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Making the case for medical cannabis vaping

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Many patients report that inhaling cannabis flower is more effective for treating their symptoms

With cannabis flower the first-choice for many patients with chronic pain, one company tells Cannabis Health about its aim to make inhalation a medically approved method of consumption.

An increasing number of countries are beginning to permit the use of cannabis for medicinal purposes. The most popular and, arguably, more effective method of administration is smoking, but due to the associate health risks, medical professionals are reluctant to prescribe cannabis flower.

Medicinal cannabis is generally prescribed as an oil or tincture, allowing doctors to give an accurate prescription. However, the majority of people who use cannabis to treat a chronic health issue, such as acute pain, choose to consume the plant via inhalation (such as smoking or vaping).

Patients claim that it is more effective for treating their symptoms and although the number of studies to back this up are limited, there is a growing body of research looking at the effects of smoking cannabis flower on pain relief.

A recent study from the University of New Mexico, for example, found that patients suffering with pain were able to better manage their condition by smoking flower,  rather than other administration methods.

Described as a ‘silent epidemic’ by the British Pain Society, chronic pain is thought to affect between one third and one half of the UK population.

Due to the side effects associated with stronger pharmaceutical painkillers, many people are turning to cannabis to treat their pain. Some people use CBD, whilst others require the THC content found in cannabis flower.

The study also revealed that THC was essential for effectively treating pain and suggests that moderate to high levels of the cannabinoid is an “effective mid-level analgesic”.

Given its high bioavailability and quick onset compared to oral consumption, smoking cannabis flower for pain appears to be a natural choice for many.

Kanabo, an Israeli company producing cannabis vapes, is aiming to “medicalise vaporisation” and convince health professionals that inhalation can be a medical route of administration.

Recognising the fact that most medical cannabis consumers favour smoking flower over consuming cannabis oils and tinctures, the company has developed a vaping device that can provide a consistent dose of cannabis, whilst also providing the benefits of inhaling the medicine.

One of the main barriers to making inhalation a medically recognised administration method is the inconsistency of smoking, not to mention the associated risks to patients’ health.

It is understandable that most doctors prescribing cannabis-based medical products favour oils, tinctures and tablets over cannabis flower. In general, doctors feel comfortable prescribing medicines that can be administered orally, despite many patients reporting that ingesting cannabis does not provide the desired effects.

Kanabo founder, Avihu Tamir

Kanabo’s CEO and founder, Avihu Tamir told Cannabis Health: “The number one thing physicians are saying is that they feel uncomfortable prescribing flower. Not because they don’t believe in the health benefits and the potential of this plant, most doctors supporting cannabis do.

“It is because they don’t see it as is a medicine, they say it’s an agricultural plant. It’s not something that you can prescribe a specific dose of, it’s not something that is consistent.”

Tamir continued: “We’re trying to come in between and make everyone happy. Vaporisers, at the end of the day, are mimicking all of the benefits you have when you smoke; the fast onset and the high bioavailability. But at the same time you don’t have the tar in your lungs and you have the metered dosing.”

Although it is easier to prescribe a measured dose of cannabis in oil or tablet form, oral consumption can be unpredictable and the effects often last longer than desired.

When inhaled, the effects can reduce to lower levels within just a few hours, however when ingested, it can take as long as eight hours or more.

Kanabo says its device, the VapePod, can accurately provide the same dose of cannabis on each inhale, allowing doctors to provide accurate prescriptions whist also giving patients their preferred administration method.

“In the cartridge, you’re getting the same consistency of formula – the same levels of CBD levels and THC and even the same levels of terpenes,” Tamir said.

“You have the capability to suddenly prescribe because it’s measurable; you can say every inhalation is one milligram for example.

“It means doctors can speak the language that they’re used to. They have something that is very consistent, which is similar to the benefit they have with oils. And on top of that, it’s a medical device with a medical certification for the formula.”

Through clinical trials currently taking place in Israel, Kanabo hopes to build the data surrounding vaping which is less abundant compared to data on smoking and cannabis oil.

“We’ll be able to see the bioavailability graphs for a vape pen, so for the first time, patients and physicians will see how it looks as a graph of bioavailability,” Tamir added.

“We know today how oils are working. We know today how smoking is working, but it will be the first time that people will see this bioavailability graphs of extract-based vape.”

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Australia lists first subsidised medical cannabis drug

Epidyolex has become the first medical cannabis product to be subsidised by the Australian Government.

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Epidyolex is the first medical cannabis product to be subsidised by the Australian Government

The epilepsy drug, Epidyolex has become the first medical cannabis product to be subsidised by the Australian Government.

Australians living with the rare form of epilepsy known as Dravet syndrome, will now have access to the cannabis-derived drug via the country’s Pharmaceutical Benefits Scheme (PBS) for the first time.

As of 1 May, 2021, Epidyolex, which contains CBD, is listed on the PBS for patients with the treatment-resistant condition, to be used in combination with at least two other anti-epileptic medicines. 

Epidyolex is only the second medicinal cannabis drug registered for supply in Australia, and the first one to be subsidised by the Government on the PBS.

Dravet syndrome is a rare, genetic epileptic encephalopathy that gives rise to seizures which don’t respond well to the standard medications.

It is estimated that around 116 patients each year will benefit from the listing of Epidyolex, who might otherwise pay more than $24,000 per year for the treatment. 

They will now pay only $41.30 per script or $6.60 if they have a concession card.

According to a report by FreshLeaf Analytics published last year, there are now around 30,000 medical cannabis patients in Australia with “record-numbers” of doctors prescribing.

But as prescriptions are not covered under the PBS, they remain costly compared to conventional medicines and out of reach for many.

In a statement announcing the listing of Epidyolex, Australian Health Minister Greg Hunt said the Government’s commitment to ensuring patients can access affordable medicines “remains rock solid”. 

 

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Experts to explore the role of medical cannabis in women’s health

A line-up of leading experts will discuss how cannabis medicines can play a vital role in women’s health.

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Many women are still unaware of female-specific health conditions such as pelvic inflammatory syndrome (PIS) or vulvodynia

Leading pain specialist, Dr Sally Ghazaleh will join a line-up of experts to discuss how cannabis medicines can play a vital role in women’s health.

The first of a four-part webinar series, taking place on Wednesday 12 May, will focus on the experience’s of women who have not felt supported by the current healthcare system – and how cannabis has helped them find relief from their conditions.

Dr Sally Ghazaleh, a pain specialist at Integro Medical Clinics, will join Sarah Higgins, clinical nurse specialist and women’s health lead at Cannabis Patient Advocacy Support Services (CPASS), alongside endometriosis patients Abby Hughes, outreach chair of PLEA (Patient-Led Engagement for Access) and Laura, author of The Endomonologues blog.

Dr Sally Ghazaleh

Dr Sally Ghazaleh is a pain management specialist

Aimed at patients, clinicians and the general public the webinar series, hosted by Cannabis Health, Integro Clinics and CPASS, aims to discuss the application of cannabis medicines in the management of complex female health conditions.

It will also highlight some of the wider issues and gender inequalities played out in the modern medical model.

Studies have shown that women’s pain is not acted on as quickly and is more likely to be dismissed than men’s, while many conditions can present differently in women than in men and therefore take longer to diagnose.

Many women are still unaware of female-specific health conditions such as pelvic inflammatory syndrome (PIS) or vulvodynia and can live with the symptoms for many years before they are correctly diagnosed and treated.

Some patients are now reporting that they have found cannabis medicines to be helpful in the management of their health conditions.

Dr Ghazaleh, a consultant at Whittington Hospital and the National Hospital of Neurology and Neurosurgery in London, joined Integro Clinics as a prescriber of medical cannabis in January. 

She specialises in managing patients with a wide range of pain conditions and has a particular interest in bladder and abdominal pain in women, and women’s health in general.

The free webinar will take place on Wednesday 12 May at 7pm.

The event is hosted by Cannabis Health, Integro Medical Clinics and CPASS, sign up for free here

If you would like further information, or to make an appointment for a medical consultation with Dr Sally Ghazaleh please contact Integro Clinics:  

Email: Contact@integroclinics.com

Twitter: @clinicsintegro

www.integroclinics.com

 

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Cannabis treatment to be trialled for common pet health issue

Trials of a synthetic cannabinoid treatment for common eye problems in dogs have been given the green light.

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Eye ulcers are one of the most common health problems in dogs

Trials of a cannabis-derived treatment which could rid dogs of common and potentially blinding eye ulcers, have been given the go-ahead.

Tetra Bio-Pharma will continue with clinical trials on its synthetic cannabinoid products in the hope of finding an easy-to-use medication for pets with the painful condition.

Eye ulcers are one of the most common health problems in dogs and, if left untreated, can lead to the loss of an eye.

The condition is particularly common among a number of breeds which have gained in popularity in recents years, including pugs, bulldogs and West Highland terriers.

Initial symptoms include a red and aggravated eye and the condition often needs to be treated by a vet.

Progress has been slowed due to the Covid-19 pandemic but now the company is looking to forge ahead with the first-of-its-kind trial after receiving authorisation from the Veterinary Drugs Directorate of Health Canada.

The company is also engage in developing a treatment for acute respiratory distress syndrome (ARDS) which could eventually be used to treat people suffering with the coronavirus.

The trials of PPP-003v, Tetra’s proprietary veterinary ocular formulation for treating ocular pain and inflammation in companion animals, could see Tetra find a way into a market expect to be worth over $220 million by 2026.

Dr Guy Chamberland, CEO and CRO of Tetra Bio-Pharma, said: “The PPP-003 program, including PPP-003v, represents a significant opportunity for Tetra since there is a substantial unmet medical need for painful inflammatory eye disease.”

He added: “We are pleased with this regulatory authorisation and the ability to re-activate the trial.

“While the active pharmaceutical ingredient used in the PPP-003v drug formulation is the same as the one used in ARDS-003, Tetra’s innovative immunomodulator drug concurrently being developed for Covid-19, there is a major difference with how the drug is delivered.

“PPP-003v is intended to be used as a topical medication and is delivered as a sterile eye drop and ointment, while ARDS-003 is a sterile injectable nano-emulsion finished drug product.”

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