker) which delivers to electrical stimulation to targeted brain areas. DBS usually involves the thalamus, subthalamic nucleus, and the globus pallidus. DBS is used only for patients who do not respond to other medications and treatments, and is an invasive procedure. Medical cannabis could help prevent such a procedure, and provide an option that Parkinson’s disease patients could use in the privacy of their own homes.

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Image credit- Strong CBD Oil

How Can Medical Cannabis Help Parkinson’s Disease Patients?

The National Parkinson’s Foundation acknowledges the current medical cannabis investigations occurring for Parkinson’s disease patients, noting that several anecdotal reports show reduced tremors in Parkinson’s patients. “Ride with Larry” is a three-part documentary involving Larry, a man with severe Parkinson’s disease who chose to consume medical cannabis to help with his tremors and other symptoms. Because medical cannabis can interact with neurological cannabinoid receptors (CB1 and CB2), it affects the brain and can calm tremors in some patients.

In general, people with Parkinson’s disease have fewer CB1 receptors than people without it; boosting CB1 receptors with medical cannabis seems to alleviate dyskinesia and reduce tremors. The difficulty of conducting medical cannabis trials for Parkinson’s disease has been and is still affected by national and international laws regarding the use of medical cannabis, as well as the difficulty of conducting a double-blind, placebo controlled trial with medical cannabis. However, some patients are positive that medical cannabis helps their tremors, and have posted videos of the treatment working on websites such as YouTube. In one pilot study, nabilone (a cannabinoid receptor agonist) significantly reduced dyskinesia in seven patients with Parkinson’s disease. Several other studies have shown different results, including tic benefits but no dyskinesia benefits.

A more recent study conducted in Europe has demonstrated that some Parkinson’s patients enjoy both pain relief and improved motor function following medical cannabis treatments. Parkinson’s disease patients in areas of the world where medical cannabis is legal have the option to discuss this form of treatment with their doctors or healthcare professionals if they are not responding to medications or DBS, but more clinical trials are needed to find reliable results for this treatment.

 

How Medical Cannabis Could Treat Parkinson’s Disease

 

 

 

 

 


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Is There a Medical Cannabis Crisis Brewing in Germany? By Marguerite Arnold

A looming product shortage, regulatory bureaucracy and insurance issues create a maelstrom of woes for German medical cannabis patients.

There is a great deal to be happy about with medical cannabis legalization in Germany. This is the first country that has mandated insurance coverage of the drug – at least at the federal legislative level.

However, as the government evaluates the finalists in the first tender bidfor domestically grown and regulated cannabis, a real crisis is brewing for patients on the ground. And further one that the industry not only sees but is trying to respond to.

Spektrum Cannabis GmbH, formerly MedCann GmbH began trying to address this problem when they obtained the first import license for Canadian cannabis last year. They are also one of the apparent five finalists in the pending government bid to grow the plant domestically for medical purposes. According to Dr. Sebastian Schulz, head of communications for Spektrum, “Shortly after the new cannabis law was reformed we experienced a huge increase in demand from the side of patients. We had prepared for that. The German population is very curious about cannabis as a medicine and in general very open to natural remedies.”

People are curious here. But like other places, the law in Germany has evolved slowly. Much like Israel, the government has allowed a trickle of patients to have access to cannabis by jumping through multiple, time consuming hoops. The process of getting cannabis prescribed, much less getting a pharmacy to stock it, was difficult. Patients had to pay out of pocket – a monthly cost of about $1,700. While that is expensive by American standards, to Germans, this is unheard of. The vast majority of the population – 90% – is on public health insurance. That means that most Germans get medications for $12 a month, no matter what they are. Allegedly, German patients were supposed to get about 5oz a month for this price. At least that is what the law says.

People are curious here. But like other places, the law in Germany has evolved slowlyAs in other countries, no matter what Germans think about recreational reform, the clear majority of them at this point support medical use. And at this point, both legislatively and via the courts, the government has said and been required to provide the drug to Germans patients at low cost.

Unintended Effects & Consequences

Since the law went into effect in March of this year however, things have suddenly turned very dire for patients.

The handful of people who had the right to grow at home – established under lawsuits several years ago – were suddenly told they could no longer do so. They had to go to a doctor and regular pharmacy. Even regular patients in the system found that their insurance companies, allegedly now required to pay, are refusing to reimburse claims. Doctors who prescribed the drug were abruptly informed that they would be financially responsible for every patient’s drug cost for the next two years (about $50,000 per patient).

Photo: Ian McWilliams, Flickr

To add a final blow to an already dire situation, German pharmacies that carried the drug, then announced an additional fee. It is about $9 extra per gram, added at the pharmacy, pushing the price of legitimate cannabis north of $20 dollars per gram. This is justified as a “preparation fee.” Cannabis bud is technically marked as an “unprocessed drug.” This means the pharmacies can charge extra for “processing” the same. In reality this might be a little bud trimming. If that. The current distributors in the market already prep and pre-package the drug.

What this bodes for a future dominated by infused products, oils and concentrates is unclear. However the impact now is large, immediate and expensive in a country where patients also must still go to the pharmacy in person for all prescription drugs.

There is no mail order here, by federal law. Online pharmacies are a luxury for Auslanders.

At minimum, this could mean that without some relief, German patients will go right back into the black market and home grow.While nobody has challenged this situation yet en masse, it is already a sore point not only for patients but across the industry. It means that an already expensive drug has gotten even more expensive. It also means that the government regulations are not working as planned.

At least not yet. For the large Canadian companies now coming into the market with multimillion-dollar investments already sunk in hard costs, Germany will be a loss-leader until the system sorts itself out.

According to Schulz, whose company is now in the thick of it, the new law is very vague. “Currently, there are almost no cannabis flowers available in German pharmacies because companies like us are not allowed to sell them,” says Schulz. “Various different regulatory demands come up that seemed to change on a monthly basis. We are ready to deliver even large amounts of cannabis for a market that might well explode soon – but we first need to overcome the regulatory nightmare that leads to the suffering of so many patients here these days.”

At minimum, this could mean that without some relief, German patients will go right back into the black market and home grow. Black market costs for cannabis are about $10-15 a gram. In other words, exactly the situation the government was hoping to avoid.

What Is Causing The Situation?

The intended effect of the legislation was twofold, according to industry insiders: To legalize cannabis in such a way to meet a rising public demand and, in the face of a court decision, to limit the home grow movement. The latter of which, despite federal regulations, is thriving here. Germans like to grow things, and cannabis is a rewarding plant to nurture.

High attendance at the Mary Jane Grow Expo in Berlin in June is just one sign that the genie is out of this particular bottle. BfArM – the federal agency in charge of regulating narcotics and medical devices – cannot stuff it back.Patients are going back to the way things were

However home grow does not build a professional, high volume cannabis market, much less a highly regulated medical one make. The government also made clear that it is going to have strict inspections and quality controls, and will technically buy all the cannabis produced, per the terms of the bid application process.

However, it is not entirely clear when the government will start actually doing the buying. And why the buying has not started yet. If insurance companies are refusing to pay, this means the government is not reimbursing them. The same government, which has also agreed to do so, as of March 2017.

What Gives On Good Old German Efficiency?

On the streets, patients are going back to the way things were. Many are used to fighting for the only drug that makes them feel better. The euphoria in May, for example, has been replaced with weary acceptance that things might get a bit worse before they really improve.

That said, there is also a realization that more activism and lobbying are required on just about every front. If an extrapolation of data from say Colorado or California is applied to Germany, there are already at least a million eligible patients here, based on the qualifying conditions. The government is planning for an annual increase in medical patients of about 5-10,000 a year, including in the amount of cannabis they are planning on buying from the licensed producers they choose. The numbers, however, are already not matching.Even existing patients are literally being forced into the black market again.

Added to this wrinkle is the other reality that is also looming, particularly now.

With one exception, all of the firms now apparently in contention as finalists for the German government bid will also be supplying a domestic market in Canada that is going rec next summer. One year, in other words, before the German companies even begin producing.

What Is The Upshot For Patients?

Guenther Weiglein is one of the five patients who sued for home grow rights in 2014. He is now suing again for the right to extend home grow privileges until the government figures out its process. He is not the only one. Earlier this year he was told he had to stop his home grow and integrate into the “mainstream” system. So far, he, along with other patients who are suing, including for insurance coverage, have not been able to get cannabis easily through the system, although they are starting to make progress.

Weiglein’s situation is made even more frustrating by the fluidity of the situation. As of late July, he had finally gotten agreement from his insurance company to cover the drug. But now he cannot find a doctor willing to accept the financial risk of prescribing it to him. And in the meantime he has no access to medication.

Talk to any group of advocates right now, and there is one ongoing story. Even existing patients are literally being forced into the black market again.

And those that can’t afford it? They are out of luck. Some patients say a tragedy like someone dying will create the impetus to move this into public eye. A hunger strike here by a leading cannabis doctor earlier this summer has so far not had much impact on policy. There is a great deal of pessimism here, as promised change earlier this year has turned into a long and drawn out multiyear question mark.

If this sounds like a bubbling and untenable situation, especially before a national election, it is. The prospect of another four years of Angela Merkel does not bode well for fast cannabis reform.

That said, the German government is now in an interesting situation. The law has now clearly changed to say that sick Germans are allowed to use cannabis as a drug of choice for chronic diseases when all else fails. Further, the national government has bound the insurance industry to cover it. So far, every patient who has sued for coverage has won. That has not, however, moved the insurance industry altogether. Nor has it solved the problem with doctors prescribing the drug.

Many now ask what will? It is clear, however, that it will change. The question is when, how fast, and in what situations.

The problem will undoubtedly ease by 2019, when the first German crops are finally ready, although it will be far from completely solved.

https://www.cannabisindustryjournal.com/news_article/is-there-a-medical-cannabis-crisis-brewing-in-germany/#comment-300


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ICRS findings highlight CBD’s therapeutic potential for cancer, epilepsy, Alzheimer’s, high blood pressure, and other disorders.

Newhttp://www.alternet.org/drugs/cutting-edge-cannabis-science-latest-findings-cbd?mc_cid=59a8c36441&mc_eid=cd290ff91e

During the last week of June, more than 400 scientists from 25 countries met in Montreal for the 27th annual symposium of the International Cannabinoid Research Society (ICRS). Several presentations and posters showcased new findings about cannabidiol (CBD), the non-euphoric component of the cannabis plant that is transforming the medical marijuana landscape.

In her Young Investigator Award Presentation, Saoirse O’Sullivan, associate professor at the University of Nottingham in the United Kingdom, discussed the cardiovascular effects of cannabidiol: “CBD causes both acute and time dependent vasorelaxation of rat and human arteries … and can improve endothelial function and vasodilator responses in a rat model of type 2 diabetes.” Moreover, a single dose of CBD was found to decrease “resting blood pressure and the blood pressure response to stress.” Other studies indicate that CBD limits brain damage in animal models of stroke. “Collectively, these data suggest that CBD is a compound of interest in the cardiovascular system and in cardiovascular disorders, which need to be tested in relevant patient groups,” O’Sullivan concluded.

A poster by Dr. Paula B. Dall’Stella, a neuro-oncologist with Sirio Libanes Hospital in San Paulo, Brazil, documented the antitumoral effects of CBD in two patients with Glioblastoma Multiforme (brain cancer) that were resistant to other therapies. Before and after MRI scans showed “a marked remission … not commonly observed in patients only treated with conventional modalities … that could impact survival.”

Several presentations focused on CBD and treatment-resistant epilepsy. Dr. Fabricio A. Pamplona, scientific director of of Entourage Phytolab in San Paulo, Brazil, compared the efficacy of a purified CBDisolate to a whole plant CBD-rich oil extract. Pamplona found the whole plant extract to be a superior option with higher potency and fewer adverse side effects than single-molecule CBD: “There were more reports of ‘improvement in seizures frequency’ in CBD-enriched extract compared to purified CBD,” a result that he attributed to the “additional compounds available in extracts (other than CBD) that may interact synergistically.”

Israeli researchers at the Technion institute in Haifa found that “not all high CBD extracts have the same anticonvulsant ability.” The Israelis noted that “the terpenoid content in the cannabis extracts are important for the anticonvulsant effect.” (Terpenoids are derived from terpenes, the aromatic botanical compounds that endow cannabis with a unique smell and confer specific medicinal effects.) “Not all cannabis extracts will be useful as a treatment for epilepsy,” the Technion researchers concluded, adding: “[T]he exact cannabinoid and terpenoid profiles are needed to evaluate the potential anticonvulsant properties of a cannabis extract.”

Another poster drew attention to the fact that daily use of CBD-rich cannabis oil extracts may lead to a positive THC finding in a drug test, a concern for many U.S. patients in so-called “CBD-only states” that have legalized CBD but not the whole plant. Unfortunately, this poster resurrected the thoroughly discredited (and financially motivated) theory that CBD may convert to THC in the stomach. A more likely explanation is that any whole cannabis plant extract that includes even a small amount of THC could generate a positive result from a drug test. Given the unregulated CBD products that proliferate online, it’s not surprising that some “CBD” oils contain higher THC concentrations than advertised.

Other scientists probed CBD’s mechanism of action with respect to nausea, neuropathic pain, anxiety, and other mood disorders. Researchers at McGill University in Montreal found that analgesic effects of acute and chronic CBD treatment are mediated by the serotonin 5HT1a receptor, but this is not the case for CBD’s antidepressant effects, which seem to be regulated via other molecular pathways.

The complex role of the 5HT1a receptor with respect to CBD’s therapeutic properties was addressed in a poster by Aidan J. Hampson and his colleagues at the National Institute of Drug Abuse. It was Hampson’s work, published in 1998, that formed that basis for the U.S. government’s patent on the antioxidant and neuroprotectant properties of cannabinoids (both THC and CBD). More recently, Hampson has shown that the anxiety-relieving effect of CBD can be blocked in vivo (in a living animal) by a 5HT1a antagonist, indicating that this receptor is in part responsible for mediating the anxiolytic effects of cannabidiol. Curiously, Hampson’s current data suggests that in addition to binding directly to 5HT1a, cannabidiol may also act as a positive allosteric modulator of 5HT1a – meaning that CBD can alter the functionality of this receptor (and other serotonin receptor subtypes) in such a way as to enhance its binding efficiency with the endogenous serotonin neurotransmitter. In other words, CBD may actually magnify the effect of serotonin, in addition to directly activating the 5HT1a receptor.

Scientists at the University of Louisville School of Medicine in Kentucky have identified two new molecular targets of CBD – the receptors designated “GPR3” and “GPR6.” (GPR refers to G-coupled protein receptor, the family of receptors that includes cannabinoid, opioid, and several serotonin receptor subtypes.) GPR3 and GPR6 are both known as “orphan receptors” because the principal endogenous compounds that bind to these receptors have yet to be identified. Some of the potential therapeutic effects of CBD for Alzheimer’s disease, Parkinson’s disease and schizophrenia may be mediated by GPR3and GPR6.

Amyloid beta plaque and tau protein tangles in the brain are hallmarks of Alzheimer’s dementia. Tim Karl from the Western Sydney University School of Medicine in Australia elaborated on CBD’s therapeutic potential for this neurodegenerative brain disease: “The phytocannabinoid cannabidiol possesses antioxidant, anti-inflammatory and neuroprotective properties and prevents amyloid beta-induced neuroinflammation, and tau hyperphosphorylation in vitro. CBD also reverses cognitive deficits of pharmacological amyloid beta models. Thus, CBD may offer therapeutic value for Alzheimer’s disease.”

Another receptor, known as GPR55, is inhibited by CBD. This is significant because preclinical research has linked GPR55 activation to several aberrant conditions, including colon cancer and Dravet Syndrome, a severe seizure disorder. By functioning as a GPR55 “antagonist,” CBD may confer a tumor-suppressing and anti-epileptic effect, although clinical studies have yet to confirm whether this mechanism of action is applicable to humans as well as animals.

At the 2017 ICRS conference, numerous presentations focused on other areas of cannabinoid science that do not involve CBD but are nonetheless relevant for cannabis clinicians and patients. Some highlights:

  • Chronic cannabis use: Carrie Cutler, assistant professor at Washington State University, provided a much-needed rejoinder to scientifically dubious assertions that chronic cannabis use during adolescence causes brain damage and significant detrimental effects on cognition and IQ. Her study found that after controlling for confounding variables no “significant effects of cannabis use were detected on … measures of memory or executive functioning” other than “modest problems with verbal free recall (i.e., remembering lists of items) and prospective memory (i.e, remembering to do things in the future).” A second study presented by Cutler drew attention to marijuana’s stress-reducing effects: “[C]hronic cannabis use is associated with a blunted stress response and a reduced reliance on top-down attentional control that does not cause overall cognitive performance to suffer.”
  • Addiction: Vincenzo Di Marzo, a leading cannabinoid scientist at the Institute of Biomolecular Chemistry in Naples, Italy, gave a fascinating presentation on the cessation of nicotine addiction among cigarette smokers who suffer a traumatic brain injury. Di Marzo identified an endogenous lipid molecule, N-oleoyol-glycine (OlGly), which activates a receptor on the membrane of the cell’s nucleus, thereby reducing the rewarding effects of nicotine and nicotine-dependence in mice. In a separate study of morphine withdrawal, Di Marzo and a team of international researchers concluded: “Oleoyl Glycine is a newly discovered endogenous cannabinoid-like compound that may have therapeutic potential in the treatment of addiction.”
  • Pain relief: Temple University scientists found that “cannabinoids used in combination with opioids have the potential to reduce the dose of opioids needed for analgesia.” Jenny L. Wiley, a scientist with RTI International in North Carolina, and her colleagues at Washington State University reported encouraging results regarding the use of THC as a prophylactic treatment for chemotherapy-induced peripheral neuropathy. “Preliminary data suggest that THC administered chronically during the course of paclitaxel treatment decreases the development of mechanical allodynia [heightened sensitivity to pain] in both male and female rats.”
  • Sleep: Gwen Wurm at the University of Miami reported that medical cannabis use is associated with a decrease in the use of prescription and over-the-counter sleep medications. Moreover, according Wurm’s poster, “There is a strong relationship between use of medical cannabis for sleep and for pain.”
  • The CB2 receptor: Tel Aviv University scientist Bitya Raphael identified an endogenous hormone H4(99-103) that activates the cannabinoid CB2 receptor, which regulates immune function, metabolic processes and the peripheral nervous system. This is the first study showing that an endogenous circulating peptide signals via the CB2 receptor. A poster presented by Makenzie Fulmer at East Tennessee State University described how CB2 receptor dysfunction increases plaque calcification in a mouse model of atherosclerosis.

There were many other significant presentations during the four-day ICRS conference in Montreal that warrant mention – too many to adequately address in this summary. Project CBD looks forward to further developments next year when the ICRS convenes again at Leiden University in the Netherlands.

Martin A Lee is the director of Project CBD and the author of Smoke Signals: A Social History of Marijuana—Medical, Recreational and Scientific.

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Tommy Chong rumored to be re-appearing at ICBC Berlin

ICBC Berlin - The BERLIN PEACE ACCORDS...putting an end to the world war on Cannabis!

ICBC BERLIN will be held April 12-13, 2018 in Berlin Germany.

Tommy Chong and his CHONGS CHOICE offerings http://chongschoice.us/ were well-received by the international cannabis executives this year and rumor has it he will be there again in 2018.

For more information on this HIGHLY RECOMMENDED event, please go to:

http://internationalcbc.com/berlin-home/