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Your First Medical Cannabis Seminar?

Robin Young • Wed, October 18th, 2017

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RRY Publications, along with Ananda Hemp (the U.S. arm of a large Australian hemp producer), is sponsoring a medical cannabis seminar in Orlando during the North American Spine Society meeting.

Cannabis derived treatments are a fact of life for 3 million U.S. patients.

A new report from market data company New Frontier put medical marijuana sales at $4.7 billion in 2016 and forecasted that they would grow 180% to $13.3 billion by 2020. New Frontier based those predictions on states that have already passed laws allowing medical cannabis sales—not those states that are expected to approve medical marijuana initiative by 2020.

Medical marijuana remains, however, a largely self-prescribed pharmacological treatment. Physicians are not a significant factor in either prescribing or monitoring patient’s intake.

It’s time to hold a best evidence and best practices seminar—conducted by scientists for physicians.

So, RRY Publications is sponsoring a medical cannabis seminar on October 25 at the Hyatt Regency Hotel in Orlando. 5:30pm. Refreshments and brownies will be served. Yes, double chocolate fudge.

The Speakers

Four experienced, published speakers on the subject of medical marijuana/cannabis will conduct the seminar:

  1. SARA JANE WARD, PH.D: Assistant Professor, Center for Substance Abuse Research, Department of Pharmacology, Lewis Katz School of Medicine, Temple University, Senior Fellow, Jefferson Institute of Emerging Health Professions, Thomas Jefferson University.
  2. DAVID CASARETT, M.D.: Chief of Palliative Care Services for Duke University Health System, Chief of the Section of Palliative Care within Division of General Internal Medicine, Professor of Medicine, University of Pennsylvania Perelman School of   Medicine, Department of Medical Ethics and Health Policy, Director of Hospice and Palliative Care.
  3. JAMES PATRICK MURPHY, M.D.: Assistant Clinical Professor at the University of Louisville School of Medicine, Medical Director of Murphy Pain Center, Fellow, American Society of Addiction Medicine, Certified in Pain, Addiction, and Anesthesiology.
  4. ALEX CAPANO, DNP, CRNP, FNP-BC: Faculty member of The Lambert Center for the Study of Medicinal Cannabis and Hemp, Thomas Jefferson University and a Senior Fellow, Jefferson Institute of Emerging Health Professions, Thomas Jefferson University.

Their topics will include:

  • “Pharmacology of Cannabis and It’s Physiologic Effects”
  • “Overview: Medical Cannabis and the Endocannabinoid System: What Every Clinician Should Know
  • “A Doctor’s Case for Medical Cannabis: Therapeutic Approaches”
  • “Real World Use of Medical Cannabinoids to Treat Chronic Pain”

Physicians’ Skepticism

A recent survey of 520 family physicians in Colorado uncovered a deep skepticism about the efficacy and safety of medical marijuana / cannabis—despite the fact that Colorado was among the earliest states to approve medical marijuana and also make it legal for recreational use.

According to the study’s authors:

“Forty-six percent of the 520 family physicians who responded did not support physicians recommending medical marijuana; only 19% thought that physicians should recommend it. A minority thought that marijuana conferred significant benefits to physical (27%) and mental (15%) health. Most agreed that marijuana poses serious mental (64%) and physical (61%) health risks. Eighty-one percent agreed that physicians should have formal training before recommending medical marijuana, and 92% agreed that continuing medical education about medical marijuana should be available to family physicians.”

Nearly ALL the surveyed physicians agreed that further medical education about medical marijuana is required.

Short History

For approximately 4,000 years of recorded history (starting in 2,737 B.C. in China and extending to 2017) cannabis has been used for medical reasons in most of the world, especially in Asia, notably China and India.

The most commonly mentioned indication in the ancient literature for cannabis were fever, digestion, constipation, blood clots, appetite, mental alertness or well-being.

During the Middle Ages in Europe it was used as a folk medicine to treat coughs, tumors and jaundice.

Notably, both in the ancient and medieval literature, there is a caution not to use cannabis excessively as it may cause intoxication.

The Spanish brought cannabis to the Americas and it was grown for hemp—to make clothes, bags, paper and rope.

By the late 1700s, American medical journals were mentioning cannabis to treat inflammation, nausea, rheumatism or incontinence.

In the early 1900s, largely because of the excessive use of opioids following the civil war, the government started to regulate opium and morphine and created a dichotomy between “ethical” drugs and “illegal drugs.” By 1937, 23 states had outlawed marijuana. In 1970, it was categorized as a Schedule 1 drug by the U.S. Food and Drug Administration (FDA), and was listed as having no medical use.

Any research into marijuana as a medical treatment in the U.S. essentially stopped.

Despite the federal government’s marijuana laws, tens of millions of U.S. adults used marijuana between 1970 and the early 2000s.

On the strength of a few studies—most from outside the U.S.—and the personal experience of hundreds of thousands of patients for whom self-medicating with marijuana had in fact helped ameliorate the adverse effects of chemotherapy, HIV/AIDS, Parkinson’s Disease, multiple sclerosis and Crohn’s Disease, California approved the use of cannabis for medical purposes in 1996.

Pharma Companies Supplying Medical Cannabis/Marijuana

Ananda Hemp, the co-sponsor of the Medical Cannabis Seminar on October 25 in Orlando is a U.S. based company which emerged from the generosity of Australian businessman Barry Lambert, who donated $34 million to the University of Sydney for what is called the Lambert Initiative for Cannabinoid Therapeutics and the technology of Ecofibre, a large scale Australian grower of hemp.

Mr. Lambert, who is also a director of Ananda Hemp, also donated $3 million to Jefferson University to fund medical cannabis research

Ananda Hemp has operations in Kentucky and is a supplier of cannabis derived CBD oil throughout the United States.

Other, similarly well financed pharma companies are entering the U.S. market.

Pre-eminent among them is Liberty Health Sciences Inc., a business that emerged from Aphria Inc., a Canadian supplier of marijuana. Aphria, which is a public company with a $1 billion market value and a stock trading on the Toronto exchange, recently reported sales of $6.1 million for the first quarter of FY2018 and a profit of more than $1 million.

Liberty, with Aphria backing them financially and operationally, is in the process of acquiring dispensary operations in Florida and hopes to, eventually, become the largest supplier of medical marijuana in Florida and other states.

To put an exclamation point on all this, it is worth noting that Aphria is building a one million square foot production facility in Canada.

“Approved” Indications

Twenty-eight states plus the District of Columbia have either approved medical cannabis or are expected to shortly.

Here are the most commonly approved indications and some of the evidence which supports using cannabis for those indications.

Medical Marijuana Indication To Treat Clinical Studies (we found several hundred)
Cancer Nausea, vomiting, loss of appetite from chemotherapy; neuropathic pain. Marta Duran, MD, Clinical Pharmacologist, Fundació Institut Català de Farmacologia, Universitat Autònoma de Barcelona, et al., Nov. 2010 "Preliminary Efficacy and Safety of an Oromucosal Standardized Cannabis Extract in Chemotherapy-Induced Nausea and Vomiting," British Journal of Clinical Pharmacology
Glaucoma Intraocular pressure (IOP). Ileana Tomida, MD, Oct. 2006, "Effect of Sublingual Application of Cannabinoids on Intraocular Pressure: A Pilot Study" Journal of Glaucoma: Assessed the effect on IOP and the safety and tolerability of low dose of delta-9-tetrahydrocannabinol and cannabidiol. CONCLUSIONS: A single 5 mg dose of Delta-9-THC reduced IOP temporarily and was well tolerated by most patients.
HIV/AIDS Neuropathic pain Ronald J. Ellis, MD, PhD, Aug. 2008; "Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial," Neuropsychopharmacology:   Double-blind, randomized, clinical trial of short term adjunctive treatment of neuropathic pain in HIV associated distal sensory polyneuropathy. Pain relief was significantly greater with cannabis than placebo. Smoked cannabis was generally well tolerated and effective.
Parkinson’s Insomnia, pain, tremors, rigidity Itay Lotan, MD, Mar./Apr. 2014; "Cannabis (Medical Marijuana) Treatment for Motor and Non–Motor Symptoms of Parkinson Disease: An Open-Label Observational Study," Clinical Neuropharmacology: 22 Parkinson’s patients assessed via Unified Parkinson Disease Rating Scale, visual analog scale, present pain intensity scale, Short-Form McGill Pain Questionnaire. RESULTS: Unified Parkinson Disease Rating Scale score improved significantly; specific motor symptoms had significant improvement after treatment in tremor, rigidity and bradykinesia. No significant adverse events.
Multiple Sclerosis Spasticity Peter Flachenecker, MD, June 2014; "Long-Term Effectiveness and Safety of Nabiximols (Tetrahydrocannabinol/Cannabidiol Oromucosal Spray) in Clinical Practice," European Neurology. RESULTS: 52 patients, 12 month follow up. Mean spasticity rating scale (NRS, 0-10) decreased significantly. 84% of patients did not report adverse events.
Epilepsy Seizures Hess EJ, Moody KA, Geffrey AL, Pollack SF, Skirvin LA, Bruno PL, Paolini JL, Thiele EA., October 2016, “Cannabidiol as a new treatment for drug-resistant epilepsy in tuberous sclerosis complex”; Epilepsia; 56 patients were treated with 5 mg/kg/day with cannabidiol (CBD), increased each day to 50 mg/kg/day. RESULTS; seizure frequency decreased from 22.0 to 13.3 after 3 months. Well tolerated.
Wasting Syndrome Appetite, insomnia Bedi G, Foltin RW, Gunderson EW, Rabkin J, Hart CL, Comer SD, Vosburg SK, Haney M., December 2010, “Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study”, Psychopharmacology, 7 patients, double blind study. RESULTS: increased caloric intake for first 8 days and improved sleep quality for first 8 days. Well tolerated by patients.
Crohn’s Disease Appetite, sleep, abdominal pain, joint pain, abdominal cramping and diarrhea. Timna Naftali, MD, Oct. 2013; "Cannabis Induces a Clinical Response in Patients with Crohn's Disease: A Prospective Placebo-Controlled Study," Clinical Gastroenterology and Hepatology: 21 patients with Crohn’s Disease Activity Index greater than 200 who failed steroid, immunomodulatory or anti-tumor necrosis factor-alpha treatment. Patients treated with 115 mg of delta 9-tetrahydrocannabinaol or placebo. RESULTS: complete remission by 5 of 11 in treatment group, 1 of 10 in placebo group. No significant side effects.
Post-Traumatic Stress Syndrome Anxiety, insomnia, appetite, depression George R. Greer, MD, Charles S. Grob, MD, Adam L. Halberstadt, PhD, Mar. 2014;"PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program,"; Journal of Psychoactive Drugs: 80 patients assessed using Clinician Administered Posttraumatic Scale for DSM-IV (CAPS). RESULTS: 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not.

 

The Medical Cannabis Seminar

Our seminar will be held in Orlando, Florida on October 25, from 5:30pm – 7:00pm.

For a copy of the meeting’s brochure, please go to this weblink.

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