By Owen Smith
In the last article I explored some of the many cannabis products emerging from the inventive and inspired medical cannabis community. The collective ingenuity of cannabis focused organizations continues to improve this vital health service for terminally ill patients. Clubs like the CBC of C in Victoria represent over a decade of the pooled skills and resources needed to competently manage a high quality, affordable selection of cannabis products. With an ever increasing number of people finding relief from this medicine, it is equally important to provide education on how to best utilize it.
As discussed in detail in previous articles, Health Canada’s MMAR program has continued to fail in the task of providing a sufficient supply of diverse, high quality, affordable cannabis medicines to those in need, and forcing their patients to smoke or eat raw plant material. Recent proposed changes to the regulations did not include the refinement of raw cannabis into any form, regardless of the health benefits attributed to these alternatives.
Cannabis treats such a wide variety of conditions that a single method of treatment isn’t always suitable. Smoking cannabis is short lasting and wasteful, as well as exposing patients to potential harms that come with inhaling burnt plant matter (vaporizing helps to avert these health concerns, also). Eating cannabis is essential for individuals who cannot smoke due to compromised lungs or who cannot afford to buy the buds due to black market prices driven up by the risks associated with prohibition. Eating is effective over a longer period of time and uses ordinarily wasted material, such as stalk and leaf, and reduces costs. Topical application can assist patients for whom smoking and eating cannabis are not feasible options as “the top side of cannabis leaves are coated with thousands of microscopic thorns, and these sometimes cause minor intestinal irritation, even after grinding.”[i] Patients who have no desire to experience full body effects from taking cannabis internally can choose to localize their relief by applying cannabis through the skin. The fat soluble cannabinoids, soaked in vegetable oil, create a simple and effective lotion.
MMAR applicants for whom smoking is inappropriate are not given adequate information on how to properly prepare and use cannabis medicinally. This leads to unnecessary harms for patients learning unhealthy practices from recreational smokers, like how make overly strong edibles. By utilizing the simple techniques and proportions detailed in “the official CBC of C recipe book” online, the cannabinoid rich trichomes can be refined into a plethora of edible and topical products specific to the needs of each patient.
Recently, The Greenline Academy in Kelowna has stepped up to teach MMAR applicants how to navigate the government system, providing “information on the legal possession, consumption and production of medical marijuana though seminars, consulting and courses.”[ii] Health care professionals can now learn about the medical properties of cannabis through the Canadian Consortium for the Investigation of Cannabinoids that offers free accredited online courses through McGill University. Hempology has been broadcasting a free online non-credit lecture series from the University of Victoria for four years, covering a vast spectrum of related topics.
For over a decade, cannabis clubs/dispensaries in Canada have been independently rising to meet the needs of the sick and vulnerable in their communities. The recently formed Canadian Association of Medical Cannabis Dispensaries aims to create “a high standard of care through education, research and the promotion of best practices”[iii]. This co-ordination will help to incorporate the vast knowledge of dispensary owners, and improve the overall health care services they provide.
Among the primary advantages to being a member of a medical cannabis club, is access to a variety of strains distinguished on the scale between dominant sativa and indica varieties. While most people are made aware of this distinction in the cannabis they smoke, few are taught to know this division in the edible product selection. At the CBC of C we make a range of edible products that offer effects on a similar scale from sativa (day) to indica (night). We do this by infusing different parts of the plant into our vegetable oils.
Every medical cannabis user should have the option of either a stimulating experience suitable for daytime activity (sativa), or a sedating experience better for bedtime (indica). This difference is embedded in each plant’s diverse chemistry—its cannabinoid profile. Sativa plants are commonly high in THC and CBN (formed by degenerating THC) and low in CBD; Indica plants can be high in THC but with a higher concentration of CBD. THC is the most commonly found cannabinoid and its action produces the psychoactive “high” as well as being analgesic, anti-spasmodic, anti-tremor, anti-inflammatory, appetite stimulant, anti-emetic[iv], and more. Cannabidiol (CBD) is the cannabinoid responsible for many of the plants relaxing effects—sedative, anxiolytic (anti-anxiety), anti-inflammatory, anti-convulsant, anti-psychotic, anti-oxidant, neuroprotective, and immunomodulatory.
When a new member is signing up at the CBC of C, they are warned that individuals with a history of heart conditions or anxiety should avoid sativa dominant cannabis because of the potential for increased heart rate, rapid breathing, and anxiety attacks. They are then advised on how to find the indica products that help to reduce the potential for an uncomfortable experience. A 2010 The Nature of Things episode with David Suzuki, titled “The Downside of Getting High” explores these problems, asserting that cannabis grown for recreational purposes is found to contain increasingly high levels of THC and little CBD. Opposed to this trend, cannabis dispensaries commonly encourage their growers to provide indica strains containing higher amounts of CBD and provide products made from the “leaves [that] usually contain a higher percentage of CBD than THC”.[v]
Ironically, doctors continue to prescribe synthetic THC without CBD under the names Marinol, Dronabinol, and Nabilone. With the recent introduction of Sativex, Bayer Pharmaceuticals has conceded to the medical community that “The CBD:THC formulation is believed to enhance the therapeutic benefits of THC while modulating the unwanted psychotropic and other THC-related side effects.”[vi] A new study by Jose A. S. Crippa and a team of Brazilian investigators confirms that symptoms of Social Anxiety Disorder (SAD) can be reduced by treatment with CBD. “These results suggest that CBD reduces anxiety in SAD and that this is related to its effects on activity in limbic and paralimbic brain areas.”[vii]
These findings reinforce the need for a refined method of selecting cannabis that takes into account patients who have pre-existing mental health or heart conditions. The kind of uncomfortable experiences that sometimes accompany the smoking of recreational cannabis can be reduced by giving patients the option to choose a CBD rich bud, massage oil, or cookie.
As medical cannabis expertise expands, more interesting alternatives to smoking emerge. Medical Marijuana Inc. is a California company intent on removing the euphoria and “high” feeling with a brand of “THC Free [Cannabinoid] water which has all of the additional 500 plus natural benefits less THC”. The “beverages will be marketed throughout similar distribution channels as bottled drinking water [...] so as to be readily available to the general populace in the next few months.”[viii]
As politicians pander pothead cliches, science is advancing the discourse with this plant medicine into new and unexpected places. A United States Health Department Patent states “one CBD benefit is to reduce DNA damage due to free radical species, anti-aging of neural, CNS, COPD, and other cellular targets.”[ix] In studies of neurodegeneration related to Parkinson’s disease “data indicated that these neuroprotective effects might be due, among others, to the antioxidant properties of certain plant-derived cannabinoids”[x]. In preliminary trials it is established that “CBD may be effective, safe and well tolerated for the treatment of the psychosis in PD.”[xi]
ProjectCBD.org is a non profit educational service dedicated to promoting and publicizing research into the medical utility of CBD and other components of the cannabis plant. Keep track of the exciting discoveries on the cutting edge of medical science in their online CBDiary.
While there are close to seventy other cannabinoids that are known to have therapeutic effects, CBD is quickly becoming the second (to THC) most commonly considered compound in the plant. These studies confirm what medical cannabis clubs have long purported to be the benefits of whole plant cannabis medicine. By continuing to provide education and access to this dynamic, and much needed medicine, the cannabis movement is riding a scientific high into more defined and diverse horizons.
[i] ‘The New Prescription – Marijuana As Medicine’ Martin Martinez M.D.
[v] The New Prescription – Marijuana As Medicine’ Martin Martinez M.D.
[vii] Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report http://jop.sagepub.com/content/25/1/121.abstract
[ix] “Cannabis as Antioxidants and Neuroprotectants” http://tinyurl.com/6hwwmt
[x] Cannabinoids provide neuroprotection against 6-hydroxydopamine toxicity in vivo and in vitro: relevance to Parkinson’s disease. http://www.ncbi.nlm.nih.gov/pubmed/15837565?dopt=Abstract