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Choosing the right CBD for you

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In an exclusive extract from her new book, The CBD Book: The Essential Guide to CBD Oil, medical cannabis journalist Mary Biles offers guidance on making the right choice for you.

I used to be a cigarette smoker, but gave up after reading Alan Carr’s hefty tome, The Easy Way To Stop Smoking. For most of the book, the reader is encouraged to continue smoking.

However, by about halfway through, you’re desperate to stop, if only to shut dear Alan up. I can imagine right now you may well be feeling the same, as all you really want to do is learn how to buy a decent CBD oil.

So, let’s get on with it, shall we?

First things first, don’t be afraid to shop for CBD oil online. Many of us struggle to trust companies selling health products online, thinking them somehow less reputable than retailers on the high street. However, with CBD, this isn’t generally the case.

When CBD oil hit the scene five or so years ago, no high-street shop would touch it with a barge pole.

Those early CBD companies could only be found online and because they were incredibly passionate and knowledgeable about CBD’s health potential, they knew their products inside out.

So, while they couldn’t give medical advice, they would go the extra mile when it came to customer service.

Overall, this level of expertise and customer service continues today when you buy CBD oil online. Unfortunately, the same

cannot be said for the high street, where staff in supermarkets and chemists often know very little about the CBD products on sale.

Not only that, buying from the high street is no guarantee of superior quality products. In 2020, CBD sold in a well- known pharmacy chain was found to contain no CBD at all, while products from a popular health-food store had less CBD than labelled and above the legal limit of THC.

DON’T BE FOOLED BY CBD MARKETING TRICKS

That said, without the right tools and knowledge, buying CBD online can feel utterly overwhelming.

Logic would suggest that the CBD companies nearest to the top on Google must be the best. Sadly, this is not necessarily the case. I’m not knocking the CBD guys rocking the Google rankings, but most of them will have employed some nifty techniques to optimise their online content so it ranks highly on Google.

One shady technique sometimesused is setting up fake ‘impartial’ CBD oil review sites that miraculously link back to a company’s own CBD products.

Also beware of any list articles claiming to review top ten CBD oils for pain or anxiety.

There is no way of saying whether one product is better than another for specific health conditions, and CBD companies have invariably paid to have their product mentioned with a backlink to their site.

A key reason CBD companies employ these tactics is to get round the regulators like the MHRA and FDA banning them from making medical claims.

So while you may be yearning to find informative articles about whether CBD will cure your migraines, if a company says so on their website, you should immediately be suspicious of their credibility.

BUYING CBD – START BY FINDING A TRUSTWORTHY CBD COMPANY

Choosing which company to buy your CBD oil from is a bit like looking for a new love interest on a dating app or website.

If you don’t set up crucial key criteria, you will be inundated by offers of varying quality.

In CBD terms, here are a few criteria you should consider:

Organic

Whether for wellness purposes or to help treat symptoms of a health condition, it’s important to make sure the CBD oil you take is organic certified whenever possible.

Why is this important? As well as providing us with the wonders of CBD, hemp can also remove heavy metals and radioactive toxins from polluted soil through a process called phytoremediation.

So imagine if the hemp used to make your CBD oil was grown on contaminated land. Thanks to hemp’s soil-cleaning powers, your CBD oil would be brimming with heavy metals and goodness knows what other toxic nasties.

So, make sure you choose a company selling CBD oil made from organic certified hemp. If the products aren’t organic, insist on seeing a certificate of analysis showing they are free from heavy metals, pesticides etc.

Transparency and Traceability

My introduction to the CBD industry came through a CBD company that controlled the whole CBD production process from seed to shelf (they grew, extracted, packaged and sold their own CBD oil).

This is of tremendous benefit to the consumer, as with minimum links in the chain, it gives total traceability, greater transparency and less room for substandard products.

Because domestically grown hemp flowers cannot be used to make CBD oil in the UK, most British CBD companies source their CBD oil from mainland Europe or the United States.

Perhaps they go straight to the farmers, or increasingly they might buy through a wholesale middleman.

There is nothing inherently wrong with this as long as every step is traceable.

So ask yourself: how transparent is the company about where they source their CBD from? If in doubt, reach out to them and ask directly

Value for Money

CBD is expensive, especially if you’re taking it on an ongoing basis for a chronic illness.

That’s why before you buy it’s good to do a bit of homework comparing CBD oil prices.

Just divide the price of comparable CBD products by the number of milligrams they contain and, hey presto, you get the price of CBD per milligram.

Make sure though you’re comparing like with like. For instance, there’s no point comparing the price per milligram of a water-soluble product with a standard CBD oil, as the water soluble is always going to be more expensive.

At the cheaper end of the market, some CBD companies offer CBD oils at around £0.025 per milligram, while some of the well-known American CBD products can cost as much as £0.19 per milligram; that’s almost eight times the price.

However, there seems to be a well- trodden middle ground at around £0.08 per milligram, occupied by the more long- standing UK CBD companies.

So if in doubt, use this as a guide price.

An Informative Website with No Medical Claims

You can glean a lot about a CBD company from its website. If any medical claims are made about their products, warning bells should immediately ring, even if they’re referencing scientific studies to back up their claims.

The MHRA has been very clear in their message that CBD cannot be said to cure or even alleviate the symptoms of any health condition.

There should also be a detailed description of each product on sale. It’s not enough to say: ‘Hemp oil, hemp paste (leaf and flower),’ as in the case of a brand of CBD oil sold by a well-known health-food store.

I would like to see not only how much CBD is in each product, but also what other cannabinoids are contained, plus, if possible, a detailed description of any terpenes.

This should all be backed up by a valid, up-to-date certificate of analysis (COA), traceable to the CBD product you are buying, and detailing not only what’s in the oil, but what is not present, such as heavy metals, mould and pesticides.

Good Ratings on Peer Review Sites

Once upon a time you could find glowing testimonials from satisfied customers on CBD websites, waxing lyrical about the amazing health-giving benefits of their products.

Since the MHRA got involved and banned the use of testimonies on CBD websites, most companies encourage customers to write reviews on sites like Trustpilot.

The good news is that CBD companies have no control over whether customers write positive or negative reviews, and once they’re public, there’s nothing they can do to take them down.

Comments usually cover good or bad customer service, as well as sharing personal CBD success stories.

Either way, you can be fairly certain that if a company has mostly four or five stars from thousands of customers, they’re doing something right.

The CBD Book: The Essential Guide to CBD Oil by Mary Biles (£12.99, HarperNonFiction) is out now.

Industry

France set to launch landmark medical cannabis trial

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The French Agency for the Safety of Medicines and Health Products (ANSM) has revealed the suppliers for the trial.

A first-of-its-kind medical cannabis pilot is expected to launch by the end of March 2021. Cannabis Health speaks to one of the companies recently selected as an official supplier.

This week, the French Agency for the Safety of Medicines and Health Products (ANSM) revealed the companies that will supply cannabis products for a landmark medical cannabis trial.

Four main suppliers from Australia, Canada, Israel and the UK will partner with French pharmaceutical distributers to provide a total of nine cannabis-based medical products for up to 3,000 patients. With no funding from patients or the French government, the participating companies will have to cover the production and distribution costs themselves.

Taking place over a two-year period, patients with one of five medical conditions, including chronic pain, epilepsy, oncology and spasticity will be eligible for the pilot.

Physicians, nurses and pharmacists will be selected for the programme and will undergo special training for issuing and dispensing medical cannabis prescriptions to patients.

The concept of the trial was first suggested in 2018 when the ANSM brought together a committee to consider the feasibility of making medicinal cannabis available to French patients.

Over the past two years, the French government has been accused of dragging its feet in putting the pilot in motion, however after finally opening applications in October 2020, the long-awaited trial is set to commence by the end of March 2021.

Aurora Europe, a subsidiary of Canadian company, Aurora Cannabis Inc., has been selected to provide the entire supply of cannabis flower for the trial, which includes three types: high-THC, balanced THC to CBD and high-CBD flowers.

Photo: Aurora Europe

 

Aurora’s Managing Director for France, Hélène Moore, told Cannabis Health: “This is what we wanted, we decided to offer the product for which we are already a leader in Europe. We went for what we do well, and we won all the [flower] lots; we were very proud of that.

“It really shows how we have mastered the art of growing pharmaceutical-grade medical cannabis.”

Cannabis flower is a difficult product to develop when it comes to medicinal cannabis. Ensuring that the plant contains the same concentration of cannabinoids from batch to batch can be challenging and relies on precisely controlling the growing environment.

“All of our cannabis is grown indoors where every single variable that you can think of for growing a plant is controlled to the [letter] and it takes a long time to get it right.

“You need to have it validated, you have to demonstrate to the authorities that you can do the same batch after batch and we have done that.”

At the end of the pilot, the French government will decide on permitting the use and sale of medical cannabis products, however Moore stresses that the pilot’s purpose is not to test the efficacy of cannabis-based medicine.

“The intention is really to test the distribution system, to test prescribers; the whole machine. The pilot is not a clinical trial, and this has to be very clear.” Moore added.

“What’s going to be assessed is the feasibility of putting together a larger scale medical cannabis programme for patients in France.

“If this pilot is successful, and there’s not like big roadblocks, the understanding is that they will generalise the offering of medical cannabis to a larger scope of patients.”

Although participating companies are not offered any guarantee as to whether they will continue as official suppliers after the trial, Moore says Aurora’s intention is to continue working with French stakeholders and be “part of the equation in the long run”.

Photo: Aurora Europe

“Our partner is well established, they want to get into this market, and we will do this together,” Moore said. “Now we have a partner that knows how to do things in France, our goal is to extend the relationship from a post-pilot perspective.”

In addition to the four main suppliers, French authorities also selected a number of substitute suppliers to cover any gaps.

Another Canadian company, Tilray, will supply two sublingual oils as a main supplier and two types of flower as a substitute.

Meanwhile, Israel’s largest manufacturer of medical cannabis, Panaxia, will supply four products, two as a main supplier and two as a substitute. In partnership with Neuraxpharm, the company is providing two cannabis-based oils in various doses of THC/CBD and two types of sublingual tablets.

Deemed a “huge success” for the company, Panaxia’s CEO, Dr Dadi Segal believes the trial is the first step towards France becoming one of the world’s “most advanced medical cannabis markets”.

Dr. Malgorzata (Gosia) Meunier, VP Innovation at Panaxia, added: “Being personally linked to France, I’m especially proud that Panaxia will participate in this prestigious experiment and provide a response to the enormous need of patients in France […] this is an amazing regulatory achievement for us.”

The Australian company Little Green Pharma will be a main supplier for two CBD-dominant sublingual oils and a substitute for a balanced CBD-THC oil.

Other substitute suppliers include Australia-based, Athlea, and UK-based independent cannabis company, EMMAC Life Sciences Group, which will supply two types of orally administered cannabis medicines together with Paris-based distributor, Boiron.

CEO of EMMAC, Antonio Costanzo, hopes the company’s involvement with the trial will “advance the industry’s understanding of the benefits of medical cannabis”.

Due to the country’s strict regulations surrounding cannabis, none of the chosen suppliers are French companies, however partnering with a French distributor was mandatory for all participants. Moore believes that involving the existing pharmaceutical ecosystem could be a key factor in the success of France’s future cannabis sector.

“This is really unique. There are no other countries in Europe that have made that distinction. I think this is something that could provide a key success factor for France in the long run.”

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Industry

‘Godfather of Canadian cannabis’ to advise European producer

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Chuck Rifici currently serves as executive chairman of Feather Company

Industry heavyweight, dubbed the ‘Godfather of Canadian cannabis’, Chuck Rifici has joined the board of one of Europe’s newest medical cannabis players.

Founding partner of UK-based Integro Medical Clinics, Eurox Pharma, plans to begin commercial production of cannabis based products in early 2021. 

Canadian entrepreneur Rifici, who currently serves as executive chairman of Feather Company and co-founder of Canopy Growth Corporation and the Auxly Cannabis Group, will bring several years of expertise to the advisory role, as the firm sets out to become a major player in the medical cannabis market over the next five years.

Chuck Rifici has joined the advisory board of Eurox Pharma

Founded in 2019, it will produce a range of cannabis-based pharmaceuticals and products in Bensheim, Germany.

Its 10,000 sq meters manufacturing plant was certified as a fully GMP facility in October 2020, with the potential to manufacture 50 tonnes of product at full capacity. 

Rifici, who previously served on the board of directors at Aurora Cannabis Inc, The Supreme Cannabis Company, Origin House and Meta Growth Corp, joins Amy Peckham, CEO of Etain Health, USA, and Michael Reckeweg, Chairman of Dr. Reckeweg & Co, on the advisory board. 

The organisation is backed by cutting-edge research and together with its partners has a global distribution network.

In addition to its’ German operations Eurox is a founding partner in the cannabis medicines based Integro Medical Clinics Limited in the UK with leading British pharmaceutical company IPS. 

Eurox was founded by ex-Deutsche Bank senior executive, Neil Smith, Bernhard Babel, ex- Partner at McKinsey & Co and David Reckeweg-Lecompte, CEO of Dr Reckeweg & Co, a 75 year old pharmaceutical company producing plant-based medicines in Germany. 

“We are absolutely delighted to welcome Chuck, an industry legend to our organisation,” said co-CEO Smith.

“The experience and advice he will be able to offer us as a new player in the European cannabis pharmaceutical market will be invaluable. It is our goal to see Eurox as a major independent player in this market within the next three to five years. 

“The market has massive growth potential which we intend to embrace and exploit.”

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Health

Over half of Parkinson’s patients report benefits of cannabis

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The German Parkinson Association says their is a growing interest in medical cannabis among Parkinson's patients

More than half of patients with Parkinson’s disease who consume cannabis have found it to be beneficial, according to a German survey. 

Over eight percent of patients with Parkinson’s disease reported using cannabis products and more than half of those (54 percent) reported a beneficial clinical effect, according to results published in the Journal of Parkinson’s Disease.

Cannabis products containing THC can be prescribed in Germany when previous therapies are unsuccessful or not tolerated, and where cannabis can be expected with not a very unlikely chance to relieve disabling symptoms. 

CBD is available without a prescription from pharmacies and on the internet.

“Medical cannabis was legally approved in Germany in 2017 when approval was given for therapy-resistant symptoms in severely affected patients independent of diagnosis and without clinical evidence-based data,” explained lead investigator Prof Carsten Buhmann, Department of Neurology at the University Medical Center Hamburg-Eppendorf.

“PD patients fulfilling these criteria are entitled to be prescribed medical cannabis, but there are few data about which type of cannabinoid and which route of administration might be promising for which PD patient and which symptoms. 

“We also lack information about the extent to which the PD community is informed about medicinal cannabis and whether they have tried cannabis and, if so, with what result.”

Investigators assessed patient perceptions of medicinal cannabis, as well as evaluate the experiences of patients already using cannabis products.

They performed a nationwide, questionnaire-based survey among members of the German Parkinson Association, the largest consortium of Parkinson’s patients in German-speaking countries with nearly 21,000 members. 

Over 1,300 questionnaires were analysed, with results showing that interest in medical cannabis among the Parkinson’s community was high, but knowledge about different types of products was limited.

Fifty-one percent of respondents were aware of the legality of medicinal cannabis, and 28 percent were aware of the various routes of administration (inhaling versus oral administration), but only nine percent were aware of the difference between THC and CBD.

Over 40 percent of users reported that it helped manage pain and muscle cramps, and more than 20 percent of users reported a reduction of stiffness, freezing, tremor, depression, anxiety, and restless legs. 

Patients reported that inhaled cannabis products containing THC were more efficient in treating stiffness than oral products containing CBD, but were slightly less well tolerated.

Patients using cannabis tended to be younger, living in large cities and more aware of the legal and clinical aspects of medicinal cannabis. 

Sixty-five percent of non-users were interested in using medicinal cannabis, but lack of knowledge and fear of side effects were reported as main reasons for not trying it.

“Our data confirms that Parkinson’s disease patients have a high interest in treatment with medicinal cannabis but lacked knowledge about how to take it and especially the differences between the two main cannabinoids, THC and CBD,” noted Prof Buhmann. 

“Physicians should consider these aspects when advising their patients about treatment with medicinal cannabis. 

“The data reported here may help physicians decide which patients could benefit, which symptoms could be addressed, and which type of cannabinoid and route of administration might be suitable.”

He concluded: “Cannabis intake might be related to a placebo effect because of high patient expectations and conditioning, but even that can be considered as a therapeutic effect. It has to be stressed, though, that our findings are based on subjective patient reports and that clinically appropriate studies are urgently needed.”

Bastiaan R Bloem, MD, PhD, director of the Radboudumc Center of Expertise for Parkinson & Movement Disorders and co-editor-in chief of the Journal of Parkinson’s Disease, added: “These findings are interesting in that they confirm a widespread interest among patients in the use of cannabis as a potential treatment for people living with Parkinson’s disease. 

“It is important to emphasise that more research is needed before cannabis can be prescribed as a treatment, and that guidelines currently recommend against the use of cannabis, even as self-medication, because the efficacy is not well established, and because there are safety concerns (adverse effects include among others sedation and hallucinations).

“As such, the present paper mainly serves to emphasise the need for carefully controlled clinical trials to further establish both the efficacy and safety of cannabis treatment.”

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