Dosage & Quality

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Wednesday, November 29 2006 @ 12:55 PM EST

Study Shows Better Quality Marijuana Preferred by Patients

<span class=postbigbold>Evaluation of herbal cannabis by medical users in controlled study</span>

IACM via BBSNews 2006-11-29 -- Canadian researchers conducted a controlled crossover trial of 4 different herbal cannabis preparations among 8 experienced and authorized cannabis users with chronic pain. Preparations were varied with respect to particle size, THC content and humidity. Subjects received each preparation on a separate day and prepared the drug in their usual way. They were asked to evaluate the products based on appearance (smell, colour, humidity, particle size, ease of preparation and overall appearance) and smoking characteristics (burn rate, hotness, harshness and taste). Particle size was defined as the size of the particles after grinding the raw herbal material.

Seven subjects completed the study, and the product with highest THC content (12 per cent), highest humidity (14 per cent) and largest grind size (10mm) was rated highest overall. Significant differences were noted between preparations on subjective ratings of appearance and colour. Researchers concluded that a "more acceptable cannabis product may increase recruitment and retention in clinical studies of medical cannabis." They noted that in September 2006 about 20 per cent of authorized cannabis users obtained herbal cannabis from Health Canada, compared to about 10 per cent in September 2004.

(Source: Ware MA, Ducruet T, Robinson AR. Evaluation of herbal cannabis characteristics by medical users: a randomized trial. Harm Reduct J 2006;3(1):32)


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MDs boost dosages of prescribed pot

<span class=postbigbold>Health Canada's study also finds the data surprised most doctors when they were told</span>

Jack Aubry, Canwest News Service
The Vancouver Sun
March 18, 2008

OTTAWA -- Canadian doctors have been increasing daily dosages of marijuana for patients using cannabis for medical purposes, Health Canada reports.

The increase in prescribed dosages is noted in a recent report on the views of physicians regarding the use of marijuana, adding that this information "surprised" most doctors when they were told during interviews.

It said the doctors identified seven "logical" explanations for the trend, including the perception that Health Canada marijuana is "not as potent" as that produced and grown by patients or their suppliers.

"Higher doses of Health Canada marijuana for medical purposes may be warranted to achieve the same result obtainable through more potent strains," added the report.

Completed by Les études de Marche Créatec, the study found physicians were unclear about Health Canada's maximum dosage recommendation, stating that "not one participant was able to guess the maximum level." For most doctors, the report said, overdose or dosage beyond an "optimal" limit was not a concern or even a consideration.

The study found unanimous agreement and even "enthusiastic support" among doctors for Health Canada to begin supplying dried marijuana to pharmacists trained to dispense it to patients, although they suggested that the quality be improved and the price be reduced while insuring that medical insurance programs cover the cost.

The reporting of the so-called trend follows Health Canada's campaign last summer to keep doses below five grams which included postings on its website referring to studies which indicated that most medical users need only one to three grams daily.

Other explanations for rising dosages offered by the doctors during the focus groups included observations that no guidelines on a common measurement standard -- "puff, joint versus gram" -- forcing them to rely on their patients for dosage information.

The doctors also pointed out that dosage is "unique" for each patient and, for example, addiction ceases to be a factor when a terminal patient is involved.

Patients also develop "a tolerance and the medication decreases in effectiveness, making a higher dose warranted."

The study, which was completed in December, was based on one-on-one telephone interviews, lasting about 45 minutes, with 30 physicians randomly selected from seven provinces and one territory. Half of the interviews were conducted with doctors in Quebec while none was secured in Manitoba, Newfoundland, Prince Edward Island, Yukon and Nunavut.

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March 13 / 15, 2009

This Changes Everything

<span class=postbigbold>Cannabidiol Now!</span>

CounterPunch
By FRED GARDNER


Two plants strains relatively rich in cannabidiol (CBD) have been identified by an analytic test lab recently established to serve the medical cannabis industry in California. That's two major stories in one sentence. Let's take it from the bottom…

In December a lab in the East Bay started testing samples of cannabis for pathogenic mold and the presence of three cannabinoids –THC, CBD and CBN (cannabinol). THC is the main psychoactive compound in the cannabis plant. CBD is a cannabinoid with intriguing medical potential that gets bred out of cannabis when the breeder's goal is high THC content (as it has been in California for generations). CBN is a breakdown product of THC, an indicator of time in storage.

The lab has been testing about 10 samples a day provided by Oakland's Harborside Health Center, whose proprietor, Steve DeAngelo, helped plan and underwrite the venture. Results from the lab are posted on labels affixed to the strains in Harborside's display cases. Thus prospective buyers are informed that the sparkly nuggets of Raspberry Kush they are savoring in a Petri dish are free of dangerous aspergillus and contain 14.3% THC by weight. (Percent CBD and CBN almost always round off to zero. That's about to change.)

DeAngelo's primary goal is to impose safety standards industry-wide. "We're giving the analytic laboratory project a beta rollout," he says, "to find the problems and eliminate them before seriously soliciting participation from other dispensaries. Then we'll see who's serious about the medical paradigm."

Running the lab are two 30-something entrepreneurs, D.L. and A.D, who spent about a year setting it up and refining their procedures under the tutelage of a sympathetic university-connected chemist. D.L. operates the gas chromatograph-mass spectrometer. A.L. is liaison to the dispensaries. They are planning to add tests for pesticides and certain terpenes –aromatic compounds that contribute to the effects of cannabis.

The advent of a test lab will change the medical cannabis industry in significant ways. For some growers and distributors thriving under the status quo, the documented presence of toxins in their products will force adjustments. The lab has found levels of mold and e coli that bear witness to unsanitary production methods. Deangelo says, "It can't be the whole family and friends sitting around with all the dogs in the living room. We're putting out the message: 'Clean up your trim areas, clean up your storage areas, do not have cannabis curing in an area that's exposed to animals. Set up a clean room and put on different clothes when you go in. Wear gloves. Wash your hands. In other words, remember that your product is medicine and treat it as medicine.'"

Harborside's savvy purchasing agent, Rick Pfrommer, notes that input from the lab has already led to growers cleaning up their acts. "Most of the people who have had mold in their cannabis are the people who didn’t have filters on their air intake. They may have had beautiful medicine, but they were pulling in whatever from the air. Now they've got filters."

When the lab begins testing for pesticides, indoor growers who have been using chemicals to kill mites and other pests will have to find organic alternatives or else peddle their wares to dispensaries that don't adopt safety standards. Expect some to argue that a little residual Avid on their cannabis buds isn't going to hurt anyone.

<span class=postbigbold>Eureka! (No, Laytonville!)</span>

CBD predominates over THC in cannabis that grows wild (ditchweed) and plants grown for fiber (hemp). When plants are bred for psychoactivity CBD is replaced by THC because the same gene codes for one or the other cannabinoid. According to research done in Europe and Israel, CBD has anti-inflammatory, anti-convulsant, anti-psychotic, anti-oxidant, and neuroprotective properties. It also has a direct inhibitory effect on certain cancer cells.

Biologists at California Pacific Medical Center, Sean McAllister and Pierre Desprez, have determined that CBD inhibits breast cancer metastasis by suppressing a gene called Id-1. This winter they started working with mouse models of breast cancer, and if all goes well, they will be conducting clinical trial at CPMC in less than two years.

A British company, GW Pharmaceuticals, has developed a high-CBD strain that it mixes with a high-THC strain to make Sativex, a plant extract formulated for spraying under the tongue that has been approved in Canada and elsewhere to treat neuropathic pain. CBD evidently bolsters the pain-killing effects of THC while moderating its psychoactivity. In various studies, patients with severe pain have reported getting significantly more relief from Sativex, the mixture, than from GW's high-THC extract.

With a few notable exceptions the California cannabis samples tested to date have contained only trace amounts of CBD. The first notable exception exception occurred in late February when D.L. saw a spike on a computer-generated graph indicating a high level of CBD in one of the samples provided by Harborside. After some additional testing he confirmed that this strain, produced indoors in San Francisco, contained 4.2% CBD (and 8.9% THC) by weight.

DeAngelo promptly made arrangements with the grower to rev up production. Buds and clones from the strain of interest should be available at Harborside within months. "It would be immoral to try to hoard the genetic material," says Deangelo. As this story goes off to CounterPunch March 12, a second high-CBD strain has been identified, grown outdoors in Mendocino County. It is a little more than five percent CBD by weight.

Thus the medical marijuana movement/industry is entering a new stage. Growers will develop strains with higher CBD to THC ratios. Pro-cannabis doctors, who have long awaited high-CBD strains, are already planning rudimentary clinical trials to determine whether and in what ways high-CBD cannabis is beneficial.

Because CBD counters the anxiety induced by THC, a high-CBD strain might prove palatable to many people who dislike the way marijuana makes them feel. High-CBD strains might also enable patients who need megadoses to ingest them while remaining functional. According to Jeffrey Hergenrather, MD, "Patients with certain cancers, ulcerative colitis and Crohn's Disease, seizure disorders... they all need to maintain a higher blood level of cannabinoids than is convenient with our high-THC strains. For them, development of a high-CBD strain could be a life or death matter."

Whatever the outcome of clinical trials involving CBD, the effort alone -the attempt to produce and evaluate less psychoactive strains of marijuans- will refute the image of stoners paying lip-service to medical use that has tarnished the industry. And if and when the effectiveness of high-CBD cannabis in treating, say, rheumatoid arthritis, can be established, a wave of older Californians will be asking their doctors if cannabis is right for them.

<small>Fred Gardner edits O’Shaughnessy’s, the journal of cannabis in clinical practice. He can be reached at fred@plebesite.com</small>

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So-called marijuana pills fail to help medicinal users


<table class="posttable" align="right"><tr><td class="postcell"><img class="postimg" src="bin\barth_russell.jpg" alt="Photograph by: Pat Mcgrath"></td></tr></table>The Ottawa Citizen | April 4, 2009

<span class="postbold">Russell Barth writes that marijuana smoke is less harmful than tobacco smoke, contrary to what a recent letter-writer claims.</span>


<span class="postbigbold">Re: Marijuana in a pill, March 30.</span>

Letter-writer Heather J. Martelock is mistaken. The "pills" that allegedly contain marijuana contain only a synthetic mimic of marijuana, but no actual cannabis.

The only medicine in the world that contains actual cannabis is Sativex from GW Pharmaceuticals/Bayer. This sublingual spray has been a disappointment for being made from only a single strain of cannabis. It is only prescribed in Canada for multiple sclerosis (MS). Its value is very limited.

I have tried the pills, Marinol and Cesamet, and they don't work. Side-effects outweigh the benefits. Every medical marijuana user I have talked to agrees. Lamentably, the only thing that seems to work is the vaporized or smoked whole cannabis, and that only takes the edge off. Even putting marijuana into tinctures or baked goods is strictly forbidden under the medical marijuana access regulations, and this method of dosing is also inconsistent. We are not allowed to possess tinctures, butter, hash, or oils -- only dried bud.

Smoking or vaporizing is the best way to quickly titrate a dose. It acts on the symptoms far better and far faster than a pill or baked good, which can take up to an hour or more to become effective. There is also the "too little too late -- too much too soon" problem with oral dosing of marijuana.

This method would also do little to help my epileptic wife, who needs to medicate as quickly as possible if one of her life-threatening seizures or asthma attacks approaches. Smoked pot can stop an asthma attack in seconds, not minutes.

As for second-hand smoke, the science indicates that marijuana smoke is less harmful than tobacco smoke. The fact that no one has ever died from using cannabis is one indication of its safety. Recent science out of Germany shows how cannabinoids stimulate the body's production of TIMP-1, which helps healthy cells resist cancer invasion.

It seems absurd and discriminatory to ask me to medicate at home or go hide in the alley, while allowing people to crowd the sidewalks and entrances of buildings smoking cigarettes as traffic pollutes the environment, too. The rights of other people need to be addressed. The government has failed to do that.

As a federally licensed medical marijuana user, I have a right to use cannabis. Imposing unfair restrictions on where I can use it violates my rights.

Russell Barth, Ottawa

Patients Against Ignorance and Discrimination on Cannabis

© Copyright (c) The Ottawa Citizen

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See: Chronic Cannabis Use in the Compassionate Investigational new Drug Program: An Examination of Benefits and Adverse Effects of Legal Clinical Cannabis. - 2002