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Study shows “powerful, real-world data” for potential of cannabis in tackling opioid addiction



Research into how cannabis can help opioid addiction is growing

A new study adds to the growing body of research exploring the potential use of cannabis in reducing opioid dependency.

Following in the footsteps of North America, the UK is facing a growing issue of opioid dependency.

The latest figures show that the number of people dying from opioid-related drug misuse has reached a record high in England and Wales, and last year, the UK government strengthened opioid addiction warnings.

With opioid deaths rising, medical cannabis has become a beacon of hope as a possible replacement for opioid-based drugs. However, there continues to be a lack of research and clinical trials to prove its efficacy and provide clinicians with peace of mind when prescribing the drug.

In an effort to close the knowledge gap, researchers have published a paper in the international Journal of Clinical Practice offering clinicians practical advice for prescribing cannabis for chronic pain.

Supported by one of the world’s leading cannabis companies, Canopy Growth Corporation, and its medical cannabis division, Spectrum Therapeutics, the consensus paper gathered recommendations from twenty-three clinicians from around the world who had experience using cannabis in their practice.

The paper sets out guidance based on these recommendations, explaining when and how to safely prescribe cannabinoids when opioids are a being used for chronic pain. The paper also includes suggestions on how to decrease patients’ dosage of opioids when on a course of cannabis-based medication.

“[The paper] was very much about distilling physicians’ clinical experience into a pragmatic consensus document that clinicians can have in their back pockets,” Dr Mark Ware, Chief Medical Officer at Canopy Growth, tells Cannabis Health. 

Dr Mark Ware

“If they choose to prescribe cannabis-based medicines, they would have some kind of recipe to follow.

“The general takeaway was that this is an approach to take for patients who are on opioids with chronic pain but aren’t getting the kinds of outcomes that you would want to see.

“The consensus was to start with low doses of CBD-predominant cannabinoid therapies to begin with, and then potentially introducing the THC containing compounds.”

As a pain physician himself, Dr. Ware says he would feel confident turning to the consensus if he chose to treat one of his patients with cannabis-based medical products.

He hopes that the paper will offer fellow clinicians the same confidence in prescribing cannabis despite the absence of evidence and also relieve the suffering of patients who have negative experiences on opioid medication.

Although clinical research remains incomplete, millions of people across the world are self-medicating with cannabis to ease their chronic pain.

“One thing we know is that these cannabinoid compounds, from a scientific background, are remarkable drugs in the way that they act in the human body,” Dr. Ware explains.

“We know that they can co-interact with opioids to improve pain control in animal models, and we know from large-scale follow up studies that people who use cannabis in their self-management of pain are able to reduce their use of opioids.

“It’s not clinical trial data, but it’s very powerful real-world data. With the experience of patients, perhaps we can then start to fill that gap of evidence with pragmatic guidance, which is what this consensus paper was intended to do.”

Despite demonstrating potential for lessening patients’ dependency on opioids, Dr. Ware stresses that cannabis alone will not solve the opioid crisis.

“Different ways of prescribing and approaching chronic pain have to come into play,” he says.

“Cannabis may be part of that toolbox of things that we can use to help shift the course of this very devastating trajectory. But it wouldn’t be right to say that this is the solve – it may just be one part of it.”

Founded in 2013 in Ontario, Canada, Canopy Growth was the first cannabis producer listed on both the Toronto and the New York Stock Exchange. As one of the world’s largest cannabis firms, Dr. Ware believes it is important that the company contributes to research efforts surrounding medicinal cannabis.

“I think we have an obligation to help clinicians understand how to use [our products] safely,” he says.

“We know that, generally, clinicians in Europe, in the UK, and across North America are not very well educated as to what cannabinoids are and how they work.

“We have an obligation to start filling those gaps by doing the clinical research. If we want our products to stand alone from others in the competition, and we want physicians to feel confident prescribing them patients to feel confident using them, we want to be able to provide that kind of support and data that they would expect.”

The full research paper is available from The International Journal of Clinical Practice.


Six big cannabis sector stories you might have missed this week



It’s been another week of big news in the cannabis world.

At Cannabis Health, our in depth coverage of the ongoing growth of cannabis as a medical and wellness product continues

Meanwhile, over at Cannabis Wealth, we’ve been following all the big industry and policy news in a week which has seen some important developments..

Been busy and want to get caught up in a hurry?

Here are the six things you need to read to stay in the loop this week.

1. Reprieve for medical cannabis patients

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year.

Medical cannabis

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020.

Read the full story.

2. UK largest’s medical cannabis trial reports back

The first findings from the UK’s largest medical cannabis patient study show quality of life improved by more than 50 percent.

Preliminary results from Drug Science’s Project Twenty21 study, have found medical cannabis significantly improves quality of life for people with life-limiting conditions such as chronic pain, multiple sclerosis (MS) Tourette’s syndrome and post-traumatic stress disorder (PTSD).

Published on Tuesday 11 May, the report is the first real-world data to be collected on medical cannabis in the UK.

Read more here.

3. Harrowing first-hand account of medical cannabis user
Diagnosed with a personality disorder and experiencing debilitating anxiety which left him housebound, Craig – whose name has been changed – had exhausted all treatment options and was losing all hope.
He speaks about how medical cannabis helped save his life here.

4. CBD market set to shrink

The UK’s CBD sector looks set to shrink significantly as the roll out of new regulations continues to batter the industry.

The FSA has confirmed to Cannabis Wealth it received applications for 803 different CBD products – but only 42 have been advanced to the next stage of the process so far.

More than half of all applications (445) were ‘incomplete’ and a further 41 have been withdrawn altogether.

Read the full story here.

5. CBD not linked to single doping case

CBD has not been linked to a single failed drugs test in UK sport despite fears about the undeclared levels of THC in some products.

The World Anti-Doping Agency removed the cannabinoid from its banned substances list in 2017 and since then several high profile athletes have publicly endorsed CBD products.

Even though CBD – which has no psychoactive properties – is not banned, the UK Anti-Doping (UKAD) still warns athletes to be cautious with treatments.

Read our exclusive report here.

6. School’s out for cannabis class

The first class on a pioneering university medical cannabis course have concluded their first year of studies.

The research programme at the Humboldt-Universitat zu Berlin examines the medical and nutritional uses of cannabis, production and the legal and economic frameworks of the business.

It’s the latest sign that medical cannabis is becoming a part of the mainstream education offering and a positive indication that new industry leaders will emerge in the coming years.

Full story here.

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Science finds a way for medical cannabis to relieve pain without side effects

Researchers have developed a molecule that allows THC to fight pain without the side effects.



Medical cannabis
Many people living with chronic pain have found that cannabis can provide relief. 

Scientists may have developed a molecule which could allow medical cannabis to provide pain relief without any side effects.

Many people live with chronic pain, and in some cases, cannabis can provide relief. 

But the drug also can significantly impact memory and other cognitive functions. 

Now, researchers have developed a peptide that, in mice, allowed THC to fight pain without the side effects.

According to the US Centres for Disease Control and Prevention (CDC) around 20 percent of adults in the states experienced chronic pain in 2019. 

In some studies, medical cannabis has been helpful in relieving pain from migraines, neuropathy, cancer and other conditions, but the side effects can present hurdles for widespread therapeutic use.

Previously, researchers identified two peptides [molecules which are made up of amino acids] that disrupt an interaction between a receptor that is the target of THC and another that binds serotonin, a neurotransmitter that regulates learning, memory and other cognitive functions. 

When the researchers injected the peptides into the brains of mice, the mice had fewer memory problems caused by THC. 

Now, this team, led by Rafael Maldonado, David Andreu and colleagues, has gone one step further to improve these peptides to make them smaller, more stable, orally active and able to cross the blood-brain barrier.

Based on data from molecular dynamic simulations, the researchers designed two peptides that were less than half the length of the original ones but preserved their receptor binding and other functions. 

They also optimised the peptide sequences for improved cell entry, stability and ability to cross the blood-brain barrier. 

Then, the researchers gave the most promising peptide to mice orally, along with a THC injection, and tested the mice’s pain threshold and memory. 

Mice treated with both THC and the optimised peptide reaped the pain-relieving benefits of THC and also showed improved memory compared with mice treated with THC alone. 

Importantly, multiple treatments with the peptide did not evoke an immune response. 

Reporting in the American Chemical Society’s Journal of Medicinal Chemistry, researchers say that these findings suggest the optimised peptide is an ideal drug candidate for reducing cognitive side effects from cannabis-based pain management.

The abstract that accompanies this paper can be viewed here.

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Dutch Government to supply medical cannabis for UK patients until 2022

The Department of Health has reached an agreement to continue the supply of Bedrocan oils



The Dutch Government will supply medical cannabis to UK patients until 2022

The Department of Health has reached an agreement with Dutch officials to extend the supply of medical cannabis oils to existing patients in the UK until 2022.

Medical cannabis patients, living with severe, life-threatening epilepsy were left without access to medication when the UK left the EU at the end of last year. 

Families, whose children are prescribed Bedrocan oils in the UK but must obtain their prescription through the Transvaal pharmacy in the Netherlands, were given two weeks notice that their medication could no longer be dispensed following the end of the Brexit transition period on 31, December 2020. 

After outrage from campaigners, the Dutch government agreed to continue supplying the life-saving products until 1 July, 2021 while a more permanent solution was reached.

This waiver period has now been extended until 1 January, 2022.

Health ministers promised to work with officials in the Netherlands to find a “long-term” solution, but according to those at the forefront of the campaign, there is still “some way to go”.

Hannah Deacon and son Alfie Dingley

Hannah Deacon’s son Alfie Dingley, who is prescribed Bedrocan products for a rare form of epilepsy, recently celebrated one year seizure-free.

In a letter to Deacon on Thursday 13 May, the DofH said it was working with the Dutch government, Bedrocan and the Transvaal pharmacy to proceed as “quickly as possible” with the UK production of these medicines.

It added that domestic production is “complex” and that manufacturing “unlicensed herbal medicines” comes with “significant challenges”. 

Deacon said that the UK production of Bedrocan products was the “only solution”.

While other cannabis-based medicines are available in the UK, experts have warned that there is ‘significant variation’ from one product to the next and switching an epilepsy patient’s treatment could be ‘life-threatening’.

“With the 1 July deadline for Bedrolite supply to cease from the Netherlands looming ever closer, we made it clear we wanted an extension to the agreement to stop the situation becoming dangerous for Alfie and the other patients receiving this vital medicine,” commented Deacon.

“The long term solution of Bedrocan products being made in the UK still has some way to go, but it can be the only solution and we thank everyone who is working very hard to achieve this. 

“This is still a long way off from being okay, but for now we have the pressure taken off on the supply issue.”

With limited access to medical cannabis on the NHS, families are still calling for the Government to help fund their children’s prescriptions, which can cost thousands of pounds each month.

Deacon added: “The ever-pressing issue of financial burden on the many families and patients wishing to use medical cannabis in the UK remains and this is a huge issue which needs dealing with.

“There are many ways in which the Government could step in and help access for very vulnerable people and we will continue working as hard as we can to make things better for all.”

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