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12 frequently asked questions about medical cannabis

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Research has shown the effectiveness of medical cannabis when treating epilepsy, but prescriptions on the NHS are still sparse

Medcan Support, has published new resources for parents and carers who want to know more about medical cannabis and childhood epilepsy. Here, the experts share some of the most common questions they get asked. 

The non-for-profit hub, co-founded by parents of epilepsy patients and high profile campaigners Matt Hughes and Hannah Deacon, provides support and education for others seeking cannabis medicines

The Medcan Support expert committee, which includes cannabis scientist Dr Callie Seaman, paediatric cannabis consultant Dr Bonnie Goldstein and paediatric neurologist Dr Evan Lewis, has responded to a list of frequently asked questions from parents and carers about how to access this treatment.

Medcan Support co-founder Matt, whose son Charlie has a rare epileptic condition known as West syndrome, has seen how medical cannabis has transformed his life and helped bring his seizures under control.

But he didn’t have access to any support or easy-to-find information when he first started researching cannabis.

Matt and Ali Hughes and son Charlie.

“When we first started out, all I had was Google,” he told Cannabis Health.

“Some of the information was incorrect or laws would be different all over the world, it was a very confusing picture and it took a lot of time to really understand everything.

“Through Medcan we have created a central hub for parents to go to. We get so many questions from parents through our Facebook group, this was just a way of bringing them all together.

“For anyone who is looking to try CBD or prescription cannabis for childhood epilepsy, these are the kind of questions you might come across.”

 

How do I get a prescription for medical cannabis?

At the time of writing, the NHS is not prescribing medical cannabis, so patients must be prepared to pay for a private prescription. However, an NHS specialist is legally permitted to prescribe the medicine, so it is always worth asking.

There are only two clinics prescribing for paediatrics, The Medical Cannabis Clinics or Sapphire, details are on our website. Fill in the details required – this usually includes information about your child and medical history. When the clinic responds, they will provide next steps which will vary by provider. They may contact your neurologist on your behalf. Your records will be sent to the clinic’s consultant who will decide whether you are eligible for medical cannabis treatments. Clinics will not see you without the relevant medical records. If you are eligible for medical cannabis treatment, you will be sent an appointment.

Who can prescribe medical cannabis in the UK?

Any doctor on the GMC Specialist Register can prescribe. This is usually a hospital consultant. A GP can prescribe under shared care arrangements under the direction of a specialist. You are more likely to be prescribed medical cannabis from a doctor working for a medical cannabis clinic as those doctors are more likely to have been trained in cannabis medicine.

What is the difference between CBD and THC?

Both THC and CBD have medical properties. THC is the cannabinoid that is the major part of recreational cannabis and in high doses can cause impairment. In lower doses it is a muscle relaxant, can help with sleep and many different causes of pain. It can also help with nausea and other chemotherapy related side effects and shown to be effective in epilepsy. CBD does not cause impairment. CBD is often used in anxiety, epilepsy and pain management also.

There is much overlap between the two when controlling symptoms. When you are assessed by a doctor they will determine the combination that is most likely to help your symptoms.

Most doctors start with a higher CBD product with small amounts of THC and increase the dose slowly, but it will depend on your previous exposure to cannabis and your symptoms. If prescribed carefully, the side effects one commonly recognises with recreational cannabis and unopposed THC use are usually very minimal and well tolerated.

What is the entourage effect?

Cannabis not only contains phytocannabinoids, but also other chemicals called terpenes (which give smell) and flavonoids (which give colour). There are over 100 terpenes and flavonoids. It is thought that the full plant with all those components in various proportions gives a better medical effect than the individual parts. That is the entourage effect. Science doesn’t fully understand the interaction of phytocannabinoids and terpenes within the human body, but observational data and open label studies are leaning towards the use of the whole plant has a better medical effect than isolated parts.

How is medical cannabis taken or administered?

Medical cannabis for childhood epilepsy is usually prescribed as an oil. For the best bioavailability it’s recommended to leave under the tongue, but generally with children suffering develop delay or learning difficulties, this is simply unrealistic. Swallowing is fine and may require a little bit more oil to reach a therapeutic dose.

For children who may have difficulties swallowing, the oil can be administered via feeding tubes although not recommended to mix with water.

What dose should I take?

Your doctor will advise on the dose. Generally, you will be started on a low dose – at around 1mg per kg of body weight and gradually increase in increments. Studies show that around 10- 15mgs/kg is in the therapeutic range, but each child will respond differently. Some may require much less and others much more. If the doctor wants to add in THC then again it starts low (even as low as 1mg THC) and builds up slowly.

We are on the ketogenic diet, can we use cannabis?

Yes you can use CBD/cannabis oil in conjunction with the Ketogenic Diet, but be very careful to the carrier used. Although most CBD oils use MCT oils as the carrier, some have added flavourings which could be from sugars which would impact ketones  produced. If prescribed your clinician should be aware of the carrier oils of products. Speak with your ketogenic dietician if uncertain.

Can CBD / cannabis be administered in hospital?

If you’re using an over the counter CBD oil then no you won’t be allowed to administer it in Hospital, if however you have a prescribed oil, then you should be allowed to administer it. You may need to give the hospital notice and let them know the dosing regime.

Can CBD / cannabis be administered in playgroup/ school?

If it’s a prescribed oil with the correct pharmacy labelling on the bottle, this should be fine, but it has been known that some schools are hesitant in administration and ask parents do so.

What are the side effects of medical cannabis?

CBD is generally very safe, but can give some people stomach upsets, diarrhoea, dizziness and tiredness. THC has more side effects and these can include dizziness, disorientation, drowsiness and dry mouth. Your doctor will start you on a low dose and increase it gradually so that side effects are minimised. Serious side effects, like a psychotic episode, should be avoided by careful screening of whether you are suitable for treatment in the first place.

Does THC affect the developing brain?

Some reports have said that THC can damage the developing brain in children and adolescents. There is no evidence of this in the low doses generally used in cannabis medicine. There are some reports of such problems in high THC recreational cannabis users, but those reports are also controversial. In the low THC doses used in medical practice, that risk is very small indeed.

What will I pay for a medical cannabis prescription?

You will pay for the cost of treatments – an average of £500 per month for your products. Families of children with epilepsy will see costs from £1000+ per month but costs are coming down. You will also pay the cost of import, which can be around £150 per prescription.

However, now bulk importation of medical cannabis products are permitted, we see prices reducing as this cost is split between multiple patients. You will also pay the costs of the pharmacy as well as the cost of any consultation – face to face or telehealth with your consultant. This is usually around £200 for the first consultation and less for follow-up visits, which need to be monthly at first but if you are stable then can then be less frequent.

 

For more FAQs and other resources and support around medical cannabis and epilepsy visit Medcan Support.

Mental health

Clinical trial will assess if CBD can be used to treat PTSD

A new clinical trial could be a breakthrough moment for the treatment of PTSD

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PTSD is particularly common among those who have served in the armed forces

US biotech firm Ananda Scientific has launched clinical trials of a cannabis-based treatment for post-traumatic stress disorder (PTSD).

The company has teamed up with New York University Grossman School of Medicine to carry out the eight-week study.

The Phase II double-blind, randomised trial will involve 120 patients in a large scale placebo-controlled experiment which could be a breakthrough moment for the drug.

If successful, the trial will be an important step on the journey to winning regulatory approval Ananda’s Nantheia treatment, a drug incorporating CBD into a liquid application.

PTSD is a common mental health disorder which occurs in people following a traumatic experience and is a particular problem among people who have served in the armed forces.

A 2014 study found as many as 12.9 percent of US soldiers who served in Iraq displayed some symptoms of PTSD.

Recent months have seen warnings health workers on the front line during the Covid-19 crisis could also be experiencing PTSD.

An increasing number of health workers have displayed PTSD symptoms during the pandemic.

A study in the British Medical Journal compiled earlier this year found 39.5 percent of staff on critical care wards ‘met the threshold for probable clinical significance’ when surveyed for PTSD symptoms.

The study will also evaluate its impact on patients with neurocognitive impairments resulting from a traumatic brain injury.

Sohail R. Zaidi, Ananda’s president, said: “This is an important milestone for Ananda’s clinical development program, and we look forward to continuing to work with the NYU Grossman School of Medicine.

“We are impressed by the scientific rigour and professionalism of the NYU team in getting a cutting-edge program in place to test the efficacy of our very promising drug.

“The initiation of patient enrolment in this study reinforces our commitment to our goal of improving health and wellness empowered by cannabinoid science.

“This is also an important step in our efforts to provide patients with PTSD with potentially improved therapeutic options.”

This trial is being led by Esther Blessing, assistant professor of psychiatry and Charles R. Marmar, chair of psychiatry.

Dr Marmar leads NYU’s PTSD research programme and is a leading expert in clinical trials for innovative treatments for PTSD and related conditions.

He said: “We are excited to get this important trial underway. Our collaboration with Ananda Scientific allows us to progress in the development of evidence-based CBD products for this debilitating condition.”

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Why are people using CBD?

New survey data reveals why people in the US are consuming CBD – here are some of the key findings.

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CBD oil
New survey data reveals how and why people in the US are consuming CBD

New survey data reveals how and why people in the US are consuming CBD – here are some of the key findings.

Data intelligence firm New Frontier has released two new reports providing in-depth analysis on CBD consumer groups in the US and the factors shaping their behaviours. 

For the survey, respondents were grouped into four cohorts based on their primary reason to consume CBD including; medical, pain management, unwinding and general wellness.

Just over half of those described as ‘unwinding’ consumers are under the age of 35, while most who use it to manage pain are aged 55 or older, according to the findings.

Medical and general wellness consumers are roughly evenly distributed across age groups.

A whopping 92 percent of medical users reported having a ‘positive impression’ of CBD and 71 percent have recommended it to someone they know.

Unsurprisingly, medical users were more likely to consume CBD on a daily basis and spent more on the supplement, with one in four claiming to be spending more than $100 per month on CBD products. 

The majority of those surveyed said they used CBD for pain management and were “highly satisfied” with CBD and most likely to believe that it has “valid medical uses”.

But in general this group was “uninformed” about the cannabis market, says the report, and only one in five weren’t  interested in learning more.

Those who consume CBD to unwind identified anxiety reduction, stress relief, sleep, relaxation and pain management as some of the common reasons for use.

This group was younger than the average and nearly three-quarters said they had discussed CBD with friends, while more than 90 percent have friends or family who also use it.

By contrast, general wellness consumers were among the least likely to have had a conversation about CBD (11 percent) and nearly 1 in 5 (17 percent) did not know any friends or family who consume it.

Oils and tinctures were the most popular consumption method, followed by topicals, edibles and drinks and vaping, with CBD in capsule and pill form the least common.

Concluding key takeaways from the survey, the authors write: “The deepening fragmentation of the CBD consumer market will continue as consumers become more familiar with the products, and more targeted in the ways by which they integrate CBD into their lives. 

“While medical consumers are most likely to be regimented in their use, more likely to be brand-loyal, and most focused on dosing, other consumers groups are far less entrenched in their product preferences or consumption habits.”

While 30 percent of surveyed consumers expected their CBD usage to increase in the next six months, just under half (49 percent) said they did not have a preferred brand.

New Frontier Data founder and executive chair, Giadha A DeCarcer, noted: “As the market is flooded with more product choices, CBD brands and retailers would be well-served to delineate and target their consumers as they would in any other mainstream product category.”

See the full report at New Frontier Data 

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Mental health

Friends and CBD founders donate profits to mental health charity

10 percent of the brand’s profits will go to the Mental Health Foundation this month

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Catherine Meardon (left) and Laura Walton co-founded Moi+Me

Two friends who co-founded a CBD brand after experiencing anxiety, are donating a percentage of the company’s profits to a mental health charity this month.

Best friends and CBD co-founders, Laura Walton and Catherine Meardon know the importance of looking after your mental health.

Both of them have experienced anxiety either personally, or through a loved one. 

This June, the pair who co-founded CBD brand Moi+Me, are donating 10 percent of their profits to the Mental Health Foundation to help raise awareness. 

The charity provides support for those experiencing mental health issues, as well as campaigning to raise awareness and reduce stigma.

The friends and former colleagues founded Moi+Me after Laura’s struggles with anxiety after losing her mum.

She says discovering CBD, along with other tools and being able to be open about her experience helped her find her “way out”.

As a friend, Catherine has found it difficult to know what to say and together they wanted to build a brand that could provide tools and support, as well as taking the confusion out of CBD.

“Both of us have been touched personally by anxiety, either through our own suffering or that of those we love,” said Laura.

“I used CBD along with other tools during her mental health journey and found them to be a great support, but I didn’t want to only create a brand or product, we want to help support as much as we can by encouraging people to take extra care of themselves and have self-love.” 

She added: “It is our mission to raise further awareness of mental health, we are fully aware it can still be hard to be open about mental health in fear of being judged so by supporting this charity who in turn helps others also suffering feels a perfect fit for our brand.”

The concept for Moi + Me came from the idea that our busy lifestyles leave us feeling pulled in different directions with little time for reflection and self-care.

The range includes CBD balm, temple roller, peppermint oil mist and massage candle to encourage customers to take time for themselves.

Catherine added: “We both understand the importance of getting your life balance right. If you don’t allow time in your life for reflection and relaxation, things can very quickly feel on top of you. 

“Our busy lifestyles can leave us feeling like you have one soul and two minds. One ‘Moi’ side of us is thriving externally while the other ‘Me’ side feels tired, worn out and has too much on.  

“We’ve designed our high-quality, pure CBD product range to help bring moments of calm into your daily routine through a combination of stimulating flavours and scents.”

 

Visit www.moiandme.com

Access mental health information and support via the Mental Health Foundation 

 

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