Medical Cannabis: quality standards and evolution through scientific research

by: Dominik Marko – Scientific Advisor @ PQE Group

Early use and discovery of medicinal properties and pharmaceutical applications

Cannabis plant in it’s cca 28 million years of evolution found popularity in fairly early stages of our civilization’s development, attracting attention of Asian cultures and travelled west to spread on. It was highly valued for it’s fiber and used often in construction and production of clothing as well as ropes and fishing nets. With lower levels of cannabinoids content, people more appreciated the plants value as a resource than otherwise. After identification of male/female traits and observation of cultivation impact on the crops depending on manipulation of removing males from the population, they also discovered the medicinal properties of female flowers. One of the main therapeutical applications were pain suppression, sleep control and mental illness treatments, meaning Chinese people went fast from observing slight mental effects to wide application in Chinese traditional herbal medicine, lasting for about 1800 years. Cannabis spread to other cultures and continents, being used more or less in the same manner and for similar purposes, showing common point of view among different cultures.

Late scientific discovery of endocannabinoid system

Scientific approach and interest in biochemical research of the plants properties came relatively late at the end of XX century with the discovery of our internal endocannabinoid system, explaining first questions that were posed since the beginning – how does the phytocannabinoid impact work in our body? After the discovery of first two endocannabinoid receptors in early 90s, we started to search for possible binding partners, which resulted in gradual identification of basic endocannabinoids such as Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). First biochemical mechanism designs came into life, resulting in clearer view over how our internal endocannabinoid (ECB) system works and how it reacts to external factors like medical cannabis treatment.

Different illnesses need different therapeutical approach

For the past 20 years, some research has been concluded on effects and clinical trials of phytocannabinoids as well as impact of our own ECB system on diverse illnesses like anorexia, epilepsy, Alzheimer’s, Multiple sclerosis, glaucoma, spasms, pain or seizures and many more. Nevertheless, rarely has the outcome of research been clear and conclusive because of either lack of significant amount of clinical trials or undiscovered side effects. Medical cannabis is not as easily defined pharmaceutical as other more classic medications such as Ibuprofen, due to its contents. Cannabis extracts or dried flowers contain vast palette of supporting compounds, apart from the cannabinoid spectrum that has the strongest therapeutical effect – cannabis patients benefit also from CBD and terpenes, creating the famous “entourage effect” (which also hasn’t been sufficiently exposed yet through thorough scientific and clinical research). Different ratio content of THC/CBD has also been identified more beneficial for different illnesses, meaning that some patients need more THC content, some more CBD and some more balanced mix in the variety of the plant used for their treatment. In order to personalize the therapy to each individual patient and causing it to be more effective, we need to understand better the mechanisms behind, which leads us back to the starting point, source of majority of problems in the entire field of medical cannabis: lack of detailed and coordinated scientific research. Due to legal state of substance of research, it is all but easy for scientists to apply for projects, ask for funds and even ask for biomaterial to work on as it is considered an illegal substance and is often being thrown into the same basket as for example heroin or LSD. FDA in USA has approved very few developed medical cannabis drugs such as CBD Epidiolex for seizures or Marinol/Cesamet for nausea and vomiting from chemotherapy, showing us how far we are from implementation of a wider spectrum of medications based on medical cannabis, largely due to DEA which is keeping cannabis as Schedule I drug. In Europe the situation is similar, although it varies from country to country. Usually universities have to collaborate with multiple bodies, including a variety of medical institutions, making research more difficult and decentralized. This in effect creates the need for more focused research projects that would involve several universities in a single effort like we see other projects released every year by European Commission. In this fashion we could witness more rapid and more conclusive results, leading to development of new and better treatments involving medical cannabis. Projects organized by such bodies might also be more recognized by legislative bodies and pushed towards clinical trials and applications, which in this moment are not being considered as viable and legal option.

Lack of centralized and unified system of control

Hard research conditions cry out for more united and common system of control that would allow not only for more centralized efforts but would also significantly increase the quality and efficiency of therapies. Medical cannabis quality control is one of the most challenging steps in the future for the sector to come. It is a common knowledge that USA has different cannabis laws changing from state to state, but frankly in Europe there is similar situation, despite EU GMP compliance regulations most countries execute their own rules and exceptions when it comes to standardization of a product that is meant to be used in healthcare and registered as a pharmaceutical medication.

Production standardization would directly benefit the patients

While many enthusiasts applaud new laws in Malta or political declarations of German government concerning cannabis legislation changes we must be aware that what matters the most is still far away from our hands reach. The concept of solution is very simple – unified legislation managed by a common geographical body. Many attempts were already made, establishing commissions and societies, nevertheless none of them achieved the official status of a regulatory body, not yet nonetheless. The standardization of medical cannabis production quality control is crucial for patients and therapies alike. It would not only help patients to receive pharma-grade medication and have efficient health support, but it would also introduce more awareness of what arsenal is at our disposal for numerous illnesses and propagate more centralized research efforts to increase the long list of beneficial effects of medical cannabis therapies and make them more available to common people suffering from ineffective existing therapies. Many countries struggle with their own production for their own needs, creating large demand majorly or entirely depending on imports from few countries that managed to standardize their own products and implement quality control systems and specification thresholds, allowing for top-grade product, expected to meet patient’s needs. The two main objectives to achieve, research and quality control go together hand in hand. There is still a long way of development and research waiting in the medical sector where we should progress more decisively – after all it’s our health we are focusing here and we can start taking care of it by spreading the awareness of needs and demands, forcing changes and introducing focus, control and centralized effort.

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