NATHAN CRAIG

Health Minister Dr Aaron Motsoaledi during the signing ceremony of The Global Fund South Africa Grant 2019-2022 at Sefako Makgatho Presidential Guesthouse in Pretoria yesterday. Siyabulela Duda

Durban - The legalisation of medicinal cannabis has been heralded as a new-found hope and burgeoning market opportunity for South Africans.

On Thursday, Dr Aaron Motsoaledi, Minister for Health, excluded preparations containing cannabidiol (CBD) from being scheduled in terms of the Medicines and Related Substances Act of 1965 for the next 12 months.

CBD is a natural chemical compound found in cannabis plants which is used for medicinal purposes and is not psychoactive.

A report of CBD by the World Health Organisation (WHO) stated it exhibited no effects indicative of any abuse or dependence potential.

Issues such as chronic pain, multiple sclerosis, and Alzheimer’s, depression, stress, and anxiety can be addressed and treated with CBD containing products. Its properties could lower blood pressure and act as a natural anti-inflammatory.

Roy Sukdhev, founder of the Phoenix North Coast Cancer Support Group, was hopeful for the future of cancer treatment but believed controlled measures would be required to regulate the endeavour.

“It will open doors and lessen suffering. Medication and correct treatment is vital for cancer patients, the more that is available the better it will be.

“Regulations, controlled environments and registered outlines will need to be implemented to prevent fly-by-night businesses from taking advantage of this new opportunity and doing more harm than good,” said Sukdhev.

Narend Singh, parliamentary Chief Whip of the IFP, said it was a step in the right direction but that it was not a new innovation.

Source:
https://www.iol.co.za/sunday-tribune/news/medicinal-cannabis-use-is-now-legal-24102387

It has been rumored for years that Monsanto plans to take over the cannabis industry with genetic engineering just as they’ve taken over the corn and soy industries. Although they have always denied having any intentions to do so, at this point it is unlikely that anybody really believes them. In contrast, many in the cannabis sphere are prepared to resist any kind of GMO takeover of marijuana by Monsanto or any of their cohorts.

Evidence is mounting, though, which points strongly to the notion that Monsanto does indeed plan to take control of the cannabis plant, and it doesn’t look good for medical users, or anyone planning on getting into the industry.

Former Nazi Collaborator Bayer Buys Out Monsanto for $66 Billion

You may remember hearing back in September that Bayer, the largest pharmaceutical company in the world, made a deal to buy out Monsanto for $66 billion. Although Monsanto was voted the most evil company in the world in 2013 and its reputation has continued to fall since, Bayer still went ahead with the buyout.

A merger between these two companies is unsurprising, as though they both have long histories of involvement with Nazism and chemical weapons like agent orange which have devastated Vietnam since the war. In fact, Bayer began as a break-off company of the infamous IG Farben, which produced the chemical weapons used on the Jews during the Nazi reign. After the war, Farben was forced to break up into several companies, including BASF, Hoeschst, and Bayer.

Soon after at the Nuremberg trials, 24 Farben executives were sent to prison for crimes against humanity. However, in a matter of just 7 years each of them was released and began filling high positions in each of the former Farben companies, and many of them began working for the Russian, British, and American governments through a joint intelligence venture called “Operation Paperclip”.

“IG (Interessengemeinschaft) stands for “Association of Common Interests”: The IG Farben cartel included BASF, Bayer, Hoechst, and other German chemical and pharmaceutical companies. As documents show, IG Farben was intimately involved with the human experimental atrocities committed by Mengele at Auschwitz. A German watchdog organization, the GBG Network, maintains copious documents and tracks Bayer Pharmaceutical activities.” – Alliance for Human Research Protection

After all these years, Bayer is now richer and more powerful than their predecessor company I.G. Farben ever was.

Monsanto And Miracle-Gro Have Intimate Business Ties

According to Big Buds Magazine, Monsanto and Scotts Miracle-Gro have a “deep business partnership” and plan on taking over the cannabis industry. Hawthorne, a front group for Scotts, has already purchased three of the major cannabis growing companies: General Hydroponics, Botanicare, and Gavita. Many other hydroponics companies have also reported attempted buyouts by Hawthorne.

“They want to bypass hydroponics retail stores…When we said we won’t get in bed with them they said, ‘Well, we could just buy your whole company like we did with Gavita and do whatever we want.’” – Hydroponics Lighting Representative

Jim Hagedorn, CEO of Scotts Miracle-Gro, has even said that he plans to “invest, like, half a billion in [taking over] the pot business… It is the biggest thing I’ve ever seen in lawn and garden.”

He has also invested in companies such as Leaf, which grows cannabis in an electronically regulated indoor terrarium accessible via smartphone.

Bayer and Monsanto Trade Industry Secrets On Producing GMO Marijuana

It is logical that Bayer, being the parent company, would work together with Monsanto in order to share secrets which would advance mutual business. Many people in the cannabis industry have been warning about this, including Michael Straumietis, founder and owner of Advanced Nutrients.

“Monsanto and Bayer share information about genetically modifying crops,” Straumietis notes. “Bayer partners with GW Pharmaceuticals, which grows its own proprietary marijuana genetics. It’s logical to conclude that Monsanto and Bayer want to create GMO marijuana.” – Michael Straumietis

Conclusion

It is possible that Bayer and Monsanto could create a monopoly on marijuana seeds in the same way that they have created a monopoly on corn and soy. Through immense corporate power and the enforcement of international patent law, these corporations could place themselves in a position of total control over cannabis as a medicine as well as for recreational use by using the same model as they do with the food crops they control.

But not all hope is lost. There is still a chance to fight back against the Bayer-Monsanto monopoly by boycotting genetically engineered products, Miracle-Gro and other Scotts brand products, Bayer pharmaceuticals, and companies that do business with any of these. If you buy cannabis seeds, they can be stored for years to be used at a later date or if you live in an area where it is legal, grow your own, while supporting hydroponics and nutrient companies that don’t do business with these corporate behemoths.

“Corporations and people with hundreds of billions of dollars know marijuana is a miracle plant. They want to come in and steal our plants, seeds, and industry from us, we must stop them.” – Straumietis

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Nevada continues to crush it with cannabis sales. On July 1, the state will celebrate its “cannaversary” or one year since it began selling recreational marijuana. So far, each month sales have outpaced original projections.

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According to state records, recreational sales hit $41 million in March, the highest month to date, a 16% sequential increase over February and breaking the previous record set in December of $35.8 million. Total taxable sales for medical marijuana, adult-use marijuana and other marijuana-related goods for the first ten months of the fiscal year are $433.51 million. April sales were lower than March, but strong enough to deliver all the anticipated tax revenue two months ahead of scheduled said the state.
Taxes collected in the first fiscal year-to-date (July 2017-April 2018) were $55.53 million with wholesale marijuana generating $21.47 million for that time period and retail marijuana tax generating $34.06 million. The state said that taxes collected are 110% above what was projected. Also, the launch of the adult-use industry now accounts for a bit more than 17% of the overall growth in Nevada’s taxable sales base so far this fiscal year.
“The Nevada market continues to be the bright spot in the cannabis industry,” said Chris Driessen of privately owned vape powerhouse Organa Brands. “I was most impressed with the state for adhering to the self-imposed timeline of July 1, 2017.”
Nevada Senator Tick Segerblom said, “This new industry has generated close to half a billion in sales and employed over 5,000 Nevadans. Best of all, none of the predicted adverse consequences have occurred.”
Still, Nevada’s program hasn’t been without its challenges. In the beginning, distribution issues caused businesses numerous headaches along with limited supplies. Driessen agreed saying that the biggest challenge has been the lack of raw material which as driven up production costs.
“This has been problematic for the state as Colorado, California, and Oregon all have far lower price points for similar products making Nevada less competitive,” he said. Dreissen went on to add, “The onerous packaging requirements have also been a big challenge and came as a surprise to us. While the requirements are simple enough on their own, the states arbitrary enforcement of what it deems to be “slang” or “jargon” has caused unnecessary costs and ultimately a burden on businesses due to random enforcement.”
Even with these issues, sales of almost a million dollars a day is drawing many companies to the state.
“All reports from Nevada are that the state has seen healthy sales since the start of commercial adult-use,” said Daniel Yi of California-based dispensary chain MedMen. “MedMen began operations at its Mustang cultivation and manufacturing facility in April, and we plan to have three stores in Las Vegas before year’s end. Nevada is key to MedMen’s strategy of gaining and maintaining a leadership position in all significant U.S. markets. Las Vegas also gives our brand global exposure.”
Celebrations
The state is gearing up for big celebrations like Reef Dispensary which is giving away hats, and prerolls and sponsoring a midnight firework show. In addition to the fireworks, the first 250 customers to make a purchase after 12AM on July 1st will be awarded the limited edition ‘Year 1’ hat, commemorating the first safe and successful year of recreational cannabis in Nevada.
Cannabition, the cannabis museum slated to open in August in downtown Las Vegas is celebrating with a scavenger hunt beginning at 4:20 pm on July 1. Cannabition will be the world’s only cannabis-themed experience of its kind. Opening Aug. 2 at Neonopolis in Downtown Las Vegas, Cannabition will feature elaborate cannabis-inspired installations created by leading experiential art and exhibit designers. The museum said that visitors will interact with unique monumental art pieces, including a slide that empties into a pool of handmade foam “nugs,” enormous 7-foot buds and, at 23 feet, the world’s largest water pipe affectionately known as “Bongzilla.”
Also on Sunday, July 1, The+Source will launch its new Prismatic products, made with highly-effective, flavorful and pure extract products. Using a modern CO2-based extraction process, the versatile products will retain the full spectrum of terpenes and cannabinoids without the harmful hydrocarbon solvents. The+Source is running a 10-day lineup of promotions called the Ten Days of Freedom.

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By Bara Vaida

From the WebMD Archives
Dustin Sulak, DO, is a doctor on the front lines of medical marijuana.
Sulak has recommended various forms of marijuana to his patients and has seen striking results. Patients with chronic pain needed fewer prescription pain meds. Patients with multiple sclerosis had less painful muscle spasms. Patients with severe inflammatory bowel disease began to eat again.
“These responses are the most impressive to me,” says Sulak, who practices at Maine Integrative Healthcare in Manchester. Maine is one of 20 states, along with the District of Columbia, where medical marijuana is legal. “With inflammatory bowel disease, we’ll see patients who were at death’s door turn around dramatically.”
Sulak’s experience is powerful and adds to the large body of personal stories -- dating from 5,000 years ago -- about the therapeutic value of marijuana.

But the scientific evidence behind the drug’s benefits remains elusive, even as 10 more states consider legalizing medical uses in 2014. The problem: In 1970, the federal government classified marijuana as an illegal, highly addictive drug with no medical value, making research harder to do.

A Marijuana Discovery

Here’s what is known: About 20 years ago, scientists discovered a system in the brain that responds to 60 chemicals in marijuana, also known as cannabis. It’s called the endocannabinoid system. This system plays a role in many of the body’s functions, such as in the heart, along with the digestive, endocrine, immune, nervous, and reproductive systems. The discovery sparked interest in finding specific chemicals made from marijuana that could be targeted for specific conditions.
Since that time, scientific projects around medical marijuana worldwide have sped up dramatically. Many of the studies that have been done show that chemicals in marijuana can help treat some conditions. They have helped manage pain and reduced muscle spasms in MS patients. They’ve worked as an appetite stimulant, and as an alternative drug for brain disorders such as schizophrenia and Tourette’s syndrome.
Few of these studies, though, followed a controlled clinical trial. This is considered the best type of trial because it compares a drug to another drug, or to a placebo (a "fake" treatment).
Also, most of the studies had fewer than 200 patients. So doubt continues about marijuana’s value and who it really can help, says J. Michael Bostwick, MD. He's a psychiatrist at the Mayo Clinic and author of a review of medical marijuana research.
Based on medical science, it seems possible that marijuana-based treatments could be developed for some conditions; but federal restrictions make it hard for the research to advance, Bostwick says.
That’s because scientists in the U.S. have to get approval from the Drug Enforcement Agency (DEA) and the FDA to do research on medical marijuana.
A series of studies allowed by the DEA came to a conclusion similar to Bostwick's. The 13 studies were done by The Center for Medicinal Cannabis Research at the University of California in San Diego between 2000 and 2010.
The conclusion: “Cannabinoids may be useful medicine for certain indications” and deserve further research, wrote Igor Grant, professor and executive vice chairman of the Department of Psychiatry at the university. The studies also showed that inhaling marijuana through a vaporizer or a spray was a better way to deliver it than by smoking.
Among the unanswered questions about medical marijuana is the risk to users. About 10% of people who smoke marijuana become addicted. It’s not known what that means if it is being used for medical reasons, Bostwick says. He adds that some patients find the effects of marijuana “intolerable.”

Marijuana-Based Drugs

Despite the obstacles, three FDA-approved drugs are made from marijuana. They include:
Marinol and Cesamet: Both drugs are used to treat nausea and lack of appetite related to chemotherapy and in AIDS patients. They are man-made versions of THC, the primary chemical in marijuana that gives users a “high.” Both were approved in the 1980s.
Epidiolex: This drug to treat children’s epilepsy received FDA approval in 2013. Its use is highly restricted.
Another drug, Sativex, is in clinical trials in the U.S. for pain with breast cancer. It is a combination of chemicals from the marijuana herb and is sprayed into the mouth. Sativex is approved in more than 20 countries to treat muscle spasms from MS and cancer pain.

Research on Marijuana

No single organization tracks all research studies of medical marijuana and marijuana-based drugs and herbs. The following review is a summary of controlled studies since 1990. It is based on reporting; research provided by NORML, the marijuana legalization advocacy group; and data found in PubMed, the National Institutes of Health’s RePORTER, and a database maintained by the International Association for Cannabinoid Medicines, a medical marijuana research organization based in Cologne, Germany.
Alzheimer’s Disease: One 1997 trial found that synthetic THC could ease symptoms of Alzheimer’s. Patients were less agitated and ate better after treatment.
Autism : Two animal studies show that chemicals in marijuana may help symptoms of some forms of autism. A study of children with autism is underway at the University of California Irvine Medical Center.
Cancer : Several studies on animal and human cells and a small study on 9 people suggested THC and other cannabinoids (chemicals derived from cannabis) might slow the growth of brain cancer. Multiple lab studies in human cells have also shown the potential for them to slow other kinds of cancers, such as breast cancer and leukemia; no studies in people have taken place.
Chronic Pain : More than 45 studies have looked at marijuana and pain related to chronic diseases such as cancer, diabetes, fibromyalgia, multiple sclerosis, HIV, rheumatoid arthritis, and spinal injuries. The studies have included smoked marijuana, along with herbal and man-made forms. The majority of the studies showed an improvement in pain relief in comparison to a placebo or to other traditional pain medications. About a quarter of the studies showed no improvement.
Epilepsy : Personal stories and animal studies have shown that cannabidiol, one of the chemicals in cannabis, may help seizures in children with epilepsy. New York University just announced it will do a study of children with epilepsy and marijuana.
Digestive Disorders : Personal stories and several early studies have shown that smoking marijuana can help people with digestive diseases such as colitis, irritable bowel syndrome, and Crohn’s disease. Some of the results included a reduction in bowel inflammation and reduced acid reflux. Further, some patients were able to retain more nutrients in their bodies, and the disease went into remission.
MS: More than 24 studies have looked at smoked marijuana, cannabinoids, and MS. Most reported that it helped relax patients’ rigid muscles and helped with pain. Sativex is approved to treat MS in 24 countries, but not in the U.S.
Schizophrenia: Two clinical trials showed that THC and cannabidiol could help with psychotic and other symptoms. The National Institutes of Health is funding a small clinical trial that also aims to show whether THC and cannabidiol can ease symptoms.

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TORONTO, March 9, 2018 /CNW/ – TerrAscend Corp. (CSE:TER) (“TerrAscend” or the “Company”) is pleased to announce that the Company’s wholly-owned subsidiary, Solace Health Inc. (“Solace Health”) has been granted a license by Health Canada to sell dried cannabis.

The sales license will permit the Company to launch the Solace Health Marketplace, an e-commerce platform for Canadian patients. The platform will offer multiple brands, cannabis products and strains with varying cannabinoid profiles and will be launching in the coming weeks.

Solace Health is also pleased to announce that it has secured in excess of 1,000kg of dried cannabis including 15 different genetic strains through its own cultivation and strategic industry partnerships.

This licence is an important milestone for the Company that enables us to execute our strategic objectives to deliver both pharmaceutical grade cannabis products and patient support programs” said. The granting of our sales license, together with the recent expansion of our Mississauga, Ontario facility, allows us the opportunity to provide the highest quality products, with a same day delivery option.

Dr. Michael Nashat, President and CEO of TerrAscend

“TerrAscend has made substantial progress since our strategic investment in December 2017” said Jason Wild, Chairman of TerrAscend and CIO of JW Asset Management, LLC. “I would like to thank all our employees, shareholders and strategic partners for their contribution in helping us reach this historic milestone. The opportunities in the global cannabis market are tremendous. My vision for TerrAscend is to be the worldwide leader in the legal cannabis industry.”

About TerrAscend

TerrAscend is a Canadian cannabis company dedicated to creating and delivering quality products and services that meet the evolving needs of consumers. The Company provides support to medical consumers through its wholly-owned subsidiaries, Solace Health Inc., a licenced producer of medical cannabis under the Access to Cannabis for Medical Purposes Regulations and Terra Health Network Inc., a clinical support program and education platform led by healthcare professionals.

 

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Aurora Cannabis Succeeds in Bid for CanniMed – Takes Up Shares

Announces Mandatory Extension of Tender Period

EDMONTON, March 9, 2018 /CNW/ – Aurora Cannabis Inc. (“Aurora”) (TSX: ACB) (OTCQB: ACBFF) (Frankfurt: 21P; WKN: A1C4WM) announced today that the Company has been successful in its offer (the “Offer”) for all the issued and outstanding common shares for CanniMed Therapeutics Inc. (“CanniMed”).

The number of CanniMed common shares (the “CanniMed Shares”) tendered as at the close of business on March 8, 2018 totals 17,847,341, representing approximately 70.66% of the total outstanding CanniMed Shares on a fully diluted basis. All of the conditions to the Offer having been met, Aurora will take up the tendered CanniMed Shares and pay for those shares as soon as possible, and in any event not later than 3 business days after the CanniMed Shares are taken up. Aurora will issue a total of approximately 50.6 million Aurora common shares and pay a total of approximately $98 million in cash for the CanniMed Shares tendered as of March 8, 2018.

Following the take up, we will immediately commence with the integration of CanniMed into the Aurora organization and start executing on realizing the strategic synergies we have identified.

Terry Booth, CEO

Combining two of the leading international cannabis brands creates a company that is exceptionally well positioned to capitalize on the tremendous opportunities in the domestic and international medical markets, as well as the Canadian adult consumer use market, once legalized. We look forward to working closely with our new colleagues to establish Aurora’s Medical Cannabis Centre of Excellence.

 

Mandatory Extension

In addition, pursuant to applicable Canadian securities laws requiring Aurora to extend its Offer, the Company has extended the period shareholders of CanniMed have to tender their shares under the Offer by 15 days to 11.59 pm (Pacific Time) March 25, 2018. Aurora has provided notice of the extension to Laurel Hill Advisory Group (the “Depositary and Information Agent”) effective March 9, 2018. There is no guarantee that Aurora will further extend the Offer after March 24, 2018, and CanniMed shareholders are encouraged to tender as soon as possible.

Full details of the extension of the period during which additional CanniMed Shares may be tendered under the Offer will be included in a notice of variation and extension (the “Notice of Variation and Extension”), which Aurora expects to file on SEDAR (under CanniMed’s profile) at www.sedar.com and mail to registered CanniMed Shareholders on or prior to March 9, 2018.

How to Tender

Aurora encourages CanniMed shareholders to read the full details of the Offer set forth in its original offer and takeover bid circular dated November 24, 2017 (as amended by its notice of change dated January 12, 2018), and its notice of variation dated February 5, 2018 and March 9, 2018, and accompanying offer documents (collectively, the “Offer Documents“), which contain detailed instructions on how CanniMed shareholders can tender their CanniMed Common Shares to the Offer. For assistance in depositing CanniMed Common Shares to the Offer, CanniMed shareholders should contact the Depository and Information Agent for the Offer, Laurel Hill Advisory Group at Phone: 1-877-452-7184 (North American Toll Free Phone) and 1-416-304-0211 (Outside North America); Facsimile: 416-646-2415; and E-mail: assistance@laurelhill.com.

About the Offer

The full details of the Offer are set out in the Offer Documents, which have been filed with the Canadian securities regulatory authorities and have been mailed to CanniMed shareholders. The Offer Documents are also available on SEDAR under CanniMed’s profile at www.sedar.com.

Materials filed with the Canadian securities regulatory authorities are available electronically without charge at www.sedar.com. Materials filed with the SEC are available electronically without charge on EDGAR accessible through the SEC’s website at www.sec.gov. Documents related to the Offer, including the Offer Documents, are also available on Aurora’s website at www.auroramj.com and shareholders are invited to visit cannimed.auroramj.com for further information.

About Aurora

Aurora’s wholly-owned subsidiary, Aurora Cannabis Enterprises Inc., is a licensed producer of medical cannabis pursuant to Health Canada’s Access to Cannabis for Medical Purposes Regulations (“ACMPR”). The Company operates a 55,200 square foot, state-of-the-art production facility in Mountain View County, Alberta, known as “Aurora Mountain”, and a second 40,000 square foot high-technology production facility known as “Aurora Vie” in Pointe-Claire, Quebec on Montreal’s West Island. In January 2018, Aurora’s 800,000 square foot flagship cultivation facility, Aurora Sky, located at the Edmonton International Airport, was licensed. Once at full capacity, Aurora Sky is expected to produce over 100,000 kg per annum of cannabis.  Aurora is completing a fourth facility in Lachute, Quebec utilizing its wholly owned subsidiary Aurora Larssen Projects Ltd.

Aurora also owns Berlin-based Pedanios, the leading wholesale importer, exporter, and distributor of medical cannabis in the European Union. The Company owns 51% of Aurora Nordic, which will be constructing a 1,000,000 square foot hybrid greenhouse in Odense, Denmark. The Company offers further differentiation through its acquisition of BC Northern Lights Ltd. and Urban Cultivator Inc., industry leaders, respectively, in the production and sale of proprietary systems for the safe, efficient and high-yield indoor cultivation of cannabis, and in state-of-the-art indoor gardening appliances for the cultivation of organic microgreens, vegetables and herbs in home and professional kitchens.

Aurora holds a 19.88% ownership interest in Liquor Stores N.A., who intend developing a cannabis retail network in Western Canada. In addition, the Company holds approximately 17.23% of the issued shares in leading extraction technology company Radient Technologies Inc., and has a strategic investment in Hempco Food and Fiber Inc., with options to increase ownership stake to over 50%. Aurora is also the cornerstone investor in two other licensed producers, with a 22.9% stake in Cann Group Limited, the first Australian company licensed to conduct research on and cultivate medical cannabis, and a 17.62% stake in Canadian producer The Green Organic Dutchman Ltd., with options to increase to majority ownership.

 

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Marijuana is widely touted as an effective medicine for an array of conditions. But what does the evidence actually tell us?

Scott Gavura

This year will bring a Canada Day for the history books. Only July 1, 2018, recreational marijuana (also called cannabis) will be legalized and regulated in Canada. The federal Cannabis Act creates a legal framework for producing, possessing and selling marijuana across Canada, meaning that each Canadian province will set its own rules to oversee its distribution, subject to federal government conditions. Provincial and federal governments will share in the responsibility for the oversight of this new system, and will also share in the tax revenue. Different provinces are taking different approaches, similar to how alcohol purchases vary between jurisdictions. This trend follows what we’re seeing at the state level in the United States, with different states moving to decriminalize recreational use.

Marijuana has been legal to some extent in Canada (and in many US states) for some time, in the form of “medical” marijuana. The Canadian government authorized the sale of marijuana for that purpose, while it simultaneously emphasizes that cannabis is not an approved therapeutic product. The medical market, for many, appears to simply be a means to access products for recreational, or non-medical use, and has generated wildly unsubstantiated claims about the medical merits of marijuana for conditions like autism and the treatment of cancer. Dispensaries have appeared across Canada and the US, usually with very easy referrals for prescriptions. Some dispensaries ignore any prescription requirement entirely and will sell marijuana directly to the public without any medical assessment or advice. With the introduction of government-overseen (and in some Canadian provinces, government-delivered) retail sales in Canada later this year, it’s reasonable to assume that unregulated dispensaries will eventually disappear.

With recreational sales imminent in Canada (and already here, in states like California), there are questions about the future market for “medical” marijuana. Should use for medical purposes be treated like recreational use, where consumers make their own selections, and purchases are taxed like other consumer products? Or should some forms or uses of marijuana be treated like prescription drugs, where a health professional remains involved, and products may be even be covered by insurance plans? Given the major changes we are seeing in how we can access marijuana, it’s worth summarizing the current state of evidence for marijuana when used for specific medical purposes. With marijuana becoming much more accessible, physicians, other health professionals, and their patients need high-quality information about its value for different medical conditions. David Gorski reviewed much of the evidence in a series of posts over the past three years. Now, three new documents prepared for Canadian physicians and health professionals concisely summarize the current evidence base for medical marijuana.

The pharmacy profession seemingly sees a bright future in medical marijuana, with big chains striking deals with producers and even hiring “brand managers” in anticipation of the shuttering of unregulated dispensaries and a continued demand for “medical” uses. The argument being made by the pharmacy profession seems to be that (1) marijuana is a legitimate drug for medical purposes, and should be treated as such, which includes (2) a pharmacy and pharmacist being involved in the provision. The latter we can set aside for now, and focus first on whether or not marijuana is indeed a drug that should be treated like other prescription drugs.

Before I continue, I should state my personal position on marijuana. I am fully supportive of the legalization of marijuana for recreational use and support regulation and taxation, treating it along the lines of alcohol or tobacco. I should also state that I have no “skin in the game” when it comes to marijuana in pharmacies, or medical marijuana more generally – I don’t work in retail pharmacy, and while pharmacy professional associations seem enamored with the idea of medical marijuana in pharmacies, I have no personal opinion on it, other that wanting pharmacies to be places that offer and promote science-based and medically useful products, not pseudoscience or harmful/ineffective products (see my post on the commercial and professional ethical obligations of pharmacists for more).

It’s worth mentioning as an aside that there’s a somewhat similar set of circumstances in US history, when alcohol was available only by prescription during Prohibition. This prescription (via the Smithsonian Institute) could be used by physicians to prescribe alcohol for an array of ailments:

Naturally, the prescription market for alcohol disappeared once Prohibition ended. But marijuana is not alcohol. It contains an array of potentially medically useful chemical substances, several of which have been clinically investigated for the treatment of different medical conditions.

The pharmacology of marijuana

As David Gorski has pointed out in previous posts, there are a number of biologically active chemicals in marijuana. The main psychoactive ingredients are called cannabinoids, and the primary cannabinoid produced is delta-9-tetrahydrocannabinol (Δ9-THC, or simply THC.). Cannabinoids are produced in the stalk, leaves, flowers, seeds and resin of marijuana plants. Marijuana can be smoked, vaporized, or eaten, among other forms of ingestion. THC is rapidly absorbed, and when inhaled, reaches the brain within minutes. (Oral absorption is lower owing to a significant reduction in available drug after passing though the liver.) These chemicals bond to cannabinoid receptors on cells throughout the body, triggering or modulating different effects. Marijuana immediately affects and impairs attention, concentration, memory, learning and motor coordination, proportional to the dose. You might wonder why our cells have receptors for THC and other cannabinoids. That’s because we (and other mammals) have an endocannabinoid system, and we naturally produce endocannabinoids. It is absolutely plausible that drugs that target endocannbinoid receptors, like THC (or derivatives), have the potential to produce beneficial medicinal effects, given the presence of receptors on nearly every organ system. With the growing understanding of the endocannabinoid system, and the identification of different types of receptors, there’s the potential for targeting specific effects on specific organs. That could mean products that produce beneficial effects and minimize any adverse effects (e.g., fewer psychoactive effects).

Cannabinoids are highly fat soluble and so are difficult for the body to eliminate – the complete elimination of a single dose may take up to one month. With repeated doses, levels can rapidly accumulate. While the liver eliminated cannabinoids, even the metabolites of THC can persist in the body, and there is little relationship between the levels of THC found in the blood and the degree of THC-induced effects. Owing to metabolism in the liver, THC has the potential to interact with other drugs. The overall impact has not been well studied. As a drug, there is lot we do not know about marijuana. However, we can be confident in observing that there is little acute toxicity of marijuana, unlike many other drugs and substances. While not addictive, there are also cases of cannabis use disorder, which while infrequent, can occur. It should be acknowledged that cannabis use disorder is a minor public health issue compared to the widespread harms and mortality caused by substances like alcohol and opioids.

The evidence check

Let’s now look at a trio of documents prepared by the Alberta College of Family Physicians. They routinely produce “Tools for Practice” which are concise, actionable answers to clinical questions. All the documents are available online, and are fully referenced, but I will summarize each document here:

Are medical cannabinoids (MC) effective for the treatment of pain?

Bottom Line: Evidence for inhaled marijuana for pain is too sparse and poor to provide good evidence-based guidance. Synthetic MC-derived products may modestly improve neuropathic pain for one in 11-14 users but perhaps not for other pain types. Additionally, longer and larger studies (better evidence) show no effect. Adverse events are plentiful.

The full document is available here.

What are the harms associated with medical cannabinoid therapy?

Bottom Line: Compared to placebo, medical cannabinoids cause multiple different adverse events in patients, from visual disturbance or hypotension (1 in 3-10) to hallucination or paranoia (1 in 20). Stopping due to adverse effects occurs in 1 in every 8-20 patients. Regardless of the type of medical cannabinoid used, adverse events are common and likely underestimated. Given the extensive harms, potential benefits must be impressive to warrant a trial of therapy.

The full document is available here.

Besides pain, are medical cannabinoids effective for other conditions?

Bottom Line: For most conditions (example anxiety), cannabinoid evidence is sparse (at best), low quality and non-convincing. Dronabinol/nabilone improve control of nausea/vomiting post chemotherapy for 1 in 3 users over placebo. Nabiximols likely improve multiple sclerosis spasticity ≥30% for ~1 in 10 users over placebo. Patients’ preference for cannabinoids exceeds cannabinoids effectiveness.

The full document is available here.

Developing an evidence base for marijuana

Studying marijuana under rigorous circumstances has been difficult until fairly recently. The plant itself isn’t patented, so even ignoring the legal access issues, there may be a lack of industry enthusiasm in conducting clinical trials. The other issue is the challenge of a proper placebo control, particularly for non-oral forms of use. Given the psychoactive effects and the widely heralded effects on conditions that can only be assessed subjectively, like nausea, fatigue or appetite, a proper placebo is essential to separate out actual from placebo effects. While some commercial products have been developed and marketed with standardized ingredients and quality control (e.g., nabilone), these products are exceptions. However, these purified and standardized products have allowed for proper placebo controls and more rigorous assessments of effectiveness. Regrettably, these products haven’t been shown to be that effective which may suggest that the perceived beneficial effects may be largely placebo effects. Hopefully, clinical trials will become more common and more marijuana-based drugs can be more rigorously evaluated.

Conclusion: Evidence is lacking

The use of psychoactive drugs like marijuana is a health issue, particularly when used for medical purposes. Regrettably, there is a lack of high-quality data that shows marijuana for most medical purposes is both safe and effective. What little evidence exists is of poor quality and may not even be representative of the purposes for which medical marijuana is sought. There are significant gaps in information necessary to treat marijuana like other forms of medicine: Dosage standardization and overall quality control may not be in place. Overall effectiveness, contraindications, drug interactions, adverse events and long-terms risks when marijuana is used as medicine are not well understood. The best evidence suggests that marijuana may be a reasonable treatment option only when safer, more effective, and better tolerated treatment options have been tried first. If marijuana is to be treated as medicine, then it needs to meet the same standards of quality, effectiveness, and safety we would expect of any other prescription drug. That standard has not yet been met.

Images from flickr users Chuck Coker and Thomas Hawk used under a CC licence.

 

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CHATHAM, ONTARIO – December 11, 2017 – AgMedica Bioscience Inc. (“AGMEDICA” or the “Company”) is pleased to announce that it has received a cannabis production licence from Health Canada under the Access to Cannabis for Medical Purposes Regulation (“ACMPR”). In the coming weeks, the Company is planning to begin cultivation in the first phase of its energy efficient indoor Riverview Cultivation Facility with a current annual production capacity of 6,000 kg (“Phase I Facility”).

This is another major accomplishment in the growth of AGMEDICA. The management team is pleased to have achieved this critical milestone and would like to thank all of our employees, partners, and shareholders for their efforts and continued support. We believe that AGMEDICA has one of the largest, if not the largest, initial capacity of any newly licensed producer of cannabis in Canada.

Art Vander Pol, CEO of AGMEDICA

While we are celebrating this accomplishment, we realize this is just one more milestone on our journey to become a global leader in cannabis production as well as the development and commercialization of cannabis-derived products that positively impacts the health and well-being of our customers.

AGMEDICA has assembled a management team with decades of experience in large-scale commercial agriculture and in the development and commercialization of pharmaceutical products. The team is now focused on operationalizing the Phase I Facility and the development of innovative products.

About AGMEDICA

AGMEDICA is a licensed producer under the ACMPR and is focused on the cultivation of high-quality and consistent medical-grade cannabis. The Company’s Riverview Cultivation Facility is located in Chatham, Ontario.  The Phase I Facility has an annual capacity of 6,000 kg of pharmaceutical-grade indoor cannabis. Plans are in place to expand this capacity within the existing building to 26,500 kg. The Company is planning to begin cultivation in the coming weeks. The Company’s second indoor facility is in the detailed review stage at Health Canada to become an ACMPR licensed producer and is forecast to add an additional 40,000 kg in annual capacity once fully built, providing AGMEDICA with a total projected indoor production capacity of 66,500 kg per year.

AGMEDICA’s vision is to be a global leader in the production of cannabis and cannabis-derived products that improve the health and well-being of its customers. The Company is working to understand and serve the needs of its customers and partners, ensuring that its products, their quality and the ongoing commitment the Company brings to health and well-being remain its fundamental priorities.

The AGMEDICA team is dedicated to the development of cannabis derived products for medical, adult-use (recreational once approved) and ultimately pharmaceutical purposes. This will be accomplished through plant and product research and development, innovative production practices, comprehensive clinical and health benefit assessments and a commitment to customer value. AGMEDICA is committed to developing and commercializing innovative, high quality products, processes and services.

Name Change to AGMEDICA

AgMedica Bioscience Inc. (formerly AgriMed Botanicals Inc. or AMBI) changed its name on December 6, 2017. “Our name change to AgMedica Bioscience reflects our evolution and strategic vision to become a dominant vertically integrated player in the medical cannabis market and to invest in world-class research and development to develop and commercialize clinically-proven cannabis-derived pharmaceutical products for human and veterinary use.” said CEO, Art Vander Pol.

For further information:

Media Questions:

Andrea Duchene

Communications Specialist

andread@agmedica.ca

Investor Relations:

Peter Van Mol

Chief Financial Officer

peterv@agmedica.ca

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As the once-vilified drug becomes more accepted, researchers around the world are trying to understand how it works and how it might fight disease.

 

Marijuana’s advocates believe the long-maligned plant can enhance life—and help deliver people from sickness and pain. A Seattle cannabis worker cradles the resin-dusted bud of a strain called Blueberry Cheesecake.

By Hampton Sides

Photographs by Lynn Johnson

This story appeared in the June 2015 issue of National Geographic magazine.

There’s nothing new about cannabis, of course. It’s been around humankind pretty much forever.

In Siberia charred seeds have been found inside burial mounds dating back to 3000 B.C. The Chinese were using cannabis as a medicine thousands of years ago. Marijuana is deeply American too—as American as George Washington, who grew hemp at Mount Vernon. For most of the country’s history, cannabis was legal, commonly found in tinctures and extracts.

Then came Reefer Madness. Marijuana, the Assassin of Youth. The Killer Weed. The Gateway Drug. For nearly 70 years the plant went into hiding, and medical research largely stopped. In 1970 the federal government made it even harder to study marijuana, classifying it as a Schedule I drug—a dangerous substance with no valid medical purpose and a high potential for abuse, in the same category as heroin. In America most people expanding knowledge about cannabis were by definition criminals.

But now, as more and more people are turning to the drug to treat ailments, the science of cannabis is experiencing a rebirth. We’re finding surprises, and possibly miracles, concealed inside this once forbidden plant. Although marijuana is still classified as a Schedule I drug, Vivek Murthy, the U.S. surgeon general, recently expressed interest in what science will learn about marijuana, noting that preliminary data show that “for certain medical conditions and symptoms” it can be “helpful.”

Left: Lily Rowland receives a dose of an oil derived mainly from cannabidiol (CBD), a non psychoactive substance in marijuana. She used to suffer hundreds of seizures with violent convulsions every day. Her family moved to Colorado, which voted to legalize marijuana in 2012, so that she could begin a daily regimen.Right: The drug doesn’t work for everyone, but today nine-year-old Lily is often seizure free and on her worst days has only one or two.

In 23 states and the District of Columbia cannabis is legal for some medical uses, and a majority of Americans favor legalization for recreational use. Other countries are rethinking their relationship to pot too. Uruguay has voted to legalize it. Portugal has decriminalized it. Israel, Canada, and the Netherlands have medical marijuana programs, and in recent years numerous countries have liberalized possession laws.

Ganja is simply around us more, its unmistakable but increasingly unremarkable smell hanging in the air. Yes, smoking it may lead to temporary laughing sickness, intense shoe-gazing, amnesia about what happened two seconds ago, and a ravenous yearning for Cheez Doodles. Though there’s never been a death reported from an overdose, marijuana—especially today’s stout iterations—is also a powerful and in some circumstances harmful drug.

Cannabis for Kids

Hoping to help their sick children, three sets of parents turn to medical marijuana as a last resort.

Still, for many, cannabis has become a tonic to dull pain, aid sleep, stimulate appetite, buffer life’s thumps and shocks. Pot’s champions say it peels back layers of stress. It’s also thought to be useful as, among other things, an analgesic, an antiemetic, a bronchodilator, and an anti-inflammatory. It’s even been found to help cure a bad case of the hiccups. Compounds in the plant, some scientists contend, may help the body regulate vital functions—such as protecting the brain against trauma, boosting the immune system, and aiding in “memory extinction” after catastrophic events.

In the apparent rush to accept weed into the mainstream, to tax and regulate it, to legitimize and commodify it, important questions arise. What’s going on inside this plant? How does marijuana really affect our bodies and our brains? What might the chemicals in it tell us about how our neurological systems function? Could those chemicals lead us to beneficial new pharmaceuticals?

If cannabis has something to tell us, what’s it saying?

Phillip Hague, the chief horticulturist at a Denver cannabis company called Mindful, sniffs the roots of a plant to check on their health. He’s grown cannabis most of his life and has traveled the world researching its many varieties. He’s interested in developing new strains with higher concentrations of marijuana’s lesser known compounds that appear to have medical uses. “Cannabis speaks to me,” he says.

The Chemist: Treasure Trove

Even into the middle of the 20th century, science still didn’t understand the first thing about marijuana. What was inside it and how it worked remained a mystery. Because of its illegality and tainted image, few serious scientists wanted to besmirch their reputations by studying it.

Then one day in 1963 a young organic chemist in Israel named Raphael Mechoulam, working at the Weizmann Institute of Science outside Tel Aviv, decided to peer into the plant’s chemical composition. It struck him as odd that even though morphine had been teased from opium in 1805 and cocaine from coca leaves in 1855, scientists had no idea what the principal psychoactive ingredient was in marijuana. “It was just a plant,” says Mechoulam, now 84. “It was a mess, a mélange of unidentified compounds.”

So Mechoulam called the Israeli national police and scored five kilos of confiscated Lebanese hashish. He and his research group isolated—and in some cases also synthesized—an array of substances, which he injected separately into rhesus monkeys. Only one had any observable effect. “Normally the rhesus monkey is quite an aggressive individual,” he says. But when injected with this compound, the monkeys became emphatically calm. “Sedated, I would say,” he recalls with a chuckle.

Further testing found what the world now knows: This compound is the plant’s principal active ingredient, its mind-altering essence—the stuff that makes you high. Mechoulam, along with a colleague, had discovered tetrahydrocannabinol (THC). He and his team also elucidated the chemical structure of cannabidiol (CBD), another key ingredient in marijuana, one that has many potential medical uses but no psychoactive effect on humans.

Left: Marijuana grows in an irrigated field on the plains east of Denver—discreetly hidden behind rows of corn. This crop is hemp, a non-psychoactive variety with little tetrahydrocannabinol (THC). Its tough fiber has long been used for rope, paper, and fabric, but it’s also rich in compounds with medical promise. Some of this harvest will be used to make CBD oil, which is in such demand to treat children with seizures that cannabis growers have stepped up production.Right: Jordan Stanley (at left) cuts down marijuana plants, and Michael Atchley collects them to stack. Jordan and his brother Jared are growing about 36,000 plants, most of them strains developed to produce high concentrations of CBD, which is sought after for its medical uses. The men believe their harvest will help the thousands of families seeking high-CBD oil.

For these breakthroughs and many others, Mechoulam is widely known as the patriarch of cannabis science. Born in Bulgaria, he is a decorous man with wispy white hair and watery eyes who wears natty tweeds, silk scarves, and crisp dress slacks. He’s a respected member of the Israel Academy of Sciences and Humanities and an emeritus professor at Hebrew University Hadassah Medical School, where he still runs a lab. The author of more than 400 scientific papers and the holder of about 25 patents, this kindly grandfather has spent a lifetime studying cannabis, which he calls a “medicinal treasure trove waiting to be discovered.” His work has spawned a subculture of cannabis research around the globe. Though he says he’s never smoked the stuff, he’s a celebrity in the pot world and receives prodigious amounts of fan mail.

“It’s all your fault,” I say to him when we meet in his book-lined, award-crammed office to discuss the explosion of interest in the science of marijuana.

“Mea culpa!” he replies with a smile.

Israel has one of the world’s most advanced medical marijuana programs. Mechoulam played an active role in setting it up, and he’s proud of the results. More than 20,000 patients have a license to use cannabis to treat such conditions as glaucoma, Crohn’s disease, inflammation, appetite loss, Tourette’s syndrome, and asthma.

Despite that, he’s not particularly in favor of legalizing cannabis for recreational use. He doesn’t think anyone should go to jail for possessing it, but he insists that marijuana is “not an innocuous substance”—especially for young people. He cites studies showing that the prolonged use of high-THC strains of marijuana can change the way the developing brain grows. He notes that in some people cannabis can provoke serious and debilitating anxiety attacks. And he points to studies that suggest cannabis may trigger the onset of schizophrenia among those who have a genetic predisposition to the disease.

If he had his way, what Mechoulam regards as the often irresponsible silliness of recreational pot culture would give way to an earnest and enthusiastic embrace of cannabis—but only as a medical substance to be strictly regulated and relentlessly researched. “Right now,” he complains, “people don’t know what they’re getting. For it to work in the medical world, it has to be quantitative. If you can’t count it, it’s not science.”

In 1992 Mechoulam’s quest for quantification led him from the plant itself to the inner recesses of the human brain. That year he and several colleagues made an extraordinary discovery. They isolated the chemical made by the human body that binds to the same receptor in the brain that THC does. Mechoulam named it anandamide—from the Sanskrit for “supreme joy.” (When asked why he didn’t give it a Hebrew name, he replies, “Because in Hebrew there are not so many words for happiness. Jews don’t like being happy.”)

At Denver’s LivWell, which has an enormous indoor growing operation, workers remove marijuana leaves before the buds are trimmed, keeping the plants destined for medical use separate from those for recreational use. After Colorado legalized marijuana, thousands of young people from all over the world flocked to the state to participate in the multimillion-dollar business phenomenon that’s been called the Green Rush.

Since then several other so-called endocannabinoids and their receptors have been discovered. Scientists have come to recognize that endocannabinoids interact with a specific neurological network—much the way that endorphins, serotonin, and dopamine do. Exercise, Mechoulam notes, has been shown to elevate endocannabinoid levels in the brain, and “this probably accounts for what jogging enthusiasts call runner’s high.” These compounds, he explains, apparently play an important role in such basic functions as memory, balance, movement, immune health, and neuroprotection.

Typically, pharmaceutical companies making cannabis-based medicines have sought to isolate individual compounds from the plant. But Mechoulam strongly suspects that in some cases those chemicals would work much better in concert with other compounds found in marijuana. He calls this the entourage effect, and it’s just one of the many cannabis mysteries that he says require further study.

“We have just scratched the surface,” he says, “and I greatly regret that I don’t have another lifetime to devote to this field, for we may well discover that cannabinoids are involved in some way in all human diseases.”

The Botanist: Into the Light

The 44,000-square-foot building hulks across from a police station in an industrial part of Denver, along a gritty stretch of converted warehouses that’s come to be known as the Green Mile. There’s nothing to indicate the nature of the enterprise. The door buzzes open, and I’m met by the chief horticulturist of Mindful, one of the largest cannabis companies in the world. A druidlike 38-year-old with keen blue eyes, Phillip Hague wears fatigues, hiking boots, and the incredulous grin of someone who—through a confluence of events he never imagined possible—has found his exact life’s calling.

Hague is a self-described plantsman, a dirty-thumbed gardener since he was eight and a devotee of the great agricultural scientist Luther Burbank. For years Hague grew poinsettias, caladiums, chrysanthemums, and other plants at his family’s nursery in Texas. But now his attentions are lavished on much more lucrative buds.

He leads me through Mindful’s bustling front offices and into its interior corridors. In freezers Mindful stores seeds from all over—Asia, India, North Africa, the Caribbean. A world traveler who’s become something of a Johnny Appleseed for marijuana, Hague is extremely interested in the plant’s historical biodiversity, and his seed bank of rare, wild, and ancient strains is a significant part of Mindful’s intellectual property. “We have to recognize that humans evolved with it practically since the dawn of time,” he says. “It’s older than writing. Cannabis use is part of us, and it always has been. It spread from Central Asia after the last ice age and went out across the planet with man.”

In northern California, Nicholas and Richard Lopez take photographs of their harvest to share online. Recovering meth addicts who’ve served time for drug offenses, the brothers say they’ve turned over a new leaf. They proudly tend a small garden of pot, which they use to cope with bouts of anxiety caused by years of meth abuse.

Hague joined Colorado’s green revolution nearly at the beginning. When the U.S. Justice Department announced in 2009 that it would not focus on prosecuting people who complied with state medical marijuana laws, he looked at his wife and said, “We’re moving to Denver.” Now he runs one of the world’s most prominent “grows,” where more than 20,000 cannabis plants thrive.

We file past the curing rooms and down a hallway pulsating with pumps, fans, filters, generators, trimming machines. A forklift trundles by. Surveillance cameras capture everything, as young workers in medical scrubs scurry about, their faces lit with the pressure and promise of an unorthodox business that’s boomed beyond comprehension. Mindful has big plans to expand, building similar facilities in other states. “Pot is hot!” Hague says with a laugh that conveys amazement and exhaustion. “I’m blown away by what’s happening here every single day.”

He throws open an industrial door, and my eyeballs are scalded by a halo of plasma bulbs. We step into an immense, warm room that smells like a hundred Yes concerts. Once my eyes adjust, I can see the crop in all its rippling glory—close to a thousand female plants standing six feet tall, their roots bathed in a soup of nutrients, their spiky leaves nodding in the breeze of the oscillating fans. Here in a sweep of the eye is more than a half million dollars’ worth of artisanal pot.

I lean over to sniff one of the powdery, tightly clustered flower buds, purple-brown and coursing with white wisps. These tiny trichomes fairly ooze with cannabinoid-rich resin. This strain is called Highway Man, after a Willie Nelson song. Hybridized by Hague, it’s a variety loaded with THC. The best parts will be trimmed by hand, dried, cured, and packaged for sale at one of Mindful’s dispensaries. “This whole room will be ready for harvest in just a few days,” Hague notes with the subtle smirk of a competitive breeder who’s won international awards for his strains.

But Hague has something else he wants to show me. He leads me into a moist propagation room, where a young crop is taking root in near darkness. These babies, tagged with yellow labels, are being grown strictly for medical purposes. They’re all clones, cuttings from a mother plant. Hague is proud of this variety, which contains almost no THC but is rich in CBD and other compounds that have shown at least anecdotal promise in treating such diseases and disorders as multiple sclerosis, psoriasis, post-traumatic stress disorder, dementia, schizophrenia, osteoporosis, and amyotrophic lateral sclerosis (Lou Gehrig’s disease).

“It’s these low-THC strains that really keep me up at night, dreaming about what they can do,” Hague says, noting that marijuana contains numerous substances—cannabinoids, flavonoids, terpenes—that have never been investigated in depth.

“It sounds hokey,” he says as he caresses one of the cuttings like a gloating father, “but I believe cannabis has a consciousness. It’s tired of being persecuted. It’s ready to step out into the light.”

Left: Members of a Seattle cannabis business association called Women of Weed gather to share trade secrets—and intoxicating talk.Right: Cash is the norm for many cannabis businesses, even in Colorado, because banks are reluctant to handle money from marijuana-related sales. Jayson “Giddy Up” Emo, who runs a Denver firm that makes machines for extracting chemicals from cannabis, protects his proceeds the old-fashioned way—with firepower.

The Biochemist: Miracle Cure?

By now nearly everyone has heard that cannabis can play a palliative role for cancer sufferers, especially in alleviating some of the nasty side effects of chemotherapy. There’s no question that pot can stave off nausea, improve appetite, and help with pain and sleep. But could it cure cancer? Troll the Internet and you’ll see hundreds, if not thousands, of such claims. A gullible Googler could easily believe we’re on the brink of a miracle cure.

The majority of these claims are anecdotal at best and fraudulent at worst. But there are also mentions of laboratory evidence pointing to cannabinoids as possible anticancer agents, and many of these reports lead to a lab in Spain run by a thoughtful, circumspect man named Manuel Guzmán.

Guzmán is a biochemist who’s studied cannabis for about 20 years. I visit him in his office at the Complutense University of Madrid, in a golden, graffiti-splotched building on a tree-lined boulevard. A handsome guy in his early 50s with blue eyes and shaggy brown hair tinged with gray, he speaks rapidly in a soft voice that makes a listener lean forward. “When the headline of a newspaper screams, ‘Brain Cancer Is Beaten With Cannabis!’ it is not true,” he says. “There are many claims on the Internet, but they are very, very weak.”

He blinks thoughtfully, then turns to his computer. “However, let me show you something.” On his screen flash two MRIs of a rat’s brain. The animal has a large mass lodged in the right hemisphere, caused by human brain tumor cells Guzmán’s researchers injected. He zooms in. The mass bulges hideously. The rat, I think, is a goner. “This particular animal was treated with THC for one week,” Guzmán continues. “And this is what happened afterward.” The two images that now fill his screen are normal. The mass has not only shrunk—it’s disappeared. “As you can see, no tumor at all.”

In this study Guzmán and his colleagues, who’ve been treating cancer-riddled animals with cannabis compounds for 15 years, found that the tumors in a third of the rats were eradicated and in another third, reduced.

This is the kind of finding that gets the world excited, and Guzmán constantly worries that his breakthrough research may give cancer sufferers false hope—and fuel specious Internet claims. “The problem is,” he says, “mice are not humans. We do not know if this can be extrapolated to humans at all.”

At a cannabis competition in Santa Rosa, California, a young enthusiast becomes a human billboard for a company that sells devices to vaporize the drug. California allows marijuana for medical but not recreational use. As “ganjapreneurs” seek to capitalize on the legalization movement, the paraphernalia industry has expanded dramatically, employing a sleek aesthetic—and a certain sex appeal—to market products once confined to head shops.

Guzmán leads me around his cramped lab—centrifuges, microscopes, beakers, petri dishes, a postdoc researcher in a white smock extracting tissue from a mouse corpse pinned under bright lights. It’s your typical bioresearch lab, except that everything is devoted to the effects of cannabis on the body and brain. The lab focuses not just on cancer but also on neurodegenerative diseases and on how cannabinoids affect early brain development. On this last topic the Guzmán group’s research is unequivocal: Mice born of mothers regularly given high doses of THC during pregnancy show pronounced problems. They’re uncoordinated, have difficulty with social interactions, and have a low anxiety threshold—they’re often paralyzed with fear at stimuli, such as a cat puppet placed near their cage, that don’t upset other juvenile mice.

The lab also has studied how the chemicals in cannabis, as well as cannabinoids like the anandamide produced by our bodies, protect our brains against various types of insults, such as physical and emotional trauma. “Our brain needs to remember things, of course,” says Guzmán, “but it also needs to forget things—horrific things, unnecessary things. It’s much like the memory in your computer—you have to forget what is not necessary, just like you need to periodically delete old files. And you have to forget what is not good for your mental health—a war, a trauma, an aversive memory of some kind. The cannabinoid system is crucial in helping us push bad memories away.”

But it’s Guzmán’s brain tumor research that has captured headlines—and the interest of pharmaceutical companies. Through his years of research he has ascertained that a combination of THC, CBD, and temozolomide (a moderately successful conventional drug) works best in treating brain tumors in mice. A cocktail composed of these three compounds appears to attack brain cancer cells in multiple ways, preventing their spread but also triggering them, in effect, to commit suicide.

Now a groundbreaking clinical trial based on Guzmán’s work is under way at St. James’s University Hospital, in Leeds, England. Neuro-oncologists are treating patients who have aggressive brain tumors with temozolomide and Sativex, a THC-CBD oral spray developed by GW Pharmaceuticals.

Guzmán cautions against overoptimism but welcomes the beginning of human studies. “We have to be objective,” he says. “At least the mind-set is opening around the world, and funding agencies now know that cannabis, as a drug, is scientifically serious, therapeutically promising, and clinically relevant.”

Will cannabis help fight cancer? “I have a gut feeling,” he says, “that this is real.”

Cannabis is a family business for Ben and Megan Schwarting and their three daughters in Washington State, where voters legalized marijuana in 2012. On a breathtaking ledge in Gig Harbor overlooking Puget Sound, Megan makes lotions, and Ben makes concentrated oils. His mother, Mari, Grows marijuana in her basement, and sometimes her granddaughters help prepare the soil. Megan made her first cannabis products in her late teens, at a time when Ben was growing pot in South Dakota. She jokes, "We each had a grown light, and that's what we brought to the relationship."

The Caregiver: Medical Migrants

The seizures started in May 2013 when she was six months old. Infantile spasms, they were called. It looked like a startle reflex—her arms rigid at her side, her face a frozen mask of fear, her eyes fluttering from side to side. Addelyn Patrick’s little brain raced and surged, as though an electromagnetic storm were sweeping through it. “It’s your worst possible nightmare,” her mother, Meagan, says. “Just awful, awful, awful to watch your child in pain, in fear, and there’s nothing you can do to stop it.”

From their small town in southwestern Maine, Meagan and her husband, Ken, took Addy to Boston to consult with neurologists. These epileptic seizures, they concluded, were the result of a congenital brain malformation called schizencephaly. One of the hemispheres of Addy’s brain had not developed fully in utero, leaving an abnormal cleft. She also had a related condition called optic nerve hypoplasia, which caused her eyes to wander—and which, further tests revealed, made her all but blind. By summer Addy was having 20 to 30 seizures a day. Then 100 a day. Then 300. “Everything was misfiring all at once,” says Meagan. “We were afraid we were going to lose her.”

The Patricks followed the advice they’d been given and heavily medicated Addy with anticonvulsants. The powerful meds reduced her seizures, but they also put her to sleep for almost the entire day. “Addy was gone,” Meagan says. “She just lay there, sleeping all the time. Like a rag doll.”

Meagan quit her job as a third-grade teacher to care for her daughter. Over nine months Addy was hospitalized 20 times.

When Meagan’s in-laws suggested they look into medical marijuana, she recoiled. “This is a federally illegal drug we are talking about,” she recalls thinking. But she did her own research. A good deal of anecdotal evidence shows that high-CBD strains of cannabis can have a strong antiseizure effect. The medical literature, though scant, goes back surprisingly far. In 1843 a British doctor named William O’Shaughnessy published an article detailing how cannabis oil had arrested an infant’s relentless convulsions.

 

At Noho’s Finest, a medical marijuana dispensary in the Los Angeles area, Damaris Diaz checks the scent and stickiness of her products. Crossbreeding has yielded powerful new hybrid strains that are much higher in psychoactive THC than those in decades past—a source of concern for health officials, who cite evidence that the prolonged smoking of high-THC varieties can adversely affect the developing brain.

In September 2013 the Patricks met with Elizabeth Thiele, a pediatric neurologist at Boston’s Massachusetts General Hospital who’s helping lead a study of CBD in treating refractory childhood epilepsy. Legally, Thiele could not prescribe cannabis to Addy or even recommend it. But she strongly advised the Patricks to consider all medical options.

Encouraged, Meagan went to Colorado and met with parents whose epileptic children were taking a strain of cannabis called Charlotte’s Web, named for a little girl, Charlotte Figi, who’d responded astonishingly well to the low-THC, high-CBD oil produced near Colorado Springs.

What Meagan saw in Colorado impressed her—the growing knowledge base of cannabis producers, the kinship of parents coping with similar ordeals, the quality of the dispensaries, and the expertise of the test labs in ensuring consistent cannabis-oil formulations. Colorado Springs had become a mecca for a remarkable medical migration. More than a hundred families with children who had life-threatening medical conditions had uprooted themselves and moved. These families, many of them associated with a nonprofit organization called the Realm of Caring, consider themselves “medical refugees.” Most couldn’t medicate their children with cannabis in their home states without risking arrest for trafficking or even child abuse.

Meagan experimented with high-CBD oil. The seizures all but stopped. She weaned Addy off some of her other meds, and it was as though she’d come back from a coma. “It sounds like a small thing,” says Meagan. “But if you have a child who smiles for the first time in many, many months, well, your whole world changes.”

By early last year the Patricks had made up their minds. They would move to Colorado to join the movement. “It was a no-brainer,” Meagan says. “If they were growing something on Mars that might help Addy, I’d be in my backyard building a spaceship.

Left: Kim Clark’s younger son, Caden, 11, suffers from severe epilepsy. Despite having brain surgery twice, he’d never had a seizure-free day until he started taking CBD oil.Right: Caden’s brother, Jax, 13, had suggested that the family move to Colorado to try CBD. “There was a person in there waiting to be unlocked. I could see him but I couldn’t reach him,” Kim says. “I want everyone to come to see him—legislators, doctors, researchers.”

When I meet the Patricks in late 2014, they’ve settled into their new home on the north side of Colorado Springs. Pikes Peak looms in their living room window. Addy is thriving. Since first taking CBD oil, she hasn’t been hospitalized. She still has occasional seizures—one or two a day—but they’re less intense. Her eyes wander less. She listens more. She laughs. She’s learned how to hug and has discovered the power of her vocal cords.

Critics contend that the Realm of Caring parents are using their kids as guinea pigs, that not enough studies have been done, that many, if not most, of the claims can be dismissed as the result of the placebo effect. “It’s true, we don’t know the long-term effects of CBD, and we should study it,” Meagan says. “But I can tell you this. Without it, our Addy would be a sack of potatoes.” No one asks, she notes, about the long-term effects of a widely used pharmaceutical that has been routinely prescribed for her two-year-old. “Our insurance pays for it, no questions asked,” she says. “But it’s highly addictive, highly toxic, turns you into a zombie, and can actually kill you. And yet it’s perfectly legal.”

Thiele says early results of the CBD study are extremely encouraging. “CBD is not a silver bullet—it doesn’t work for everybody,” she cautions. “But I’m impressed. It clearly can be a very effective treatment for many people. I have several kids in the study who’ve been completely seizure free for over a year.”

Reports like these only deepen Meagan’s frustrations with what she has come to regard as the imbecility of federal marijuana laws that put her at risk of arrest for transporting a drug that “wouldn’t get a mouse high” across state lines. “It’s unacceptable,” she says, “that we’re allowing our citizens to suffer like this.”

But the Patricks are in a good place now—happier than they’ve been in years. “We have Addy back again,” Meagan says. “If I wasn’t living through this, I don’t know that I’d believe it myself. I don’t feel like cannabis is a miracle cure. But I feel like it should be a tool in every neurologist’s toolbox, all around the country.”

Orrin Devinsky, a neurologist at New York University, is more skeptical. He’s leading a clinical trial to test CBD against a placebo in treating forms of epilepsy. “There’s real potential,” he says, “but we urgently need valid data.”

The Geneticist: Building the Map

“It’s such an interesting plant, such a valuable plant,” says Nolan Kane, who specializes in evolutionary biology. “It’s been around for millions of years, and it’s one of man’s oldest crops. And yet there are so many basic problems that need to be answered. Where did it come from? How and why did it evolve? Why does it make all these suites of compounds? We don’t even know how many species there are.”

We’re standing in a laboratory greenhouse on the campus of the University of Colorado Boulder looking at ten hemp plants that Kane recently procured for research purposes. They’re spindly, stalky little things, like gangling teenagers, a far cry from the lascivious crop that Hague had shown me. These plants, like nearly all hemp varieties, carry extremely low levels of THC.

They may not look threatening, but their very presence here, in the confines of a major university lab, represents years of wrangling to win federal and university approval. Right now, Kane’s allowed to grow only hemp strains. The rest of his research material is cannabis DNA, which is supplied by Colorado growers who extract it using methods he’s taught them.

Kane fingers one of his innocuous-looking plants, expressing mild bemusement at the U.S. ban on commercial hemp cultivation. “Hemp produces fibers of unparalleled quality,” he notes. “It’s a tremendously high biomass crop that replenishes the soil and doesn’t require much in terms of inputs. We import tons and tons of hemp each year from China and even Canada, yet as a matter of federal policy, we can’t legally grow it. There are places where farmers in the U.S. can literally look across the Canadian border and see fields that are yielding huge profits.”

A geneticist, Kane studies cannabis from a unique perspective—he probes its DNA. He’s an affable, outdoorsy guy with a bright face and eyes that wander and dart inquisitively when he talks. He has studied chocolate and for many years the sunflower, eventually mapping its genome, a sequence of more than three and a half billion nucleotides. Now he’s moved on to marijuana. Though its sequence is much shorter, roughly 800 million nucleotides, he considers it a far more intriguing plant.

A sketchy outline of the cannabis genome already exists, but it’s highly fragmented, scattered into about 60,000 pieces. Kane’s ambitious goal, which will take many years to achieve, is to assemble those fragments in the right order. “The analogy I use is, we have 60,000 pages of what promises to be an excellent book, but they’re strewn all over the floor,” he says. “We have no idea yet how those pages fit together to make a good story.”

Many people are more than a little eager to learn how Kane’s story will play out. “There’s a certain pressure,” he says, “because this work will have huge implications, and anything we do in this lab will be under a lot of scrutiny. You can feel it. People are just wanting this to happen.”

Once the map is complete, enterprising geneticists will be able to use it in myriad ways, such as breeding strains that contain much higher levels of one of the plant’s rare compounds with medically important properties. “It’s like discovering some hidden motif deep in a piece of music,” Kane says. “Through remixing, you can accentuate it and turn it up so that it becomes a prominent feature of the song.”

As Kane leads me around his lab, I see the excitement on his face and on the faces of his young staff. The place feels almost like a start-up company. “So much of science is incremental,” he says, “but with this cannabis work, the science will not be incremental. It will be transformative. Transformative not just in our understanding of the plant but also of ourselves—our brains, our neurology, our psychology. Transformative in terms of the biochemistry of its compounds. Transformative in terms of its impact across several different industries, including medicine, agriculture, and biofuels. It may even transform part of our diet—hemp seed is known to be a ready source of a very healthy, protein-rich oil.”

Cannabis, Kane says, “is an embarrassment of riches.”

 

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