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Cannabis Shows Great Promise in Treating Cancer—Let’s Not Wreck It With Hyperbole

DR. DAVE HEPBURN – LEAFLY

There’s no topic like cancer to inspire cacophonous claims of a cure, pegged to everything from the rinds of fruits nobody has ever eaten to powders drawn from Micronesian beaches no one has ever visited. As such, claims of miracle cures for cancer typically cause the medical establishment to roll their eyes and avert their attention.

This is why it’s so important to eschew such cure-related hyperbole when discussing the cancer-treating components of cannabis, which could all too easily be lumped into the same National Enquirer“wonder cure” category.

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Government-Run Cancer Institute Quietly Acknowledges That Cannabis Kills Cancer Cells

Such talk is especially counterproductive given that there is little doubt that cannabis plays a very important role as a treatment option for cancer—a fact even government agencies are ready to acknowledge, issuing statements on cannabis and cancer that are profoundly encouraging.

The National Cancer Institute has said that “Cannabis has been shown to kill cancer cells in the laboratory.” (Presumably it does something similar outside of the laboratory, but taking cannabis from lab to bedside is an exercise in Schedule-I bureaucratic frustration.) In addition, the NCI states that “[c]annabinoids appear to kill tumor cells but do not affect their non-transformed counterparts and may even protect them from cell death.”

Anecdotes of success in treating cancer with cannabis can’t be ignored—they’re what’s driven the medicalization of cannabis for a long time.

This is because cannabis is what’s known as “pro-apoptotic.” Apoptosis means that a cell commits suicide. Cannabis encourages this in some cancer cells while protecting non-cancer cells from the same fate. As any oncologist will tell you, killing cancer cells while not affecting normal tissue is one of the Holy Grails of treatment. Cannabis can also prevent cancer cells from further dividing, spreading, and growing.

Even the National Institute of Drug Abuse—an organization historically devoted to vilifying cannabis—has gotten on board, stating that “marijuana extracts may help kill certain cancer cells and reduce the size of others.” Not even they can ignore the science.

Anecdotes of success in treating cancer with cannabis can’t be ignored—they’re what’s driven the medicalization of cannabis for a long time. But anecdotes aren’t enough to support touting cannabis as a miracle cure. As always with cannabis and its 144 cannabinoids, the range of effects and variations is vast. Medical cannabis is still the wild west. One size simply does not fit all. There are just too many permutations.

So let it be said, loudly and often: Cannabis is not a cure for cancer. It is not a panacea that has been evilly suppressed by greedy pharmaceutical corporations.

Exaggerations such as these do nothing but sabotage the potential of cannabis. T-shirts emblazoned with “Cannabis Cures Cancer” and assorted leafy greens simply give the appearance of Rastafarian snake oil.

Let’s not further embolden biased clueless conservatives, who look for reasons to further vilify cannabis and stigmatize cannabis users. Now is the time for common sense and reason rather than common screech and rhetoric. Overcoming stigma means reversing ideas that are all too often loosely formed yet firmly held.

Progress in cannabinoid science is truly exciting and packed with great promise If we are to advance, the focus needs to be on objective science and studies. Let’s keep it that way.


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Legal, regulatory obstacles preventing Canadian ‘Big Cannabis’ from diving headfirst into U.S. – from MJBiz Daily

August 10, 2017

Legal, regulatory obstacles preventing Canadian ‘Big Cannabis’ from diving headfirst into U.S.

(This is the second article of a four-part series examining how Canadian cannabis companies are expanding globally. Part I ran Aug. 9, and Parts III and IV will be published on Aug. 15-16.)

By Matt Lamers

Canadian cannabis companies eyeing U.S. medical and recreational marijuana markets can encounter a host of legal and regulatory pitfalls, prompting most of the big licensed producers to shun America altogether – at least for now.

“The rule right now is ‘no.’ You cannot do business in the United States,” said Aaron Keay, CEO of Ottawa-based ABcann Global, a licensed producer (LP) that trades on the TSX Venture Exchange under the ticker symbol ABCN.

In particular, the company doesn’t want to jeopardize its listing on the TSX Venture Exchange, given the stipulations laid out by the exchange’s parent company.

On its face, the United States is an attractive market:

  • Thirty states – plus Washington DC – have legalized medical marijuana.
  • Eight states also have legalized sales of recreational cannabis.

Canadian licensed producers seem poised to invade the U.S. industry, as many are spreading their wings to gain a first-mover advantage in newly legalized marijuana markets globally.

Most of these companies ultimately want a slice of the U.S. market, which could generate up to $9 billion in retail sales next year, according to the Marijuana Business Factbook 2017.

But several issues have made the United States off limits for some Canadian companies – notably the biggest players.

Hurdles aplenty 

Catch No. 1: MMJ exports to the United States are a nonstarter. Health Canada won’t issue an export license without an import certificate from a foreign counterpart – which can’t happen in the United States, because marijuana is illegal in the eyes of the U.S. government.

To get around the need for an export permit, some Canadian cannabis companies are investing directly in licensed producers based in the United States.

Catch No. 2: You’ll have a hard time listing on either of Canada’s two largest stock markets. TMX Group – the parent of the Toronto Stock Exchange (TSE) and the TSX Venture Exchange (TSXV) – mandates that its listed companies comply with relevant laws and regulations where they do business.

And because MMJ is illegal in the eyes of Uncle Sam, listed cannabis companies on Canada’s two biggest exchanges are technically not supposed to do business in the United States.

In fact, only one of the five cannabis companies on the TSE has cannabis-related assets in the United States, while around a dozen of the 47 cannabis stocks on the smaller Canadian Securities Exchange (CSE) have U.S. holdings.

Catch No. 3: You might have a limited ability to raise capital. While the CSE is a respected exchange, it doesn’t have nearly the clout, exposure to institutional investors, or access to capital that firms listed on the TSE and TSXV enjoy.

Big Canadian companies kept at bay

Ironically, U.S. prohibitions blocking the development of the cannabis industry on a national scale are shielding the country’s state-sanctioned cultivators from competing against well-capitalized and more experienced Canadian peers.

Most of the biggest licensed marijuana growers in Canada, behemoths compared to their under-capitalized American counterparts, are holding off on any U.S. expansion plans to avoid breaking laws in either country – and to stay in good standing with TMX Group regulations.

A case in point: The United States is a no-go zone for Alberta-based Aurora Cannabis (TSE: ACB).

“It has to be federally legal. We’ve got to make sure that everything we do is kosher with the exchange,” said Cam Battley, executive vice president of Aurora. “We will not touch anything in the U.S. while it’s federally illegal.”

Two years ago Aurora had a “growth strategy south of the Canadian border” – it agreed to build a production facility in Washington state – but the plan was superseded by the 2015 Canadian election. That plan is no longer in the cards.

“I’m very interested in the U.S. market, but I’m not going there until it’s federally legal, and we are not going to jeopardize our relationship with the TSE,” Battley said.

Saskatoon-based CanniMed Therapeutics (TSE: CMED) says it has a facility in the United States, but it’s not producing cannabis to avoid running afoul of regulators. But “when regulations change it’s something we can and will ramp up extremely quickly,” a company spokesperson said.

According to the company’s website, CanniMed’s wholly-owned subsidiary, SubTerra LLC of White Pine, Michigan, “is a key strategic asset in the Company’s longer-term strategy to service a potential medical cannabis market in the United States.”

Neil Closner, CEO of Markham, Ontario-based MedReleaf (TSE: LEAF), told Marijuana Business Daily the company only considers markets that are regulated at a federal level.

MedReleaf’s vice president of strategy, Darren Karasiuk, acknowledged the “substantial” potential of the U.S. market, but said “the company is not currently considering making any investments in the cannabis industry there, and would only consider doing so in the future after consideration of the impact on the company of all laws affecting any such investment and in compliance with all applicable guidance and requirements of the TSE.”

For Smiths Falls-based Canopy Growth Corp. (TSE: WEED), the United States is not currently on its radar.

“International expansion for CGC is only going to be done in jurisdictions where it’s federally legal to do so,” said a spokesperson.

Keay, the CEO of ABcann Global, said he’s keeping an eye on opportunities south of the border and communicates on a regular basis with executives in the country.

But “right now we cannot go down that path because we’re listed on the TSX,” he said. “You can’t right now. But I have my eye on it. It’s the land of some of the biggest consumer products in the world.”

Some undeterred 

Still, some analysts and Canadian executives are bullish on the U.S. cannabis sector’s potential – and a few licensed cannabis producers have entered the American market.

Vahan Ajamian, an analyst at Canada’s Beacon Securities, sees great potential in the U.S. market as more states legalize medical and adult-use cannabis, but notes “it’s really 50 separate markets” owing to the plant’s illegal status at the federal level.

“We are big believers in the U.S. opportunity,” he said.

Among the five cannabis companies trading on the TSE, only one is actively involved in the U.S. marijuana market.

Leamington, Ontario-based Aphria (TSE: APH), which boasts a “U.S. expansion strategy,” has business interests in Arizona and Florida, and belongs to a partnership vying for a license to grow medicinal cannabis in Ohio.

Through Aphria (Arizona) Inc., Aphria owns 18.5% of Copperstate Farms Investors, which in turn has a 95% interest in Copperstate Farms – a licensed medical cannabis producer in Arizona.

In Florida, Aphria’s stake in Liberty Health Sciences gives it a financial interest in an MMJ company operating in a state poised to become a major market for medical cannabis.

Liberty Health Sciences CEO George Scorsis told Marijuana Business Daily his company is focused exclusively on the United States “because of its tremendous opportunity.”

Scorsis’ strategy involves going into markets that are “completely medical. That’s one premise we will never deviate from. Second, we look at states that do not have canopy restrictions, because that permits us to grow at a scale of greenhouse that allows us to be the lowest cost producer. We also like states that have high barriers to entry.”

With a market cap of CA$100 million ($79 million), Ottawa-based CannaRoyalty (CSE: CRZ) is one of the larger companies on the CSE with investments in the United States.

Marc Lustig – CEO of the marijuana-focused investment company – told Marijuana Business Daily that, regardless of the federal policies, the United States “is the largest opportunity and will be for some time.” 

CannaRoyalty has financial stakes in cannabis companies operating in Washington state, Oregon, California and Arizona.

It’s also indirectly involved in Florida, where one of its investee companies, AltMed, agreed to combine its Florida operations with Plants of Ruskin. It’s also looking at Nevada, Massachusetts and Maryland.

“Our whole strategy is surrounding producers with the whole toolbox that they need,” Lustig said. “We’re building a diversified company across different product segments, and across multiple geographies.”

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


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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.

Asia CBD

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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CHONG’S CHOICE CBD – by Diamond CBD, Inc.

PotNetwork Holding Inc. (OTC: POTN) announced that Tommy Chong, counter-culture legend, marijuana legalization advocate and half of the incomparable creative team of Cheech & Chong, has selected its subsidiary, Diamond CBD, Inc., as his partner to introduce a proprietary brand of hemp-derived CBD oil products, under the brand name, Chong’s Choice CBD. Tommy’s brand will include CBD-infused edibles, concentrated solvent-free vaping additives and hemp oil tincture drops. Production of the new line is expected to begin within a month, with immediate online availability. As Tommy’s partner, Diamond CBD will offer the new brand to its distribution channels and assist in overall marketing. Tommy Chong stated, “I use Diamond CBD products and love them. They help me relax and often soothe the occasional pain of an old stoner.” He continued, “I want to be part of this 21st century CBD revolution which promises unprecedented health benefits to millions of people and Diamond CBD has a premier line of products, many of which I am pleased to bring to the market under my brand.”

Gary Blum, Chief Executive Officer, PotNetwork Holding, added, “We are honored to get to work closely with Tommy, and anticipate this partnership will further solidify Diamond CBD as the category leader in beneficial CBD products.”

 

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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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PATIENT UPDATE: The patients in the study had used opioid-based pain medication within the past six months: 97 percent were able to decrease their opiate intake with cannabis, 92 percent said that cannabis possessed fewer adverse side-effects than opioids, 80 percent said that the use of medical cannabis alone provided greater symptom management than did their use of opioids.

Berkeley, CA: Pain patients report successfully substituting cannabis for opioids and other analgesics, according to data published online in the journal Cannabis and Cannabinoid Research.

Researchers from the University of California, Berkeley and Kent State University in Ohio assessed survey data from a cohort of 2,897 self-identified medical cannabis patients.

Among those who acknowledged having used opioid-based pain medication within the past six months, 97 percent agreed that they were able to decrease their opiate intake with cannabis. Moreover, 92 percent of respondents said that cannabis possessed fewer adverse side-effects than opioids. Eighty percent of respondents said that the use of medical cannabis alone provided greater symptom management than did their use of opioids.

Among those respondents who acknowledged having recently taken nonopioid-based pain medications, 96 percent said that having access to cannabis reduced their conventional drug intake. Ninety-two percent of these respondents opined that medical cannabis was more effective at treating their condition than traditional analgesics.

The study’s conclusions are similar to those of several others, such as these herehereherehere, and here, finding reduced prescription drug use and spending by those with access to cannabis. Separate studies report an association between cannabis access and lower rates of opioid-related abuse, hospitalizations, traffic fatalities, and overdose deaths.

For more information, contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “Cannabis as substitute for opioid-based pain medication: patient self-report,” appears in Cannabis and Cannabinoid Research.norml