Patients and healthcare practitioners are often overwhelmed by the wide variety of cannabis strains available to them. With no idea where to. As the cannabis industry matures, consolidates and economies of scale come into play, producers will need to automate their operations, and. While much of the IOM team's efforts focused on reviewing the accumulated scientific evidence of marijuana's medical risks and benefits, the team also charted a.
of Cannabis Healthcare Future
For an opposing view, perhaps the best existing source is a scholarly review that appeared in the Annals of Internal Medicine in During the past two decades researchers have taken important steps toward understanding how cannabinoids exert their effects on the human body.
These advances, summarized in Table Although the marijuana plant represents a rich source of cannabinoids, and of THC in particular, chemists are also synthesizing new versions of cannabinoids with properties that may improve their usefulness as medications, such as increased solubility in water.
In the early s researchers had yet to determine whether THC acted on specific cellular receptors—as it is now known to do—or whether the cannabinoid acted nonspecifically, altering any cell with which it came in contact. The discovery of cannabinoid receptors means that it should be possible to design medicines that target the cells and tissues bearing the receptors.
For example, researchers have found cannabinoid receptors in moderate abundance in areas of the brain and spinal cord that control pain perception and also in peripheral nerve cells, which detect pain sensations on the body's surface.
Perhaps a drug based on THC, which slows nerve impulses when it binds to one class of cannabinoid receptors, or a chemical derivative of that compound could be used to reduce pain sensations along these nerve pathways. On the strength of these findings, along with the results of experiments in animals and a few clinical studies, the IOM study team concluded that cannabinoids hold particular promise as pain relievers.
This is an instance where basic research has played an especially important role in identifying potential new medicines. The opposite is true of evidence that cannabinoids can relieve nausea and vomiting, most of which comes from clinical studies of cancer patients undergoing chemotherapy. Scientists have a great deal to learn about the biological mechanisms that cause nausea and vomiting before they can attempt to identify ways to use cannabinoids to control these processes.
And since highly effective antiemetic medicines already exist, there are far fewer incentives to develop cannabinoid drugs for nausea and vomiting than for other indications, such as pain.
In addition to pain, nausea, and vomiting, the IOM researchers identified appetite stimulation as a promising area for further development of marijuana-based medicines i.
They also noted that some scientific evidence supports the possibility of treating muscle spasticity with cannabinoids but that these findings are neither especially strong nor consistent. For example, published reports fail to make the distinction between reducing muscle spasticity by inhibiting specific physiological processes or simply by relieving anxiety, which is known to exacerbate spastic symptoms.
Even less evidence exists to indicate that cannabinoids might relieve movement disorders, the IOM report states, while noting encouraging results from relevant animal experiments. Although researchers have yet to fully explore the variety of possible indications for marijuana-based medicines, one thing is clear: Marijuana smoke contains many of the same carcinogens and other harmful compounds found in tobacco smoke—agents that pose an even greater threat to people whose health is compromised by disease.
Moreover, as is the case for other herbal remedies, whole marijuana plants contain variable mixtures of active compounds and are therefore likely to produce inconsistent results. Crude marijuana may also contain fungal spores and other potentially harmful contaminants that could pass into the respiratory tract. If there is any future in cannabinoid drugs, it lies in the safe, effective delivery of pure, active compounds. To this end, several researchers and companies are pursuing the development of a smokeless inhaled delivery method for cannabinoid medications.
For example, scientists at HortaPharm B. It is slated for use in upcoming individual trials to test the effectiveness of the extracts in patients with a variety of disorders, using a protocol similar to that recommended by the IOM for short-term trials of smoked marijuana. Researchers have also submitted plans to Britain's Medical Research Council for two double-blind clinical trials to compare the effectiveness of inhaled marijuana extracts with oral THC and placebo.
The first trial is expected to include patients with multiple sclerosis who will test these treatments for their ability to relieve muscle spasticity. The second is a study of postoperative pain relief in patients; it will also include a standard pain medication as a positive control. Both protocols were reviewed and approved, but at the time of writing only the multiple sclerosis trial had been funded. Unfortunately, the very efficiency of cannabinoid inhalers raises the likelihood that they will be abused.
Thus, manufacturers will probably need to build safeguards into cannabinoid inhalers to prevent their use for nonmedical purposes and also to limit the amount of drug the devices can deliver.
These protective features can already be found in medical inhalers used to administer other controlled substances, including opiate painkillers. Concern about possible abuse is but one of several barriers to developing medicines from marijuana or cannabinoids. As described in the previous two chapters, the issue of abuse has far-reaching economic and legal consequences, and the current status of marijuana as a Schedule I controlled substance represents a significant disincentive to both research and commercial development.
Despite these odds, a few scientists and companies continue to pursue marijuana-based medicines. We can take this same path with medical cannabis, potentially inciting less harm to the body. Marrying this concept with emerging technology, such as artificial intelligence AI and big data, affords an even greater level of precision for those who need it most.
The first step to make this concept a reality is overcoming the stigma associated with cannabis. While the perception around cannabis has started shifting from a recreational gateway drug with no medicinal value to one with the potential to improve the lives of those living with chronic or terminal illnesses, cannabis still remains under the label of a schedule I drug by the United States Drug Enforcement Administration.
Schedule I substances are defined as having no currently accepted medical use and a high potential for abuse. To prescribe correctly, physicians need clinical data around proper dosing, formulation and means of administration, as well as intel on how side effects vary among individual patients. The schedule I classification inhibits necessary cannabis research.
To address the desperate need for additional research, many companies have turned to conducting their studies outside the U. This is a major missed opportunity for the United States.
Despite these hurdles, technology is going to play a major role in the personalisation of medical cannabis. In our Cannabics Pharmaceuticals Israel-based laboratory, our researchers are developing a platform that leverages big data and AI to better personalise cannabinoid-based therapies for palliative care and cancer. But while recreational use of cannabis has steadily gained acceptance — it will be legal in Canada on October 17 — its medical use has been more contentious.
Medical cannabis has been legal in Canada since , but the past 17 years have seen contrasting viewpoints and sometimes public spats, all while failing to produce a consensus among medical stakeholders as to its efficacy and, more importantly, its suitability.
As with any debate around healthcare, there are myriad viewpoints among medical professionals about medical cannabis. They say that unlike powerful opioids such as fentanyl, it also carries zero risk for overdose. While Boivin says there is evidence supporting the use of medical cannabis in treating symptoms such as chronic pain and chemo-induced nausea, he cautions that data supporting more widespread use is incomplete.
Earlier this year, the CBC quoted Dr. Jeff Blackmer, vice president of medical professionalism with the Canadian Medical Association CMA , as saying that eight out of every nine Canadian physicians are uncomfortable discussing or providing access to medical cannabis. But while doctors might still be on the fence, producers seem confident that medical cannabis will continue to emerge as a viable health treatment.
It is currently adding between and new patients each week. In late , Aphria signed what has been reported as a five-year deal to become one of the suppliers of medical cannabis to Shoppers Drug Mart. Neufeld says that Aphria and Shoppers parent Loblaw Corp. He has been using medical cannabis for a variety of ailments since his 50s, claiming it has markedly improved his quality of life. Even though they were the first generation to embrace its recreational use en masse, much of that use occurred under a cloud of disapproval from society, the government and lawmakers.
Verbora says Boomers could account for anywhere from 60 to 70 percent of that group, since they are increasingly dealing with the types of medical complaints for which medical cannabis is being prescribed. The debate around the merits of medical cannabis arrives against a backdrop of rising prescriptions for opioids such as fentanyl and oxycodone.
The Future of Medical Cannabis in Canada Feels Good
While the perception around cannabis has started shifting, it still remains under the label of a schedule I drug by the US Drug Enforcement. Aurora Cannabis disagrees with the position suggested by the Canadian Medical Association and promotes working with physicians when using medical. Many of the changes are also affecting the medical cannabis industry on these five medical cannabis industry trends now and in the future.