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’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.”
NFL to explore effects of CBD in players with chronic pain
America’s National Football League (NFL) is looking into how cannabis and CBD can help in managing player’s chronic pain.
The league and player’s association (NFLPA) made a formal request for information to researchers on “pain management alternatives to opioids” earlier this month.
In an official statement, the NFL-NFLPA Pain Management Committee (PMC) said it is working to “improve player health through evidence-based treatment of acute and chronic pain” and to “facilitate research to better understand and improve potential alternative treatments.”
The NFL is seeking out qualified researchers who could lead studies into pain management and athletic performance in its players.
Areas of investigation include the potential therapeutic role of medications and “non-pharmacological interventions” that are considered to be alternatives to opioids in routine pain management of NFL players, including, but not limited to, cannabinoids such as CBD.
The committee also wants to explore the cannabis or cannabinoids on athletic performance in NFL players.
The PMC was formed in 2019 as part of the NFL-NFLPA Collective Bargaining Agreement with the goal of benefitting the health and safety of NFL players through education and research.
Last year it conducted two informational forums on CBD to learn about the current state of CBD science and manufacturing in the US, as part of its aim to find alternatives to opioids in the pain management of players.
Respondents to the request are expected to have experience conducting controlled, experimental studies in the relevant areas and should be affiliated with institutions or companies that meet state, federal, and IRB requirements.
However the NFL is not committing to funding any specific studies at this stage, and instead wants to seek out qualified scientists who can assist with future research projects.
CBD is not currently listed on the World Anti-Doping Agency’s Prohibited List and, as a result, is permitted for use in sport.
However, all other cannabinoids such as cannabis, marijuana and THC are prohibited in competition due to the receptors activated in the brain which cause a ‘high’.
A 2018 review assessed the impact CBD has on relieving chronic pain. The review examined a number of studies, concluding that CBD was effective in overall pain management and didn’t cause any other negative side effects.
In addition, it has been suggested that CBD can speed recovery and fight fatigue – welcome news for athletes suffering from long-term or recurring injuries.
How can CBD help arthritis?
In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints – and many are turning to CBD products to ease their pain and discomfort.
With an ever-expanding range of drinks, gummies and edibles on thee market CBD could be seen as something aimed at the younger generation.
However, there is a growing body of research that suggests CBD can also be of great use for the older members of the population – and one condition in particular.
Arthritis is a common condition that causes pain and inflammation in a joint, and while it can affect people of all ages, it is more likely to begin when people are in their 40s and 50s, worsening with age.
A Canadian study from 2020 found that up to one in five patients who consulted an orthopedic surgeon for chronic musculoskeletal pain were using a cannabis product to treat them, with the express aim of reducing pain.
The researchers also found that interest in the compound was high, with two thirds of non-users curious to try a cannabis product to treat their muscle and joint pain.
Furthermore, those patients already using CBD had generally positive experiences using the products. Nine out of 10 said it was effective in managing their pain, and four in 10 said it decreased their reliance on other pain medications. Nearly 6 in 10 said cannabis products were more effective than other drugs.
Such findings corroborate what we already know about CBD; thanks to its anti-inflammatory and analgesic properties, early research into its use as a treatment for acute and chronic pain is promising.
A 2016 study found that transdermal cannabidiol has potential for reducing pain and inflammation associated with arthritis without any noticeable side effects.
Cannabis-based medicines can help manage the pain of arthritis by rebalancing the body’s natural endocannabinoid pain-processing system and soothing inflamed body tissues.
There are two primary ways of taking a CBD supplement; topically or orally.
In the case of arthritis, a cream or ointment containing CBD would be rubbed into the affected area. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, which could make it difficult to determine if any positive effect is due to the CBD or another ingredient.
There are a number of ways to take CBD orally, from gummies, snacks and drinks to tinctures and capsules – although gummies are discouraged in households with children, due to their similarity with sweets.
However, all work in largely the same way, being absorbed through the digestive tract. However, it is worth noting that absorption can be slow and dosing is tricky due to the delayed onset of effect (one to two hours), unknown effects of stomach acids, recent meals and other factors.
Whichever method you choose, it is always a good idea to check with your medical practitioner first, as CBD, although it is natural, may interact with other treatments, such as prescription medications.
However, for those looking for an alternative to prescribed drugs, with fewer side effects, CBD could well prove to be the answer.
9 out of 10 readers have self-medicated with cannabis
Nine out of 10 Cannabis Health readers have consumed cannabis for medical purposes without a prescription – and almost all said they found it to be more effective than conventional medicines.
Over the last few weeks, we’ve been asking for your views on social media to delve deeper into how people are consuming cannabis.
As expected, the proportion of our readers who self-medicate with cannabis was high, but the results also demonstrate the perceived effectiveness of cannabis in comparison with traditional medication, highlighting a need for wider access to safe cannabis based medicines.
Despite the law around medical cannabis changing over two years ago, gaining a prescription can still be challenging, particularly on the NHS.
This has forced a lot of patients to take matters into their own hands.
According to research, as many as 1.4 million Brits are self-medicating with cannabis, equivalent to just over two percent of the country’s population.
Studies from the US have backed this up, with one suggesting that as many as a third of teenagers with a chronic health condition have taken it upon themselves to manage their symptoms with cannabis.
We asked our readers if they were self-medicating to treat a health condition, with the results confirming that almost 94 percent of people said they were.
On top of this, a further five percent said they were not currently, but were open to the idea.
Just over one percent said they weren’t self-medicating due to the stigma attached, however no one responded that the law was a factor in this.
Effectiveness of self-medicating
Anecdotal evidence and some early studies suggest that cannabis can ease symptoms of some chronic pain conditions, such as fibromyalgia, where other, more conventional medicines have failed.
There is also promise in the potential of cannabis to relieve some mental health conditions, with some saying it has provided huge relief for disorders such as PTSD.
Ninety five percent of Cannabis Health readers polled said they found cannabis extremely effective at relieving symptoms.
In addition no one said they had found it ineffective when it comes to treating their condition.
The remaining five percent said they found it to have a similar effect as their conventional treatments.
Route to administration
How patients consume cannabis can have an impact on its effectiveness, as well as how quickly it kicks in.
With such high numbers both self-medicating and reporting positive effects, we wanted to discover the common consumption methods.
Smoking the flower is the traditional method of consuming cannabis and often viewed as the one which can provide the most relief.
However, even though it has been seen to be less harmful than tobacco, smoking can still lead to a number of other health issues and is note recommended by health professionals.
Despite this, it remained the most popular choice among Cannabis Health readers, with just over a third saying this is how they consume cannabis.
The modern alternative to this is vaping, which was the second most common route to administration among Cannabis Health readers.
Around a third of readers said this was their preferred consumption method.
Some professionals argue this is the healthiest way for consumption, with clinics recommending vaping cannabis flower, but more research is needed in this area.
One method which has few negative effects is the use of oils or tinctures.
This is typically how CBD is consumed, with 21 percent of readers saying this was their preferred method.
Self-medicating alongside conventional medicines
The NHS says it is unlikely that many people in the UK will be able to gain access to a medical cannabis prescription.
Despite this, many patients have chosen to self-medicate with cannabis either alongside or often in the place of conventional therapies.
The majority of readers agreed with this, with 55 percent saying they no longer use conventional medicines in favour of cannabis.
A further 22 percent said they would only use their conventional medicines if they did not have access to cannabis and the remainder said that they still consume cannabis alongside conventional medication.
Want to get involved? Cannabis Health will be running a number of polls over on our social media pages, to find out more about your views on CBD and cannabis for medical and wellbeing purposes.
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- How can CBD help arthritis?
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