30 March 2015

Medical Cannabis

There are marked differences in the knowledge on the medical uses of cannabis and cannabinoids in different diseases. For nausea and vomiting associated with cancer chemotherapy, anorexia and cachexia (weight-loss) in HIV/AIDS, chronic, especially neuropathic pain, spasticity in Multiple Sclerosis (MS) and spinal cord injury there is strong evidence for medical benefits. For many other indications, such as epilepsy, pruritus and depression there is much less available data. However, the scientific evidence for a specific indication does not necessarily reflect the actual therapeutic potential for a given disease.

Clinical studies with single cannabinoids or whole plant preparations have often been inspired by positive anecdotal experiences of patients employing crude cannabis products. The anti-emetic, the appetite enhancing, relaxing effects, analgesia and therapeutic use in Tourette syndrome (aka Tourette's syndrome) were discovered in this manner.

Incidental observations have also revealed therapeutically useful effects. This occurred in a study of patients with Alzheimer's disease wherein the primary issue was an examination of the appetite-stimulating effects of Δ-9-Tetrahydrocannabinol (THC). Not only appetite and body weight increased, but disturbed behaviour among the patients decreased. The discovery of decreased intra-ocular pressure with THC administration in the beginning of the 1970's was also serendipitous. Additional interesting indications that have not been scientifically investigated, but remain common problems in modern medicine may benefit from treatment with cannabis or cannabinoids. For this reason, surveys have been conducted questioning individuals that use cannabis therapeutically. They were conducted either as oral non-standardised interviews in the course of investigations of state or scientific institutions (House of Lords Select Committee on Science and Technology in the UK, Institute of Medicine in the USA) on the therapeutic potential of cannabis or as anonymous surveys using standardised questionnaires. In Australia, such information is garnered from the likes of the University of New South Wales, Australia (UNSW Australia) which is involved in cannabis related research in association with the National Drug and Alcohol Research Centre (NDARC). A survey involving 1,500 chronic pain sufferers showed there was a high rate of medicinal cannabis use in Australia. Australians suffering from chronic pain may get more relief from their symptoms using cannabis than they do from conventional medications, researchers found.

A positive influence on body weight was reported in patients with Alzheimer's disease who were previously refusing food. Clinical studies have shown that cannabis may not only increase appetite in patients with Alzheimer's disease but also reduce disturbed behaviour and agitation.

An appetite enhancing effect of THC is observed with daily divided doses totalling 5 mg. When required, the daily dose may be increased to 20 mg. In longer-term studies (for example) of AIDS patients, the appetite-stimulating effect of THC continued for months, confirming the appetite enhancement noted in a shorter 6 week study. THC doubled appetite on a visual analogue scale in comparison to placebo. Patients tended to retain a stable body weight. In addition, cannabis products can improve appetite in cancer patients and in Chronic Obstructive Pulmonary Disease (COPD).

Experiments examining the anti-asthmatic effect of THC or cannabis date mainly from the 1970's, and are all acute studies. The effects of a cannabis cigarette (2% THC) or oral THC (15 mg), respectively, approximately correspond to those obtained with therapeutic doses of common bronchodilator drugs (for example, salbutamol). Since inhalation of cannabis products may irritate the mucous membranes, oral administration or another alternative delivery system would be preferable. Very few patients developed bronchoconstriction after inhalation of THC.

Autoimmune Diseases, Inflammation and Allergies
In a number of painful syndromes secondary to inflammatory processes (e.g. ulcerative colitis, arthritis), cannabis products may act not only as analgesics but also demonstrate anti-inflammatory potential. For example, some patients employing cannabis report a decrease in their need for steroidal and non-steroidal anti-inflammatory drugs. Moreover there are some reports of positive effects of cannabis self-medication in allergic conditions. It is as yet unclear whether cannabis products may have a relevant effect on causative processes of autoimmune diseases.

Dependency and Withdrawal
According to historical and modern case reports, cannabis is a good remedy to combat withdrawal in dependency on benzodiazepines, opiates and alcohol. For this reason, some have referred to it as a gateway drug back. In this context, both the reduction of physical withdrawal symptoms and stress connected with discontinuance of drug abuse may play a role in its observed benefits.

Use in Epilepsy is among the historically oldest indications of cannabis. Animal experiments provide evidence of the anti-epileptic effects of some cannabinoids. The anti-convulsant activity of some epilepsy medications have been potentiated by THC. According to case reports, many epileptic patients utilise cannabis to control otherwise unmanageable seizure disorders.

review published in Current Gastroenterology Reports in February 2015 examined the role of cannabinoids in the treatment of gastrointestinal symptoms like nausea, vomiting, and visceral pain (pain that originates from in/around organs) and found that certain targeted cannabinoid therapies may be useful in GI disorder/disease management. Read details of a clinical trial from Israel on Cannabidiol (CBD) for Inflammatory Bowel Disease.

In 1971, during a systematic investigation of its effects in healthy cannabis users, it was observed that cannabis reduces intra-ocular pressure. In the following 12 years a number of studies in healthy individuals and glaucoma patients with cannabis and several natural and synthetic cannabinoids were conducted. Cannabis decreases intra-ocular pressure by an average 25-30%, occasionally up to 50%. Some non-psychotropic cannabinoids and to a lesser extent, some non-cannabinoid constituents of the hemp plant also decrease intra-ocular pressure.

Cannabis may be beneficial in patients suffering from ADHD (attention deficit hyperactivity disorder).

Miscellaneous, Mixed Syndromes
There are a number of positive patient reports on medical conditions that cannot be easily assigned to the above categories, such as hiccup, high blood pressure, tinnitus, chronic fatigue syndrome, restless leg syndrome and others. Several hundred possible indications for cannabis and THC have been described by different authors. One example is the successful treatment of a chronic hiccup that developed after a surgery. No medication was effective, but smoking of a cannabis cigarette completely abolished the symptoms. Cannabis products often show very good effects in diseases with multiple symptoms that encompassed within the spectrum of THC effects, for example, in painful conditions that have an inflammatory origin (e.g. arthritis), or are accompanied by increased muscle tone (e.g. menstrual cramps, spinal cord injury), or in diseases with nausea and anorexia accompanied by pain, anxiety and depression, respectively (e.g. AIDS, cancer, hepatitis C).

Large clinical studies have proven analgesic properties of cannabis. Among possible indications are neuropathic pain due to MS, damage of the brachial plexus and HIV infection, pain in Rheumatoid Arthritis, cancer pain, headache, menstrual pain, chronic bowel inflammation and neuralgias. Combination with opioids is possible.

According to small clinical studies cannabinoids taken internally or externally as ointment ameliorate pruritus by different causes, for example severe pruritus in the course of liver diseases.

Psychiatric Symptoms
An improvement of mood in reactive depression has been observed in several clinical studies with THC. There are additional case reports claiming benefit of cannabinoids in other psychiatric symptoms and diseases, such as sleep disorders, anxiety and bipolar disorders, schizophrenic psychosis and dysthymia. According to some case reports THC was effective in otherwise treatment refractory heavy compulsive disorders. Cannabinoids may also reduce symptoms of post-traumatic stress disorders. Various authors have expressed different viewpoints concerning psychiatric syndromes and cannabis. While some emphasise the problems caused by cannabis, others promote the therapeutic possibilities. Quite possibly cannabis products may be either beneficial or harmful, depending on the particular case.

Treatment of side effects associated with anti-neoplastic (anti-tumour) therapy is the indication for cannabinoids which has been most documented, with about 40 cannabis studies. Most trials were conducted in the 1980's. THC has to be dosed relatively highly, so that resultant side effects may occur comparatively frequently. Some recent investigations have shown that THC in low doses improves the efficacy of other anti-emetic drugs if given together. There is evidence from clinical studies that cannabinoids are also effective in nausea and vomiting due to radiotherapy and after surgery. In folk or 'alternative' medicine, cannabinoids are popular and are often used in other causes of nausea including AIDShepatitis and nausea in pregnancy.
United Kingdom Medical Cannabis Activist Clark French

In many clinical trials of cannabis, a beneficial effect on spasticity caused by MS or spinal cord injury has been observed. Among other positively influenced symptoms were pain, paraesthesia, tremor and ataxia. In some studies improved bladder control was observed. There is also anecdotal evidence of a benefit of cannabis in spasticity due to lesions on the brain.

Tourette syndrome and other Movement Disorders 
There are some positive anecdotal reports of therapeutic response to cannabis in Tourette syndrome, dystonia and tardive dyskinesia. The use in Tourette syndrome is being investigated in clinical studies. Many patients achieve a modest improvement, however some show a considerable response or even complete symptom control. In some MS patients, benefits on ataxia and reduction of tremor have been observed following the administration of THC. Authors of a controlled animal study published in the journal Neuropharmacology have found that long-term stimulation of cannabinoid receptors may prevent onset of movement/motor dysfunction symptoms that result from Huntington’s disease. Cannabis products may prove useful in Parkinson's disease without worsening the primary symptoms. In a study published in the Journal of Psychopharmacology in 2014, patients treated with 300 mg/day of cannabidiol (CBD) with Parkinson’s Disease, without dementia or co-morbid psychiatric conditions, experienced increased well-being and quality of life compared to patients who had received a placebo.

Prescribing Patients Medical Cannabis for Pain
In December 2014, the College of Family Physicians of Canada published its preliminary recommendations for physicians recommending/prescribing smoked cannabis for chronic non-cancer pain in the organisation’s journal, Canadian Family Physician. The authors reviewed the information available on cannabis for medical use, utilising mainly level II (“well conducted observational studies”) and level III (“expert opinion”) evidence to create guidelines on the following aspects of medical cannabis use for chronic non-cancer pain: conditions recommended for use; circumstances under which medical cannabis should not be recommended; circumstances under which caution should be taken when recommending medical cannabis use; and, dosing. The number of Canadians authorised to use 'medical marijuana' has been sky-rocketing. In 2002 – a year after the government first permitted access through Health Canada regulations – 500 patients had registered. Today, there are more than 50,000. This has happened despite the official position of the Canadian Medical Association (CMA) that “there is insufficient scientific evidence available to support the use of marijuana for clinical purposes.” The CMA also believes we don’t know enough about its risks and benefits, about the interactions between marijuana and other medications or how to prescribe an appropriate dosage. It advises doctors they are not obligated to write cannabis prescriptions for patients.

Meanwhile the Australian Medical Association (AMA) are not interested in anything but pharmaceutical cannabis which has limited applications. Quoted in the Australian mainstream media, "Medicinal cannabis should be subject to the same safety and efficacy tests as any other 'drug' before being made available on the Australian market", said the AMA. They also warned against the legalisation of the raw 'dope plant', or any oils and tinctures made from it and urged that only fully-tested cannabis-based medicines should be considered for use.

In a significant development for those who argue cannabis is effective in alleviating chronic pain and providing relief from symptoms including nausea and muscle spasms and should be legalised, the NSW government has secured the support of the Commonwealth and its state and territory counterparts to 'trial' the use of cannabis for medicinal purposes. In March 2015 the Australian Broadcasting Commission (ABC) reported that NSW was running three medical trials to allow children with severe epilepsy, adults with a terminal illness and people with nausea and vomiting caused by chemotherapy to use medical cannabis. The Terminal Illness Cannabis Scheme (TICS) was launched with patients and carers allowed to 'register' with the government (NSW) as using medical cannabis but with no support whatsoever from the government; even when law enforcement arrested a 'carer' and confiscated the medicine/s (the scheme notates that law enforcement may use their discretion not to charge).

Australian Epilepsy sufferer Deisha takes cannabis oil which allows her to live seizure free (seen here with Dad, David). 
Deisha was having seizures every five to eight seconds, cannabis stopped them completely.

Big and Not-so-Big 'Pharma' are targeting a very small number of patients to get their pharmaceuticals into as many countries as possible to make their drugs the only preparations available at exorbitant prices, it would seem (pharmaceutical companies care about profits not patients). The Victorian (Australia) government quoted the cost of Sativex, a cannabis-derived pharmaceutical mouth spray, to be $500 per month in New Zealand (NZ), but Fairfax media (NZ) reported that Sativex, classed as a Schedule B drug like cannabis, would cost for a typical yearly prescription, about NZ$20,200. Somewhere in between lies the true cost but the latest research reiterates that the whole, organic cannabis plant is needed for the best medicinal applications (the Entourage Effect).

A San Diego, California Scientist, Igor Grant, said recently "It's now well-established that 'marijuana' can soothe neuropathic pain in patients with diseases like HIV/AIDS. It can reduce spasticity in MS and, perhaps obviously, it can stimulate appetite in underweight patients. More research is needed before reaching conclusions about marijuana's usefulness with other diseases, like epilepsy and schizophrenia." Grant says there's now more than enough evidence to justify rescheduling 'marijuana' in the US. Other scientists agree. The American Academy of Paediatrics recently called for rescheduling. Even US Surgeon General Vivek Murthy has acknowledged 'marijuana' can be helpful in treating certain conditions.

additional medical and scientific references compliments of Granny Storm Crow's List 2015

18 March 2015

The Endocannabinoid System

In many states in the US medicinal cannabis is routinely recommended for a wide variety of conditions. For example, in California, patients can qualify for medicinal cannabis if they have AIDS, anorexia, arthritis, cachexia, cancer, chronic pain, glaucoma, migraines, muscle spasms, seizures, nausea or other chronic symptoms. This begs the question, how can cannabis be recommended for so many different conditions? The answer is the Endogenous Cannabinoid or Endocannabinoid System (ECS).

What is the Endocannabinoid System?
The Endocannabinoid System (ECS) literally means 'the cannabinoid system inside the body'. By regularly supplying our ECS with the nutrients it was designed for, vital communications can be restored between the control centres of the body and every other system. Due to the persecution of cannabis over the past 80 or so years, most humans today have gone their entire lives without feeding their bodies these raw materials. Imagine a large orchestra being made to play blind-folded; can’t see the conductor, can’t read the music! Sometimes they get it right but most of the time it’s a mess. Bringing the body back into harmony could be as simple as replacing this lost nutrition.
Therapeutic functions of the Endocannabinoid System
The ECS is comprised of cannabinoid receptors, endogenous ligands (binding molecules) for those receptors and enzymes that synthesise and degrade the ligands. The most well known cannabinoid receptors are CB1 and CB2. Studies in the early 1990's provided initial evidence of the existence and purpose of CB1 and CB2 receptors. Both types of cannabinoid receptors are found throughout the entire body but are distributed differently. CB1 receptors are concentrated primarily in the brain while CB2 receptors are mainly found in the immune system. However, CB1 receptors are also distributed in a variety of peripheral areas like adipose (fat) tissue and CB2 receptors are expressed to some degree in the brain.

The primary endocannabinoids are anandamide and 2-arachidonoyl glycerol (2-AG). Anandamide was discovered in 1992 and determined to be the endogenous ligand for the CB1 receptor. Its chemical structure is very similar to tetrahydrocannabinol (THC). 2-AG was discovered in 1995, and unlike anandamide has a high affinity for activating both CB1 and CB2 receptors. Anandamide and 2-AG are synthesised from arachidonic acid, an Omega-6 fatty acid, although the specific pathways and synthesising enzymes vary.  Both endocannabinoids are manufactured 'on demand' (as needed), using precursor molecules from cell membranes.

The Primary Function of the Endocannabinoid System
The primary function of endocannabinoid activity is to maintain a stable internal environment despite changes in the external environment. This stability is known as homeostasis, which endocannabinoids promote at the most basic levels. These endocannabinoids regulate homeostasis through a wide variety of mechanisms, including facilitation of intercellular communication between different cell types. For example, at the site of an injury, cannabinoids can be found decreasing the release of activators and sensitisers from the injured tissue, stabilising the nerve cell to prevent excessive firing, and calming nearby immune cells to prevent release of pro-inflammatory substances. Three different mechanisms of action on three different cell types for a single purpose: minimise the pain and damage caused by the injury. When cells communicate, neurotransmitters normally flow from presynaptic neurons to postsynaptic neurons.

Endocannabinoids are unique, being able to travel in the opposite direction and deliver feedback to the presynaptic cell. This process is a fundamental mechanism by which endocannabinoids maintain homeostasis. For example, if a neuron is firing messages too quickly, then endocannabinoids (usually 2-AG) instruct it to slow down by travelling upstream and activating presynaptic CB1 receptors.

The Endocannabinoid System in Disease Pathology
Dr Robert Melamede, the former Chairman of the Biology Department at the University of Colorado, dedicated his career to cannabinoid research. He has described endocannabinoids as “multi-scaled, global homeostatic regulators of cells and society”. Evidence suggests the earliest components of the ECS evolved 600 million years ago in sea squirts. Furthermore, diseases often emerge when there is a deficiency or dysfunction of the ECS. These facts alone demonstrate the importance of proper ECS function to the healthy existence of higher-level organisms.

15 March 2015

Black Pepper To Relieve 'Cannabis Anxiety'

While benefiting from the medicinal effects of delta-9-Tetrahydrocannabinol (THC), some patients at the Victorian Cannabis Buyers Club suffered bouts of anxiety. Most simply took a few sniffs of black pepper to receive almost immediate relief. Others reported chewing on black peppercorns for relief within an hour. So how does this work?

This is a traditional method, referred to in Pliny The Elder’s Natural History Book, XXIV. Pliny writes: “The gelotophyllis [‘leaves of laughter’ or cannabis] grows in Bactria and along the Borysthenes. If this be taken in myrrh and wine all kinds of phantoms beset the mind, causing laughter which persists until the kernels of pine-nuts are taken with pepper and honey in palm wine.”

The British Journal of Pharmacology: Cannabinoids in Biology and Medicine, Part 1 (August 2011) includes numerous articles exploring the nature of the cannabis plants’ chemical dynamism. In the article, Taming THC, scientists report having discovered more than a hundred terpenes that “may contribute meaningfully to the entourage effects of cannabis-based medicinal extracts”. Terpenes create the many scents of cannabis and are shared among the plant kingdom. Scientists explored how these aromatic oils synergise and mitigate the active cannabinoids contributing to the 'EntourageEffect'.

Cannabis is known to produce a wide variety of effects from rendering an individual wide-awake to sending them soundly to sleep. Growers have been tailoring their heirloom heritage varieties of cannabis to uniformly exhibit certain cannabinoid/terpene profiles to produce particular effects. CBD is quickly becoming an essential component to combat some of the purported unwelcome effects of using THC rich cannabis, such as anxiety. Another option may be to introduce terpenes from other plant sources to mitigate the effects.

The terpene Myrcene in mangos can increase the quality of low potency cannabis when eaten an hour before medicating. Anecdotal evidence suggests that Pinene (found in pine needles and black pepper for example) is alerting; Limonene (found in citrus for example) is sunshiny and Myrcene (mango, hops [Humulus] etc) is sedating. Traditional responses to cannabis induced anxiety include Pinene-rich black pepper, Limonene-rich citrus and Myrcene-rich calamus root or hops, the only other member of the Cannabaceae plant family. “Cannabis terpenoids and flavonoids may also increase cerebral blood flow, enhance cortical activity, kill respiratory pathogens and provide anti-inflammatory activity.”

Scientists have discovered that beta-Caryophyllene (Caryophyllene [BCP], a US Food and Drug Administration [USFDA] approved food additive), another terpene that contributes to aroma and flavour (found in other herbs, spices and edible plants), activates the CB2 receptor and acts as a non-psychoactive anti-inflammatory. As it binds to a cannabinoid receptor and is ingested daily with food, it is the first known dietary cannabinoid. One of those leading the way on terpene identification is GreenHouse Seed Company in the Netherlands who have performed spectral analysis of each of their strains and developed a flavour wheel identifying 16 different terpenes to help individuals decide on their strain of choice.

Terpene Flavour Wheel - GreenHouse Seed Company

Cannabis Science Inc. is exploring the possibility that certain terpenes act as building blocks for the production of cannabinoids, with the hope that this will open up to cultivators the opportunity to manipulate cannabinoids to desired ratios. They are exploring how terpenes act synergistically with other terpenes to either catalyse or inhibit the formation of other compounds within a plant. Up until now, 'BIG Pharma' have been focusing on single synthetic compounds that can be patented and brought to market. In light of these discoveries, scientists isolating cannabinoids into synthetic compounds have to consider the terpene interaction as another variable potentially responsible for the plants therapeutic effects. Cannabis grown with care and attention to the curing process will contain more terpenes. Many terpenes are USFDA approved and therefore easy to obtain for testing.

adapted from an article by Owen Smith - Cannabis Digest Blogs

13 March 2015

Cannabidiol (CBD) Misconceptions

It doesn’t get you 'high', but it’s causing quite a buzz among medical scientists and patients. The past year has seen a surge of interest in Cannabidiol (CBD), a non-intoxicating cannabis compound with significant therapeutic properties. Numerous US commercial start-ups and internet retailers have jumped on the CBD bandwagon, touting CBD derived from industrial hemp as the next big thing, a miracle oil that can shrink tumours, quell seizures and ease chronic pain, without making people feel 'stoned'. But along with a growing awareness of CBD as a potential health aide there has been a proliferation of misconceptions about CBD.

  1. CBD is medical, THC is recreational” - Project CBD receives many inquiries from around the world and often people say they are seeking “CBD, the medical part of the plant, not THC, the recreational part that gets you high". Actually, delta-9-Tetrahydrocannabinol (THC) 'The High Causer', has awesome therapeutic properties. Scientists at the Scripps Research Center in San Diego reported that THC inhibits an enzyme implicated in the formation of beta-amyloid plaque, the hallmark of Alzheimer’s-related dementia. The US federal government recognises single-molecule THC as an anti-nausea compound and appetite booster, deeming it a Schedule III drug, a category reserved for medicinal substances with little abuse potential. But whole plant cannabis, the only natural source of THC, continues to be classified as a dangerous Schedule I drug with no medical value.
  2. “CBD is the good cannabinoid and THC is the bad cannabinoid” - in the US the drug warrior’s strategic retreat is to give ground on CBD while continuing to demonise THC. Diehard cannabis prohibitionists are exploiting the good news about CBD to further stigmatise high-THC cannabis, casting THC as the bad cannabinoid, whereas CBD is framed as the good cannabinoid. Why? Because CBD doesn’t make you high like THC does. Project CBD categorically rejects this moralistic, reefer madness dichotomy in favour of whole plant cannabis therapeutics.
  3. “CBD is most effective without THC” - THC and CBD are the power couple of cannabis compounds, they work best together. Scientific studies have established that CBD and THC interact synergistically to enhance each other’s therapeutic effects. British researchers have shown that CBD potentiates THC’s anti-inflammatory properties in an animal model of colitis. Scientists at the California Pacific Medical Center in San Francisco determined that a combination of CBD and THC has a more potent anti-tumour effect than either compound alone when tested on brain cancer and breast cancer cell lines. And extensive clinical research has demonstrated that CBD combined with THC is more beneficial for neuropathic pain than either compound as a single molecule.
  4. “Single-molecule pharmaceuticals are superior to ‘crude’ whole plant medicinals” - According to the US federal government, specific components of the cannabis plant (THC, CBD) have medical value, but the plant itself does not have medical value. Uncle Sam’s single-molecule blinders reflect a cultural and political bias that privileges Big Pharma products. Single-molecule medicine is the predominant corporate way, the US Food and Drug Administration (FDA)-approved way, but it’s not the only way and it’s not necessarily the optimal way to benefit from cannabis therapeutics. Cannabis contains several hundred compounds, including various flavonoids, aromatic terpenes and many minor cannabinoids in addition to THC and CBD. Each of these compounds has specific healing attributes, but when combined they create what scientists refer to as an holistic “entourage effect” so that the therapeutic impact of the whole plant is greater than the sum of its single-molecule parts. The FDA, however, isn’t in the business of approving plants as medicine.
  5. Psychoactivity is inherently an adverse side effect” - According to the politically correct drug war catechism, the cannabis 'high' is an unwanted side effect. Big Pharma is keen on synthesising medically active cannabis-like molecules that don’t make people high, although it’s not obvious why mild euphoric feelings are intrinsically negative for a sick person or a healthy person, for that matter. In ancient Greece the word euphoria meant 'having health', a state of well-being. The euphoric qualities of cannabis, far from being an unwholesome side effect, are deeply implicated in the therapeutic value of the plant. “We should be thinking of cannabis as a medicine first,” said Dr Tod Mikuriya, “that happens to have some psychoactive properties, as many medicines do, rather than as an intoxicant that happens to have a few therapeutic properties on the side”.
  6. “CBD is legal in all 50 US states” - Purveyors of imported, CBD-infused hemp oil claim it’s legal to market their wares anywhere in the US as long as the oil contains less than 0.3% THC. Actually, it’s not so simple. Federal law prohibits US farmers from growing hemp as a commercial crop, but the sale of imported, low-THC, industrial hemp products is permitted in the US as long as these products are derived from the seed or stalk of the plant, not from the leaves and flowers. Here’s the catch: Cannabidiol can’t be pressed or extracted from hemp seed but can be extracted from the flowers, leaves and, to a very minor extent, from the stalk of the hemp plant. Hemp oil start-ups lack credibility when they say their CBD comes from hemp seed and stalk. US congress may soon vote to exempt industrial hemp and CBD from the definition of cannabis under the Controlled Substances Act. Such legislation would not be necessary if CBD derived from foreign-grown hemp was already legal throughout the US.
  7. “’CBD-only’ laws adequately serve the patient population” - Nearly a dozen (11) US state legislatures have passed 'CBD only' (or more accurately 'low THC') laws and other states are poised to follow suit. Some states restrict the sources of CBD-rich products and specify the diseases for which CBD can be accessed; others do not. Ostensibly these laws allow the use of CBD-infused oil derived from hemp or cannabis that measures less than 0.3% THC. But a CBD-rich remedy with little THC doesn’t work for everyone. Parents of epileptic children have found that adding some THC (or THCA, the raw unheated version of THC) helps with seizure control in many instances. For some epileptics, THC-dominant strains are more effective than CBD-rich products. The vast majority of patients are not well served by CBD-only laws. They need access to a broad spectrum of whole plant cannabis remedies, not just the low THC medicine. One size doesn’t fit all with respect to cannabis therapeutics and neither does one compound or one product or one strain.
  8. “CBD is CBD – It doesn’t matter where it comes from” - Yes it does matter. The flower-tops and leaves of some industrial hemp strains may be a viable source of CBD (legal issues notwithstanding), but hemp is by no means an optimal source of cannabidiol. Industrial hemp typically contains far less cannabidiol than CBD-rich cannabis. Huge amounts of industrial hemp are required to extract a small amount of CBD, thereby raising the risk of toxic contaminants because hemp is a 'bio-accumulator' that draws heavy metals from the soil. Single-molecule CBD synthesised in a lab or extracted and refined from industrial hemp lacks critical medicinal terpenes and secondary cannabinoids found in cannabis strains. These compounds interact with CBD and THC to enhance their therapeutic benefits.
from an article by Martin A. Lee
February 2015

Medical Cannabis Australia - Gathering Political Momentum

A Timeline Of Change

Public and media pressure grew around Australia throughout 2014 and into 2015 to address a burgeoning community concern about the illegality of cannabis consumption by seriously and terminally ill people. Politicians were seemingly remarkably quick to act on this normally sensitive topic, with a number of key announcements and decisions occurring, leading to the Council of Australian Governments (COAG) meeting on 10th October giving a green light to trials of medical cannabis in New South Wales (NSW). A timeline of events includes:
  • May 2013: A NSW cross-party Upper House committee unanimously recommended making cannabis available in small quantities for terminally ill and AIDS patients. The committee, covering five political parties, said: 'Our reading of the evidence – including rigorous scientific evidence – is that cannabis products are emerging as a promising area of medicine, most notably in respect of a number of painful conditions that do not respond to existing treatments'. Despite the committee’s favourable report to Parliament, NSW Health Minister Jillian Skinner ruled out decriminalisation, saying there was limited evidence on the clinical efficacy of cannabis for medical purposes.
  • January 2014: Queensland (Qld) Premier (now former), Campbell Newman, announced his support for trials of medical cannabis.
  • April 2014: On behalf of her terminally ill son, Lucy Haslam launched an online petition seeking decriminalisation of the use of medical cannabis (over 200,000 supporters signed).
  • May 2014: Nationals NSW MP Kevin Anderson announced plans to introduce a Private Member's Bill seeking approval for the use of cannabis by terminally ill patients only. He gained the approval of NSW Premier Mike Baird to work on the Bill. Greens NSW MP John Kaye delayed moving a similar Bill to allow time for Mr Anderson’s to proceed.
  • July 2014: WA Opposition Leader Mark McGowan announced the WA ALP’s support for specific forms of cannabis to be available under supervision/s for chronically and  terminally ill people when other medications have failed.
  • July 2014: a Parliamentary inquiry into the medical use of cannabis in Tasmania called for submissions after the Legislative Council backed its establishment.
  • July 2014: ACT Greens Minister Shane Rattenbury put forward draft legislation to allow terminally and chronically ill Canberrans to grow cannabis and use the drug to alleviate their pain and symptoms. A Legislative Assembly committee report on the issue is to be tabled by June 2015.
  • August 2014: Commonwealth Government states it would not oppose state or territory moves to decriminalise cannabis for medicinal purposes (Source: Medew, J &  Harrison, D 2014. 'Australian National Council on Drugs takes a deep  breath on cannabis', Canberra Times, 1 September 2014).
  • August 2014: Northern Territory Minister for Health Robyn Lambley announced that the NT Government will discuss the idea of legalising medical cannabis as a matter of priority in order to reach a policy position.
  • August 2014: release of Australian National Council on Drugs 2014, Medicinal use of cannabis: background and information paper, ANCD, Canberra.
  • September 2014:  NSW Government announced that a clinical trial for medical cannabis will be established by the government to further explore the role that cannabis can play in providing relief for patients suffering from a range of chronic or terminal illnesses. A Working Group is formed to set up the trial, due to report back by the end of 2014.
  • September 2014: Legislation to facilitate clinical trials of medical cannabis is passed by the Victorian State Parliament. An Expert Advisory Committee will be appointed to work through the complex issues of obtaining approval to trial the use of cannabis compounds.
  • September 2014:Tasmanian Health Minister Michael Ferguson announced support for trials of  medical cannabis, if subject to strong regulation.
  • September 2014: Prime Minister Tony Abbott spoke publicly of his support for the legalisation of cannabis for medical purposes: “I have no problem with the medical use of cannabis, just as I have no problem with the medical use of opiates.” He also said further medical trials were not needed; i.e. that should go straight to provision of medicinal cannabis: “My basic contention is that something that has been found to be safe in a reliable jurisdiction shouldn’t have to be tested again here.”
  • TICS registration letter
    September 2014: NSW announced that under new measures police will be allowed to exercise discretion not to charge terminally-ill adults who use cannabis (Terminal Illness Cannabis Scheme).
  • October 2014: Media reported that Hemp Foods Australia had been approved to produce a form of medicinal cannabis (hemp oil) in NSW for export.
  • October 2014: COAG meeting led to a national agreement to allow a trial of medical cannabis in NSW. The Australian Capital Territory (ACT) Government announced that it will take part in the research. The Victorian Government appointed an expert advisory committee to advise the state on its involvement in a national approach to medical cannabis. Tasmanian Premier Will Hodgman said his government will collaborate on a national approach, which could include conducting trials in that state.
  • November 2014: Regulator of Medicinal Cannabis Bill 2014. The Bill would establish a Regulator of Medicinal Cannabis to be responsible for formulating rules and monitoring compliance with those rules for licensing the production, manufacture, supply, use, experimental use and import and export of medicinal cannabis; and provides for a national system to regulate the cultivation, production and use of medicinal cannabis products, and related activities such as research. In the House of Representatives MP Warren Entsch co-sponsored the Bill with George Christensen MP (National Party), Melissa Parke MP (Labor) and Adam Bandt MP (Australian Greens). MP Warren Entsch congratulated Australian Greens Senator Richard di Natale for his “outstanding work and research” on the Bill. Senator di Natale co-sponsored the Bill when it was introduced to the Senate alongside Senator Ian Macdonald (Liberal Party), Senator David Leyonhjelm (Liberal Democratic) and Senator Anne Urquhart (Labor).
  • February 2015 - Dan Haslam died from bowel cancer at age 25 years. NSW is now running three medical trials that allow children with severe epilepsy, adults with terminal illnesses and people with nausea caused by chemotherapy to use medical cannabis.
  • February 2015 - Public submissions to the ACT inquiry, considering legislation introduced by Greens MP Shane Rattenbury to legalise medicinal cannabis, closed on 13 February (submissions will be released after they have been considered). "There are some medical professionals who think that every medicine should always go through (the Therapeutic Goods Administration testing) process. Of course this ignores the fact that alternative medicines are used by many, many people in Australia all the time." Public hearings as part of the inquiry will take place in the coming months.
  • March 2015 - The PHAA told an ACT enquiry that doctors should manage a tightly regulated, compassionate regime for the use of medicinal cannabis in Australia. They labelled state and territory governments, including the ACT, "out of step with the attitudes and behaviour of much of the general public and professional opinion" on the use of cannabis to treat some illnesses. A position statement incorporated into the organisation's submission to the Legislative Assembly inquiry considering the use of cannabis for medical purposes says the fact the drug is already widely used illegally means a regulated system is unlikely to lead to more illicit drug taking in the community. It calls for the ACT and NSW to offer terminally ill people access to cannabis "where their doctors and the state or territory health department agree that cannabis may provide palliation benefits to the patient".
  • March 2015 - Submissions to the (federal) Senate Standing Committees on Legal and Constitutional Affairs regarding the Regulator of Medicinal Cannabis Bill 2014 close 13 March 2015. Submissions to date can be accessed here.
Expanded from

07 March 2015

Cannabis: Terpenes and Their Effects

Terpene1 - any of a large group of volatile unsaturated hydrocarbons found in the essential oils of plants, including cannabis (with over 120 terpenes) which play a large part in the aromas and flavours of plants. Cannabinoids are a class of terpenophenolic (part terpenoid, part phenol) compounds. While terpenes are hydrocarbon groups created by various combinations of the isoprene units that make them up, and may be aromatic, all phenols are aromatic hydrocarbons, which means they have a very pronounced aroma. Terpenoids are compounds related to terpenes but may also include oxygen or have molecules rearranged; the terms are often used interchangeably. Cannabinoids, being half terpene and half phenol, have very pronounced aromas and flavours.

Cannabinoids were originally believed to only exist in family Cannabaceae, but have since been found in other families of plants such as Linaceae (flax), Asteraceae (echinaceae and helichrysum) and at least a dozen plants containing cannabidiol (CBD) have been identified. Not surprisingly, the heated/vaporised 'smoke' of cannabis contains up to 50% terpenes (primary terpenes and terpenoids identified in cannabis are limonene, myrcene, pinene, linalool, eucalyptol, γ-terpinene, β-caryophyllene, caryophyllene oxide, nerolidol and phytol), with cannabinoids usually accounting for 10-20% and others accounting for a further 10-30%. The wide array of medicinal properties of terpenes and the fact that each has many different medical benefits gives rise to the overlapping synergies between them; the strategy of deliberately overlapping benefits greatly increases the chances of good results in treatment. Different strains of cannabis contain different amounts of the various terpenes (including cannabinoids). As a result, different diseases and disorders are more effectively treated by some strains than others.

Jack Herer (strain) Cannabinoid and Terpenoid Profile

At harvest, cannabis contains about 1% essential oil, composed mostly of very volatile monoterpenes2 (80-90%) that evaporate very quickly. Once completely dry, the amount of essential oil is only 0.1% and about 50% of that is sesquiterpenes which are far less volatile. More than 100 different terpenes have been detected in cannabis, but many more are available if variants of each are considered. Terpenes are a major component of essential oils and aromatherapy uses the medicinal properties to regulate mood, address sleep problems, improve acuity and overall health. For example, the essential oil from lavender is calming and relaxing, while rosemary essential oil increases concentration and produces a feeling of well being. It is possible to make essential cannabis oil through steam extraction to use in perfumes, cosmetics, soaps, candles and also as a flavouring agent in cooking, for candies and beverages.

Hops, a member of the family Cannabaceae
ß-Myrcene (Myrcene)
Boiling Point: 168°C (334°F)
Decarboxylation3 Point: 115-145°C (239-293°F)
Myrcene, from Myrcia sphaerocarpa (Brazilian medicinal shrub). A folk remedy for treating type 2 diabetes, dysentery, diarrhoea and hypertension, a 1997 study in Switzerland analysed various cannabis strains for terpenes and found myrcene to be the most abundant (others included pinene, limonene, carene, humulene, bergamotene, terpinolene and caryophyllene). Myrcene is a monoterpene and is crucial in the formation of other terpenes. Found in mango, hops, bay leaves, eucalyptus, lemongrass and many other plants, it smells similar to cloves, with a herbal, balsamic, spicy aroma.
*analgaesic (pain relief) in synergy with ∆9-Tetrahydrocannabinol (THC) *antibacterial *anti-diabetic (stabilises / controls blood glucose levels among diabetics) *anti-inflammatory in synergy with ∆1-Tetrahydrocannabinolic Acid (THC-A) *anti-insomnia (sedative effect to aid sleep) *anti-proliferative / anti-mutagenic (inhibits cancer cell growth and cell mutation) *anti-psychotic / calmative in synergy with CBD and linalool, to relax mentally and physically *anti-spasmodic in synergy with THC, THC-A and CBD.
Myrcene has properties that lower resistance across the blood/brain (hemato encaphalic) barrier, allowing it and many other chemicals to cross the barrier more easily and quickly. In the case of cannabinoids, like THC, it allows it to take effect more quickly. More uniquely still, myrcene can increase the maximum saturation level of the CB14 receptor, allowing for maximum psychoactive effect. For most people, the consumption of a fresh mango, 45 minutes before inhaling cannabis, will result in a faster onset of psychoactivity and greater intensity (myrcene acts in synergy with THC). Myrcene can be used in this same manner to improve uptake with a wide variety of chemical compounds. Less well known is that fact that high myrcene levels in cannabis (usually above 0.5%) result in the well known ‘couch lock’ effect of classic Indica strains of cannabis; sativa strains normally contain less than 0.5%.

D-Limonene (Limonene)
Boiling Point: 176°C (349°F)
Limonene is an abundant monoterpene present in cannabis (second only to myrcene) with a strong citrus odour and a tangy, bitter taste. Unsurprisingly, limonene is most commonly found in highest concentrations in the rinds of citrus. Used in alternative medicine, it has the ability to reduce heartburn and gastric acid reflux; is used widely as a flavour additive in food production, is a common aroma compound in perfumery and the main active ingredient in citrus cleaners. A natural, renewable solvent in cleaning products due to its ability to dissolve oils and other lipids; it is capable of stripping paint and is considered an effective substitute for turpentine (must be handled with care as at high concentrations it can act as an irritant). A major reason for limonene’s widespread use is its very low toxicity to humans.
*aids digestion *antidepressant *anti-fungal (particularly toenail fungus, athlete's foot, yeast infections) *anti-inflammatory *anti-proliferative (inhibits cancer cell growth) *anxiolytic (relieves anxiety) *immuno-stimulant (similar to garlic) *increases attention, mental focus, well-being and the human sex drive *prevents gastric distress *promotes weight loss *protects from aspergillus (a common infective fungus/mould) *protects from carcinogens in smoke *topical antiseptic agent *treats gastric acid reflux and oesophageal ulcers.
Limonene quickly and easily penetrates the blood-brain (hemato encaphalic) barrier which increases systolic pressure. Limonene assists in absorption of other terpenoids and chemicals through skin, mucous membranes and digestive tract. Limonene is one of two major compounds formed from α-Pinene.

Pinene (α-pinene and β-pinene)
Boiling Point: 155°C (311°F)
Pinene is one of the most common monoterpenes which occurs naturally as two isomers8 (α-pinene and β-pinene). Usually sourced from turpentine (dry distillation of coniferous wood) α-pinene makes up 58-65% and β-pinene around 30%. Found in cannabis, pines and other conifers, sage (salvia), sagebrush (artemisia) and eucalyptus, α-pinene is also found in olive, rosemary (memory herb), sassafras, bergamot and β-pinene is also found in hops and cumin. Pinene has been used for centuries in 'alternative' medicine.
*analgaesic (pain relief) *antibacterial *antibiotic *anti-inflammatory *antioxidant (prevents oxidation damage to other molecules in the body) *anti-proliferative (inhibits cancer cell growth) *apoptosis5 *bronchodilator *expectorant
It also crosses the blood-brain (hemato encaphalic) barrier very easily, where it acts to prevent destruction of molecules responsible for transmission of information which results in memory improvement. This terpene, in part, counteracts the effects of THC. The result is that memory fails more with pure THC than with THC mixed with pinene. 'Skunk' strains are recognised for their high levels of pinenes.

βeta–Caryophyllene (β–Caryophyllene)
Boiling Point: 160°C (320°F)
Black peppercorns
β–Caryophyllene, a sesquiterpene is found in many plants including, Thai basil, cloves, rosemary and black pepper, with a rich spicy odour and flavour. This terpene selectively binds to the CB26 receptor and is a functional CB2 agonist7. Intriguingly, β–Caryophyllene is a common constituent of the essential oils of numerous spice and food plants and a major component in cannabis, even though it is not a cannabinoid. Some sources speculate that β–Caryophyllene is so powerful it could threaten existing pharmaceuticals, and synthetic cannabinoids currently being developed.
*active ingredient in cloves and a remedy for toothache *analgaesic (pain relief) *antibacterial *antidepressant *antifungal *anti-inflammatory *antioxidant *antiseptic *anti-proliferative (inhibits cancer cell growth) *anxiolytic (relieves anxiety) *neuroprotective (slows damage to nervous system and brain).
Caryophyllene oxide is the substance in cannabis that is identifiable by drug-sniffing dogs.

Terpinolene (γ-terpinene)
Boiling Point: 183-220°C (361-428°F)
Terpinolene, a monoterpene, has a smoky or woody odour and is found in apple, cumin, lilac, tea tree, various citrus fruits and herbs such as oregano and marjoram.
*anti-bacterial *anti-fungal *anti-insomnia (sedative effect to aid sleep in cancer treatment in synergy with linalool and cannabinol, CBN) *antioxidant *anti-proliferative (inhibits cancer cell growth).
Terpinolene has been shown to be an effective natural method to repel both mosquitoes and weevils and is often found in cannabis strains that have a high level of pinenes, and these aromas can hide the terpinolene scent.

Boiling Point: 213°C (451°F)
Borneol is a monoterpene described as having a minty, spicy, cooling, herbal aroma and is found in high concentrations in camphor, rosemary and mint. Used in Chinese traditional medicine alongside acupuncture, topically and orally since the late 1600's, the first mention by western doctors was in 1888 at Edinburgh University. Borneol is a natural insect repellent, preventing disease being passed by mosquitoes (effective disease vector control method for West Nile and other mosquito borne pathogens), fleas and other pests.
*analgaesic (pain relief) *antibacterial *anti-fibrosis (balance body’s fibrosis response to injury) *anti-fungal *anti-inflammatory *antioxidant.

β–Linalool (Linalool)
Boiling Point: 198°C (388°F)
Linalool is best known for the pleasant floral odour it gives hundreds of different plants including lavender, citrus, cinnamon, laurel, birch, coriander and rosewood. Linalool has been used for thousands of years as a calmative and sleep aid (partly responsible for sedative effects of certain cannabis strains) and is a critical precursor in the formation of Vitamin E.
*analgaesic (pain relief) *anti-depressant *anti-epileptic agent *anti-inflammatory *anti-proliferative (inhibits cancer cell growth) *anxiolytic (relieves anxiety).
Its vapours are an effective insecticide against fruit flies, fleas and cockroaches.

Eucalyptol (1,8 Cineole or Cineole)
Boiling Point: 176°C (348.8° F)
Eucalyptol is a monoterpene, the primary terpene of eucalyptus trees and found in high concentrations in tea trees, mugwort, bay leaves, basil, sage, cannabis and as an ingredient in mouthwash and cough suppressants. It's the characteristic smell of the 'gum' tree.
*analgaesic (pain relief) *anti-bacterial *anti-inflammatory *anti-fungal *antioxidant *anti-proliferative (inhibits cancer cell growth) *controls airway mucus hyper-secretion and asthma *effective treatment for sinusitis *improves concentration and meditation *kills leukaemia cells in vitro *reduces inflammation *taken orally (inhaled, tincture, eaten) *topically on skin and gums.
Eucalyptol has been found to play an important role in the sensory perception of 'eucalyptus' character in some wines. Eucalyptol is an anti-fungal, but despite that, a fungus has been discovered that produces eucalyptol in large amounts which have potential for use in future biofuels.

Nerolidol (known as Peruviol)
Nerolidol is a naturally occurring sesquiterpene found in the essential oils of many types of plants and flowers. Nerolidol, with a woody, fresh bark aroma, can be found in neroli (orange flower), ginger, jasmine, niaouli and citronella.
*anti-fungal *anti-leishmaniasis (Leishmaniases are diseases caused by protozoan parasites, transmitted to humans by the bites of infected female sandflies) *anti-malarial *sedative effect.
Nerolidol is currently being investigated as a facilitator for transdermal delivery of drugs (due to its ability to penetrate the skin) and as an inhibitor of Leishmania protozoa.
Vietnamese coriander

α-Humulene (Humulene or α–Caryophyllene)
Boiling Point: 198°C (388°F)
Humulene is a sesquiterpene found in common hops (Humulus lupulus) from which it gets its name. Also found in cannabis, sage, ginseng, Vietnamese coriander and gives beer its ‘hoppy’ aroma, it is well-known to Chinese medicine.
*analgaesic (pain relief) *anti-bacterial *anti-inflammatory (when blended with β–Caryophyllene) *anti-proliferative (inhibits cancer cell growth).
Humulene is unique because, like Tetrahydrocannabivarin (THCv), it acts as an appetite suppressant, making it promising for weight loss treatments.

Phytol is another interesting terpene, different from most others, offering more medicinal options to patients. Phytol is one of the breakdown products of decomposed chlorophyll. Its aroma is floral and balsamic in nature and it is an ingredient of fragrances.
*immuno-suppressant *topical to reduce itching and treat slow-healing tissue wounds.
Phytol is a non-toxic yellow pigment suitable for dying foodstuffs and is used in manufacturing synthetic Vitamins E and K.

Pure Terpenes (Mark Heinrich)
The endless profile possibilities of terpenes are responsible for the variations in taste and effects of cannabis. Some combinations of terpenes can act in synergy (the effects are added) while others are antagonists (the effects inhibit each other). Some terpenes increase the assimilation of THC, while others affect the flow of dopamine and serotonin, two of the main regulators of mood and behaviour.

Unfortunately, current chromatography techniques do not allow accurate identification of all terpenes present in cannabis. This diversity offered by nature is impossible to reproduce for the pharmaceutical industry which attempts to isolate the active principles in order to patent synthetic reproduction. Pure THC causes very different effects than whole cannabis because it is missing all the other cannabinoids and terpenes that modulate its effects. A plant’s age, maturity and time of harvest may also modulate levels of terpenes. Usually, the smell becomes more intense during flowering, but it can vary depending on weather conditions, environment (fertilisers for example) and even plant stress. For example, the scent of a plant is usually stronger at dawn rather than at dusk. Terpenes are responsible for both the flavour and aroma of plants and it is important to remember that a plant with little aroma will always have little flavour.

Glossary of Some Terms
1. Terpene - One of a class of hydrocarbons with an empiric formula of C10H16, occurring in essential oils and resins. Terpenes containing 15, 20, 30, 40 etc, carbon atoms are called sesquiterpenes, diterpenes, triterpenes, tetraterpenes etc
2. Monoterpenes - Hydrocarbons or their derivatives formed by the condensation of two isoprene units, and therefore containing 10 carbon atoms
3. Decarboxylation - a chemical reaction that removes a carboxyl group and releases carbon dioxide (CO2). Usually, decarboxylation refers to a reaction of carboxylic acids, removing a carbon atom from a carbon chain.
4. CB1 - cannabinoid receptor type 1 is a G protein-coupled cannabinoid receptor located primarily in the central and peripheral nervous system
5. Apoptosis - Genetically directed cell self-destruction marked by fragmentation of nuclear DNA, activated either by presence of stimulus or removal of suppressing agent or stimulus, and is normal physiological process eliminating DNA-damaged, superfluous, or unwanted cells
6. CB2 - cannabinoid receptor type 2 expressed in the immune system
7. Agonist - a substance which initiates a physiological response when combined with a receptor
8. Isomers - molecules with the same chemical formula but different structures