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Medical cannabis could help long-term effects of COVID-19, says David Nutt

Medical cannabis could play an important role in combatting the long-term health problems associated with COVID-19, says David Nutt, former government drug advisor and professor of Neuropsychopharmacology at Imperial College London.

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“What I find disappointing with the current government response is that we know that the long-term consequences COVID aren’t going to be chronic lung disease, they’re going to be psychiatric problems.

“We’ve already got a massive rise in the number of healthcare professionals, and people who’ve had COVID, with post-traumatic stress disorder (PTSD). We haven’t got very good treatments for PTSD, and cannabis is a potential treatment, particularly nightmares and flashbacks. Why don’t we start trying medical cannabis in these people?”

However, Nutt concedes that there are numerous barriers to overcome before medical cannabis could be used readily, for COVID-19 or any other health issues. 

“Very few people in Britain using medical cannabis are getting it through the NHS or a private prescriber, many are getting it through the black market. That’s unacceptable – people don’t know what they’re getting and are running the risk of a conviction if they get caught,” Nutt says. 

The UK’s medical cannabis regulations are “backwards,” despite the fact it could be the most important revelation in medicine over the lifetime of doctors practicing today, he says. 

Since changing the law in November 2018 to allow specialist doctors to prescribe medical cannabis, the government has “taken away with one hand and given with the other hand, in a series of perverse and bureaucratic hurdles”.

Nutt described the series of changes needed to get medical cannabis to those who need it at this week’s Prohibition Partners online event. 

Since November 2018, no NHS doctor has prescribed cannabis to a patient, which Nutt says is because practitioners have very little independence.

“The NHS is very monolithic organisation,” he says. “Every person in the NHS comes under a spotlight – if a doctor in Cornwall prescribes cannabis, someone in the Department of Health knows about it and questions can be put to bear. This has extinguished individual creativity and thought in doctors.”

Instead, the prescribing of medical cannabis should be opened up to GPs, Nutt argues, because they “see the value” in it. 

“Specialists, by their nature, tend to be more academic, more concerned about doing things differently, whereas GPs are in the real world, they have to help people and reduce suffering.”

More widely, Nutt blames bureaucracy for the lack of progress in the UK with allowing patients access to medical cannabis.

“Maybe part of it is that, reluctantly, patients dragged [the government] into a new world and they’re clinging onto the fact that if we make difficult for long enough people will give up, partly because of bureaucracy, and there’s no coordinated decision-making.”

In March this year the government changed import restrictions to allow patients with prescriptions faster access to medical cannabis. However, Nutt argues that the government needs to liberate imports and import a year’s supply into the UK at a time to allow for continuity.

There are concerns doing so would leak cannabis onto the unregulated ‘black’ market, but, Nutt argues, this market is already saturated and the benefits would outweigh the costs. 

Responsibility for drug control, he adds, should be taken from the Home Office and given to the Department of Health. 

“We’re one of the few countries in the world that divides decision-making about cannabis between two government departments – getting two government departments to agree on anything is very difficult,” he says. 

Nutt argues that medical cannabis will save the NHS money, and that the current cost of not properly prescribing medical cannabis in the UK is driven of bureaucracy. 

“If we liberated importation, got rid of the scheduled two status and maybe make it schedule four, if we had a rational approach to the regulation and stopped being so hysterical and fearful about it, it would halve the cost. There’s so much cost involved in importation and regulations.”

Nutt is chair of the Drug Science’s Medical Cannabis Working Group, comprising stakeholders from patient organisations, academics and industry members, with the remit to develop and research and policies for the UK. 

Last year, Nutt set up TWENTY21, which has since published a number of policy documents, including one looking at clinical approaches to prescribing medical cannabis, and a pending report looking at potential dependence of medical cannabis compared to recreational cannabis use. The group is also developing teaching materials for doctors. 

“We’re aware that most doctors don’t have an understanding of cannabis medicines,” Nutt says, who have spent years “vilifying them as dangerous drugs that cause psychosis and dependence”.

“Getting doctors to change from that prohibitionist view is challenging, and the way to do it is to educate them, which is difficult, but less difficult than educating med students.”

Nutt has set up groups of medical students in different medical schools to educate doctors on medical cannabis. 

Also, last year Nutt launched the project TWENTY21, an initiative of prescribing medical cannabis for anxiety disorder, chronic pain epilepsy, MS, PTSD, substance use disorder and Tourette’s syndrome, overseen by academic experts working voluntarily, who are collecting data on the treatments. 

“Let’s see if we can get prescribing set up in a way which is useful in terms of gathering data and monitoring potential harms of these drugs, and hopefully it’ll assuage some of fears of psychosis development and dependence,” Nutt says. 

There are currently 7,000 people signed up to the registry, and Nutt aims to get 20,000 patients signed up by the end of 2021. They each pay £150 per month, which is estimated to be what they’d be paying through the unregulated market. 

Researchers will collect data about their quality of life and self-reported outcomes, and can follow patients up for up to two years. 

“One of the things that became clear when talking to patients who use medical cannabis is that they find it very helpful but doctors aren’t interested in what they think. We think patients should be driving this,” Nutt says. 

The registry has built a network of independent prescribers, and has trained 15 doctors so they can prescribe “in a sensible, evidence-based way,” Nutt says.

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Feature

How CBD lube is heating things up in the industry

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The CBD wellness industry is booming, so it was only a matter of time before cannabidiol slipped between the sheets.

The American market is overflowing with lubricants and intimacy products to help couples spice things up in the bedroom, but the trend has so far been relatively slow to catch on in the UK.

Although much of the research is anecdotal, many fans have touted its benefits, which are said to include reducing pain and anxiety during sex, increasing arousal and boosting the intensity of orgasm.

This side of the Atlantic, UK CBD producer Medivita is one of the first companies to catch on to its potential.

They teamed up with Sam David at Bnatural to launch their first lubricant earlier this month, after noticing a boom in the adult toy industry during the coronavirus lockdown.

“During lockdown, we were discussing which industries were succeeding, and the two that were performing the best were alcohol and adult toys,” Medivita director, Mike Peates told Cannabis Health.

“We saw CBD lube as a product which had to come to the UK.

“It’s a little bit different to what’s on the market at the moment. There’s a lot of cosmetics and skincare out there but only one other lubricant in the UK, so if people want CBD lube they have to import it from the States.”

Since having the idea Mike has learned how the lubricant can help women experiencing issues such as vaginal pain, dryness and irritation.

It is particularly beneficial for those with gynecological conditions such as endometriosis and vaginismus, where the vaginal muscles automatically tighten up whenever penetration is attempted.

CBD is thought to decrease inflammation, increase blood flow and help with muscle relaxation, which means it could provide welcome relief for those experiencing pain during intercourse.

One woman, who lives with both endometriosis and vaginismus, is Laura, 29, who chronicles her health journey through Instagram account The Endo Monologues.

She first tried US brand Foria – which is renowned for its products aimed at improving women’s health – in 2019.

Now Laura claims CBD lube has allowed her to enjoy having sex again.

“My boyfriend and I use CBD every time,” she said.  “It helps the blood flow and reduces pain internally and around my vulva, so I can enjoy sex as opposed to finding it a really painful experience.

“I’m at a point now where I can have penetrative sex and it doesn’t hurt, which is a huge thing that hasn’t happened for a long time.”

Laura vapes CBD and applies the lube 15 minutes before the couple plan to have sex.

She explained: “There’s a warming sensation and you can feel the blood flow increasing, so there’s also that element to it, but for me, it’s more about the fact that it relaxes my muscles and it makes it less painful.

“Sometimes it’s still uncomfortable but it’s definitely helped me to overcome the fear of it hurting.”

She added: “When you live with any chronic illness which affects your ability to have sex, it really takes a toll on your mental health.

“I don’t think I’d be having sex at this point if it wasn’t for CBD. I think it’s something I would still be trying to overcome.”

Mike who has been in contact with Laura since the launch of Medivita’s lube, is now offering discounted rates to followers of The Endo Monologues who live with endometriosis.

But you don’t necessarily need to be experiencing pain and inflammation for CBD lube to boost your sex life, as wellness journalist Ruby Deevoy discovered.

She was initially dubious about trying The Tonic Clit Spritz with her partner recently but found it helped get her in the mood.

“I was pleasantly surprised by how effective it was,” she said. “I’m generally pretty dubious about putting anything on my easily-irritated nethers, so I was a little nervous when I read that this particular lube contained terpenes found in Tea Tree, Eucalyptus and Menthol.

“But I needn’t have been, it was extremely gentle and barely noticeable when first massaged in.

“The inclusion of these extracted terpenes, plus the 100mg CBD made for heightened sensitivity in the best possible way.”

Ruby added: “It’s hard to completely relax and enjoy sex with a three-year-old sleeping next door, but the CBD lube helped amplify sensation and as a result, keep my awareness wholly on the task at hand.

“It’s definitely a product I’ll be using again. In all honesty, it was the best sex I’ve had in quite a while.”

However, Ben Hofmeister, founder of UK CBD brand Kokora warned not to get too carried away.

“As CBD is a potent, natural anti-inflammatory, in the right context it can help reduce inflammation pain, and due to Endocannabinoid receptors being present throughout the female reproductive tract, it can heighten female senses,” he said, while recommending sticking to a natural coconut-oil base.

“CBD is also well known for supporting the processes to reduce stress and anxiety including promoting the production of Anandamide, commonly known as the ‘bliss’ molecule.”

He added: “I think a CBD lube can help, but I don’t think it should be relied upon.”

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“If only my uterus could talk”: The story behind The Endo Monologues

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The woman behind unflinching Instagram page The Endo Monologues talks to Cannabis Health about battling to get a diagnosis, using her platform to help others – and why she shouts about CBD at any opportunity.

Laura – as she’s known to her followers – asked me not to reveal her surname as she prefers to remain anonymous.

It might seem odd for a social media star with almost 6,000 followers to shy away from the limelight, but it’s not Laura they’re there for – it’s Patricia, her angry uterus.

The 29-year-old, who has endometriosis – a chronic condition where tissue similar to the lining of the womb starts to grow in other places and reacts with the menstrual cycle each month – launched her Instagram account The Endo Monologues at the turn of 2020.

It came about after a few too many drinks on New Year’s Eve (as all good ideas do) and an upsetting incident at work where a colleague assumed her bloated stomach was a baby bump.

“When I have a flare I bloat and it tends to look as if I’m pregnant,” says Laura.

“I thought, that is a really offensive question. I was telling my friends about it at the pub and I said ‘if only my uterus could talk’.

She adds: “After a couple too many, I announced I was going to start a blog from the perspective of my uterus.”

The satirical diary of a woman and her reproductive organs as they battle endometriosis, adenomyosis, vaginismus and vulvodynia was born.

Endometriosis is the second most common gynecological condition in the UK, affecting around one in 10 UK women – although frequent misdiagnosis and a lack of understanding and awareness mean this figure could well be higher.

Symptoms include pain, nausea, intense fatigue and in some cases infertility – with sufferers experiencing heavy, excruciatingly painful periods, and many like Laura being completely debilitated by their menstrual cycle each month.

It takes an average of seven and a half years to get a diagnosis. Laura battled for around a decade before she got hers.

“I started my period when I was 11 and they would last two or three weeks at a time, but my mum and grandmother all had a similar experience so it was just perceived to be normal in my family,” she says. “I just pushed it to the back of my mind.”

Over the years medics dismissed her as just having ‘bad periods’, but by her early 20s they were leaving her bed-bound each month, she was missing university and it was becoming painful to have sex.

Still, Laura says she wasn’t taken seriously, with one doctor suggesting it was a result of her ‘being promiscuous’.

Others ran tests which appeared to come back clear. All returned with the same conclusion – she just had heavy periods.

It wasn’t until a routine check-up for the contraceptive pill where a nurse mentioned a note on her file of suspected endometriosis.

“I had absolutely no idea what she was talking about,” remembers Laura.

“After that, I was rushed through and referred to a gynaecologist.

“In August 2016, I had a laparoscopy and there was endometriosis on both my ovaries, bowel, bladder and my pouch-of-Douglas and it was stage four – so really deep infiltrating endometriosis.”

In January 2019 Laura travelled to London to visit a stockist of the US brand Foria, which is renowned for its products geared towards supporting women’s health.

“I don’t like taking painkillers and I had smoked cannabis before in Amsterdam and it had helped with my symptoms, so I thought I’ve got nothing to lose at this point,” she says.

“I ended up buying the CBD lube and a vape.

“In the last year I’ve started to explore more CBD products and I’m actually at a point now where I barely ever take pharmaceutical painkillers, I can rely completely on CBD.”

Laura now takes around 30-40mg a day – upping her dose if she’s having a particularly bad pain flare – and uses balm and muscle cream on specific areas.

Meanwhile, CBD lube has allowed her to have penetrative sex with her boyfriend again.

“I have vaginismus [when the vaginal muscles automatically tighten up whenever penetration is attempted] that came as a consequence of having really negative experiences with pelvic exams, so not only did it hurt to have sex, but I was also involuntarily tensing,” Laura explains.

“We use CBD lube every time now and for the most part it relaxes me, I can actually enjoy having sex.”

Laura’s boyfriend, who she has been with for most of her post-diagnosis journey, is one of the few people who know about her secret internet identity.

The Endo Monologues, which began as a personal wellbeing project, is now a place thousands of fellow sufferers turn to for advice and a sense of community.

“It just exploded – the fact that I’m now near to 6000 followers just absolutely blows my mind,” she says.

“It’s helped my wellbeing tremendously but it’s also really connected me to other people. I’ve made some really lovely friends and get messages every week from people thanking me.”

Laura continues: “I feel very privileged that people trust me and ask for my advice because there’s a lot of misinformation out there.

“I feel like it’s my responsibility now to spread awareness and make sure people get the right support and education.

“It’s not just a wellbeing project for me anymore, it’s a port of call for people to get information and that’s something I feel really strongly about.”

Laura also uses her platform to share recommendations and reviews of her favourite CBD products, with brands queuing up to feature on her blog.

“I never expected to have so many companies contacting me,” she says.

“I have become really passionate about it because it’s made such a difference to my life. CBD means I can function on a day to day basis. If I forget to take it for a day or two, I literally can’t get out of bed.”

And she’s the first to admit she will mention it at any given opportunity.

She laughs: “Whenever I get asked for recommendations I’m just like ‘have you tried CBD?’”

Find Laura at www.theendomonologues.com and on Instagram @theendomonologues

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Slow and steady wins the race – a Q&A with the CBD Sloth

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Tom Bourlet – aka the CBD Sloth – tells Cannabis Health how his award-winning blog became the go-to place for those wanting to know more about CBD.

Tom Bourlet has only been using CBD for 18 months, but his blog the CBD Sloth is renowned for helping people find the right product for them.

It won the Media of the Year award at the Cannabiz Summit in Malta just six months after it launched in early 2019 and Tom was invited to be a judge in the CBD category at the Men’s Health awards.

Here he reveals how much the industry has changed in such a short space of time – and what he’s learned so far along the way.

Tell us a bit about you, what’s your background – and do you have a ‘day-job’?

As well as CBD Sloth, I have worked in marketing for a decade now and outside of the CBD world, I’ve been writing my travel blog www.spaghettitraveller.com for seven years.

How did you discover CBD?

I was doing some freelance work with a beauty brand that was considering launching some products that would contain CBD. I didn’t know much about it at the time so I began researching.

I became transfixed with the potential of cannabis and how it was being used to help people with various ailments. But I was also frustrated by the limited levels of regulations in place and felt nervous to try CBD oil, with negative stories coming from brands that didn’t have high standards. I even found a few CBD brands that refused to provide their lab reports – which would hint that they might have lower levels of the cannabinoids they’re stating, they could have pesticides present in the oil or they might not even have a lab report to show.

Why did you set up the blog?

I wanted to provide a place where people could quickly check whether the brand provided lab results and what the certificate of analysis showed, a place where the brands were held accountable and where I could offer real, genuine advice without an ulterior motive.

I still think there needs to be a greater level of transparency from brands. Every time I talk with a brand I’m reviewing, I try to offer advice if I don’t feel their website is offering everything the customer needs to know.

Did you feel people should have somewhere reliable to turn to for advice?

CBD products cost such a large amount of money and people are putting their trust in these brands. When I review products or where I list the best CBD brands, I’m not basing my opinion on anything commercial, I’m basing it on how well it worked for me and whether I feel they’re providing the best quality product at the right price.

I have found that paying a higher price doesn’t necessarily mean a higher quality of product. Some brands overprice their products and call them ‘premium’ without any real differentiation.

How has CBD helped you?

Before CBD, it used to take me around 40 minutes to fall asleep at night. I’m not going to say I fall asleep the moment my head hits the pillow, but it now takes around three to five minutes. CBD isn’t sleep medication, it doesn’t make you tired or drowsy, but it completely alleviates any stress or anxiety in my mind, which allows me to drift off without a million thoughts going through my head.

Are you surprised by how much the blog has taken off?

Surprised would be an understatement! It is becoming increasingly clear that there are a huge amount of people asking questions around CBD and predominantly landing on brand pages, which are trying to sell to you, so I loved offering an unbiased viewpoint and sharing my experiences with others.

It has been an amazing journey and I’m keen to see where it takes me in the years to come – the website traffic has doubled in the last three months alone.

What have you learned since you started out?

There is a real community feeling within the CBD industry. CBD brands are not all started by entrepreneurs trying to make a quick buck, but are often set-up by people trying to find a solution to a health issue they or someone close to them has.

I’ve also learned that brands will mix CBD into anything. I’ve tried CBD coffee, tea, gin, rum, honey, brownies, flapjacks, chai latte and chocolates. I’m not sure what’s next but I’m always guaranteed an occasional surprise.

I’ve recently begun learning more about the other cannabinoids present in cannabis, of which they all have their own set of benefits and potential uses as treatments, but we need a lot more test studies into them in order to fully understand their potential. CBG is probably the fastest-growing behind CBD – I can see CBG oil being a huge seller in a number of years.

Find Tom’s blog at https://www.cbdsloth.com/

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