It is easy to experience medical benefits from cannabis, for example a puff or two of tetrahydrocannabinol (THC) and/or cannabidiol (CBD) can do the trick for a lot of people. However, in terms of a medical product one must look at the medical and/or pharmaceutical approach. It’s no longer a question of whether cannabis has medical value. Now it’s more about figuring out how to regulate, register and manufacture such products and provide a safe medical product to the end consumer.
For example, many people in the current cannabis industry are cultivating it for personal use, and some are even extracting oil from the cultivated material. This will then be supplied to friends, family and even sold to people to treat various conditions. The end consumer of these products is not aware and does not have any idea what the product they have been supplied with contains, nor what process was used to make it. It is possible, therefore, that an end consumer may consume more alcohol, butane, ethanol etc. than the actual product (cannabis) they thought they had consumed, not to mention the infusion of other ingredients added to the product. Thus, testing from laboratories, regulation and compliance with pharmaceutical standards are crucial to ensure a safe product to the consumer and to ensure that the same quality of product can be produced again by consistent production and manufacturing practices.
One also needs to understand the dosing of cannabis. Many research studies have shown that different strengths of cannabis oil, cultivars/strains and quantity of consumption may have different effects on different conditions. Cilo Cybin Pharmaceutical is working with a network of specialists and doctors who have been treating patients for various conditions using cannabis.
As per the previous article in Landscape SA Issue 100, Cilo Cybin Pharmaceutical will manufacture oils under its Good Manufacturing Practice (GMP) license. Says Slabber: “We’ve acquired Commercial markets for export of medical grade cannabis oil, as well as local supply to the South African market. Manufactured products are strictly regulated as per the Medicines and Related Substances Control Act, Act 101 of 1965.
The case for cannabis: a medical view
Dr Patricia Montagner, a Brazilian neurosurgeon at the NeuroVinci Clinic in Rio de Janeiro, works with a multidisciplinary team to treat patients with severe neurological disorders, chronic pain, cancer and degenerative spine diseases. She was not satisfied simply to prescribe pharmacological medication and decided to look for alternatives, wanting to help her patients who had not improved after surgery.
In 2015 she began studying the endocannabinoid system and cannabis as a medicine, working with professionals who had experience with this, in particular Dr. Leandro Ramirez, a highly experienced doctor in medical cannabis. After further study she began to prescribe THC and CBD, the latter having unique therapeutic potential and being essential for chronic pain, spasticity, dementia and cancer.
She stresses that cannabis products should only be used under the guidance and assistance of a qualified medical professional. The medication has the potential to treat the patient, not only the symptoms. In one case study, a brain cancer patient of hers responded positively to cannabis, after suffering post-surgery seizures. This enabled her to suspend an anti-convulsant drug and she believes the cannabis is also helping him to control the tumour lesion. “The patient has been disease-free for just over three years and is enjoying an excellent quality of life,” she says.
In another case, a patient with a long history of back pain underwent hernial disc surgery, a lumbar spinal arthrodesis, further surgery and pain blocks. Thereafter, Dr Montagner performed a sequence of minimally invasive procedures for pain and included cannabis in his treatment. After this, the patient reported a great improvement in his condition.
“I became a better doctor and neurosurgeon after bringing cannabis into my professional life and knowledge of it should be available to all doctors, as an alternative and therapeutic tool. My purpose is to share this knowledge, and train doctors to use cannabis carefully and effectively. It has a transformative potential in many situations,” she states.