Source – https://www.wakingtimes.com – “…Tetrahydrocannabivarin or THCV. While very similar to THC, which is the psychoactive part of marijuana, THCV is not psychoactive, but can still induce a sense of “focused euphoria…“It’s a wonderful feeling, I think, for [those with] depression and anxiety,” Frankel says. It’s also helpful for pain, which is a really important […]
MEDICINE WHEEL: Cannabis in Modern Medicine – By Dr. Mercola — RIELPOLITIK
**UPDATE**
The Cabinet Secretary for Health has responded to our cross party letter that was addressed to herself, Nicola Sturgeon and the CMO Dr Catherine Calderwood. The contents of the response were as follows: blah blah blah blah, blah blah blah, blah blah blah blah, inbetween numerous inaccuracies and finished off with some BARE FACED LIES. We said a few sweary words when we were reading it. The civil servant who clearly wrote this letter for Jeanne Freeman must have been living on the moon for the last couple of months because they have managed to make her look like an incompetent clown. (we already knew she was an incompetent clown but now we have it in writing) Our cross party group have however been invited to a meeting to discuss the matter further. That should be fun.
We have just left a meeting with Pauline McNeill MSP for Scottish Labour who is heading the cross party group. She is absolutely flabbergasted at the amount of inaccuracies and how economical with the truth the Cabinet Secretary for Health has been in her letter. We have accepted their invitation for a meeting so we are waiting on a time and date, but we are also working with the cross party group on a follow up letter and further action. We are very lucky to have Pauline doing this for us because she believes we should have the right to grow our own medicine and have safe and private access to cannabis clubs, as well as being able to access it on an NHS prescription. Pauline believes very strongly in the “RIGHT TO CHOOSE” so she is also keen to address the criminal justice side of things and is looking to get the ball rolling with the Scottish Sentencing Council and other relevant Governemnt bodies. Paulines lovely husband is ex Procurator Fiscal so we’re hoping that comes in handy 🤣
Meanwhile the SNP and most of their MSP’s/MP’s are pissing all over devolution and turning into Scotlands shame. Every one of them made a commitment to the people of Scotland at their previous conferences when they passed motions on medicinal cannabis, we all heard them. Now that its been made a DEVOLVED issue and the only people stopping access in Scotland is their own party, apart from the 3 SNP MSP’s who have signed our cross party letter and pledged us their support the rest of them have switched on their selective hearing. SHAME ON THE LOT OF THEM.
MCRS 💚💚
“Every cell in the body needs sugar to survive. But cancer cells seem to require more than healthy cells do. They also seem to break sugar down faster. Cancer’s mechanism of quickly and efficiently metabolizing sugar is known as the Warburg effect.”
Every cell in the body needs sugar to survive. But cancer cells seem to require more than healthy cells do. They also seem to break sugar down faster. Cancer’s mechanism of quickly and efficiently metabolizing sugar is known as the Warburg effect.
In fact, we’ve know about the Warburg since the 1920’s when Otto Warburg and colleagues observed tumors taking up enormous amounts of glucose compared to what was seen in the surrounding tissue. Additionally, glucose was fermented to produce lactate even in the presence of oxygen, thus the term aerobic glycolysis.
It’s also recently been discovered that the sugar industry buried evidence of links between sugar and cancer and sugar and heart disease for over 50 years.
Scientists have long pondered whether this phenomenon is related to how aggressively tumors grow and how cancer cells ferment sugar rather than using the normal mechanisms that cells use to produce energy. It is this fermentation process that has now been positively linked to continually encouraging tumor growth.
November 27, 2017 by Admin Leave a Comment
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Every cell in the body needs sugar to survive. But cancer cells seem to require more than healthy cells do. They also seem to break sugar down faster. Cancer’s mechanism of quickly and efficiently metabolizing sugar is known as the Warburg effect.
In fact, we’ve know about the Warburg since the 1920’s when Otto Warburg and colleagues observed tumors taking up enormous amounts of glucose compared to what was seen in the surrounding tissue. Additionally, glucose was fermented to produce lactate even in the presence of oxygen, thus the term aerobic glycolysis.
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It’s also recently been discovered that the sugar industry buried evidence of links between sugar and cancer and sugar and heart disease for over 50 years.
Scientists have long pondered whether this phenomenon is related to how aggressively tumors grow and how cancer cells ferment sugar rather than using the normal mechanisms that cells use to produce energy. It is this fermentation process that has now been positively linked to continually encouraging tumor growth.
According to one of the researchers, Prof. Johan Thevelein:
“Our research reveals how the hyperactive sugar consumption of cancerous cells leads to a vicious cycle of continued stimulation of cancer development and growth. Thus, it is able to explain the correlation between the strength of the Warburg effect and tumor aggressiveness.
This link between sugar and cancer has sweeping consequences. Our results provide a foundation for future research in this domain, which can now be performed with a much more precise and relevant focus.”
Dear Coventry Live aka. COVENTRY TELEGRAPH.
We’d all really appreciate if you taught your staff some basic facts about the media you push. Specially the writers of this article namely MICHAEL GOODIER and BEN ECCLESTON.
You say:
“The number of people being hospitalised after smoking Spice, weed and other strains of cannabis has more than doubled since the start of the decade.”
1) Spice is NOT a Cannabis strain. It is an isolated chemical produced by Israeli scientists. You’d do yourself a favour to highlight this fact first, as we’re not the only ones that know this.
2) Can you provide statistics of people “hospitalised” due to consuming organic cannabis plants? You’d probably learn that Cannabis is keeping people out of hospitals upon investigation.
3) Did you actually go down the colloquial route of calling Cannabis “weed”. I can only assume that this is your attempt to look “cool” in front of the kids, yet your inability to grasp basic facts makes your paper, yet again, look so far removed from reality that you might aswell in sell up your Canal Basin site and call it a day.
Go back to doing some real reporting please.
Because this article just makes it look like that your lack of sales, and inability to reach the people means you’re taking handouts from people who have interests in big pharma.
Just a thought like…
please please be aware of the cancer act 1939 section 4 and making claims for any product to treat cancer that is not from a medical professional.
This is the link to the cancer act. I really dont want anybody to lose their business over this and the MHRA section 165. That one is in the files for you. Along with other useful guidelines.
P.C.B. Proprietors of Cannabis belief- 12/06/2020- Derbyshire *UPDATE*
1st aid paramedic .. ah was ace chatting to him a decent gent and so so helpful . So just sending over correct paperwork and thats another job done With regards having a paramedic under 1000 you dont need one But as P.C.B. Proprietors of Cannabis belief- 12/06/2020- Derbyshire will have a lot of disabled folk there i want to have the paramedics there full weekend day & night …https://pcbmsw.home.blog/
Cannabis has been used to alleviate pain for centuries, however it is only now that we are beginning to unravel the molecular and cellular pathways involved in pain perception and pain relief. Pain is a complex phenomenon with no singular physical characteristic, for instance a painful stimulus may be too hot or too cold (or something else entirely) and its physiological response may differ at the point of induced pain (e.g. the stimulus contact being a cold object or a hot cup of tea). However, pain in its peripheral and central mechanisms appears to have commonalities in the underlying endocannabinoid signalling which partially mediates nociception (the perception of painful stimuli). Many of the hormones and signalling cascades related to the analgesic activities of pain-relieving medications are mediated by cannabinoid signalling, for instance the action of Propofol a common anaesthetic is partially mediated by the expression of cannabinoid receptors (Guindon et. al. 2007 & Jarzimski et. al. 2012). Whilst the focus of the evidence base is centred around human studies some research that is included has been conducted in animals and presents a unique insight into the fundamental mechanisms underlying analgesia, such as the Guindon et. al. (2007) study. More translational research is needed in humans to validate these discoveries and see how they can contribute towards drug discovery and lead the development of safer analgesic practices in medicine.
The current theoretical model for the pain-relieving mechanisms of cannabis and its chemical constituents is based upon the interaction of cannabinoid signalling with hormonal and cellular signalling. This includes action upon targets such as prostaglandins, cell-to-cell signalling (such as neuron-glia interactions) and intra-cellular signalling (related to alterations in gene-transcription and metabolism of the cannabinoid receptors, fatty-acid-amide hydrolase receptors (FAAHrs), Transient Receptor Protein (TRPRs), various G-protein coupled receptors (GPCRS), and other typical and atypical neurotransmitters and receptors such as the 5-HT1a receptor at the neuron-neuron and neuron-glial synapses (e.g. tripartite synapses – Zogopoulos et. al. 2013 & Luongo et. al. 2014).
Altogether, the endocannabinoid system appears to play an important part in nociception and pain relief and has a complex role in both the main inhibitory and stimulatory pathways in the nervous system. This includes a role of the ECS in the function of the Glutamatergic and GABAergic neural pathways, which have yet to be fully understood (Simon & Cota 2017 & Aizpurua-Olaizola et. al. 2017).
The aim of this article is to provide a brief overview of key research studies and to share insight into the scientific research on cannabis, cannabinoids and nociceptive pain. Neuropathic pain will be covered as a separate topic when discussing neurological related disorders, however findings from research into different types of pain are still relevant to the overall discussion, as there is some overlap between the phenomena of nociceptive pain and neuropathic pain.
Area of research: Pain
What is currently in the evidence base surrounding cannabis, cannabinoids and pain? Included in the evidence base is a diverse range of studies on various medical conditions that provide insight into the science of pain ranging from conditions such as (but not limited to);
Pain is a difficult topic to investigate with a large variety of personal experiences surrounding pain and the diversity of different types of painful stimuli. With this in mind, it’s important to note that observational and naturalistic studies, whilst not as rigorous as laboratory and experimental studies, provide key insights into the way in which medical cannabis usage affects patients’ lives, their choices of pain-relieving medications and sense of wellbeing. Whatever the type of study or approach used to investigate pain there is still the fundamental issue of how do we actually measure pain?
Measuring pain
As pain is a difficult experience to describe and measure in the laboratory and clinic, the most common approach in pain studies is to use psychometric tests that correlate with the experience of pain such as the visual-analogue scale (VAS) also known as VAS pain scores (or VAS Pain Scale) which are commonly used in research and clinical practice. The psychometric VAS of testing pain is influenced by the subjectivity of the patients or participants in that moment in time and therefore provide a measurement of self-reported well-being and pain in that moment. The use of VAS-scores still provides key insights into the ways in which cannabis and cannabinoids act as pain-relieving medicines, especially as the drugs can be compared with other analgesic medications or placebo conditions. However, as cannabis can cause intoxication (similarly to other psychoactive medications such as opioids and benzodiazepines) the usage of VAS-pain scores could be regarded in some types of pain as misleading, as the person might be reporting a lower pain score based on their intoxicated mood. Nonetheless the relationship between nociception and subjective intoxication is an important area of research and may be a vital part of the pain relieving mechanisms underlying analgesic medications.
Other methods of researching pain include experimentation that may involve more objective lab-based processes such as direct measurements of the nervous system or brain measurements (e.g. EEG) that correlate with the painful experience and stimuli. There are also a variety of experimental pain models developed for use in animals and humans that utilise a diversity of nociceptive stimuli such as pressure, cold, heat and toxins (such as capsaicin injections). Often these experiences are used to study more acute ‘transient’ pain.
Further observational methods have been employed to study cannabis and cannabinoids in pain management, examples include using patient records to see how medical cannabis affects the use of opioids and other medications as well as accessing other important patient data that may correlate with pain such as biological imaging or assays of inflammatory biomarkers.
Case studies
The case studies of cannabis and cannabinoids for pain-management vary enormously in their detail, yet, N = 1 studies still provide a useful resource for healthcare professionals to share key knowledge from patients and help pave the way for anecdotal reports to be studied in more depth in experimental trials.
Some notable case studies include: reports of patients with chronic pain who wean themselves off all-other medications apart from cannabis (J. Rosado 2019), pain-management of Familial Mediterranean fever (Holdcroft et. al. 1997) and topical applications of cannabinoids for wound pain (Vincent Maida 2017 & Maida & Corban 2017).
Herbal cannabis (cold pressor tests)
Herbal cannabis as flower material has been investigated in experimental models of pain, usually using a vaporiser to administer the dose, however some studies have utilised cannabis cigarettes.
For example, Cooper et. al. (2013) investigated an experimental model of pain (cold pressor test) and compared smoked cannabis with oral Dronabinol (THC). Overall the two conditions did not differ in peak analgesic activity, however the oral dronabinol had a longer lasting effect.
Another study by the same group utilising the cold pressor test by Cooper et. al. (2018) investigated smoked cannabis cigarettes co-consumed with oxycodone to investigate potential analgesic synergy. The findings showed that the co-administration of smoked herbal cannabis and oxycodone produced greater pain relief than either medicine administered alone. There also seems to be little effect on the abuse liability of herbal cannabis with the administration of opioids, however the results did indicate a slight increase in the abuse liability of opioids during co-administration of cannabis and opioids (measured using subjective tests). The results suggest synergy between herbal cannabis and opioids as a potential method for more effective management of pain.
Another study by Wilsey et. al. (2016) looked at the vaporisation of herbal cannabis for its analgesic activity in central neuropathic pain (related to spinal cord injury and disease) and the results indicated that the pain-relief was dose dependent as inferred by the blood-concentrations of metabolites of THC. As the dosage of cannabinoids increased so too did the reported analgesic activity. Further research is on-going from this preliminary trial on herbal cannabis for the treatment of neuropathic pain.
Van Amerongen et. al. (2018) also conducted a study of oral THC and compared it against paracetamol in a cold-pain and pressure-pain test. The authors concluded that paracetamol as well as cannabis and promethazine wasn’t significant in reducing pain in these measures and that other tests should be considered for future experiments.
Hamann et. al. (1999) showed that Nabilone analgesia was not mediated by u-opioid receptors, inferred by the administration of Naltrexone (an opioid receptor blocker) that had no effect on the analgesic activity experienced by the patient. More research is needed to underpin the mechanisms by which cannabis and cannabinoids work, it’s likely to be mediated by a complex pathway of CBRs and other GPCRs.
See the evidence base for further studies and cannabis research.
Examples of experimental models of pain (heat and injections)
Redmond et. al. (2008) Nabilone did not reduce experimental heat pain at 1mg and 0.5mg doses. Kalliomäki et. al. (2012) investigated an experimental model of pain (injections of capsaicin) and found that small doses of oral Nabilone (THC) at 1mg, 2mg and 3mg were not significantly effective at reducing pain. Further, there were adverse events reported that led to the withdrawal of several participants (e.g. anxiety). The lack of effect observed might be due to the doses administered or the experimental methods, more research is needed to elucidate the pain-relieving mechanisms of Nabilone.
Chronic pain
In a study conducted by de Vries et. al. (2016) on chronic abdominal pain caused by chronic pancreatitis the researchers looked at a single-fixed dose of d-9-THC in an analgesic study comparing 8mg (d-9-THC) with an active placebo of Diazepam (5mg & 10mg). The results showed no significant difference in analgesic activity between the active placebo and d-9-THC administration. However, the PK data for THC metabolites indicated an enormous variation amongst participants and only mild side-effects were reported. Overall, the authors suggest future research is needed into the administration of d-9-THC and that further studies should look at different dosing regimens and pharmacokinetics.
Another study on non-cancer chronic pain by Crowley et. al. (2018) looked at the administration of a cannabis extract using a lozenge (Trokie ®) and found that patients self-report measures of pain decreased significantly within the trial. The onset of analgesia varied enormously between 5minutes and 40minutes (consistent with buccal absorption) and a large majority of participants (90%) were ‘satisfied’ or ‘very satisfied’ with the product. This research indicated that a lozenge may be an efficacious and safe way to administer cannabinoids to treat chronic pain.
See the evidence base for further studies and cannabis research.
Arthritis
A preliminary trial investigating Sativex, a THC:CBD product in the management of arthritic pain was conducted by Blake et. al. (2006) on a cohort of 58 patients. They found that the group taking Sativex reported a significant improvement in pain when compared against a placebo group, however there was no effect on morning stiffness. Average dose consumed across the group was 5.3 actuations of Sativex (approximately 14.1mg THC and 13.2mg CBD per day), however there was significant individual differences in experiences and pain relief. Overall the safety profile was deemed minor with no serious adverse events occurring. The role of cannabinoids in rheumatic related pain is under studied and the authors suggest further studies on arthritis patients and related conditions.
Fibromyalgia
Van de Donk et. al. (2019) conducted a single-dose trial with chronic pain patients who have Fibromyalgia and demonstrated that the responses to medical cannabis varied enormously based on the chemical profile of the cannabis, individual differences and the type of painful stimuli being investigated. They found that vapour inhalation of cannabis had no significant effect on spontaneous or electrical pain stimuli, however did report a significant analgesic effect in the pressure pain condition. Further, THC containing cannabis caused a significant increase in the pain threshold when compared against placebo. Overall, more research is needed on a variety of cannabis types with different chemical profiles, dosing regimens (e.g. repeated dosing) and models of pain.
Surgeries
Ostenfeld et. al. (2011) conducted research on a synthetic cannabinoid called GW842166 (Glaxo Smith Kline) that is a selective CB2 receptor agonist and trialled it in an acute-pain experiment in humans. The protocol was to compare the analgesic activity of GW842166 against ibuprofen and placebo after a minor dental procedure (molar tooth extraction). The findings showed that a single dose of 100mg or 800mg of GW842166 was not effective at reducing pain when compared with ibuprofen (which was superior in all end-points) and the 100mg GW842166 condition was similar in effect to placebo.
Post-operative surgery pain management
Post-operative care has been an area of research for cannabis and cannabinoid medicine in many different domains ranging from post-operative nausea and vomiting through to pain-management. The usage of cannabis and cannabinoids has been investigated in case studies of herbal cannabis and cannabinoids as well as some more stringent trials on synthetic cannabinoids and/or isolated compounds.
Holdcroft et. al. (2006) used a standardized cannabis extract in a test investigating post-surgery pain management properties in a group of patients who would usually require overnight opiate-based pain relief (typically morphine). The investigators administered a single fixed dose of the cannabis extract post-operation that consisted of three different dosage strengths of either 5mg, 10mg or 15mg THC-rich cannabis extract (capsules). They had a total of 65 patients taking the single fixed dose of cannabis extract with 11 patients taking 5mg, 30 patients taking 10mg and 24 patients taking 15mg (see Table 1 of the study for more details). Following this they measured various pain scores, adverse-effects and observed whether the patients needed to take any ‘rescue medication’ to relieve pain. Pain relief was positively associated with the increasing dosage of oral cannabis extract in this study which was inferred by measuring pain via verbal report along with the request for rescue medication by patients. For instance, rescue medication was requested by 11/11 (100%) of the patients in the 5mg THC-extract cohort, whereas 15/30 (50%) for the 10mg THC-extract group and 6/24 (25%) for the 15mg THC-extract group (see Table 2 of the study for more details).
Weizman et. al. (2018) show that the emotional centres of the brain are functionally active in the analgesic activity of psychoactive cannabis and THC. In this study they showed that THC oil reduced neuropathic pain in patients (that was associated with activity in the anterior cingulate cortex and the dorsolateral prefrontal cortex brain regions).
Other studies on pain, cannabis and cannabinoids
The way in which medical cannabis is being dispensed into cannabis using populations has an observable impact on consumer behaviour, drug-choices and preferences for pain-relief. However, the use of pain-relieving medication is a complex factor that must also consider socio-economic factors as well as the level of mental health facilities and education around pain-relieving medicines (such as opiates). Data emerging from various countries which have employed medical cannabis ranging from the USA and Canada (which have medical cannabis specific outlets) to countries like Denmark, Italy or Germany (which have completely different models of cannabis regulation) are producing observational reports.
Boehnke et. al. (2019) investigated a cohort of USA medical cannabis users who have access to medical and recreational cannabis and results indicated that consumers are using cannabis as a substitute for opioids and benzodiazepines.
In another trial Ware et. al. (2010) investigated cannabis smoking (of various THC potencies) in 21 neuropathic pain patients (related to surgery or trauma). The results indicated a reduction in pain scores that were positively associated with the THC-strength of the cannabis, for instance 9.4% THC cannabis provided greater pain-relief when compared with 0% THC cannabis. The authors report that medical cannabis may be used as an effective pain management tool.
Chronic pain
Other studies have produced different findings for example de Vries et. al. (2017) conducted a clinical trial on chronic abdominal pain using isolated d-9-THC (3mg three times a day and 5mg three times a day) and reported that it wasn’t effective in reducing pain in this trial when compared against placebo. More research is needed on this kind of pain and with isolated THC in relation to individual differences in pharmacokinetics, dosing regimens and potential medicines with a variety of active pharmaceutical ingredients.
O’Connell et. al. (2019) investigated the use of various pain medications used alongside side cannabis over a six month period. They found that medical cannabis users had significantly lower morphine use. Interestingly, no significant reduction in diazepam use was observed in this study. Further investigations on larger cohorts of patients are needed, especially as cannabis use is becoming increasingly popular. This will lead to greater insights into the co-consumption of cannabis and other pain relieving medications.
A note on patient perspectives
Patients and healthcare professionals have varying perspectives on medicine choices when it comes to pain medicine and it’s crucial to understand patients’ attitudes, concerns and needs, as well as that of their families. Aside from the numerous case studies and anecdotes available there are several reports detailing the attitudes of patients and their families. One such study by Rochford et. al. (2019) demonstrated that the majority of Irish patients and their families are pro-cannabis as a medical choice and believe it will be therapeutic for their conditions. Though at present there is limited access to medical cannabis, the authors suggest the health authorities change this to empower and reflect the therapeutic options that patients need.
See the evidence base for further studies and cannabis research.
In conclusion the scientific evidence base surrounding the efficacy and safety of cannabis and cannabinoids for pain management is varied with findings from lab experiments through to observational studies demonstrating an enormous amount of individual differences amongst participants. The safety, efficacy and quality of cannabis products for medicinal use is of paramount importance to medicine and scientific research, especially in order to accurately study the effects of active pharmaceutical components that aren’t just restricted to a single compound such as THC (or a similar compound e.g. Nabilone). Currently as cannabis laws change and facilitate access to medical cannabis, the research associated with it will become increasingly important to understand. Whilst there are still barriers to access for many patients wanting to use cannabis and cannabinoids as pain relief, the increase in medical cannabis use will result in larger scale and better scientific research (e.g. on the ECS & analgesia) as well as medical trials. Across the board medical cannabis dispensaries and clinics are paying attention to patients’ experiences and aiding regulators and governing authorities in exploring cannabis as a cost-effective and efficacious treatment for pain management.
By Zack Bellman, Researcher at The Academy of Medical Cannabis.
Poor testing standards and lax regulation means that some CBD products in the UK have illegal levels of THC or no CBD at all. Now the industry is starting to regulate itself
Depending on who you ask, CBD oil is either a cure-all or the snake oil of our age. It’s been touted as a treatment for epilepsy, psychosis and anxiety and has found its way into chocolates, gummies and chewing gum, adding up to an overall market that is set to be worth almost £1 billion per year by 2025 in the UK alone.
But while the argument over whether a bottle of CBD oil can really calm your nerves rumbles on, there’s a far more pertinent problem: that bottle might not even have any CBD in it.
Lab tests from the Centre for Medicinal Cannabis (CMC) in June found that 62 per cent of the UK high street products studied didn’t contain the CBD content promised on the label. One product (retailing for £90) had no measurable amount of the non-toxic cannabis compound at all. And where lacking in advertised cannabidiol, some products were packing tetrahydrocannabinol (THC), the intoxicating – and illegal – chemical that causes a cannabis high. According to the report nearly half of tested products had low levels of THC or cannabinol (CBN), another psychoactive substance.
And although these products are unlikely to get anyone dazed and confused, they indicate that the CBD industry’s standards are hardly high. So how are the CBD companies slipping illegal cannabis compounds onto high street shelves? And why aren’t the regulators spotting them?
“It’s not like people are wilfully doing this,” says Shomi Malik, development director at the CMC. “People don’t know what they don’t know.” This ignorance can be partly blamed on the CBD labs’ unfamiliarity with cannabis chemistry. Packed with over 400 unique compounds – which have been notoriously difficult to study due to the drug’s prohibition – cannabis isn’t your average cosmetic. And as its medicinal use only became legal in the UK last November, the country is still lacking qualified cannabis chemists. “It is a lack of domain experts in the field,” Malik says. And in the CBD labs, this lack of experts is causing some clumsy errors.
The problem, Malik says, is that many testing machines are way off the mark. “When you calibrate a [testing] machine [..] I need to tell it what peak is THC, what peak is CBD, and all the other cannabinoids. To be able to do that, you need to buy standards,” he says. “So you buy highly refined pharmaceutical-grade THC. And then once you’ve calibrated it, your machine knows what THC looks like. Now, if you buy a standard from a company that isn’t accredited, then you’re starting off on the wrong foot in a massive way.”
According to the CMC, these aren’t one-in-a-million mistakes, they’re easy-to-make errors that could be avoided if more lab analysts in the UK knew how to work with cannabis material. But while that may be the manufacturers’ excuse, the UK’s health and safety regulators may need a better one.
“There’s no real quality control and manufacturing standards,” says Harry Sumnall, a professor of substance use at Liverpool John Moores University. “In the UK, we have a number of regulatory agencies which could be looking at this, including the Medicines and Healthcare products Regulatory Agency (MHRA) and the Food Standards Agency (FSA) – all of those organisations are under resourced […] so it’s difficult for them to provide that oversight, which they might do for other products, because the [CBD] market’s too big.”
Having grown from a botanical novelty to a £300 million market in just three years or so, it’s not surprising that CBD’s retail demand has outpaced its regulation. Thankfully, there are a couple of rules under UK law. Any claims around medical benefits are a strict no-go – CBD is only considered medically beneficial when given in clinical doses – and any measurable amount of THC in a product requires a license from the Home Office. But according to the CMC report, this latter rule is already being broken, and thanks to global media exposure and wellness hype, retail CBD products are already inextricably tied to compound’s medical benefits in the public eye.
“CBD is all over the media, and has been presented as a miracle substance,” says Sumnall. “There’s often a focus on big US celebrities launching products ranges, and some of the claims they make that perhaps those sorts entrepreneurs wouldn’t be able to make here in the UK because of medicines regulations.”
So with rules already being broken and little oversight from regulators, how can people be confident that their CBD products are safe?
“Thankfully, we’ve not come across any issues around harmful CBD products in the UK,” says Sumnall. “But just look across the Atlantic to the USA where there’s an unregulated market around THC-based vaping oils. And we know that poorly regulated markets can be associated with harms, so there [are] concerns there.”
Fortunately, several studies have found CBD to be well tolerated in most people and the World Health Organisation has said that “to date, there is no evidence of public health related problems associated with the use of pure CBD.” But with UK testing so unreliable, it’s not the CBD that’s got people like Sumnall and Malik concerned about consumer health. It’s everything else the retail products could contain. After all, one of the CBD products from the CMC’s report contained 3.8 per cent ethanol, legally making it an alcoholic beverage. So to help limit such contaminants, the CMC recently launched a new review of analytical testing in the UK CBD industry, which it hopes will help establish robust, standardised methods for analytical labs.
“We at the CMC will be setting up the standard, that [says], ‘this is the quality we want in the testing of these samples’,” says Parveen Bhatarah, CMC’s regulatory and compliance lead. “So we’ll be setting up all those standards and sharing them with the CMC members, and hopefully sharing it with the FSA to ensure that we are actually sowing the seeds [as to] how we are going to regulate this market.”
One such CMC member that will be taking part in the new review is Dragonfly CBD, a cannabidiol brand stocked by Boots pharmacies and Harrods department store. “We became a member of the CMC because I think it’s really good to have insightful conversations with those across a lot of different parts of cannabis,” says Hannah Skingle, Dragonfly’s chief operating officer. “[As a CMC member], we consider how we can properly regulate this market in its current state and what we as companies, ethically, should do to really ensure our customers are getting the highest quality product.”
Dragonfly CBD is also bound to the CMC’s recent CBD charter, which commits every member to work with accredited labs and keep to a marketing code that prohibits inaccurate labelling and any reference to medical claims, sexuality or violence. Along with the CMC’s testing review, the charter is another sign that the UK’s CBD industry might be finally maturing and accepting accountability. But there are some who wonder if this kind of internal regulation is ultimately for the benefit of CBD consumers or companies.
“Because of these difficulties in regulation, you have organisations like the Centre for Medicinal Cannabis – they have stepped into this role,” says Harry Sumnall. “Even though very well intentioned, it’s very much a form of self-regulation, which might actually be modelled on the interests of their members and their donors.”
“I think in an ideal world, we’d have much better resourced regulatory agencies, which are independent, such as the FSA and the MHRA, who would be doing this job,” Sumnall says. “So it’s understandable that self-regulation has emerged in the absence of those agencies having that capacity.”
But ultimately, whether it arises internally or externally, any form of lab standardisation should benefit CBD customers. By equipping themselves with the same machines and standards, there’s a good chance labs will be able to spot illegal impurities and finally agree on their products’ CBD contents. And as funding new equipment and training will likely drive up businesses’ production costs, the move could also help see the end of the smaller, CBD companies, which may have always been light on the testing.
“I think as the industry grows, we will whittle out those who may be entrepreneurial… and they’re just kind of working it out,” says Skingle. But, she warns, while regulatory oversight remains light, the ultimate responsibility of making sure CBD products contain what they say the do will rest with the CBD firms themselves. “It’s important not only to get third party test, but to also internally test yourself and really ask questions to your testers like, ‘what are the standards that you’re setting?’ Because, realistically, there aren’t any.”
Center for BrainHealthSummary:
Researchers have investigated the effects on the brain of concurrent cannabis and nicotine use, versus the use of solely cannabis and solely nicotine.
Researchers at the Center for BrainHealth® at the University of Texas at Dallas investigated the effects on the brain of concurrent cannabis and nicotine use, versus the use of solely cannabis and solely nicotine.
The results, recently published in the journal Brain Structure and Function, show that not only were the effects in these three categories different, but also that the group using both nicotine and cannabis more closely resembled the control (non-user) group in brain connectivity. The isolated nicotine and isolated cannabis users showed equally less connectivity in general.
Previous research in rats has suggested that nicotine may be a “gateway drug” leading to cannabis and other drug use. Studies performed with rats exposed to THC — the main psychoactive compound found in marijuana — demonstrated an increased likelihood to self-administer nicotine that was not observed with rats exposed to heroin or cocaine, suggesting that there is something unique about the cannabis-nicotine interaction.
“Most of the literature to date has focused on associations of isolated cannabis and nicotine use, even though concurrent cannabis and nicotine use is more prevalent in society than cannabis use alone,” said the study’s lead author, Dr. Francesca M. Filbey, the Bert Moore Chair in BrainHealth at UT Dallas. “Our findings confirm the limitations of existing research.”
While the outcome of the study could be, in part, due to the opposing effects nicotine and cannabis have on the brain, the difference in the brains of concurrent users versus isolated users of each product begs for further research in functional connectivity metrics in these populations, Filbey said.
MRI scans were used to evaluate resting state functions in 12 different regions of the brain among four groups of participants: 28 nicotine users, 53 cannabis users, 26 nicotine and cannabis users, and 30 non-users in a control group. These scans revealed that the control group displayed greater connectivity in almost all of the networks compared to the nicotine and cannabis groups, while the combined nicotine plus cannabis group had greater connectivity than the only-nicotine and only-cannabis groups. Notably, this study did not demonstrate a correlation between substance use severity and functional connectivity.
Differences in brain network connectivity suggest alterations in the underlying neural architecture of the brain that support brain function. Overall, Filbey said the study suggests unique and combined contributions of cannabis and nicotine on brain network connectivity, which could be helpful knowledge for intervention programs.
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