Marijuana. Dope. Pot. Weed. Ganja. These are just some of the slang names of the psychoactive drug from the Cannabis plant stereotyped as the preferred drug of hippies, stoners and irresponsible members of society. This image of cannabis, however, is the corrupt twin brother of a plant that has been used for thousands of years to treat a wide range of ailments. Chinese physicians in 2,700 B.C. were the first to prescribe cannabis tea to treat illnesses such as poor memory, malaria, and rheumatism.
Cannabis as a medicine went out of favor in the early 20th-century when the plant’s alter ego – mind-altering marijuana – grew popular and many governments worldwide banned the cultivation and use of cannabis and its derivatives. A century later, scientific investigations are revealing that the effects of pot and medicinal cannabis on the human body lie on opposite sides of the spectrum.
One of the most famous case studies to illustrate the therapeutic properties of cannabis is Charlotte Figi from Colorado, USA. Charlotte was diagnosed with Dravet Syndrome – a rare, genetic drug-resistant childhood epilepsy – and had 300 seizures a week. Where modern medicine failed, cannabis succeeded to calm Charlotte’s frantic brain activity. Today her seizures are limited to two or three per month.
A report published in 2017 by the National Academy of Science in the USA stated that there is conclusive evidence that cannabis acts as an antiemetic in adults with nausea or vomiting induced by chemotherapy; an analgesic in adults with chronic pain; and as an antispasmodic in adults with spasticity or Multiple Sclerosis. Other investigations, albeit with limited evidence, have shown how cannabis can reduce inflammation caused by Crohn’s disease, and help patients with PTSD by suppressing dream memory recall. Although the short and long-term health benefits and risks of treating patients with cannabis remain elusive, drug laws in several countries – such as Israel, Canada, Australia, Uruguay, parts of the USA, and Colombia – have softened to allow the cultivation, harvest, and use of cannabis for medical purposes.
The Colombian government, however, has more ambitious plans than just legalization. At the end of 2017, the Ministries of Health, Justice, and Agriculture authorized the harvest of 40,5 tons of medicinal cannabis for export, and aims to provide 44% of the global demand of cannabis in 2018. More than just growing medicine, this new venture will provide thousands of jobs. Already twenty-one companies have applied for licenses to cultivate the plant, among them are Khiron Life Sciences Corp., Canmecol S.A.S. and PharmaCielo Colombia Holdings. Companies are only permitted to handle converted products such as oils and serums, and the entire process – from seed production to the manufacture of cannabis derivatives – will be highly regulated by several government Ministries.
To provide Colombian physicians with an introduction to applying medicinal cannabis within their clinical practice, Khiron and the Colombian Association of Neurologists co-hosted Colombia’s first International Medicinal Cannabis Symposium last month in Bogotá. Over 250 neurological specialists attended to hear both national and international doctors explain this plant’s role in modern medicine.
Cannabis versus Marijuana
Despite the escalating scientific evidence of the restorative properties of Cannabis, how do societies remove the stigma and negative emotions attached to this plant? Are sick patients really getting high? The answer lies in biochemistry and a name change.
Dr. Vincent Maida, a consultant in Palliative Medicine and Wound Management at the William Osler Health System in Toronto explained at the Symposium that “we need to understand the difference between the recreational versus the medical side of things. What is used in medical applications is a different chemical profile than the recreational side. Even words like marijuana are misleading.”
The main distinction lies in the user’s end objective and in the concentration of cannabinoids, specifically psychoactive tetrahydrocannabinol (THC) and the key therapeutic chemical, Cannabidiol (CBD).
Marijuana refers to the dried buds and seeds of the plant and contains relatively high THC concentrations. The percentage of THC has increased over the last decades to suit users’ demands. Strains in the 60s and 70s contained 2-7% THC; today, some strains can have as much as 30-35%. Marijuana is grown purely for recreational purposes, and smoking can cause long- term cerebral damage. Dr. José Fernando Hernández, a neurologist at the Militar Hospital in Bogotá, says studies have shown that adolescents who frequently consume marijuana tend to have low brain connectivity and impaired cognitive function when they reach adulthood.
Conversely, medicinal cannabis consists of plant extracts in the form of an oil. And according to Dr. Danial Schecter, co-founder of the Cannabinoid Medical Clinic in Toronto, and one of Canada’s leading experts in medical cannabis, the goal of cannabis treatment is to improve people’s lives, to enable them to re-engage with society and have a normal, comfortable life. Current scientific research has revealed that CBD has antipsychotic, anticonvulsant, anti-inflammatory, and analgesic properties. So depending on the needs of the patient, different extracts will contain different concentrations of CBD and THC. Furthermore, CBD may actually mitigate the euphoria-producing effects of THC by blocking certain cannabinoid receptors – the so-called “entourage effect” where cannabinoids interact to produce a synergistic chemical result. Israeli researchers have recently discovered how specific strains of cannabis stopped the growth of specific types of cancer. “We are only beginning to see the possibilities of cannabis,” says Dr. Michael Dor, Senior Medical Advisor of Israel’s Ministry of Health.
Destigmatizing the future
Cannabis may seem to be the elixir of life, the “cure-all” treatment but studies are showing that not every patient responds to cannabis and not every patient should take it. “Medicinal cannabis is rarely used as a first-line in defense”, says Dr Michael Boivin, Pharmacist Consultant for CommPharm. “A patient who insists on cannabis could be a warning sign of a cannabis-use disorder.” He goes on to explain that patients who suffer from or are genetically prone to psychiatric problems such as schizophrenia, psychosis, drug addiction, or manic depression can worsen after cannabis treatment.
“There is still a wide gulf of knowledge concerning the administration of prescribed medicinal cannabis around the world,” explains Dr. Paulo Vega, Medical Director for Khiron. “The full range of alternative cannaceuticals and phytotherapeutic products needs to be reviewed and discussed.”
There are 113 cannabinoids and scientists have only studied THC and CBD. With so many therapeutic properties being extracted from this powerful plant, the full range of possible cures may still take centuries to be revealed.
In the picture above (left to right): Dr. Paulo Vega, Dr. Vincent Maida, Dr. Michael Boivin, Dr. Michael Dor, Dr. Danial Schecter during the first Medical Cannabis Symposium in Bogotá.