Jabed Chowdhury, Medical Science Liaison at Grow Pharma explores the benefits of cannabis capsules for patients and doctors.
Following the announcement in April this year that Columbia Care International launched solid-fill medical cannabis capsules in the UK, a survey of doctors and patients who have been prescribed these capsules have shown some very promising early results.
The Columbia Care capsules aim to provide patients, some of whom are suffering from the most debilitating conditions, such as long-term chronic pain or neurodegenerative diseases, such as Parkinson’s or multiple sclerosis, but for whom other treatments have failed, with a one-shot, easy-to-take, medically-formulated dose of their required THC (tetrahydrocannabinol) and CBD (cannabidiol).
Columbia Care International is part of Columbia Care, which has built an enviable reputation as one of the most respected and trusted medical cannabis companies in the U.S. Columbia Care International are now in the UK, Germany and other territories. Founded as a healthcare company, Columbia Care has always valued accuracy, detail and data and they aim to deliver predictable products in the category.
UK patients and doctors have been calling for an easy-to-take cannabis-based medicinal product (CBMP) for quite some time and Columbia Care’s goal is to now fulfil this unmet medical need, with a range of THC and CBD dosing options for patients, including capsule-form, previously unavailable in the UK.
Says Columbia Care’s CEO, Nicholas Vita: “Not only are most patients familiar with a capsule, but many will also see other benefits of this formulation. We are thrilled to see this product come to fruition in the UK and we are grateful to our partners for helping us achieve this goal.”
A recent study in the UK, and published in the British Medical Journal 1, estimates that approximately 28 million adults are affected by chronic or widespread pain, fibromyalgia or chronic neuropathic pain. This represents one-third of the UK’s population.
With such a significant statistic and one which is responsible for a major impact not just in people’s own lives, but in the UK’s economic productivity, through millions of lost working days through illness, addressing this urgent health requirement should be a public health priority. For people’s well-being, the secondary health impacts of such debilitating illness can lead to a constellation of other conditions, such as anxiety, depression, PTSD, feelings of loneliness and isolation, and a significant deterioration in the overall quality of people’s everyday lives.
Columbia Care’s mission is to help these patients, for whom other treatments just have not worked, with access to medical-grade formulated cannabis, prescribed by their doctor.
So what formulations are available?
In consultation with their doctor, patients may have a range of options available to them to obtain pharmaceutical-quality medical cannabis capsules. Three different ratio dosages of THC:CBD are offered, THC dominant, balanced and CBD dominant. The differing proportions of THC and CBD content formulations are designed to cater for different patient types with their own specific medical needs and so patients are advised to consult with their doctor on which formulation would be best to treat their specific condition. The capsules are manufactured under the highest standards, by Columbia Care’s UK partner, IPS Pharma – a leading pharmaceutical manufacturer that is licensed by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and distributed by Columbia Care’s UK market access partner, Grow Pharma Ltd.
A small survey, recently conducted by Grow Pharma, to understand the experience of a handful of doctors and their patients who had been prescribed Columbia Care’s capsules, showed some very promising early results.
The doctors found that capsules were well-tolerated by patients of all age groups – from those in their early ‘30s to those in their post-‘60s – and that it was easier for patients to maintain their dosing routine and compliance, compared to when they took oils or other types of product.
Patients reported that capsules have a neutral taste, and this avoided the need for them to adjust to any unfamiliar smells or tastes, as would be expected to be the case for other herbal cannabis products.
Doctors found that it was easier to explain dosages when patients consumed these in capsule-form versus having to explain to patients how they should dose when taking oils. It also avoided the need for patients to measure out doses for themselves.
The patients themselves also found that capsules were also much easier to consume whilst they had the convenience of easily being able to transport the capsules around with them whilst going about their daily lives and whenever they needed to travel; there were fewer worries for patients when doing this, because there was no risk of spillage, whilst the risk of accidental over-dosing was minimised.
The benefit of oral consumption of a single dose capsule also proved beneficial, particularly for elderly patients, or those with dexterity and mobility problems (such as those with joint problems and rheumatoid arthritis), who found oils to be difficult to pour and measure – since capsules were able to be orally taken, as a fixed-dose medication, this was of great benefit to these more vulnerable patients.
With the gradually increasing adoption of medical cannabis by doctors and their patients in the UK, Columbia Care’s medical cannabis capsules offer a potentially valuable treatment alternative for those patients (and their prescribing doctors), for whom treatment has not been successful using opioids or other types of pain or symptom-relieving medication.
Hari Guliani, who heads Columbia Care’s UK operations explains: “The Columbia Care International approach to medicinal cannabis formulations is fundamentally oriented around the patient and their care. The capsules are exciting to us because they are so unremarkable as a formulation for carers and patients that it means they can be adopted easily in patients’ ordinary lives whether at home, in a care home or at work.”
These dosing options enable prescribing doctors to offer proven, cannabis-based medical solutions with the current degree of precision that was previously unavailable in the UK. When compared with other CBMP formulations, capsule-form cannabis medication has longer-lasting effects. Data collected by Columbia Care, through its proprietary IMPACT RegistryTM database has shown in the demonstrated success in the US, by offering patients relief that lasts all night, or throughout their day. The database also shows that this formulation is preferred to other product types by certain groups of patients, especially those over the age of 65.
With such pioneering ambitions, together with the growing demand and proven health improvement impact, the overall future for medical cannabis is set to greatly expand in the UK. To this end, Columbia Care is working towards developing further formulations and more convenient ways by which patients can be administered medical cannabis.
Guliani add:“We are currently prioritising the next formulation to introduce, and we’d welcome the opinions of healthcare professionals in identifying where they have the greatest need for their patients.”
Study: States with full legal access show fewer registered medical cannabis patients
“If true, this could have implications for public health and policy,” say researchers.
Study shows U.S states where cannabis is legal for recreational purposes have experienced a decrease in patients registering for medical cannabis programmes.
The study on different US states, published in the International Drug Journal, revealed that numbers of registered and active medical cannabis consumers increased while it was not legal for recreational use.
Researchers in Arizona took data from the medical cannabis registry from two dozen states between 2013 and 2020. These are mandatory registries that record the number of medical cannabis patients. They analysed the data to see if there were any changes around the times that recreational legalisation was introduced.
There are currently 19 states in the US that have legalised recreational cannabis including New Jersey, Vermont, Arizona and New York. However, more states have medical cannabis programs although some are still not operational. Some states such as Colorado have had recreational access since 2012, the year before the study was started.
Medical cannabis patients
The results confirmed that medical cannabis cardholders increased during times when recreational use was not legal. It then subsequently decreased when it became legal.
It also revealed an increase of 380 patients per 100,000 people per year when just medical cannabis was legal. This corresponded to a decrease of 100 patients per 100,000 after recreational cannabis was allowed. The researchers noted that active registered active male patients decreased faster than women. In states where only medical cannabis was legal, the older age groups (35 or older), increased faster.
They also found that in three states with medical-only use, the results showed significant increases in enrollment from 2016 to 2020 across white, African-American and Hispanic patients.
The researchers wrote: “There is speculation that enrollment in U.S. state medical cannabis programs differs depending on whether adult recreational cannabis use is legal. If true, this could have implications for public health and policy.”
“Findings suggest that recreational cannabis legalisation is associated with decreasing enrollment in medical cannabis programs, particularly for males.”
Latin American cannabis clinic Zerenia arrives in UK – promising patients more ‘affordable’ access
The clinic has recently joined Project Twenty21 with the promise of making medical cannabis more accessible.
Latin American medical cannabis clinic, Zerenia, has launched in the UK, with a bid to improve patient access as it joins Project Twenty21.
The clinic also offers competitive costs, with consultation fees at £80.
The clinic’s three doctors will initially prescribe for chronic pain and mental health, with the majority of patients so far seeking treatment for indications such as anxiety, ADHD, PTSD and insomnia.
Zerenia, which already has 14 clinics across Latin America, has treated around 14,000 patients with medical cannabis, and according to Zerenia’s UK clinical operations director, Freeda Solliman, mental health is the predominant indication prescribed for.
Many of these patients now get their prescriptions funded via private insurers, a model which the clinic now hopes to replicate in the UK.
“In Latin America we’ve built a body of evidence there to support private insurers to fund medical cannabis treatment,” Solliman told Cannabis Health.
“We’ve seen about 14,000 patients who have been treated with medical cannabis and a large number of those actually get their prescriptions funded by private insurers. That’s the kind of model that you want to bring here.”
Zerenia has partnered with T21, which subsidises the cost of prescriptions, to help build the growing body of evidence for the safety and efficacy of medical cannabis.
“Our goals are quite well aligned, we want to build the evidence and we want to make medical cannabis more affordable for patients,” continued Solliman.
“We want to work to encourage the NHS first and foremost, but also private insurers to fund at least part of the costs involved in being treated with medical cannabis.”
She added: “We did our research to understand some of the bottlenecks in the industry and how hard it is for some patients to go through the process, so we wanted to support patients through that and try to offer them more of a seamless experience.”
Zerenia is now taking on new patients who wish to join T21, or those who may want to try a different clinic.
Initial consultations for new patients are priced at £80, for those transfering from a different clinic, £40. Find more information here
CiiTECH to launch medicinal cannabis range Provacan THC in Israel
Israeli patients will have access to the first Provacan THC oil in January 2022, followed by Brazilian and British patients.
CiiTECH and Cannassure have announced a major deal to develop and market Provacan THC products for medical cannabis use in Israel.
It marks CiiTECH’s long-awaited move into medicinal cannabis.
In addition to offering established consumer CBD brands, CiiTECH’s flagship brand Provacan is considered one of the most respected in the UK.
Clifton Flack, CEO and founder of CiiTECH, intends to bring Provacan’s reputation for quality and consistency to the troubled Israeli medical cannabis market.
“CiiTECH is unique in its approach to the CBD wellness and medicinal cannabis markets. We built an international reputation as a market-leading CBD company by producing pharmacy trusted CBD oil tinctures and selling them as food supplements before making our move into THC. Our intention is to bring these International standards to the Israeli market,” says Flack.
“As a UK company with strong roots in Israel, CiiTECH is well-positioned to make its THC debut and there is no better place to do so than in Israel, the epicentre of global cannabis research.”
“Cannassure is known for producing high-grade medical cannabis in Israel with an advanced indoor-aeroponic growing system and state-of-the-art extraction.”
The collaboration with CiiTECH, a leading company in the field of cannabis research and marketing and owner of the leading brand Provacan, is an important step in the field of cannabis oils for us, an area that enjoys significant growth among patients who do not want to consume inflorescence cannabis. We are confident that this collaboration will bring value for us, for CiiTECH and for cannabis patients in Israel, and we believe that it will help us conquer a more significant share of the cannabis oil market in Israel,” said Ran Amir, Cannassure CEO.
As part of its business strategy, CiiTECH seeks and collaborates with best-of-breed cannabis providers up and down the supply chain in multiple geographies. With this agreement, CiiTECH continues to demonstrate its effective business strategy, commitment to quality assurance, and speed of entry into the market that the industry has grown to expect from CiiTECH.
With the help of Cannassure, CiiTECH will help reform, standardise, educate and establish quality, consistency, and reliability in the Israeli medical cannabis market. In order to achieve this goal, CiiTECH is developing a hybrid solution in which a superior quality product is offered to patients and a unique professional enrichment program is offered to help doctors and pharmacists support patients on a deeper level.
Around 80 per cent of Israel’s 100,000 licensed medical cannabis users smoke, rather than using tinctures. The biggest complaint in those groups is the lack of quality and consistency. It is CiiTECH’s mission to show these users how much better tinctures are than smoking. Provacan ambassadors and users will benefit from comprehensive education courses provided by CiiTECH as part of this re-education so they will feel more confident and better supported while using CiiTECH products.
“As cannabis market experts and our involvement in the cannabis ecosystem in Israel, we understand the nature of the demand and the gaps in the Israeli market. Our new THC tincture will revolutionise the lives of many patients who are currently suffering from inconsistencies in the medical cannabis supply chain, and it will be made to the same strict UK and European guidelines as our current products,” concluded Flack.
Israeli patients will have access to the first Provacan THC oil in January 2022, followed soon by Brazilian and British patients.
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