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Natural vs Synthetic: Do ‘green’ cannabinoids always come out on top?

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Professor Edvinas Orentas is head of research at Sanobiotec

Synthetic cannabinoids are often regarded as a lower-quality alternative, but often they surpass natural compounds in terms of product quality and purity, Professor Edvinas Orentas, head of research at Sanobiotec, argues here. 

The widespread notion about the superiority of natural products in terms of health benefits and safety, and commonly held attitude that ‘Natural = good’ and ‘synthetic = bad’ are often exploited in advertising behind such labels as green or organic. 

In reality, however, natural products may not always be worth the hype. 

With the ever-increasing popularity and assortment of cannabis sativa derived extracts and compounds, as well as a large number of suppliers entering the market every year, more careful consideration of the quality of these products is required.

Most common pollutants – in arable lands

The most common environmental pollutants bearing the greatest impact on human health are relevant to agriculture: polychlorinated compounds such as derivatives of dioxins or biphenyls, herbicides, and pesticides, among which glyphosate is the most notorious representative.

The sources producing these contaminants are, in fact, abundant. The major identified contributors of chlorine-containing compounds include combustion, metal smelting, refining and processing, various types of industrial manufacturing, or even natural sources and environmental reservoirs. Pesticides, on the other hand, are inevitable in modern large-scale agriculture to maintain the required level of crop productivity and food supply.

Hurdles in toxic impurities’ control

The possible contamination of the environment and the risk associated with possible entries of these persistent pollutants into the food chain has raised great concerns about their impact on well-being. 

Indeed, multiple recent studies focusing on the toxicity of dioxin-like compounds indicate their carcinogenic effect. They are also associated with an increased risk of type 2 diabetes and other diseases.

Moreover, since dioxins are poor substrates for most of the enzymes, they are poorly metabolized and eventually accumulate in adipose tissues resulting in a remarkably long half-life of up to 15 years. 

Although most of the approved pesticides and herbicides used in agriculture are regarded as generally safe at low concentrations, their overall spread in the environment and food is also strictly regulated in order to prevent long-term exposure and possible impact on health.

The control of dioxins in the environment is further complicated by multiple sources and modes of their release. Often produced during the combustion of waste or fuels, they are spread over large distances before getting washed down by rain. Even the remote areas regarded as clean of industrial pollution and used to grow organic food might eventually become contaminated.  

Advantage of synthesized cannabinoids

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The initially low levels of dioxins are further amplified in the animal food chain, whereas in plants they are absorbed through roots or leaves. Unlike in animals, the concentration of these compounds in plants generally remains at levels too low to pose any danger to the consumer, however, the situation might become worse in the case of natural isolates due to the peculiarities of the manufacturing procedure. 

“One should not forget that when the products are isolated from plants using the extraction process, the material gets concentrated thousand-fold, as do all the impurities. If no additional precautionary measures are taken, the concentration of harmful pollutants thus might well exceed the safety threshold,” says Prof Orentas, head of research at Sanobiotec.

Ironically, the often-discredited synthetic compound might be, in fact, much safer compared to the one coming from fully natural sources.

“Of course, it is impossible to fully replicate natural mixtures consisting of many constituents by combining synthetic components because the full composition of the former is either unknown or too complex,” he continues.

However, for pure compounds, synthetic analogues are preferred. In fact, the majority of pharma companies are choosing synthetic components over natural as the quality of lab-made material is easier to monitor and reproduce. When adhered to good manufacturing practice, synthetic compounds are ultimately safer.”

Precautionary measures in the production process

The large disregard for possible contamination of natural products by manufacturers comes with no surprise. The constant screening of production for pesticides or dioxins requires expensive, sophisticated and highly specialised analytical set-ups, whereas outsourced analysis is also very costly.

“This is why we developed our equipment and implemented an extra purification procedure specifically designed to substantially reduce these contaminants in the extraction products,”  says Prof Orentas. 

“We cannot simply rely on chance that all these impurities are below the threshold and therefore, each batch is quantitatively tested.”

Consumers should be aware that due to the risks these contaminants present, all natural cannabinoid products on the market should be analytically tested. 

Otherwise, one should avoid products for which detailed COAs (certificates of analysis) including the quantitative results of the aforementioned impurities cannot be provided.

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Is it time for a T (tolerance)-break?

A medical cannabis prescriber explains why it’s important to take a break

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medical cannabis flower tolerance break
Medical cannabis users may experience their treatment becoming less effective

How do you know if it’s time to take a tolerance break? Dr Niraj Singh, a consultant psychiatrist and member of the Medical Cannabis Clinicians Society, explains.

Dr Niraj Singh

Dr Niraj Singh

Medical cannabis is used increasingly for a range of conditions including anxiety, depression, PTSD, ADHD, pain, fibromyalgia and others.

But we all need a break from time to time, and so it seems do our cannabinoid receptors. 

Readers will be familiar with the issue of tolerance developing with continuous use of medical cannabis. The definition of tolerance is “a person’s diminished response to a drug, which occurs when the drug is used repeatedly and the body adapts to the continued presence of the drug.”

The cannabinoid receptor 1 lies mainly within the brain and spinal cord. THC binds directly to this and CBD indirectly. With continuous binding of THC, CB1 become ‘down regulated’ ; this means a decrease in the number of receptors on the surface of target cells, making the cells less sensitive to THC binding. 

Medical cannabis users may experience this as their treatment becoming less effective and the requirement to take more for symptomatic relief.

Timing for development of tolerance will depend on one’s history of cannabis use, the chemovar of the product itself and other physiological factors. 

At times therefore the CB1 receptors need a rest. With reduced consumption, this gives the ‘overworked’ receptors a break, giving them a chance to expand in number again, a term called ‘up regulation’. 

The idea of reducing consumption can be anxiety provoking for users and not an easy one, however the benefits are unquestionable. With up regulation, a lesser amount of medical cannabis product is required for the same effect. Using less product, also means less financial expense. 

There is no specific guidance on the time frame for how long a tolerance break should be. Up regulation is said to take place 48-72 hours hours after stoppage and levels out between 21 days and 4 weeks after, so this is the range after which most benefits can take place. This is because THC clears the system completely within this latter period.  

A T-break has to be balanced with the patient’s circumstances, current symptoms, as well as risk of any deterioration in health. Treatment dosages can also be reduced gradually rather than sudden stoppage.

It’s important therefore that any tolerance breaks take place during periods of less stress. Alongside ensuring regular exercise and a healthy diet to boost the endocannabinoid system (ECS) is important. 

One can still use CBD and terpenes during the tolerance break periods. If there are any problems with sleep, natural supplements can be used.

Once medical cannabis is re-started, it’s important that this is gradually built up rather than starting back on the dosage used prior to the tolerance break.

It’s vital that the doctor and patient discuss the tolerance break and agree on a plan.  It’s important that patients discuss this with people in their household and those in close proximity as irritability and frustration can occur particularly in the early stages.

A few things to remember:

  • A T-break should be planned and measures put in place to ease it as best possible. Decide on a realistic time frame. Doctors and patients need to discuss and agree this also.
  • Ensure it happens at a time of fewer stressors but at the same time ensure a good level of activity is taking place to ensure the mind is focused elsewhere.
  • Ensure a healthy diet and adequate exercise. Connect with the natural environment.
  • Use natural supplements for sleep where required.
  • If needs be use CBD oil which is broad spectrum with a good range of terpenes.
  • Stay resolute but also realistic. Remember any break above 72 hours will be beneficial.
  • Build up the dosage gradually after re-starting.

Find out more about joining the MCCS here

If you’d like to share your experience and insight as a medical cannabis prescriber or patient, we’d love to hear from you. Please email sarah@handwmedia.co.uk

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Cannabis offers new hope to those with chronic back pain

Medical cannabis is offering new hope to those living with chronic back and spinal pain, writes Dr Anthony Ordman

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Medical cannabis is offering new hope to those living with chronic back pain

Medical cannabis is offering new hope to those living with chronic back and spinal pain, writes Dr Anthony Ordman, hon. medical director of Integro Medical Clinics.

Anthony Ordman spent over 20 years working in the Pain Management Clinic of London’s Royal Free Hospital, having set it up in 1997 and is a former president of the Pain Medicine section of the Royal Society of Medicine.

Awarded the Fellowship of the Royal College of Physicians in 2005 in recognition for his work, Anthony is now senior clinical adviser and hon. medical director of Integro Medical Clinics and is a medical advisor to charities helping musicians, and those in the performing arts. 

Dr Anthony Ordman

I became a consultant in pain medicine some 24 years ago, and have always had a special interest in back and spinal pain which trouble so many of the people attending the pain clinic as patients, and indeed so much of the general population.  

Perhaps back pain is so common because our spines are designed by evolution for walking on all four limbs and supported at both ends.

But we, as humans, insist on walking only on our hind limbs and sitting upright, putting much more mechanical strain on every structure in our backs than they were designed for. Many of us also mobilise our backs through exercise rather less than we perhaps should.

We only have to look at our pet cats, to see how regular bending and stretching of our spines should be done several times a day, to keep spines healthy.

We also tend to be much more sedentary than we should be, and so the postural ‘core stability’ muscles surrounding our spines, can become rather less effective as “guy ropes” than they should be. Then, as intervertebral discs become worn, and facet joints at the back of the spine become enlarged and stiff, nerve roots leaving the spine to go down the arm or leg become pinched, and spinal muscles can become painfully tight, and spines can become stiff and painful.  

Often, with the right balance of rest and exercise, and simple pain medicines such as paracetamol and ibuprofen, an episode of back pain can settle down relatively quickly.

But sometimes people are not so fortunate, and pain in the spine and limbs can go on to become long-term or chronic. 

There are many other people, who suffer spinal pain brought on by their long-term medical conditions, such as multiple sclerosis, inflammatory arthritis, fibromyalgia, or hypermobility and Ehlers-Danlos syndromes, who have a very difficult time, despite the best medical treatment of the underlying condition itself.

Modern physiotherapy and medicine can often be of great help in such circumstances.

But sometimes, even in the best of pain clinics, with x-ray guided spinal injections, the best pain medicines, expert physiotherapists, clinical psychologists, acupuncture and homoeopathy, are not enough, and we struggle to help people rid themselves of back pain, enough to be able to enjoy life again. Often, this is because the pain has been ‘centralised’ by changes in the nerve cells of the central nervous system. 

Thinking in particular of the specialist pain medicines we have to offer, choices can be surprisingly limited, and we have to be careful not to do more harm than good.

Opioids such as codeine, tramadol and morphine don’t often help after a few weeks but continue to cause sedation, brain fog and constipation, with a high risk of dependency.

Medicines such as amitriptyline used for nerve pain, low mood and poor sleep, often take more away more from patients in terms of memory and alertness, than they give through pain reduction. The same is so often true for gabapentin and pregabalin, and many of the other medicines licensed for treating pain. And while we are hopeful that the new classes of pain medicines will come along soon, we can’t expect any miracles just yet.

The role of the endocannabinoid system

But throughout my years in pain medicine, I’ve always attended national and international scientific medical meetings and, interestingly, almost every scientific conference seemed to have at least one lecture on the mysterious endocannabinoid system (ECS).

This is a system of natural biological pathways present in all of our bodies, where nerve cells, and immune and others cells use natural ‘cannabinoid’ substances to signal to each other, regulating bodily processes such as pain transmission, inflammation, and so on.

The function of the ECS seems to have to do with normalising body activity after illness or injury. The hope had always been that, very soon, the big mainstream pharmaceutical companies would find us the medicines we needed to modulate the ECS to reduce pain and improve lives. 

Exploring medical cannabis

I was keen to find out for myself what cannabis medicines might have to offer patients who I could not help in other ways

I was extremely fortunate to be approached by the chief executive of Integro Medical Clinics to see if I would take up the medical leadership role in a service that would specialise in using the new cannabis-based medicines.

With the partnership and expert support of IPS, the country’s, leading expert pharmacy in dispensing pharmaceutical cannabis medicines, and several months of study on cannabis medicine, I found myself prescribing cannabis medicines for people whose lives were on hold because of pain.

Many had already tried CBD oil and found this just wasn’t enough to help, something we’re seeing more and more now. But in the clinic, we find that by blending just the right amount of THC and terpenes in each patient’s cannabis oil or flower, we are improving patients’ nerve and inflammatory joint pain and the painful muscle spasm of spinal pain, as well as improving sleep at night, without the daytime sedation or dependency of conventional pain medicines.

People can begin to get back to their work and childcare and leisure activities, with a clear head and sharper memory.

Within two or three months we can begin to relieve people of the burden of their conventional pain medicines. The very same cannabis medicines can also restore healthy sleep to patients, and lift mood, which had been depressed by pain for so long. People also felt brighter and less anxious than before.

Integro Medical Clinics Ltd always recommends remaining under the care and treatment of your GP and specialist for your condition while using cannabis-based medicines. The Integro clinical team would always prefer to work in collaboration with them.

If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:  www.integroclinics.com email: Contact@integroclinics.com and Twitter: @clinicsintegro

Visit backcare.org.uk further support with your back pain

 

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Why we need to reframe CBD as good nutrition

The absence of CBD as daily nutrition is causing a major health crisis, says an industry veteran.

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"Adding CBD to daily nutrition is a game changer"

The absence of CBD as daily nutrition is causing a major health crisis, writes founder of Master Plant and Mee CBD, Oli Osgood.

The conversation around CBD, particularly in the mainstream media, has focused on factors that have been detrimental to a true understanding of its benefits.

Rather than viewing cannabis as a ‘cure’ we need to reframe the debate and focus on how the absence of CBD as daily nutrition is causing a major health crisis. 

CBD can help restore balance for us as individuals and for wider society. After 18 months of lockdowns and a growing mental health crisis, changing thinking has never been more important. 

Entrenched misperceptions

A quick Google search on top questions related to CBD highlights some of the spurious notions about CBD – ‘Is it a bad drug?’ or ‘is it legal?’ or even ‘is it a cure for cancer?’

CBD should be a part of our daily nutrition. Photo: Mee CBD

These ill-informed views highlight the scale of the challenge we have in seeing its wide embrace in this country as a key component of our daily nutrition.

It is subject to the kind of scrutiny that simply doesn’t exist in the rest of the wellbeing industry. And therein lies the problem. It is viewed as somehow separate and other due to being sourced from a beneficial plant that has been outlawed for nefarious reasons for so many years. The upshot is any sensible debate is stifled. 

With cannabis as a drug first being banned in 1928 in the UK, we have no living memory about a time before prohibition.

As a result, we lost any understanding of its potential benefits for society. Instead a moral panic grew up around it. The fact that this prohibitionist culture has existed for close to a hundred years means misperceptions are sadly hard wired into many psyches. 

In a way it is not dissimilar to how discussions around mental health are suppressed by some cultures and societies. Of course our mental health is a vital part of life and so is CBD.

As a society we need to move away from the prohibitionist culture and mindset. We need to throw off the shackles of the past to develop a laser-like focus on the clear scientific basis on its vital role within the regulation of our bodies.

Activating what is already inside us

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Adding CBD to daily nutrition is a game changer and we need to communicate this more publicly.

It has the ability to regulate and balance so many processes in the body, including immune response, communication between cells, appetite and metabolism and memory. There is a host of new compelling evidence highlighting its benefits that seems to get little traction in the mainstream media. 

A recent report from the Frontiers in Public Health showing patients with chronic pain, PTSD and sleep disorders found their conditions improved after starting medical cannabis treatment. Thankfully titles like Cannabis Health report on these important breakthroughs.

CBD nutrition

Cannabis has been shown to improve sleep. Photo: Mee CBD

All CBD is doing is activating the body’s endocannabinoid system (ECS). The ‘absence’ of CBD has had a detrimental impact on the health of us as individuals and I would argue our society.

We’ve seen from our own evidence remarkable results in our tests with the product of people who have clearly suffered from a range of ailments from chronic pain to anxiety.

One client had struggled to walk for seven years due to pain in her feet. She takes CBD and is now dancing and smiling – this seems like a miracle – but it’s just good nutrition performing miracles in the absence of a balanced diet that includes cannabinoids.

Having a wider perspective

Part of reframing the debate around CBD is looking outside our own narrow and parochial parameters to benefit from the perspective of a wider lens.

In my long experience of working overseas and travelling I have been struck by the much more mature understanding other societies have of the power of plant science and botanicals to help regulate our systems.

Indeed the inspiration for our brand was Margaret Mee who in the 1950s was one of the foremost figures to go deep into the Amazon and highlight the rare, valuable botanicals she discovered there. Margaret Mee used her fearless creativity to show the world the beauty and power of plants, a mission we share today. 

The opening up of the world particularly in the last 20 years has gone some way to also open minds to the role CBD and other botanicals can play as part of a balanced life. These are fundamental to the wellbeing of so many societies. Meanwhile Western countries dominate the list of countries suffering from a mental health epidemic as revealed by Our World In Data.

These countries are also suffering from imbalances caused by eating too much or drinking too much alcohol – the permitted and by far most dangerous drug of all.

Government’s role to play

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Of course the ‘solution’ to these crises is neatly provided by the pharmaceutical industry to ensure their profits remain sky high.

Hugely well funded global corporations with armies of powerful lobbyists have Governments at their beck and call and bombard doctors with information on why prescription drugs are the answer to all our ailments. With so much money to be made it is inevitable. But these drugs merely tackle the symptoms and not the cause. 

In regulating our systems and restoring balance, CBD has the ability to negate the need for powerful prescription drugs, yet our industry is nascent. David compared to the Goliath of big Pharma.

Government needs to reject the lobbying and look at the compelling evidence, promoting CBD like they promoted milk for good teeth and bones rather than having a slightly uncomfortable arm’s length relationship.

They should invest in some mass double blind studies showing the benefits of CBD in a range of areas. This would help to level the playing field and of course ultimately save the Government huge amounts by not requiring so much use of the NHS.

Project Twenty21 which will see 20,000 patients supplied with subsidised cannabis products by the end of 2021, should help provide compelling data to shift thinking.

Water-soluble CBD can change the game

CBD nutrition

Water-soluble CBD could be a game-changer. Photo: Mee CBD

As well as winning the argument with Government, we of course still need to win round the public. Key to this is a method of consumption that appeals to people.

The next generation of CBD is water-soluble and can be the catalyst for change. As it can be added to food and drink, people will see how it can seamlessly integrate into our daily lives, moving CBD from our medicine cabinets to our kitchens.

This will help to literally reposition it as part of our daily nutrition and away from the misperceptions of the past. Additionally the enhanced bioavailability and super fast acting nature of water-soluble create noticeable results, and we believe, should further propel CBD further into mainstream life.  

With consumers and the media better educated about the benefits of CBD we can start to see it in a new light. No longer something on the fringes of society – an unknown and frowned upon substance, but instead a vital component in helping us achieve a balance that is vital for our wellbeing.

Oli Osgood is CEO of Mee CBD and Master Plant and was formerly a CEO in the Virgin and Strauss Groups following 14 years private equity investment and financial director experience. He is a London Business School Alumni and ACA qualified.

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Cannabis Health is a journalist-led news site. Any views expressed by interviewees or commentators do not reflect our own. All content on this site is intended for educational purposes, please seek professional medical advice if you are concerned about any of the issues raised.

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