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Red Cross Meets Green Cross

CannaCraft, Red Cross

A major legal medical marijuana factory in Northern California has become the headquarters of the American Red Cross’ relief efforts for tens of thousands of displaced evacuees fleeing the state’s historic series of wildfires.
By David Downs On October 17, 2017

From Greenstate.com

A major legal medical marijuana factory in Northern California has become the headquarters of the American Red Cross’ relief efforts for tens of thousands of displaced evacuees fleeing the state’s historic series of wildfires.

The 140-employee company CannaCraft in Santa Rosa is feeding and hosting 200 Red Cross staff for the next five weeks, said Kial Long, spokeswoman at the company. CannaCraft is providing 12,000 square-feet of office space to be used as the American Red Cross Regional Headquarters for Northern California fire relief.

Cannabis remains a federally banned controlled substance considered as dangerous as heroin. But eight states and Washington D.C. have legalized its over the counter use by adults 21 and over. Twenty-nine states have medical cannabis laws. Some 61 percent of U.S. voters support cannabis legalization and 91 percent support medical access to the pain-relieving botanical drug.

Hosting the Red Cross came out of company discussions about ways to help. After surveying available space and equipment, CannaCraft leaders reached out to the Red Cross and offered office space. The Red Cross sent a project leader over to evaluate the space.

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Fire, Brimstone & Dioxin

Fire and cannabis

Heavy smoke has blanketed the skies in the nine-county San Francisco Bay Area, poisoning the air to an unprecedented degree and prompting air quality alerts and health advisories throughout the region.
By Adrian Devitt-Lee On October 16, 2017

Toxic Smoke Threatens Cannabis Crop and Public Health
Highlights:
  • Smoke from major fires will contaminate crops in Northern California’s prime cannabis-growing region.
  • Cannabis, a bioaccumulator, will uptake heavy metals from the soil that have deposited on the ground.
  • Analytical labs should test cannabis products for an array of fire-related heavy metals, aromatic hydrocarbons, and dioxins, even those that are not mandated by regulations.

The October firestorms raging in Northern California have incinerated nearly a quarter million acres and displaced more than 100,000 residents. Heavy smoke has blanketed the skies in the nine-county San Francisco Bay Area, poisoning the air to an unprecedented degree and prompting air quality alerts and health advisories throughout the region.

“We have never recorded higher levels of air pollution in the Bay Area,” said air district spokeswoman Kristine Roselius.

While a limited number of deaths have been reported thus far, the public health impacts of this disaster will be felt for many months to come. This is not a typical wildfire; in Santa Rosa, flames have melted gas pipes, power lines, even a cellphone tower. The blaze has scorched thousands of homes and cars, releasing metals into the air. Rubber, fibreglass, paint, and electrical equipment burn to uncommon and highly dangerous toxins, such as dioxins and other biphenyl compounds.

Poisons contained in the smoke will slowly fall from the air and be absorbed by plants and the watershed, contaminating agricultural crops, including those in the Emerald Triangle, America’s cannabis breadbasket. The timing couldn’t have been worse for cannabis farmers as these fires came at the start of harvest season. Cannabis producers and consumers need to be cautious about the chemicals that could accumulate.

There are three common ways that toxins and carcinogens in smoke can be removed from the atmosphere:

  • Volatile chemicals like formaldehyde and carbon monoxide will dissipate by reacting with trace gasses in the air, perturbing the concentration of ozone and other gasses. When carbon monoxide reacts with oxygen radicals, for example, it converts to carbon dioxide.
  • Hardier chemicals may be removed from the sky by wet deposition, whereby rain pulls pollution out of the atmosphere. But that requires precipitation. And if it rains, highly toxic run-off will pollute the watershed.
  • Other chemicals will simply fall from the sky and deposit onto plants, soil, and other solid surfaces. These compounds include benzene, polycyclic aromatic hydrocarbons, and dioxins. The chemicals that settle on cannabis or nearby water and soil can be absorbed by the plant and passed on to the consumer. Cannabis, a bioaccumulator, will uptake heavy metals from the soil that have deposited on the ground.

While these toxins can pose serious health hazards, it is important not to exaggerate harms. Cannabis smoke (even from untainted, organically grown cannabis) also contains carcinogens, but smoking marijuana does not increase the risk of oral and lung cancers—possibly because THC, CBD, and other plant cannabinoids exert a direct anti-tumor action against oral and lung cancer.

Another factor that may mitigate harm from inhaled cannabis smoke is the inhibition of a group of enzymes called CYP1A. Polycyclic aromatic hydrocarbons become more carcinogenic when metabolized by CYP1A enzymes in the body: By inhibiting CYP1A in the lungs, cannabinoids could reduce the activation of these carcinogens.

In cannabis smoke, roughly 0.5% of the plant material converts to polycyclic aromatic hydrocarbons. That is 5000 parts per million by weight (ppm). Carcinogenicity of aromatic hydrocarbons is usually discussed at concentrations on the order of 10 ppm.1 It remains to be seen if toxins deposited by the fires will be greater than the concentrations normally found in cannabis smoke. If not, then this cannabis is likely safe to consume (though it may require a warning under prop 65). To reduce further toxicity, it would be best for people to avoid smoking cannabis tainted by the wildfires: vaporization and ingestion are alternatives.

But consumers should also be aware that extraction processes (including butane, ethanol, and CO2) may concentrate these unwanted chemicals, though this is not precisely known. Cannabis producers and consumers should make sure, if possible, that any lab tests apply to the final product, not just the plant material that was used for extraction.

Accurate testing is paramount. Unfortunately, some cannabis labs have a record of providing results before they have validated their methods and can be certain that their numbers are correct. (Validation involves spiking precise amounts of contaminants into clean cannabis samples to ensure that accurate results are obtained.)

Several fire-generated toxins that may be deposited on cannabis crops—including benzene and toluene—are on the list of regulated solvents that California labs will likely have to quantify in cannabis products as of 2018. In preparation for the upcoming regulations, analytical labs may have already validated methods for detecting these compounds.

But other, less common toxins, such as benzopyrenes and polychlorinated dibenzo dioxins (PCDDs; sometimes simply called dioxins), are not included in the new regulations. Dioxins are particularly important: they are formed when chlorinated plastics burn, such as PVC pipes. One kind of dioxin, which is called TCDD, disrupts endocrine, immune, and reproductive systems as well as fetal development. It is also a carcinogen at larger concentrations. (TCDD was also a contaminant in Agent Orange, a chemical weapon created by Monsanto and used in the Vietnam war.)2

Whether mandated by state regulations or not, cannabis labs should also test for these compounds.3 Thus far, however, cannabis labs have not validated testing procedures for these compounds.

Another concern: helicopters and planes have been dumping tons of fire-repellant in an effort to contain the fires. The fire-repellant used, another Monsanto-designed product called Phos-Chek, may also have adverse health consequences. One of the main constituents of Phos-Chek is ammonium salt. Ammonium is a fertilizer: If absorbed through the plant, it is unlikely to be toxic, but smoking or vaporizing ammonium stuck on cannabis resin should be avoided.4

Project CBD hopes that some lab in California will validate methods and offer tests to detect the major contaminants that result from the wildfires. We expect these will include benzene, toluene, benzopyrenes, and heavy metals, as well as some dioxins and polychlorinated biphenyls.

Adrian Devitt-Lee, a Project CBD contributing writer, is a senior research associate with CannaCraft.

Footnotes:

  1. Parts per million is a unit that can cause some confusion. It can mean concentration by weight (ppmw) or by volume (ppmv). When discussing cannabis and lab tests, parts per million is measured in weight: ppmw means microgram of contaminant per gram of cannabis. (A microgram, written µg, is one millionth of a gram.) But when talking about safety data, especially for inhaled compounds, parts per million is usually micrograms of contaminant per liter of air. This makes it much easier to determine the concentration of contaminants in a person’s lung. Since an adult human’s lungs contain about 4-6 liters and a joint weighs about half a gram, ppmv is roughly 10 times larger than ppmw. In other words, the lab test for a contaminant should be no more than 10 times larger than the safety parameter for inhaling that contaminant. This is a rule of thumb, not a definitive statement. See the report in footnote 4 for more information on safety data.
  2. TCDD is pervasive in the environment. It can be found at low concentrations in milk and meat, with beef being the worst offender. This is partly because dioxins are extremely durable compounds—the half life of TCDD is close to 10 years. The average human body has roughly 1-5 parts per trillion dioxin in their fat tissue (that is, 1-5 picograms of dioxin per gram of fat). These levels have been declining greatly since the 1970s.
  3. This list is not finalized. The proposed regulations were repealed after the public comment period by the trailer bill, the bill that merged recreation and medical cannabis regulations. The new regulations have not yet been released.
  4. Inhaling ammonia in cannabis at concentrations below 100 ppm is likely safe. 100 ppm means 100 µg ammonia per g cannabis product. The number is based on the equation described Appendix A of this report by Project CBD. Using the terminology from that document, the STEL for ammonia is 27 µg/L. It is reasonable to assume that children use less than 0.25 grams of cannabis and that adults use less than 1 gram of cannabis in a 15 minute period. This increases the estimates in the document by a factor of four.

Sources

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Target Sold CBD Online: Was it Legal?

BuzzFeed recently reported on Target’s short-lived effort at selling cannabis-based products online. By the end of the day on which the story ran, the major retailer had already removed the product from its website. The Phoenix New Times quoted Target spokesperson Kate Decker as saying, “We started carrying Charlotte’s Web hemp extract items last week on Target.com. After further review, we have decided to remove it from our assortment.” However, the Phoenix New Times reported earlier in September that Target was selling CBD products online. Decker could not confirm exactly when Target started selling CBD. The only certainty is that it ended the same day as BuzzFeed’s article.

The thing is that many online retailers (WalMart, Groupon, and Amazon) sell or have sold CBD online. This is in part likely because of the complex legal status of CBD. The Drug Enforcement Agency’s (“DEA”) stance is that CBD, and other cannabinoids derived from cannabis, are Schedule I substance under the Controlled Substances Act (“CSA”), regardless of their source. Last year the DEA created a rule defining “marihuana extract” as an extract “containing one or more cannabinoids derived from any plant of the genus Cannabis,” as marijuana, a Schedule I controlled substance. Use of “any” means it applies to any derivative of the cannabis plant including, CBD and other cannabinoids found in cannabis. This far-reaching definition, on its face, purports to make parts of the cannabis plant that were seemingly legal illegal.

Setting aside the Rule, there are three scenarios in which cannabis extracts are arguably legal under federal law. The first being when extracts are derived from the “mature stalk” of the cannabis plant because the CSA’s definition of marijuana “does not include the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted therefrom), fiber, oil, or cake, or the sterilized seed of such plant which is incapable of germination.” 21 USC § 802(16). The DEA has clarified that the Rule does not include portions of the plant specifically exempt from the CSA’s definition of marijuana but also maintains that products that contain any meaningful amount of CBD can be derived from the mature stalks.

The second scenario is when extracts are derived from an industrial hemp plant lawfully grown in compliance with section 7606 of the 2014 US Farm Bill (“the Farm Bill”). The Farm Bill allows states to enact pilot programs for hemp research making hemp legal in the state’s borders. Hemp cultivated in compliance with a State’s program is expressly legal under the Farm Bill. Extracts from compliant hemp are legal in the State in which they were derived though the sale of these products in other states is not explicitly allowed.

The final scenario is when products are derived from imported hemp. In the early 2000s, two cases out of the Ninth Circuit, Hemp Indus. Ass’n v. DEA, 357 F.3d 1012 (9th Cir. Cal. 2004) and Hemp Indus. Ass’n v. DEA, 333 F.3d 1082 (9th Cir. 2003) determined that the DEA cannot regulate hemp products simply because they contain trace amounts of THC. This is because some portions of the cannabis plant are explicitly outside the scope of the CSA and the DEA was not permitted to expand its scope to encompass all parts the plant. At the time of the ruling, it was illegal to grow hemp so it only applied to hemp imported from outside the USA. However, its holding could also apply to hemp grown pursuant to the Farm Bill. In other words, marijuana extracts from non-psychoactive (industrial) hemp with only trace amounts (or less) of naturally occurring THC are permitted under the Ninth Circuit’s ruling.

The Hemp Industries Association has sued the DEA over the “marijuana extract” rule and that case is still pending and until it is decided, uncertainty remains as to the legality of CBD products. The DEA may very well lose because the Rule appears to conflict with the Farm Bill and the Hemp Industry cases from the early 2000s. Nonetheless, despite potential legal flaws, the Rule is currently in place and anyone who distributes “marijuana extracts” is a potential target of the DEA. This is likely why online retailers like Target have flirted with selling CBD products online but often end up pulling products.

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Target Sold CBD Online: Was it Legal?

BuzzFeed recently reported on Target’s short-lived effort at selling cannabis-based products online. By the end of the day on which the story ran, the major retailer had already removed the product from its website. The Phoenix New Times quoted Target spokesperson Kate Decker as saying, “We started carrying Charlotte’s Web hemp extract items last week on Target.com. After further review, we have decided to remove it from our assortment.” However, the Phoenix New Times reported earlier in September that Target was selling CBD products online. Decker could not confirm exactly when Target started selling CBD. The only certainty is that it ended the same day as BuzzFeed’s article.

The thing is that many online retailers (WalMart, Groupon, and Amazon) sell or have sold CBD online. This is in part likely because of the complex legal status of CBD. The Drug Enforcement Agency’s (“DEA”) stance is that CBD, and other cannabinoids derived from cannabis, are Schedule I substance under the Controlled Substances Act (“CSA”), regardless of their source. Last year the DEA created a rule defining “marihuana extract” as an extract “containing one or more cannabinoids derived from any plant of the genus Cannabis,” as marijuana, a Schedule I controlled substance. Use of “any” means it applies to any derivative of the cannabis plant including, CBD and other cannabinoids found in cannabis. This far-reaching definition, on its face, purports to make parts of the cannabis plant that were seemingly legal illegal.

Setting aside the Rule, there are three scenarios in which cannabis extracts are arguably legal under federal law. The first being when extracts are derived from the “mature stalk” of the cannabis plant because the CSA’s definition of marijuana “does not include the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted therefrom), fiber, oil, or cake, or the sterilized seed of such plant which is incapable of germination.” 21 USC § 802(16). The DEA has clarified that the Rule does not include portions of the plant specifically exempt from the CSA’s definition of marijuana but also maintains that products that contain any meaningful amount of CBD can be derived from the mature stalks.

The second scenario is when extracts are derived from an industrial hemp plant lawfully grown in compliance with section 7606 of the 2014 US Farm Bill (“the Farm Bill”). The Farm Bill allows states to enact pilot programs for hemp research making hemp legal in the state’s borders. Hemp cultivated in compliance with a State’s program is expressly legal under the Farm Bill. Extracts from compliant hemp are legal in the State in which they were derived though the sale of these products in other states is not explicitly allowed.

The final scenario is when products are derived from imported hemp. In the early 2000s, two cases out of the Ninth Circuit, Hemp Indus. Ass’n v. DEA, 357 F.3d 1012 (9th Cir. Cal. 2004) and Hemp Indus. Ass’n v. DEA, 333 F.3d 1082 (9th Cir. 2003) determined that the DEA cannot regulate hemp products simply because they contain trace amounts of THC. This is because some portions of the cannabis plant are explicitly outside the scope of the CSA and the DEA was not permitted to expand its scope to encompass all parts the plant. At the time of the ruling, it was illegal to grow hemp so it only applied to hemp imported from outside the USA. However, its holding could also apply to hemp grown pursuant to the Farm Bill. In other words, marijuana extracts from non-psychoactive (industrial) hemp with only trace amounts (or less) of naturally occurring THC are permitted under the Ninth Circuit’s ruling.

The Hemp Industries Association has sued the DEA over the “marijuana extract” rule and that case is still pending and until it is decided, uncertainty remains as to the legality of CBD products. The DEA may very well lose because the Rule appears to conflict with the Farm Bill and the Hemp Industry cases from the early 2000s. Nonetheless, despite potential legal flaws, the Rule is currently in place and anyone who distributes “marijuana extracts” is a potential target of the DEA. This is likely why online retailers like Target have flirted with selling CBD products online but often end up pulling products.

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Growers Supply joins National Hemp Association

SOUTH WINDSOR, Conn. (September 7th, 2017) – Growers Supply, the manufacturer of GrowSpan Greenhouse Structures, has become a proud member of the National Hemp Association.

Growers Supply announced its support for the NHA and is excited to help hemp growers and the entire industry. The company has nearly four decades of experience designing and building the highest-quality greenhouse structures. With greenhouse specialists and expert consultants on staff, Growers Supply is dedicated to providing hemp growers with the cultivation solutions they need, while also promoting and advancing the entire industry.

“NHA is thrilled to have Growers Supply join our membership” said Erica McBride, the Executive Director of NHA. “It is the support of our valued members that allows us to focus on our prime mission of passing HR3530 (The Industrial Hemp Act of 2017) and building a multi-billion dollar industry.”

Growers Supply is committed to helping the NHA develop the hemp industry, and in recent years, the company has revamped their line of products to better meet the needs of emerging hemp growers. With new greenhouse systems and light deprivation systems, Growers Supply has designed and created a wide range of products to help growers improve their operation’s functionality and profitability.

Growers Supply is eager to work with the NHA to further develop the hemp industry. To find out more, visit Growers Supply’s greenhouse-dedicated website, GrowSpan.com.

For more information on Growers Supply, visit www.growspan.com or call 1.800.476.9715 to speak to a Greenhouse Specialist.

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There is still time to apply for a hemp license in NY

The deadline to apply for a 2018 hemp license in NY has extended until November 22, 2017

New York is cultivating the industrial hemp market and supporting new opportunities to grow this multi-million dollar crop, which is used in the manufacture of an estimated 25,000+ products—from clothing and food to building materials and pharmaceuticals.

https://www.agriculture.ny.gov/PI/Hemp_Program_Application.pdf

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Reflections on Farm Aid 2017

NHA was thrilled to have the opportunity to set up in the Homegrown Village at Farm Aid this year. We teamed up with our PA partners, Pennsylvania Hemp Industry Council, Limeworks and Hemp Heals Foundation.

This year Farm Aid was held in Burgettstown, PA. It was a beautiful venue with all of the fall harvest decorations everywhere and the entire show was extremely well organized.

It’s always a wonderful thing to have such an opportunity to educate not only the general public but farmers as well. While many of us are immersed in the hemp world, its easy to forget just how important education is. There are still so many misconceptions to overcome. But the good news is that once people are shown the tremendous potential of hemp – support is nearly universal.


Check our our Facebook live video:


It was great to see hemp so well represented! In addition to our display Elishewa ShalOm from Artisan Hemp was in the Skills Tent and gave a hands on paper making workshop.

The highlight of our display was our Hempcrete Wall deomonstration hosted by our friends at Limeworks. Concert goers had the opportunity to help mix the Hempcrete and build the wall. It was a big hit!

Doors opened at 11 and the Homegrown Village ran until 5 o’clock. Once the people began arriving we had a non-stop stream of interested visitors. Because we were so busy and the day flew by so fast, we didn’t get a chance to take as many photos or videos as we would have liked. Even if we had, it would have been very difficult to capture the excitement and over all good vibes of the day.

And then there was the music….

The show started in the afternoon but the headliners didn’t start until after the Village had closed. We were thrilled to have the opportunity to join the tens of thousands of people there to enjoy the awe inspiring talent that took the stage to benefit farmers. For a taste of the amazing performances we experienced check out some of the videos and photos posted on the Farm Aid Website.

Should Farm Aid ever come to a town near you we highly recommend you go! Not only is it an experience you won’t soon forget, its for a great cause. A cause that closely aligns with our mission to see emerald fields of hemp being grown all across this great nation!

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DC Fly-In Update

Update from our Chairman, Geoff Whaling:

Over the last number of weeks, we have continued to grow our reach and leadership within a number of States and in our nation’s capital. We are pleased to be able to represent your interests with State legislatures, Congressional Members, their Staff and with the new Administration.

As many may know, I also represent farmers in my Board position with the Farmers Union. These two roles allow me to represent hundreds, if not thousands of farming families on the important issues that are the most challenging – fair markets, fair wages, keeping the Farm Bill intact and affordable health care. What this role also affords me is to point to the opportunities and solutions that could be achieved if we had Federal Industrial Hemp legislation.

The National Farmers Union Fly-in was September 8-11th. More than 350 NFU Members descended in Capital Hill to raise these issues. They all were armed on the most pressing talking points, but also carried NFU’s full endorsement of Industrial Hemp legislation with them into their discussions. Many elected are now beginning to see the tie in to farmers and our crop.

From there, NHA Executive Director, Erica McBride and I joined in with NHA’s Business Council affiliate, the US HEMP ROUNDTABLE, for a full-day of meetings focused specifically on HR3530 – the Industrial Hemp Farming Act. This also included a meeting with the Bill’s Sponsor, Representative Jamie Comer (R-KY), who updated us on discussions to date with Committee Chairman and Senate Members (who will no doubt have their own, separate, Industrial Hemp Bill).

You can play an important role in helping advance HR3530. The Bill will go to 2 House Committees – Energy and Commerce and Judiciary. Each of those will assign it to a sub-committee for consideration and a vote. We now know that HR3530 is assigned to the Energy and Commerce Health Sub Committee. Please check out their membership and see if you are represented by one of these Congressman/woman. If so, please research and contact their office. Speak with the Congressman/woman’s Legislative Director or AG Policy staffer. Lend your support for HR3530 and ask that they become a co-sponsor of the Bill or support its passage through the Health Sub-Committee and the full Energy and Commerce Committee. Once we know which committee the Bill will land at in Judiciary, we will send an update and request.

Please let us know of your legislative approaches and achievements! We’d like to highlight them in a future post.

We could not undertake our work without your input and support. Membership is important to demonstrating the reach of the industry and the growing numbers who want access to our crop. Thank you!

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Vicki & Aubrie Hill and Intractable Epilepsy

patient testimony on using cannabis for epilepsy

The story of Aubrey Hill and her mom who moved to California to get reliable access to cannabis oil to treat her intractable epilepsy — with positive results.
A patient story with a happy ending

A few weeks ago I met Vicki and Aubrie at an event here in Northern California. When they found out that I was the medical director for Hawaiian Ethos, Vicki couldn’t wait to talk to me. With courage and persistence over many years, they have figured out what works best for Aubrie’s epilepsy, and were eager to have me tell their tale. There is a wealth of scientific evidence on the use of cannabis in seizure disorders but nothing carries the message as well as a good story with a happy ending.

This is the story of a vibrant young girl and her determined, brave mother. In 2000, at age five, Aubrie got her scheduled MMR booster. Ten days later she developed a low-grade fever that lasted for 24 days. As the fever persisted, she was getting dehydrated and going deeper into what her mother called a ‘deep, strange sleep.’ She lost her ability to speak and her personality changed, with a loss of interest in her surroundings – unusual for this active five year old. After three weeks, her mother insisted she be hospitalized in Huntsville, Alabama where they lived, because she knew something was terribly wrong. Aubrie was seen by neurologists and, along with a myriad of other diagnoses, they assumed she might have multiple sclerosis. After one week in the hospital she experienced her first seizure, had a lumbar puncture, and they found grey matter in her cerebrospinal fluid. She was diagnosed with meningitis, transferred to Birmingham for ICU care and given 21 days of antibiotics, and started on several seizure medications.

Image

Aubrey Hill

After the 21 days of antibiotics, the doctors realized it was not infectious meningitis at all and gave her steroids for Acute Disseminated Encephalomyelitis (ADEM), a rare side effect of the MMR booster. She improved immediately and was apparently back to normal.

But it turned out she was not normal. For the next two years, unbeknown to her parents, she was having conversations with cartoon characters in her mind. Finally, her mother observed a partial-complex seizure that looked like the original ADEM. They took her to the University of Alabama Children’s Hospital where she was given multiple anti-seizure medications, none of which were effective. At this point, she was getting partial-complex seizures 3-4 times a week and they were increasing in intensity and frequency.

The left temporal lobe appeared to be the source of the seizures, so she was referred to neurosurgeons who recommended surgery for a seizure disorder that was not responsive to any of the medications available. The family finally agreed to this so the surgeons removed a large amount of brain tissue: the left temporal lobe, some of the hippocampus and some of the frontal lobe. Then, in the ICU, right after surgery, she had her first grand mal seizure. She was in 8th grade.

A young girl this age wants to get her driver’s license. Despite medications, she was still having small seizures regularly but was able to hide them from her parents for a while. But when it became evident she was not seizure-free, another surgery was recommended. Aubrie consented. Again, in the ICU after the surgery, she had a large seizure and noticed that she had lost vision on the right side of her visual field. Six years later, the family was finally informed what the doctors already knew: she had had a stroke causing hemianopia (blindness over half her field of vision). There were also cognitive issues, and alexia without apraxia – difficulty seeing words, an inability to read, and difficulty pronouncing the right words for what she meant to say. She was in 9th grade. The trauma for a girl at this age was intense.

Then, when Aubrie was 18, puberty came along. With the onset of puberty, she developed tonic-clonic grand mal seizures, some lasting more than 20 minutes. They were violent and often difficult to stop with any medications at hand. She was tried on 17 different medications and ended up on 2: Vimpat and Depakote – at maximum dosages. The other fifteen drugs had to be abandoned with “unacceptable side-effects.” Still, every time her period would come around, or the full moon, she would have at least one grand mal seizure, often requiring ER visits due to the severity and inability to control with home medications. She would have more than 4 in a 24-hour period during this early-puberty time.

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Aubrey hugged by Emerald Pharms director Chelsea Lucich

Aubrie had a boyfriend, and they began to secretly smoke recreational marijuana. She was stealing money from her mother to buy it and telling no one. But her mother noticed that she suddenly changed from a suicidal miserable girl who wouldn’t come out of her room into a happy young woman with an enormous appetite. Asked ‘What gives?’ Aubrie told her about the cannabis. Vicki said no more stealing, but it’s obviously good for you so I’ll get it for you in a safe way. So, Mom took over finding marijuana for her daughter in the prohibitive state of Alabama. It did not seem to affect the seizures, but it did make her happy and helped her gain some weight back. At $400/ounce every month for substandard weed, they would parse it out to last the whole month. It was worth it.

Then Vicki found some oil being made in Santa Barbara, CA. Over an 8-month period, she sold some land she had inherited, and spent $16K for the oil that helped, but still didn’t stop the seizures. She knew she was on the right track.

Through Facebook, she connected with a grower in Tuolumne County, CA and he suggested she take the green herb, crush it, and sprinkle that and the kief over her daughter’s pizza. This increased dosage decreased the severity of the seizures, but she still had grand mals every month around her period time. They decided to move to California, where they could really learn and use this medicine.

Vicki sold her house in Huntsville, and $20K in debt, she, Aubrie, and their Maltese dog landed at an Airbnb in Santa Rosa, CA with no local connections or set plans. Two days after landing in CA, Aubrie had a grand mal and Vicki knew she had to get some cannabis quickly. They drove to Tuolumne County where her new friend provided medicine that was rich in THCA. It helped, but she needed large amounts. The THCA decreased the severity and frequency of the seizures, and she could stop one from coming on if the aura was noticed and the medicine was given under Aubrie’s tongue. For the next year they regularly drove to Tuolumne County (4 hours each way) to get this medicine. They then added THC to the mix and found that this would stop the seizures immediately, but would not prevent them. Plus, Aubrie was stoned all the time, not a great situation. But they knew they were getting closer. As Vicki is quick to point out: “There are worse things than Aubrie stoned. She can function with THC, but she could not function on the maximum doses of Depakote.”

A year ago through Emerald Pharms, they found Care By Design and purified CBD products. Aubrie started taking CBD oil capsules twice a day, each with 30mg of CBD for a total of 60mg a day. She stayed on 200mg of Vimpat twice a day, with no side effects. And she took a single dose of Ativan 0.5mg every night, allowing her to sleep well through the night. The seizures decreased in frequency dramatically.

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Fit &
healthy

Still, during full moons and her period, Aubrie could get grand mals. They had several visits to the local hospital when rectal Diastat would not work for stopping violent seizures. (Diastat, which would knock her out for hours, often causes withdrawal seizures within 24 hours of taking it.)

Earlier this year, they met a physician who specializes in pediatric epilepsy and it was recommended that Aubrie take 300mg each day of CBD, according to her size and weight. So they increased the CBD. She is up to 125mg twice a day and it is holding her nicely. In addition, she is using a concentrated oil-extract that has 8.48mg CBD and 12.65mg THC, taking mom-made capsules in MCT (medium-chain triglyceride) oil twice a day. She has had stretches as long as 2-3 weeks with no seizures which they consider a miracle. If she gets an aura, she takes THC or THCA, which have been successful in stopping the seizure before it starts.

One year after starting the CBD, she is brighter, clearer and more active than she has been in years. She had made friends, will take an Uber to town to play pool, and has recently stated that she is ready to learn again. Aubrie is having a life.

At 22, Aubrie may never live independently, she wears an ID bracelet with her condition and medications listed, and she will never drive a car. But she is finally managing her ‘intractable’ seizure disorder and is happy to be alive.

Stacey Kerr MD is a teacher, physician, and author living and working in Northern California. Dr. Kerr was in private practice until she decided to write and educate full-time. After several years working with the Society of Cannabis Clinicians, and co-developing the first comprehensive online course in cannabinoid medicine, she is now serving as the Medical Director for Hawaiian Ethos, an evidence-based cannabis company on the Big Island of Hawaii.

This article was reprinted by Project CBD with permission. It may not be reproduced in any form without approval from the source.

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Statement on Cannabidiol for the FDA

Project CBD's statement to the FDA on cannabidiol

Project CBD responds to the Food and Drug Administration’s call for statements on the use of CBD.
By On September 14, 2017

Sept. 13, 2017

The legal and regulatory status of cannabidiol (CBD), a component of the cannabis plant with a huge therapeutic upside, has emerged as a contentious subject in the United States, even though CBD is not intoxicating, has a stellar safety profile, and has no intrinsic abuse liability. When, as expected, CBD becomes an approved pharmaceutical, it will be a matter of enforcement discretion on the FDA‘s part as to whether producers of artisanal CBD-rich formulations will be allowed to operate. Accordingly, Project CBD makes the following recommendations to the FDA:

  • Do not make CBD a prescription-only drug. This would only serve the interests of a few pharmaceutical companies while hurting patients who have benefited from CBD-rich food supplements, topicals and other artisanal preparations.
  • Fast track clinical studies designed to compare the efficacy of CBD isolates and whole plant CBD rich extracts. Let’s learn more about the pros and cons of both in order to maximize their benefits and minimize harm.
  • Require safety warnings for CBD isolates regarding drug interactions.
  • While facilitating access to pharmaceutical CBD, don’t impede safe access to artisanal CBD-rich products. We recognize that the FDA is generally not in the business of approving plants as medicine. Nor should the FDA be in the business of undermining plant medicine in general and CBD-rich cannabis therapeutics, in particular.
  • Prohibit the use of toxic thinning agents and flavoring additives in CBD-rich vape oil products. Several additives (propylene glycol and polyethylene glycol, for example) that are commonly found in CBD vape oil cartridges become toxic when heated and inhaled. Most flavoring additives have not been safety tested for inhalation; some are known to be highly toxic when combusted.
  • Publish all FDA test results pertaining to CBD hemp oil products. Artisanal CBD producers have a mixed record thus far with respect to product safety, labeling accuracy, and quality control. The FDA has already documented instances of fraud and product mislabeling when it analyzed the content of several CBD hemp oil items. The bad apples – hemp oil extracts with little or no CBD or excess THC – should not be a pretext for the FDA to prohibit or restrict access to safe, non-pharmaceutical CBD products.
  • Don’t privilege pharmaceutical priorities at the expense of the fledgling, domestic CBD-rich agricultural sector and the CBD food supplement and topical industry. In Denver, Colorado, state law permits wholesale manufacturers of CBD extracts and edibles to source hemp biomass from within and outside Colorado provided that it originates from a farmer who cultivates CBD-rich plants under regulations guided by safe consumption criteria.
  • Implement procedures to harmonize the patchwork of state regulations regarding CBD. Thus far a coherent regulatory framework is lacking. It’s federally illegal to sell food supplements and other products infused with CBD across state lines, but there’s a gap in federal oversight of CBD manufacturing operations.

Here’s why:

Extensive preclinical research has documented the anti-inflammatory properties of single-molecule CBD in animal models of various pathologies, including neuropathic pain, epilepsy, rheumatoid arthritis, irritable bowel syndrome, multiple sclerosis, obesity and diabetes. Scientists are beginning to understand the specific pharmacological mechanisms underlying CBD‘s potential as a treatment for cancer, heart disease, addiction, depression and numerous other health disorders. Cannabidiol is a pleiotropic compound that produces many effects through multiple molecular pathways. It taps into how we function biologically on a very deep level: CBD can penetrate the cell membrane and bind to receptors on the nucleus (PPARs), which regulate gene expression and mitochondrial activity.

A 1998 study sponsored by the National Institutes of Health is the basis for a U.S. government patent on the antioxidant and neuroprotective qualities of plant cannabinoids, specifically CBD and psychoactive THC (tetrahydrocannabinol). CBD and THC were found to limit “neurological damage following ischemic insults, such as stroke and trauma.” Both compounds are described as having “particular application … in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia.”

But double blind, randomized clinical trials that could “prove” CBD‘s efficacy as a medical treatment have gotten short shrift in the United States because of marijuana prohibition. The few clinical studies involving single-molecule CBD that are underway pale in comparison to the enormous amount of anecdotal data already generated by cannabis clinicians and numerous patients in states where the therapeutic use of cannabis is legal.

Since the rediscovery of CBD-rich cannabis in Northern California in 2009, a growing number of physicians have been recommending CBD-infused oil extracts and concentrates for patients – often with good, and sometimes with jaw-dropping, results in difficult-to-treat cases. Until recently, however, single-molecule CBD formulations were not part of the grassroots medical marijuana experience. While scientists focused on the pharmacology of CBD isolates and other single-molecule cannabinoids, medical marijuana product-makers and providers have been dispensing an array of whole plant CBD-rich options – tinctures, sublingual sprays, gel caps, topicals, edibles, and raw herb – to a wide demographic of patients, many of whom turn to cannabis therapy as a last resort.

In addition to whole plant CBD-rich products sold by medical marijuana dispensaries, CBD isolates derived from industrial hemp are currently available via unregulated online storefronts and delivery services. If, as expected, GW Pharmaceuticals wins FDA approval of Epidiolex, an almost-pure CBD anti-seizure medication, in the near future, it will become available on a prescription basis at a hefty price. Millions of uninsured families in the United States won’t be able to afford it.

The pharmaceutical development of cannabinoid compounds is based upon controlled experimentation with molecular isolates in keeping with the assumption that sick people benefit most from predictable, reproducible medicine that never varies. While isolates can facilitate precision dosage and confidence in the chemical make-up of a drug, monomolecular medicine also has serious drawbacks.

Several scientific studies report that pure, single-molecule CBD, while possibly effective at high doses in preclinical tests, has a much tighter therapeutic window and is much less potent compared to a whole plant CBD-rich concentrate. Moreover, whether synthesized in a lab or heavily refined from industrial hemp paste, pure CBD isolates lack the full array of phytocannabinoids and medicinal terpenes found in whole plant CBD-rich cannabis, which includes hundreds of biologically active components. These constituents interact with CBD and THC to create what scientists refer to as an “entourage” or “ensemble” effect, so that the therapeutic impact of the whole plant is greater than the sum of its parts.

It’s not that single-molecule CBD won’t work — pure CBD can be helpful in certain cases, as clinical trials with epidiolex have shown. But whole plant CBD-rich oil has a much wider therapeutic window than a CBD isolate. This was demonstrated in a 2015 preclinical experiment by Israeli scientists who found that single-molecule CBD required a much higher dose to be effective as an anti-inflammatory and an analgesic compared to a whole plant CBD-rich oil extract. Moreover, if one missed the mark slightly, either too low or too high, then the CBD isolate had little impact on pain and inflammation — unlike the full spectrum CBD-rich oil, which was effective at a much lower, and broader, dosage range. “The therapeutic synergy observed with plant extracts results in the requirement for a lower amount of active components, with consequent reduced adverse effects,” the Israeli researchers concluded.

Other scientists and clinicians have reported similar findings. A 2016 study by Italian researchers found that a whole plant CBD-rich oil extract attenuated inflammation and hypermotility in an animal model of colitis, whereas “pure CBD did not ameliorate colitis” symptoms. “These findings sustain the rationale of combining CBD with other minor Cannabis constituents and support the clinical development of CBD [as a] botanical drug substance for irritable bowel disease treatment.”

Problematic drug interactions are much more likely with high doses of single-molecule CBD, which can inhibit the metabolism of 60 percent of marketed pharmaceuticals. At high doses, CBD will deactivate certain cytochrome P450 enzymes in the liver, thereby altering how we metabolize a wide range of medications, including clobazam, an anti-epileptic drug. This was evident in GW‘s epidiolex trials, when children with intractable seizure disorders were given CBD dosages ranging from 5 to 50 mg per kg of body weight. Doctors had to adjust the amount of clobazam the children were taking because of potentially dangerous interactions with epidiolex. Compare the high dose regimen employed by GW Pharmaceuticals to 1 mg per kg of artisanal whole plant CBD-rich oil that cannabis clinicians in California and elsewhere recommend as an initial dosage for treating pediatric epilepsy.

In cancer treatment, the precise dosing of chemotherapy is extremely important; it can be a challenge for doctors to find the maximum effective dose that will not be catastrophically toxic. Many chemotherapy drugs are oxidized by cytochrome P450 enzymes before their inactivation or excretion. This means that for patients also using CBD, the same dose of chemotherapy may produce higher blood concentrations. If CBD inhibits the metabolism of chemotherapy drugs and dosage adjustments aren’t made, the chemotherapy agent could accumulate within the body to highly toxic levels.

There is no clearly established cut-off dose below which CBD does not interact with other drugs. Any pharmaceutical or nutraceutical scheme to exploit the health benefits of cannabidiol must reckon with the fact that therapeutically relevant doses of CBD isolates can potentially impact a wide range of medications. Drug interactions are especially important to consider when using life-saving or sense-saving drugs, drugs with narrow therapeutic windows, or medications with major adverse side effects. By and large, however, there have been few problems reported by cancer patients and others who medicate with artisanal CBD-rich cannabis products. The same can’t be said for CBD isolates.

We recognize there is therapeutic value in CBD isolates as well as in whole plant CBD-rich remedies. The FDA should not ordain pharmaceutical CBD as the only legitimate medical option. Single-molecule medicine is the predominant corporate way, the Big Pharma way, but there’s ample evidence that it’s not always the best way to benefit from cannabis therapeutics. Pure CBD is a molecule, not a miracle, and it doesn’t work for everyone. No-THC and low-THC cannabis oil products represent a small slice of the cannabis therapy spectrum. Patients of all ages and economic means should have access to a range of cannabis-based therapeutic options with different concentrations and ratios of CBD and THC, along with other whole plant components.

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Statement on Cannabidiol for the FDA

Project CBD's statement to the FDA on cannabidiol

Project CBD responds to the Food and Drug Administration’s call for statements on the use of CBD.
By Project CBD On September 13, 2017

The legal and regulatory status of cannabidiol (CBD), a component of the cannabis plant with a huge therapeutic upside, has emerged as a contentious subject in the United States, even though CBD is not intoxicating, has a stellar safety profile, and has no intrinsic abuse liability. When, as expected, CBD becomes an approved pharmaceutical, it will be a matter of enforcement discretion on the FDA‘s part as to whether producers of artisanal CBD-rich formulations will be allowed to operate. Accordingly, Project CBD makes the following recommendations to the FDA:

  • Do not make CBD a prescription-only drug. This would only serve the interests of a few pharmaceutical companies while hurting patients who have benefited from CBD-rich food supplements, topicals and other artisanal preparations.
  • Fast track clinical studies designed to compare the efficacy of CBD isolates and whole plant CBD rich extracts. Let’s learn more about the pros and cons of both in order to maximize their benefits and minimize harm.
  • Require safety warnings for CBD isolates regarding drug interactions.
  • While facilitating access to pharmaceutical CBD, don’t impede safe access to artisanal CBD-rich products. We recognize that the FDA is generally not in the business of approving plants as medicine. Nor should the FDA be in the business of undermining plant medicine in general and CBD-rich cannabis therapeutics, in particular.
  • Prohibit the use of toxic thinning agents and flavoring additives in CBD-rich vape oil products. Several additives (propylene glycol and polyethylene glycol, for example) that are commonly found in CBD vape oil cartridges become toxic when heated and inhaled. Most flavoring additives have not been safety tested for inhalation; some are known to be highly toxic when combusted.
  • Publish all FDA test results pertaining to CBD hemp oil products. Artisanal CBD producers have a mixed record thus far with respect to product safety, labeling accuracy, and quality control. The FDA has already documented instances of fraud and product mislabeling when it analyzed the content of several CBD hemp oil items. The bad apples – hemp oil extracts with little or no CBD or excess THC – should not be a pretext for the FDA to prohibit or restrict access to safe, non-pharmaceutical CBD products.
  • Don’t privilege pharmaceutical priorities at the expense of the fledgling, domestic CBD-rich agricultural sector and the CBD food supplement and topical industry. In Denver, Colorado, state law permits wholesale manufacturers of CBD extracts and edibles to source hemp biomass from within and outside Colorado provided that it originates from a farmer who cultivates CBD-rich plants under regulations guided by safe consumption criteria.
  • Implement procedures to harmonize the patchwork of state regulations regarding CBD. Thus far a coherent regulatory framework is lacking. It’s federally illegal to sell food supplements and other products infused with CBD across state lines, but there’s a gap in federal oversight of CBD manufacturing operations.

Here’s why:

Extensive preclinical research has documented the anti-inflammatory properties of single-molecule CBD in animal models of various pathologies, including neuropathic pain, epilepsy, rheumatoid arthritis, irritable bowel syndrome, multiple sclerosis, obesity and diabetes. Scientists are beginning to understand the specific pharmacological mechanisms underlying CBD‘s potential as a treatment for cancer, heart disease, addiction, depression and numerous other health disorders. Cannabidiol is a pleiotropic compound that produces many effects through multiple molecular pathways. It taps into how we function biologically on a very deep level: CBD can penetrate the cell membrane and bind to receptors on the nucleus (PPARs), which regulate gene expression and mitochondrial activity.

A 1998 study sponsored by the National Institutes of Health is the basis for a U.S. government patent on the antioxidant and neuroprotective qualities of plant cannabinoids, specifically CBD and psychoactive THC (tetrahydrocannabinol). CBD and THC were found to limit “neurological damage following ischemic insults, such as stroke and trauma.” Both compounds are described as having “particular application … in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia.”

But double blind, randomized clinical trials that could “prove” CBD‘s efficacy as a medical treatment have gotten short shrift in the United States because of marijuana prohibition. The few clinical studies involving single-molecule CBD that are underway pale in comparison to the enormous amount of anecdotal data already generated by cannabis clinicians and numerous patients in states where the therapeutic use of cannabis is legal.

Since the rediscovery of CBD-rich cannabis in Northern California in 2009, a growing number of physicians have been recommending CBD-infused oil extracts and concentrates for patients – often with good, and sometimes with jaw-dropping, results in difficult-to-treat cases. Until recently, however, single-molecule CBD formulations were not part of the grassroots medical marijuana experience. While scientists focused on the pharmacology of CBD isolates and other single-molecule cannabinoids, medical marijuana product-makers and providers have been dispensing an array of whole plant CBD-rich options – tinctures, sublingual sprays, gel caps, topicals, edibles, and raw herb – to a wide demographic of patients, many of whom turn to cannabis therapy as a last resort.

In addition to whole plant CBD-rich products sold by medical marijuana dispensaries, CBD isolates derived from industrial hemp are currently available via unregulated online storefronts and delivery services. If, as expected, GW Pharmaceuticals wins FDA approval of Epidiolex, an almost-pure CBD anti-seizure medication, in the near future, it will become available on a prescription basis at a hefty price. Millions of uninsured families in the United States won’t be able to afford it.

The pharmaceutical development of cannabinoid compounds is based upon controlled experimentation with molecular isolates in keeping with the assumption that sick people benefit most from predictable, reproducible medicine that never varies. While isolates can facilitate precision dosage and confidence in the chemical make-up of a drug, monomolecular medicine also has serious drawbacks.

Several scientific studies report that pure, single-molecule CBD, while possibly effective at high doses in preclinical tests, has a much tighter therapeutic window and is much less potent compared to a whole plant CBD-rich concentrate. Moreover, whether synthesized in a lab or heavily refined from industrial hemp paste, pure CBD isolates lack the full array of phytocannabinoids and medicinal terpenes found in whole plant CBD-rich cannabis, which includes hundreds of biologically active components. These constituents interact with CBD and THC to create what scientists refer to as an “entourage” or “ensemble” effect, so that the therapeutic impact of the whole plant is greater than the sum of its parts.

It’s not that single-molecule CBD won’t work — pure CBD can be helpful in certain cases, as clinical trials with epidiolex have shown. But whole plant CBD-rich oil has a much wider therapeutic window than a CBD isolate. This was demonstrated in a 2015 preclinical experiment by Israeli scientists who found that single-molecule CBD required a much higher dose to be effective as an anti-inflammatory and an analgesic compared to a whole plant CBD-rich oil extract. Moreover, if one missed the mark slightly, either too low or too high, then the CBD isolate had little impact on pain and inflammation — unlike the full spectrum CBD-rich oil, which was effective at a much lower, and broader, dosage range. “The therapeutic synergy observed with plant extracts results in the requirement for a lower amount of active components, with consequent reduced adverse effects,” the Israeli researchers concluded.

Other scientists and clinicians have reported similar findings. A 2016 study by Italian researchers found that a whole plant CBD-rich oil extract attenuated inflammation and hypermotility in an animal model of colitis, whereas “pure CBD did not ameliorate colitis” symptoms. “These findings sustain the rationale of combining CBD with other minor Cannabis constituents and support the clinical development of CBD [as a] botanical drug substance for irritable bowel disease treatment.”

Problematic drug interactions are much more likely with high doses of single-molecule CBD, which can inhibit the metabolism of 60 percent of marketed pharmaceuticals. At high doses, CBD will deactivate certain cytochrome P450 enzymes in the liver, thereby altering how we metabolize a wide range of medications, including clobazam, an anti-epileptic drug. This was evident in GW‘s epidiolex trials, when children with intractable seizure disorders were given CBD dosages ranging from 5 to 50 mg per kg of body weight. Doctors had to adjust the amount of clobazam the children were taking because of potentially dangerous interactions with epidiolex. Compare the high dose regimen employed by GW Pharmaceuticals to 1 mg per kg of artisanal whole plant CBD-rich oil that cannabis clinicians in California and elsewhere recommend as an initial dosage for treating pediatric epilepsy.

In cancer treatment, the precise dosing of chemotherapy is extremely important; it can be a challenge for doctors to find the maximum effective dose that will not be catastrophically toxic. Many chemotherapy drugs are oxidized by cytochrome P450 enzymes before their inactivation or excretion. This means that for patients also using CBD, the same dose of chemotherapy may produce higher blood concentrations. If CBD inhibits the metabolism of chemotherapy drugs and dosage adjustments aren’t made, the chemotherapy agent could accumulate within the body to highly toxic levels.

There is no clearly established cut-off dose below which CBD does not interact with other drugs. Any pharmaceutical or nutraceutical scheme to exploit the health benefits of cannabidiol must reckon with the fact that therapeutically relevant doses of CBD isolates can potentially impact a wide range of medications. Drug interactions are especially important to consider when using life-saving or sense-saving drugs, drugs with narrow therapeutic windows, or medications with major adverse side effects. By and large, however, there have been few problems reported by cancer patients and others who medicate with artisanal CBD-rich cannabis products. The same can’t be said for CBD isolates.

We recognize there is therapeutic value in CBD isolates as well as in whole plant CBD-rich remedies. The FDA should not ordain pharmaceutical CBD as the only legitimate medical option. Single-molecule medicine is the predominant corporate way, the Big Pharma way, but there’s ample evidence that it’s not always the best way to benefit from cannabis therapeutics. Pure CBD is a molecule, not a miracle, and it doesn’t work for everyone. No-THC and low-THC cannabis oil products represent a small slice of the cannabis therapy spectrum. Patients of all ages and economic means should have access to a range of cannabis-based therapeutic options with different concentrations and ratios of CBD and THC, along with other whole plant components.

Read More

Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads

Dr. Ethan Russo and Jahan Marcu PhD give an extensive summary of cannabis terpenes, minor cannabinoids, and flavonoids.
By Ethan Russo, M.D. & Jahan Marcu PhD On September 12, 2017

Published in full in Advances in Pharmacology.

Abstract: The golden age of cannabis pharmacology began in the 1960s as Raphael Mechoulam and his colleagues in Israel isolated and synthesized cannabidiol, tetrahydrocannabinol, and other phytocannabinoids. Initially, THC garnered most research interest with sporadic attention to cannabidiol, which has only rekindled in the last 15 years through a demonstration of its remarkably versatile pharmacology and synergy with THC. Gradually a cognizance of the potential of other phytocannabinoids has developed. Contemporaneous assessment of cannabis pharmacology must be even far more inclusive. Medical and recreational consumers alike have long believed in unique attributes of certain cannabis chemovars despite their similarity in cannabinoid profiles. This has focused additional research on the pharmacological contributions of mono- and sesquiterpenoids to the effects of cannabis flower preparations. Investigation reveals these aromatic compounds to contribute modulatory and therapeutic roles in the cannabis entourage far beyond expectations considering their modest concentrations in the plant. Synergistic relationships of the terpenoids to cannabinoids will be highlighted and include many complementary roles to boost therapeutic efficacy in treatment of pain, psychiatric disorders, cancer, and numerous other areas. Additional parts of the cannabis plant provide a wide and distinct variety of other compounds of pharmacological interest, including the triterpenoid friedelin from the roots, canniprene from the fan leaves, cannabisin from seed coats, and cannflavin A from seed sprouts. This chapter will explore the unique attributes of these agents and demonstrate how cannabis may yet fulfil its potential as Mechoulam’s professed “pharmacological treasure trove.”

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