Excessive Regulation Keeps Illegal Cannabis Markets in the Black!

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Since 2012 many American states and Canada legalised use and sale of recreational Cannabis. An expected benefit of legalisation is establishment of a legal Cannabis market to eliminate the black-market. Even though legal options are available for Cannabis producers and consumers, the black-market is still thriving. The reasons behind the persistence of the Cannabis black-market are complex but one main argument is, legalised states have failed to establish a regulatory framework which effectively keeps producers and consumers in the legal market. Instead, strict regulations and the high cost of compliance have created an environment favourable to big players, driving small-scale businesses to the black-market. Published in July 2019 the study, Effects of Regulation Intensity on Marijuana* Black-Market After Legalisation (the Oregon study), found excessive US state regulations may be the reason illegal Cannabis markets continue to exist post-legalisation. The research looked at data from the first two US states to end Cannabis prohibition, Colorado and Washington.

“The qualitative analysis of news reports reveals that regulation is one of the main reasons that people stay in the illicit market. The comparison of marijuana* crime trends in Colorado and Washington shows mixed findings. While -offence rates in Colorado largely remained steady over the years, those in Washington increased dramatically after the implementation of more intensive regulations”.

Meanwhile, in ‘Cannabis-legal’ California, in July 2019, Riverside County Sheriff’s Department served search warrants on 56 illegal Cannabis cultivation sites. Spearheaded by 390 law enforcement personnel, whose mission was to combat the ongoing problem of illegal Cannabis cultivation sites throughout California, the raids resulted in:

  • 47,939 Cannabis plants confiscated
  • 2,132 pounds of processed Cannabis
  • 47 tons of Cannabis plants disposed
  • 2 Butane Honey Oil Labs located
  • 71 firearms
  • 49 arrests

Illegal cultivation is far from just a California problem, however. If Oregon halted Cannabis production today, the state would not experience a shortage; it has a six-year surplus! But, US states that legalised recreational Cannabis with the intent of re-imagining the vast underground market as an above-board business to bolster state economies via transparent dealings have been disappointed as, to date, the US Federal Government has refused to budge regarding Cannabis’ status as an illegal Schedule 1 substance. One of the tenets of legalising Cannabis is stemming the proliferation of black-market suppliers and reducing negative effects of the ‘war on drugs’, particularly on minorities. These positive impetuses have yet to flourish as a result of the illegal status of Cannabis at US federal level leaving Cannabis-legal states to operate as islands. Taking legally purchased Cannabis from a legal to an illegal state is not only illegal, but confusing and a recipe for complications, leaving Cannabis-legal states vulnerable in an environment extremely hospitable to black-market activity.

US states that legalised production have inadvertently made it easier for illegal producers to hide in plain sight where the line between legal and illegal operations blurs. Black-market growers in legal states destabilise the market as legitimate companies pay taxes and jump through every legal hoop and cannot compete. This creates frustrations for law enforcement and cuts into the legal trade. But putting the genie of legalised recreational Cannabis back in the bottle simply isn’t feasible for operational, financial and political reasons in North America. With the proliferation of attendant illegal operations it is however becoming clearer that some form of US federal legalisation is inevitable. In legal states, growers, sellers and consumers have legitimate channelsto produce, trade and obtain Cannabis, and as such, illegal avenues should diminish, yet research shows they havent disappeared. A 2018 report found 18% of Cannabis consumers in California purchased Cannabis products from an unlicensed seller.

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An association between how intense state Cannabis-related regulations are and the extent of the remaining illegal market has been investigated. In Washington (from June 2016) and in Colorado (from November 2015 and January 2017 [in 2017 Colorado lawmakers passed new rules regarding labelling and packaging of Cannabis flower and trim, concentrates and other products]), most people grew or sold illegally due to “strict regulations and the high cost associated with the compliance … ‘over-regulation’, ‘cost of compliance’, ‘high taxes’ … Other reasons for staying in the illegal market included market fluctuations and organised crime. Washington’s crime rate increased after the state introduced more regulations. “In 2014 and 2015, marijuana* crime rates/100,000 residents were around 26. This number increased to >28 incidents in 2016. In 2017, 2,628 -crimes were reported, making the annual crime rate 35.96/capita”. Colorado did not see any significant short/long-term changes to its Cannabis-related crime rates after they implemented new regulations. 

“Although the findings are not conclusive, the results of Washington data show regulation intensity may be one of the main factors that influences or explains the persistence of illegal Cannabis transactions after the legalisation”, and, “The fact that Washington’s black-market kept growing after the implementation of more complex and sophisticated regulations at least indicates a correlation between regulation intensity and the increase of the black-market …”, the Oregon study stated.

Similar findings were not reported in Colorado suggesting “the magnitude of illicit marijuana* activities may be affected by regulation intensity …”. These results raise questions about “possible adverse effect of intensive regulations to researchers and policy-makers”. If one of the goals of Cannabis legalisation is to eliminate the unregulated market, it’s important lawmakers consider the implications of unnecessarily strict rules and focus on creating an “equitable and accessible market that allows the coexistence of both large and small businesses. The cost of compliance to regulations should be reduced to remove the barriers of establishing a legal -business”, the study concluded, and, “future policies should also pay more attention to cracking down on persistent illegal growers/ sellers and organised crime groups unwilling to participate in the legal market”.  Thus, the question may no longer be, should the US legalise Cannabis federally, but, howA path forward needs to be found. Cobbling together a pastiche of laws inevitably bolsters black-market activity as quasi-legislation at state level provides neither a check nor balance. The most likely next step for US public health, stemming black-market activity and generating maximum revenues is comprehensive national legalisation, sooner rather than later.

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In Australia, Cannabis legislation remains incredibly complicated despite changes to the Narcotic Drugs Act in 2016, to purportedly allow Cannabis to be legally grown for medical and scientific purposes. The uptake of ‘medicinal Cannabis’ has been slow, with access incredibly difficult due to long waiting periods, high costs and uninformed doctors. Canada legalised Cannabis, 17 October 2018, with ‘medicinal Cannabis’ available since 2001. However, the Canadian Civil Liberties Association reported in 2018, “The way the Federal Government has decided to pursue legalisation of Cannabis is concerning. Many Canadians think … Cannabis will be legal – maybe not legal like buying milk or eggs – but something akin to alcohol, or tobacco. The belief is Cannabis will be a tightly regulated substance that people of a certain age are pretty much entrusted to use as they see fit. This is a mistake. There are a raft of new criminal offences … The fact you have a patchwork of provincial, territorial and municipal laws and by-laws that interact with the federal criminal prohibitions means something that’s perfectly legal at home may be a crime when you’re visiting your friend in another city”.

“As of 2016, the Australian Institute of Health and Welfare estimated that some 10.4% of the total population used Cannabis and that the tolerance for regular use had risen from 9.8% to 14.5% between 2013 and 2016. It is not completely unrealistic that the number of recreational users could double as a percentage of the population over the next decade, although this would be tempered by the fact that many users are likely to remain light or occasional users”, said Prohibition Partners Head of Insights, Alexandra Curley. In January 2018 the Australian Federal Government announced plans to become the fourth country in the world to legalise ‘medicinal Cannabis’ exports. Shares soared for the >20 Cannabis producers on the Australian Stock Exchange (ASX) and Cannabis Jobs Australia estimated by 2028 there would be 50,000 Cannabis jobs in Australia. The climate makes it the perfect place for growth with a potential for two crops a year in areas with high sunlight.

“Australia boasts an optimum climate for growing some strains of Cannabis that are expensive to produce in more established markets such as Canada. This, coupled with anticipated changes to the law, will create an environment that will enable the region to capitalise on strong growth within the industry. That’s going to make Australia a very attractive proposition to investors”, Alexandra Curley, Prohibition Partners.

The bill that would legalise Cannabis for personal use in the ACT could be passed next week.

However, growers are unable to use the outdoor environment according to Barry Lambert, chairman of Ecofibre, an industrial hemp company. “On the growing side, we can only grow it indoors … Compare that to where we (Ecofibre) grow in the US … outdoors under the Kentucky sun”, he said. According to Statistics Canada, close to 5.4 million Canadians will buy Cannabis over the next 12 months. The US is also a growing market for exporters where sales grew by 30% in 2016 to US$6.7 b, without it being legal nationwide. The US now makes up 90% of the Cannabis stock trade, which can only go up with federal legislation. But Mr Lambert said there was no market in those countries for Cannabis exporters. “Who are they going to export it to? America, you can buy it over the counter at a fraction of the price. Canada, it has been legal for some time to sell Cannabis and they are trying to export it”

HLB Mann Judd (Accounting and Financial firm) partner Marcus Ohm says there are a lot of uncertainties in the industry. “Australia is at an early stage in relation to the regulatory environment relative to other jurisdictions … countries vary on whether marijuana* is illegal, permitted for medicinal purposes or permitted for recreational and medicinal use. Australia has eased some aspects … but compared to the US (state level) and Canada (federal), Australia has narrower applications”Mr Lambert said, “I personally haven’t invested in any other company … and I see no reason why I would …”, further stating most of the companies on the stock exchange are not making money, but spending it. “Australian companies will find it very hard ever to make a dollar … There’s no revenue and they’re spending millions …”.

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President of the Australian Industrial Hemp Alliance, James Vosper, said, “There is a lot of investment in the industry but there have been some issues with people getting access to medicines so therefore the number of people being treated in Australia isn’t as high as it could be”Mr Lambert said legalising ‘medicinal Cannabis’ in Australia did absolutely nothing for promotion of the industry. There are two reasons. One … no demand for the product because the rules around getting the product are unworkable … no doctor understands it because they aren’t trained … until 2016 it had been illegal. Secondly, there’s been no research in this country because it’s been illegal. So, doctors don’t know about it, therefore they don’t prescribe it”Mr Lambert said the US system allowed for ‘medicinal Cannabis’ to be sold over the counter, a system Australia needed to adopt. Without that the industry was dead before it even began.

“We don’t believe that the prescription system works. And, therefore, those medical Cannabis companies are going to find it very hard or impossible to be successful and that their solution is adoption of the American system”, Barry Lambert, Ecofibre.

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Others remain more optimistic, with Mr Vosper saying the future looked bright. “I think Australia has a great future in this industry. The whole world is moving towards an organic model and Australia has half of the world’s organic farmland. Put that with a great reputation for products and you have a great future in the medicinal Cannabis industry”The Australian Capital Territory (ACT) government passed laws in September 2019 that essentially fully decriminalised Cannabis under certain and very specific conditions.  When the legislation comes into effect on 31 January, 2020, it will be legal, under ACT law, for adults in Canberra to grow, smoke and own small amounts of Cannabis (50 grams). But the Commonwealth has laws of its own in this area and those laws explicitly prohibit possessing any quantity of Cannabis (with the exception of ‘medicinal Cannabis’, a completely separate thing). Introduced by Labor backbencher Michael Pettersson in 2018, to legalise possession of 50 grams of Cannabis for adults, the ACT Government stated, 

“It is important to note that, even after the passage of this bill, possessing and growing Cannabis will carry a degree of risk arising from interactions between territory and Commonwealth law”. Mr Pettersson said, “In order to reduce harm and stigma, we need to make sure that people can feel free to come forward and get help. In order to do this, we need to remove the penalties and charges associated with the possession and use of small amounts of Cannabis …”.

Across the ditch (from Australia) in New Zealand, Cannabis is classified as an illegal ‘drug’ under the Misuse of Drugs Act 1975 and possession, use and supply are subject variously to penalties ranging from fines to many years imprisonment. The Helen Clark (former Prime Minister of New Zealand and member of the Global Commission on Drug Policy) Foundation, released a report setting out the case for legalising and regulating Cannabis. The prospect of invoking criminal sanctions has had little impact on people’s behaviour as longitudinal studies indicate by age 25, 80% of New Zealanders had tried Cannabis at least once. Simply, prohibition-based policy approaches have not eradicated and will not eradicate Cannabis consumption and supply in New Zealand or anywhere else where use is established. The New Zealand Referendum due in 2020 will be to legalise and regulate. Decriminalisation is not expected to be an option.Image result for new zealand cannabis

Helen Clark herself stated, “The time has come for New Zealand to face up to the widespread use and supply of Cannabis in the country and to legalise and regulate it accordingly. No useful purpose is served by maintaining its illegal status. A “yes” vote in the 2020 referendum will be positive for social justice and equity, contribute to reducing the country’s excessively large prison population and enable those health issues associated with Cannabis to be dealt with upfront. These are the reasons why I support legalisation”. However, in legalising and regulating in New Zealand, it will be important not to create another ‘big tobacco’ or ‘big alcohol’. Both industries fought and continue to fight efforts to reduce harm they cause, including regulation of access, product promotion and taxation aimed at disincentivising use.

503e589cab97b59cc53421127b6291af_400x400On the weighted score for harms of drugs in the United Kingdom developed by scientist David Nutt, former chair of the Advisory Council on the Misuse of Drugs and colleagues, published in the Lancet in 2010, Cannabis is assessed as immensely less harmful to those who use it and to others, than is alcohol. Various other rankings concur Cannabis use is significantly less problematic for individual health than either tobacco or alcohol. The classification of drugs  pursuant to international drug conventions, however, is based on more cultural and political factors than scientific evidence. Those classifications have scarred the lives of countless millions of people worldwide, caught up in the criminal net cast over what is deemed to be illegal ‘drug’ possession, use and supply. It is not surprising, therefore, a growing number of jurisdictions have been moving away from the prohibitionist approach promoted by the international conventions.

Countries and individual states/provinces/territories have legalised possession, use and supply of Cannabis. Other jurisdictions have decriminalised personal possession and use. President of New Zealand’s criminal lawyers’ society supports legalising Cannabis for personal use and says existing law criminalises too many people. Len Andersen, Criminal Bar Association President, said banning Cannabis created demand for more harmful drugs, including synthetic ‘cannabinoids​’, implicated in at least 70 deaths. Mr Andersen said prohibition put otherwise law-abiding people who chose to use Cannabis “in the position of constant illegality”. The Association said its membership comprised 700 practising criminal lawyers across New Zealand. “I think most members would support legalisation of Cannabis for personal use”, Andersen said. An amendment to New Zealand’s Misuse of Drugs Act directed police only to prosecute those using ‘drugs’ when there is ‘public interest’. The New Zealand Federal Government has been clear it wants to take a health and well-being-based approach. Drug law reform, including legalisation of Cannabis, helps meet both objectives.

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The ‘war on drugs’ has failed. In Australia, 35% have tried Cannabis, but this choice could earn a criminal record, just for having a small amount of Cannabis in your possession (or system). This ‘tough on drugs’ approach causes enormous harm, driving people away from getting help and exposing them to a dangerous black-market. From Uruguay to Spain, New Zealand to the US and Canada, countries around the world are realising prohibition causes more harm than it prevents. Cannabis use is a health issue, not a criminal one. Legalising Cannabis use would reduce harm, increase protection for vulnerable people and break the business model of criminal gangs. World-wide, the Cannabis ‘cake’ should be big enough for everybody; corporates, government/s, home-growers, not-for-profits and the most-oft-forgotten sick and suffering, to get a slice. It’s all in how you carve it up, and it could and should be, equitable. The world has seen enough of the double-standards, mass-hypocrisy and worst of all, ignorance of science fact, because it is not profitable. It is way past time to put people before profits and free Cannabis from the constraints of prohibitionistic regulations and the out-and-out lies that have besmirched this wonderfully efficacious herb for far too long! Save lives and legalise!

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Adapted from Heavy Regulations Allow Illegal Marijuana Sales to Persist, Study Argues with Effects of Regulation Intensity on Marijuana Black-Market After LegalizationStemming the Cannabis Black-MarketTHE BLUNT TRUTH, Cannabis prohibition doesn’t work anywhere. It’s New Zealand’s turn to legalise itLaws to legalise cannabis for personal use in the ACT could pass next weekCannabis laws bound for the courtroom to work out whether ACT or Commonwealth is rightLegalise weed, criminal lawyer group president says and Legalise It

*marijuana – Cannabis sativa is the correct botanical term for the plant, the term marijuana is a North American colloquialism, at best.

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Australian Legal ‘Medicinal Cannabis’, Overpriced and Difficult to Obtain

It is estimated that close to a million patients are now seeking access to ‘medicinal Cannabis’ in Australia. Australian government figures show around 20,000 patients now have approvals for access to legal ‘medicinal Cannabis’ products. The Medical Cannabis Users Association of Australia Inc. (MCUA) reports many patients are still having to turn to the ‘black’ market or are self supplying because, access to and cost of, the majority of legal ‘medicinal Cannabis’ products is way beyond their financial reach. This is happening in Queensland, for example, partly because public hospital policy does not permit its doctors to prescribe Cannabis-based products.

The MCUA states the rate of approvals has increased substantially with a mushrooming of corporate clinics set up to move products that had been languishing on warehouse shelves because General Practitioners (GP’s) were refusing to prescribe ‘medical Cannabis’. These clinics have the sole purpose of prescribing corporate ‘Cannabis’-based products and have become the gateway to moving these over-priced, often longitudinally untested pharmaceuticals off the shelves. It appears these clinics are given ‘special treatment’ in this highly regulated environment as the MCUA noted when CEO of ‘medical Cannabis’ company, THC, David Radford said on Sky News;

“… We are working with individual state governments to get their approvals (for clinics) … not the same as a health clinic that you go through so we are not expecting the same regulatory hurdles …”.

The current modus operandi of the clinics when communicating with ‘patients’ is an offering of either/or teleconferencing and face to face consultations with doctors who it is being alleged have no prior experience using or prescribing ‘Cannabis’-based medicine in a clinical situation and who also have had limited training via educational videos and ‘medical Cannabis’ company backup. Some patients have said to the MCUA that consultation processes have been amateur in approach. In some cases, no medical history of the patient was recorded and prospective patients weren’t even asked about current medications or allergies they might have. As to consultation fees the MCUA report these can vary enormously between clinics.

The majority of ‘medical Cannabis’ patients do not receive a Medicare rebate and on average, patients are charged fees by third parties of around $200 to apply to the Therapeutic Goods Administration (TGA) online (a process for which there is no fee attached if one registers directly). Other costs,  it is reported, vary from <$100 to >$1,000 for an initial consultation and an application for ‘medical Cannabis’. Due to the increasing number of complaints about these clinics the MCUA is conducting a patient satisfaction survey asking about patient experiences overall with the delivery model set up by the Australian Federal Government. Responses to their survey have been consistent throughout with +45% of patients saying they are paying up to $500-$1,000 a month for products.Image result for australian medical cannabis products

Most survey respondents are on Centrelink payments because of their illness and some have got themselves into debt with family or friends to enable them to purchase the medicine. Almost half of the prescriptions written have not been filled. Peter Crock, CEO of the Cann Group and Chairman of Medicinal Cannabis Industry Australia reinforces this scenario.  He said on ABC radio that, “All medicinal Cannabis is being imported … that is what is keeping prices high … and people are taking the opportunity to make super profits on the way through”. Many survey respondents say they have had more than one approval with 20% saying they have had more than five approvals. The dissatisfaction rate with the delivery system is consistently 86% .

Patient experiences gathered via the survey include the following;

  • One MCUA member reported being charged $700.00 in consultation fees and product for her fathers palliative medicine. The product was delivered in November 2019, a six week supply of Cannabis oil with an expiry date of October 2019. They were told the family GP would need to sign off on the prescription and treatment would not begin until the Clinic doctor saw the GP because the state owned aged-care facility could not give out-of-date medicine. The woman’s dying father was denied medicine to make his passing easier. 
  • Another wrote they were worried their Cannabis clinic was ‘taking them for a ride’. Their first prescribed medicine was bought as two 25 ml bottles to avoid an extra $50 for shipping. The first script cost $633.30, the next $330.30 due to the distributor lowering the cost. After three months the ‘patient’ had to pay the clinic to write a new script, which needed to be approved again by the TGA. When the clinic couldn’t get the same product they had to re-apply for TGA approval and supplied a different product altogether at a cost of $540.00 for two bottles (50 ml). The cost to use on a daily basis was initially (February 2019) an average of $15.20. When the price dropped it reduced the daily cost to $7.92 and now the ‘patient’ is paying $16.20 daily. 
  • One said she recently applied for the ‘legal version’, knowing full well it was beyond what she could afford after the initial appointment cost $200.00. Subsequent scripts, she was told, would cost $59.00. It would be $80.00 for a follow-up appointment and $59.00 whenever there was an adjustment to dose or product. Requiring two products, one at $660.00 a month and the other at $300.00 a month, needless to say, she could not afford to fill the scripts and believes this circumstance to be discriminatory against people on low incomes. 
  • And one, with Multiple Sclerosis (MS), Fibromyalgia, Rheumatoid Arthritis (RA), degenerative spinal conditions (previous high impact crush injury – L5/4/3), a dislocated neck (C4/3), Scheuermann’s Kyphosis Scoliosis, Complex Regional Pain Syndrome (CRPS), high blood pressure, diabetes, Sarcoidosis, Chronic Obstructive Pulmonary Disease (COPD), is going blind because of the MS. This 36 year old, on a Total and Permanent Disability (TPD) Pension, 18 months ago was looking at being an invalid, possibly under palliative care but that simply was not an option as they had children. They researched and made Full Extract Cannabis Oil (FECO). According to them it was the only reason they did not become wheelchair-bound and paralysed. For $350.00/ounce of black-market Cannabis they could make 250 ml of oil. They used 50 ml ($70.00 worth) a month. Image result for FECO cannabis productsBefore the illegal oil, they took 19 ‘pills’ every morning, 20 at night and another ten throughout the day. They no longer take opioids or other pain-killers except the Cannabis oil which healed the broken back and dislocated neck, when they were told they’d never walk again. They sought approval for legal supply through a prescription, because they go to hospital regularly due to lung and kidney issues, but the hospital won’t let them use their oil because it’s not ‘legal’. They now have a script for legal supply but the bottle of oil is waiting at the pharmacy as they cannot afford it. It’s a THC/CBD blend, 25 ml for $300.00. The doctor said that was the dose for one month. With no way to maintain that cost the ‘patient’ has no option but to continue to make their own oil and run the risk of being raided and prosecuted. Which they were; arrested and charged when caught by police for sending a bottle of home-made medicine to a fellow sufferer. 
  • Another paid $110.00 for two consultations, first with a nurse to see if they met the criteria and second with a doctor to go through the application. They were told they would hear back within a week. After four weeks, they emailed the clinic and got no response. They called the mobile numbers and found they were disconnected, so they wrote a bad review online and looked into reporting the clinic as a scam. The clinic contacted them and asked them to remove the review. In exchange the clinic said they would pay for half the prescription. The full cost was beyond the ‘patient’, so they agreed and drove 1½ hours (round trip) to collect it. The ‘patient’ very quickly worked their way to the maximum dose, without any noticeable impact and was not prepared to spend $385.00 every five days on something that did not work. They were told they would have ongoing follow up care from the team, that they were not going to have to go through the process alone, the entire team was behind them. They never heard from the clinic again. 
  • And yet another at a popular access clinic felt badly treated after commenting about the high cost of the consultations and product. The clinic pharmacist said if they couldn’t afford it to go back to their GP! The ‘patient’ complained to the practice manager and got nowhere. Left without any oil since June, the clinic didn’t care they were not coping, in extreme pain and couldn’t afford to keep paying for consultations, approval applications and the outrageous cost of the oil which they felt was very diluted and not effective at the low dose prescribed. They repeatedly told the clinic they couldn’t afford $450.00 every three weeks on a Disability Pension. They noted that the system is not working and nobody seems to want to help.

Image result for australian medical cannabis productsThis is a small sample. There are many such ‘horror’ stories and MCUA has witnessed firsthand how the system has failed the ill and suffering. There needs to be a review with public input and recommendations made to facilitate a quicker more affordable delivery system. MCUA President, Deb Lynch, is currently waiting for a trial date after being arrested and charged for self-supply following many attempts to acquire a prescription through Queensland (Qld) Health, whose doctors have been advised not to prescribe Cannabis under public hospital policy. Being on a disability pension, there is no way she can afford the costs involved in getting a script from one of these corporate Cannabis clinics.

The MCUA is still seeking patients who have been through the legal process to fill in their Medical Cannabis Access – Patient Satisfaction Survey (2019) which will be forwarded to the Federal Senate, via the Australian Labor Party (ALP) Senator Anne Urquhart, along with their current petition asking for a full review of the delivery system put in place by the Liberal/National Party (LNP). Cannabis is a herbal remedy and trying to squeeze it into the pharmaceutical delivery model will mean that the hold-ups will continue and prices will remain high as companies who have spent millions to get into the market are not turning a profit. The MCUA is asking anyone with an opinion to comment on their petition asking for this review.

The MCUA is contactable via their website.

Image result for australian medical cannabis productsAdapted from Australian Medical Marijuana Patients Find It Difficult To Get and Medical Cannabis Rip Offs result in patients charged with self supply

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It’s Past Time to Remove False Claims About Cannabis

In 2017, the United States (US) Drug Enforcement Administration (DEA) removed some false claims about Cannabis from their website. The nonprofit advocacy group, Americans for Safe Access, used government policy against the DEA, filing a petition that stated they had violated the Information Quality Act (Data Quality Act), meant to ensure objective, fact-based information is supplied on government websites and literature meant to educate the public. The group cited at least 25 misleading statements found on the DEA’s website and in a report from the agency titled, “The Dangers and Consequences of Marijuana Abuse”, that not only contradicted commonly accepted facts about Cannabis backed by science and research, but also the DEA’s own statements from 2016 when then-US Attorney General Loretta Lynch said Cannabis is not, in fact, a gateway drug’. “We usually … are talking about individuals that started out with a prescription drug problem”, she said.

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Image result for ban the deaAmong the other misinformation the DEA was passing off as purported fact was that marijuana’ induces psychosis and causes long-term brain damage. “We are pleased that in the face of our request the DEA withdrew some of the damaging misinformation from its website”,  said Vickie Feeman of law firm Orrick, Herrington & Sutcliffe“We are hopeful the DEA will also remove the remaining statements rather than continue to mislead the public in the face of the scientifically proven benefits of ‘medical Cannabis’”, she said. “However, the DEA continues to disseminate many damaging facts about the health risks of ‘medical Cannabis’, and patients across the country face ongoing harm as a result of these alternative facts’”. In 2019, there are still concerning statements on the DEA website that contradict accepted facts about Cannabis.

The Australian Government’s Department of Health (DoH) website states the following:

… ‘drugs’ can be categorised by the way in which they affect our bodies;

  • depressants — slow down the function of the central nervous system
  • hallucinogens — affect your senses and change the way you see, hear, taste, smell or feel things
  • stimulants — speed up the function of the central nervous system

Some ‘drugs’ affect the body in many ways and can fall into more than one category. For example, Cannabis appears in all three categories.

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The links to individual substances listed on the DoH website lead you to the Australian Alcohol and Drug Foundation (ADF) website for the purported facts (to use the term, facts, extremely loosely). On Cannabis it notes the effects include anxiety, blurred vision, clumsiness, dry mouth, excitement, fast heart rate, feeling sleepy, increased appetite, low blood pressure, paranoia, quiet mood, reflective mood, relaxation, slower reflexes, spontaneous laughter … and calls it a cannabinoid drug’, contradicting the DoH, using an adapted Drug Wheel (from the United Kingdom).

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Checking the references of the ADF article on Cannabis there are no surprises as to the misinformation, on the short list of names there are several of the usual culprits; high-profile Australian prohibitionists who profit from pushing propaganda with scant regard for actual science or the truth (many ‘brought to us’ by the pharmaceutical industry, among others with vested interests).


Australian Cannabis statistics from the Alcohol and Drug FoundationRelated image
Australians Nationally

34.8%, 14 years and over, have used Cannabis once or more in their life,
10.4%, 14 years and over have used Cannabis in the previous 12 months,
Young People in Australia
• Most do not use Cannabis – 68.7% of 12-17 year olds have never tried it.


Image result for Cannabis and those pernicious substances, the drugs, are wholly unalikeThe therapeutic index (larger the TI, the safer) of Cannabis is estimated to be between 4,000:1 to 40,000:1. Nobody really knows because no one has ever died from an overdose of natural Cannabis. This is because there are few or no CB1 receptors in the brain stem so there is NO respiratory depression from cannabinoids. Respiratory depression can be caused by many psychoactive drugs such as benzodiazepines, alcohol, anti-depressants and opiates. As most people who have tried Cannabis (estimated to be more than one-hundred million US citizens alone) know, the effects can often be quite pleasant and the side effects, such as they are, are mild and less often seen in people with serious medical conditions. Like all therapeutic agents, Cannabis can cause side effects for some, which may include anxiety, paranoia, dysphoria and cognitive impairment. These side effects appear to be dose related, tend to occur in naïve users and are entirely temporary. Due to this (in 1988), US Judge Francis Young, DEA’s Chief Administrative Law Judge, after a two-year rescheduling hearing, recommended rescheduling Cannabis to Schedule II, adding,  “Cannabis was one of the safest therapeutic agents known to man”.cannapharmaco

 


The reality is clear: Cannabis and those pernicious substances, the drugs, are wholly unalike. As the word ‘drug’ is wrong and inapplicable to Cannabis, it is necessary to establish a correct word, veracious vocabulary, which is fitting. “Because Cannabis has been loosely, widely and incorrectly referred to in the past as a ‘drug’ does not mean that this basic untruth can become acceptable. On the contrary, since the introduction of Prohibition the legal situation compels veracity and clarity more than ever, for not to articulate the truth accurately involves perjury. Yet truthful language, the truth, exposes the mendacious basis to the crime that is this prohibition of Cannabis”. 

From The Report of the Family Council on Drug Awareness (FCDA) (Europe, 2000)


Anti-weed activists say violent crimes have increased in states like Colorado. Picture: AP Photo/Dave Zalubowski

Image result for addiction to cannabis less than coffeeThe US Federal Government’s Independent New Drug (IND) program, instituted in 1978,  showed there are no troubling chronic effects from regular long-term use of Cannabis. A 2004 study by Dr Ethan Russo and Mary Lynn Mathre, RN, performed a battery of tests and physical exams on several IND patients supplied with government-grown Cannabis for over 25 years. They found these Cannabis patients to have had no adverse health effects from decades-long respiratory consumption of 7.5-9 lbs (3.4-4+kg) per year. There is plenty of data to demonstrate the safety of Cannabis. Not only the US Government’s IND program but also epidemiology studies demonstrate there are no proven long­-term adverse effects of Cannabis use. Prohibitionistic propagandists will say Cannabis is addictive. However, Cannabis addiction does not exist (except as an oxymoron). It is a misunderstanding of the definition of addiction alongside a lack of knowledge of the action of cannabinoids on the human Endocannabinoid System (ECS). Of course there is a dependency risk to Cannabis, one shared with other medications and/or recreational substances. As substance abuse experts Drs Hennigfield and Benowitz pointed out decades ago, the dependency risk of Cannabis is less than coffee. The 1972 report of the Nixon Marijuana Commission also debunked the idea that Cannabis is addictive.

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Another common fallacy is the possibility Cannabis use is linked to adverse cognitive effects. Studies that purport to show these effects are poorly done. A prime example is they do not control for important variables such as use of drugs, traumatic brain injury, PTSD, other medical conditions, growing up in a dysfunctional family, and/or environmental factors. One study cited to support the bogus claim found a reduction in IQ of 8 points in long-time users. This has not been replicated. Several studies including a twin study done by University of California, Los Angeles (UCLA) and University of Minnesota showed this adverse IQ was not true. In fact, Cannabis has helped many with ADD and ADHD pay better attention and raise their academic scores from C’s and D’s to A’s and B’s. One of the most egregious allegations is that Cannabis can change brain structure. Those trying to make the case point to effects in the hippocampus, amygdala and prefrontal cortex. Of course, there are effects on this part of the brain, because it is where many CBl receptors are located. This is why Cannabis has such beneficial effects on treating anxiety, depression and impulse control.

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Another canard (unfounded rumour or story) is that regular Cannabis use is linked to an increased risk of psychotic symptoms. This too is untrue. If it were true, epidemiology would show an increased incidence of psychotic behaviour in the 1970’s or 1980’s because of the pervasive use of Cannabis. There was no such increase. Over the past 60 years the incidence of psychosis has stayed flat or slightly declined. Instead, Cannabis has been shown to be beneficial in the treatment of bipolar disorder and schizophrenia.  Then there are those who insist Cannabis is linked to lower educational attainment. This too is untrue. The work of Dr Melanie Dreher with children exposed to Cannabis in utero and in breastmilk demonstrated that these children did better in school and reached their developmental landmarks sooner than those children whose mothers did not use Cannabis in pregnancy. And the lies continue to percolate wherever it is politically and economically advantageous to those in power in so many jurisdictions, worldwide.

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The International Drug Policy Consortium (IDPC) recommended that, beyond 2019, United Nations (UN) member states should end punitive ‘drug’ control approaches and put people and communities first. The IDPC’s Shadow Report, ‘Taking stock: A decade of drug policy’ evaluates the impacts of policies implemented across the world over the past decade, using UN data, complemented with peer-reviewed academic research and grey literature reports from civil society. Image result for IDPC LOGOThe important role of civil society in the design, implementation, monitoring and evaluation of global policies is recognised in the 2009 Political Declaration and Plan of Action on drugs, as well as in the Outcome Document of the 2016 United Nations General Assembly Special Session (UNGASS). It is in this spirit the IDPC produced the Shadow Report, to contribute constructively to high-level discussions on the next decade in global drug policy. The Shadow Report concluded that member states should identify more meaningful policy goals and targets in line with the 2030 Agenda for Sustainable Development, the UNGASS Outcome Document and international human rights commitments.


IDPC’s Shadow Report, ‘Taking stock: A decade of drug policy’ – Key Conclusions

• Data from the Shadow Report show targets and commitments made in the 2009 Political Declaration and Plan of Action have not been achieved, and in many cases have resulted in counterproductive policies.
• The Shadow Report highlights the urgent need to conduct more comprehensive and balanced research and evaluations on the impacts of drug policies worldwide, taking into account government data, but also academic research and civil society findings.
• The Shadow Report concludes member states should identify more meaningful drug policy goals and targets in line with the 2030 Agenda for Sustainable Development, UNGASS Outcome Document and international human rights commitments.


Crossing out Lies and writing Truth on a blackboard.Image result for cannabis is not a drug

 

 

 

 

 

 

The right to the truth is a human right. Cannabis is a herb, not a drug, and should be removed from all the various drug conventions, worldwide; then it could be provided to all in need, just as ‘Mother Nature’ intended. In the interim, how about the whole, organic truth about the Cannabis sativa plant; it might just set us all free.

 

Adapted from DEA Removes False Claims About Cannabis from Their WebsiteDEA Finally Removes Misinformation about Pot from WebsiteLIES USED TO JUSTIFY RESTRICTIVE CANNABIS POLICIES, Illegally HealedDEA Drops Inaccurate Cannabis Claims From WebsiteWhat You Should Know About MARIJUANAGranny Storm Crow’s List and CANNABIS IS NOT A DRUG.

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Cannabis is a Significant Non-Toxic Substitute for Dangerously Addictive Pharmaceuticals

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Giving patients legal access to Cannabis will influence a significant portion of them to use Cannabis as an alternative to traditional pharmaceuticals, two 2019 studies found. In the first, published in the Journal of Pain, researchers analysed data from online surveys submitted by 1,321 adult Cannabis consumers in legalised states throughout the United States. It found that +80% of respondents had used Cannabis as a substitute for pharmaceuticals, primarily opioid painkillers. Seventy-two percent of those who reported substitution said they had completely ceased opioid use, 68% stopped taking benzodiazepines and 80% eliminated SSRI anti-depression medication. The participants were asked why they chose Cannabis over pharmaceuticals. The top reasons given included that Cannabis had fewer adverse side effects and was more successful in managing symptoms. Almost 90% of respondents said their pain improved after using Cannabis and 71% said their health improved overall. “The current study and the consistent nature of the observational findings provide additional nuance to the ongoing debate about Cannabis’ analgesic value for chronic pain, as well as a potential substitute for opioids or other drugs”, researchers wrote. The second study, published in the Harm Reduction Journal in January 2019 surveyed  +2,000 Canadian adult medical Cannabis patients registered with federally authorised manufacturer Tilray. They completed online questionnaires about why they use Cannabis and whether they’ve used it as a substitute for other medications and substances. The exhaustive survey included 239 questions.

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About 70% said they used Cannabis as a substitute for prescription drugs, 35% for opioids, 11% for anti-depressants, 8% for anti-seizure medications, 4% for sleeping pills and muscle relaxants and 4% for benzodiazepines. A significant fraction of those who used Cannabis as an opioid substitute reported complete cessation: 59%. About 20% said they reduced their opioid usage by at least 75%. Like the US survey, the researchers asked the Canadian patients about the reasons behind their decision to substitute. Fifty-one percent said it was because they felt Cannabis was safer than pharmaceuticals they were prescribed, 40% said Cannabis had fewer adverse side effects and 20% reported better symptom management with Cannabis. Additionally, 44% of respondents said they used Cannabis to partially or completely stop using alcohol and 31% cut out tobacco. “This study offers a unique perspective by focusing on the use of a standardised, government-regulated source of medical Cannabis by patients registered in Canada’s federal medical cannabis program”, researchers wrote. “The findings provide a granular view of patient patterns of medical Cannabis use, and the subsequent self-reported impacts on the use of opioids, alcohol, and other substances, adding to a growing body of academic research suggesting that increased regulated access to medical and recreational Cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco, and other substances”. Nearly half of patients using Cannabis to help with their respective medical conditions stopped taking prescribed benzodiazepines, another study, published in the journal Cannabis and Cannabinoid Research, reported.

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“Within a cohort of 146 patients initiated on medical Cannabis therapy, 45.2% successfully discontinued their pre-existing benzodiazepine therapy”, authors wrote. “This observation merits further investigation into the risks and benefits of the therapeutic use of medical Cannabis and its role relating to benzodiazepine use”. While much research has been dedicated to understanding how medical Cannabis could potentially replace opioids for patients who deal with chronic pain and other ailments, the study suggests patients who take Valium, Xanax and other popular tranquilisers for neurological conditions (anxiety, insomnia, seizures etc) may find relief through Cannabis. Researchers in Canada conducted a retrospective analysis of data collected from a group of patients who had been referred to the Canabo Medical Clinic for medical Cannabis to treat a variety of conditions. They identified 146 patients who reported taking benzodiazepines regularly at the start of their Cannabis therapy. According to their findings, 44 patients (30%) had discontinued benzodiazepines by their first follow-up visit. Another 21 had stopped by their second follow-up visit and one more person reported doing so at the third visit. Sixty-six patients, or 45%, stopped taking benzodiazepines after starting a medical Cannabis regimen. “Patients initiated on medical Cannabis therapy showed significant benzodiazepine discontinuation rates after their first follow-up visit to their medical Cannabis prescriber, and continued to show significant discontinuation rates thereafter” the study stated. “Discontinuation was not associated with any measured demographic characteristic. Patients also reported decreased daily distress due to their medical condition(s) following prescription cannabinoids”.

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The amount of CBD and THC content did not appear to play a role in who continued to discontinue taking the tranquilisers. “The study results are encouraging and this work is concurrent with growing public interest in a rapidly developing Canadian Cannabis market”, said the lead author, Chad Purcell. The study also served as an opportunity to draw more attention to the potential risks associated with benzodiazepines, Purcell said. “I was interested in this project because it presented an opportunity to address benzodiazepines and Cannabis use, both of which are becoming increasingly socially relevant. Benzodiazepines can be effective in treating many medical conditions but unlike opioids, there seems to be little public awareness of the risks associated with these commonly used prescription medications”. According to the US Centres for Disease Control and Prevention, overdose deaths related to benzodiazepines rose 830% between 1999 and 2017. Another study (August 2018) showed how Cannabis could be an effective treatment option for both pain relief and insomnia, for those looking to avoid prescription and over-the-counter pain and sleep medications – including opioids. The study, published in the Journal of Psychoactive Drugs, looked at 1,000 people taking legalised Cannabis in an American state and found among the 65% taking Cannabis for pain, 80% found it was very or extremely helpful. This led to 82% of these people being able to reduce, or stop taking over-the-counter pain medications and 88% being able to stop taking opioid painkillers. 74% of the 1,000 bought it to help them sleep – 84% of whom said Cannabis had helped and over 83% said they had since reduced or stopped taking over-the-counter or prescription sleep aids.

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The study suggests Cannabis could lower opioid use. However, researchers caution more needs to be done to understand potential therapeutic benefits of Cannabis. “Twenty percent of American adults suffer from chronic pain, and one in three adults do not get enough sleep”, said Dr Gwen Wurm, Assistant Professor, University of Miami Miller School of Medicine. Traditional over-the-counter medications and painkillers can help, however they may have serious side effects. Opioids depress the respiratory system, meaning that overdoses may be fatal. “People develop tolerance to opioids, which means they require higher doses to achieve the same effect”, said Dr Julia Arnsten, Professor of Medicine, Albert Einstein College of Medicine. “This means that chronic pain patients often increase their dose of opioid medications over time, which in turn increases their risk of overdose”. Although less common, sleeping pills can lead to dependence and cause grogginess the next day, interfering with people’s work and social lives. As a consequence, some people are looking to Cannabis to help. To find out more about these users, Wurm and her colleagues used survey data from people who purchased Cannabis from two retail stores in Colorado, US, where it is legal for both medical and recreational use – meaning any adult over 21 with a valid government ID may purchase product. “In states where adult use of Cannabis is legal, our research suggests that many individuals bypass the medical Cannabis route (which requires registering with the state) and are instead opting for the privacy of a legal adult use dispensary”, said Wurm.

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Although the survey was conducted among customers willing to participate (meaning the results may not reflect the overall population of dispensary customers) other national survey data and data from medical patients at medical Cannabis dispensaries, demonstrates that people who use Cannabis to treat symptoms both decrease and stop their use of prescription medications. The study adds weight to the theory that widening access to Cannabis for medicinal purposes could lower the use of prescription painkillers, allowing more people to manage and treat pain without relying on opioid prescription drugs that have dangerous side effects. This is backed up with other research that shows US states with medical Cannabis laws have a 6.38% lower rate of opioid prescribing and that Colorado’s adult-use Cannabis law is associated with a relative reduction in opioid overdose death rate from 1999 to 2010. Wurm added, “Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen cause GI bleeding or kidney damage with chronic use. Paracetamol (Acetaminophen) toxicity is the second most common cause of liver transplantation worldwide and is responsible for 56,000 ER visits, 2,600 hospitalisations, and 500 deaths per year in the US”. Again, however, researchers caution more research is needed to understand the health benefits and side effects of Cannabis. “The challenge is that health providers are far behind in knowing which Cannabis products work and which do not. Until there is more research into which Cannabis products work for which symptoms, patients will do their own ‘trial and error’, experiments, getting advice from friends, social media and dispensary employees”, said Wurm.

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Adapted from Patients Are Substituting Marijuana For Addictive Pharmaceutical Drugs, Two New Studies ShowA ‘Significant’ Number Of Patients Stopped Taking Benzodiazepines After Starting Medical MarijuanaCould marijuana be an effective pain alternative to prescription medications?

THC-Free Might Not Mean Zero THC!

Image result for thc freeThere’s a buzzword alive-and-well in marketing hemp-based cannabidiol (CBD) rich products; Δ-9-Tetrahydrocannabinol (THC)-free. Industrial hemp is defined by its scant THC content, with the legal threshold in the United States being anywhere below 0.3%. The threshold set by the European Union is slightly lower at 0.2%. Switzerland says hemp should be <1% THC, Thailand says 0-3%, and wet, wild and wonderful West Virginia in the US boldly states <1% THC as well.

 

According to the Australian Government’s Office of Drug Control, hemp is a colloquial term used to describe any Cannabis plant cultivated for fibre and seed. It will generally contain very low levels of THC, but potentially high CBD. As ‘hemp seed oil’ is an extract of Cannabis seeds and does not contain any extracts from the Cannabis plant, by the Australian Government’s definition, ‘hemp seed oil’ is not a ‘drug’. 

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The Australian Government’s Office of Drug Control states ‘hemp oil is defined as an extract of Cannabis and, for the purpose of the Narcotic Drugs Act 1967 (the Act), an extract of Cannabis is any substance obtained by separation of components from a plant in the genus Cannabis. The Act implements the Single Convention on Narcotic Drugs of 1961 (Single Convention) which states an extract of Cannabis is a drug (wrongly described, however). But, by this incorrect definition, hemp oil is also a drug

The Single Convention and Australian law are silent on the levels of THC in Cannabis extracts and deems all extracts of Cannabis as drugs, regardless of specific cannabinoid levels. Therefore, in Australia, ‘hemp oil that is deemed a medicinal Cannabis product may only be accessed by prescription from a doctor granted Special Access Scheme Approval or has Authorised Prescriber status and may only be imported under a licence and permit to import. Image result for thc free

Related imageHistorically the international definition of hemp was developed by a Canadian researcher, Ernest Small, in 1971. His arbitrary 0.3% THC limit became standard around the world as the official limit for ‘legal’ hemp, after he published The Species Problem in Cannabis. In his book, Small discussed how “there is not any natural point at which the cannabinoid content can be used to distinguish strains of hemp and ‘marijuana’”. 

Despite this he continued to “draw an arbitrary line on the continuum of Cannabis types and decided that 0.3% THC in a sifted batch of Cannabis flowers was the difference between hemp and ‘marijuana’”, and this continues to add to the controversy and confusion as to what truly constitutes the difference between Cannabis and hemp.


Image result for botanical name of a plant consists of ‘Botanical Latin’ words, denoting a generic name (the genus) and the specific epithet (the species)A simple botany lesson shows the botanical name of a plant consists of ‘Botanical Latin’ words, denoting a generic name (genus) and the specific epithet (species, usually two words, can be three). Cannabis sativa L., is a member of the Cannabaceae  family.  Cannabis is the plant genus, sativa (Latin for ‘cultivated’) is the species (included in many plant species names, e.g., rice is Oryza sativa L.), and the ‘L’ (not always used) denotes the authority who first named the species, Carolus (Carl) Linnaeus, Swiss botanist considered the ‘Father of Taxonomy’. Cannabis sativa L., is;
– an annual,
– herbaceous – denoting or relating to herbs (in the botanical sense), 
– usually dioecious – either exclusively male or exclusively female,
– or monoecious – having the stamen (male, pollen-containing anther and filament) and the pistil (female, ovule-bearing) in the same plant (hermaphrodite).
Thus, as the Help End Marijuana Prohibition (HEMP) Party of Australia so rightly point out, Cannabis is a herb!


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Across the United States (and other jurisdictions where Cannabis use is legal) there are products that are technically legal to ship across state or country borders, depending on the THC potency. Perhaps to the chagrin of those seeking the entourage effect, many companies are opting for what they’re calling THC-free’, which, like caffeine-free, implies there is 0% of the substance. However, depending on how the product was created, THC-free might not really mean there’s no THC, just like caffeine-free and decaffeinated beverages are not the same. Decaf coffee still contains some caffeine.

A CBD product made with isolate might represent a true THC-free product. A broad-spectrum product that has lots of other phytomolecules like cannabinoids and terpenes requires THC removal, perhaps through a method like supercritical fluid chromatography. What’s important to know, though, is that in cases where the THC has been removed there still might be traces of it present. When a laboratory measures how much THC is in a given sample, they are limited in how low they can accurately quantify.

THC free

Labs have limits of detection and quantitation for their methods, and these metrics can vary from lab-to-lab. Additionally, there are gradients in detection technology, such as the use of ultraviolet (UV) detector versus mass spectrometry. The sensitivity of the method changes depending on the sophistication of the detection technology. What this all means is that one lab may not detect THC, while another might employ a different method that does. And while all labs can ensure compliance through measuring the required limits of THC content mentioned above, to say that a product is 100% THC-free could be misleading. One fate of this could be in workplace drug testing.

There have been many stories across North America of prospective employees losing out on a job because they bought a CBD product and tested positive for THC when drug tested. One method used by laboratories performing urinalysis (in the US) typically measures down to 50 nanograms per millilitre (ng/ml). Other thresholds might be 5 to 100 ng/ml, but regardless, these are very small concentrations. Some will measure THC metabolites in hair samples and these tests can often get to even lower quantities such as 1 picogram per millilitre (a picogram is 1/1000 of a nanogram).

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Thus it’s important to differentiate between truly THC-free products and those products where the laboratory who provided the certificate of analysis (CoA) just didn’t detect the THC with their validated method on their instrumentation. So be careful when selecting CBD products and note that if you look at the CoA of a product and next to Δ-9-THC, it says n.d., that means not detected and not necessarily free.

Adapted from Free at Last, but is it Really Free?Myth and Reality: Cannabis and Hemp

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Bioavailability of Cannabis Oils and Optimal Dosing

Most Cannabidiol (CBD) and Δ-9-Tetrahydrocannabinol (THC) oil goes to waste in the body. Amid the current frenzy in many North American jurisdictions surrounding legal Cannabis and its therapeutic benefits, it’s easy to gloss over the bioavailability of Cannabis products. Bioavailability refers to the degree and rate at which a substance is absorbed into the bloodstream to be used where needed. Physiological processes and consumption methods can affect Cannabis absorption, rendering its effects somewhat hit-and-miss. It’s critical to understand bioavailability in order to maximise the medicinal potency of Cannabis. The more bioavailable the Cannabis is, the lesser quantity of plant is required to reap all the benefits. The surge in Cannabis popularity in legal jurisdictions around the world can in part be attributed to the range of consumption methods available.

Edibles and tinctures can have less of the traditional stigma attached to them than the likes of joints, for example. However, when cannabinoids such as CBD and THC are ingested in oil form—oil is also used to make edibles—their bioavailability becomes compromised. CBD and THC oils resist absorption into the bloodstream because the human body is up to 60% water. Basic science dictates that oil and water do not mix and the same is true for Cannabis oil and the human body. “Cannabinoids are fat-loving molecules and have to traverse a cellular environment that is aqueous or watery”, explained Dr Patricia Frye, member of the Society of Cannabis Clinicians and current chief medical officer at Hello MD (US). When Cannabis is consumed as an oil, the onset of effects can become delayed and bioavailability limited.

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Another phenomenon that limits oil-based Cannabis extracts from reaching the bloodstream is the first-pass effect. When Cannabis is ingested orally, it is absorbed in the gastrointestinal tract and transported via the portal vein to the liver, where it is metabolised. As a result of this process, only a limited quantity reaches the circulatory system. Since Cannabis oil is often taken orally, its efficacy can be hindered. 
There has been some investigation into CBD, THC, and less into cannabinol, or CBN. Studies have shown the bioavailability of cannabinoids depends on the method of delivery. When applied as a topical ointment or transdermal patch, CBD can penetrate the tissue ten times more effectively than THC. The same is true of CBN. THC, however, is more bioavailable than CBD when administered orally or delivered via the lungs.

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clinical study found concentrations of THC in the bloodstream appeared 30-50% higher than CBD following oral delivery as a sublingual spray. However, bioavailability of THC is still limited and when consumed orally, averaged 4-12%. When smoked or vaped, the bioavailability of THC leaps to an average of 30%Some of the most common and convenient Cannabis products available across much of North America, such as capsules, soft gels, tinctures and edibles, limit bioavailability due to the first pass through the liver. “With edibles, absorption is slow, unpredictable and highly variable”, said Frye. “Only about 6% of the dose is absorbed. The onset of action can be as long as 6 hours; it’s very easy to take too much, and the effects can last as long as 20 hours”.

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Oral administration lasts longer than smoking, eliminating the need for frequent dosing and avoids irritation to the airways and risk of malignancies associated with smoking, for example. That said, inhaling Cannabis guarantees increased bioavailability because molecules are transported by vapour particles directly to the alveoli in the lungs. This allows cannabinoids to rapidly enter the bloodstream without being metabolised by the liver. Another lesser known method of administration is intranasal delivery, which enables cannabinoids to be easily absorbed with a rapid onset of ten minutes or less. “Intranasal methods are highly bioavailable at 34-46%”, said Frye. “It’s a particularly helpful mode of delivery for patients who are having a seizure or for patients trying to abort an impending seizure or migraine”.

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Transdermal patches can be super effective at targeting localised or systemic pain. They allow for a steady infusion of active ingredients to the delivery site, so the patient is unlikely to experience spikes of THC in the bloodstream. One method that boosts the absorption of edibles is to combine the Cannabis product with fats. Frye recommends combining edibles or tinctures with healthy fats such as guacamole, hummus, or dark chocolate. The same goes for alcohol-based tinctures. For those who smoke or vape, bioavailability can be enhanced by minimising sidestream loss and increasing the number of puffs. “Using a desktop or handheld vaporiser with flower will eliminate sidestream losses”, Frye advised. If you think you get more bang for your buck by holding your breath, think again. “There is no evidence supporting holding one’s breath for more than 10 seconds”, said Frye. 

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For those looking to optimise Cannabis bioavailability, Dr Fyre said: “The most cost-effective way to use Cannabis is not to use more than you need. Less is more”. Due to its biphasic nature, excessive dosing may exacerbate symptoms. Therapeutic Cannabis products consumed as oils or liquid capsules are more slowly absorbed with effects generally delayed for 30-90 minutes. Bioavailability of oral cannabinoids is low (10-20%) because of intestinal and first pass liver metabolism. Peak effects can occur two to four hours after consumption. Given the longer time frame, it is important to allow at least three hours between administration of single oral doses. Effects can last eight hours and as long as 24 hours. Given the slower onset and longer duration, taking therapeutic Cannabis products orally would be more useful for medical conditions or symptoms where control over longer periods of time is sought – similar to use of slow release medications.


Coconut Oil Canna Capsules

Cannabis oil capsules, infused/mixed with coconut oil, are an alternative way to therapeutically use Cannabis without having to inhale it via smoking or vaporising. Coconut oil is used due to its high amount of medium chain triglycerides (MCT) which makes it a good binding agent for the cannabinoids, not to mention its amazing health properties. Half the fat in coconut oil is comprised of lauric acid, a fat not frequently found in nature. Lauric acid has been called a ‘miracle’ ingredient due to its health promoting capabilities. Present in mother’s milk, it can be found in only three dietary sources – small amounts in butterfat and larger amounts in palm kernel and coconut oil. In the body, lauric acid is converted to monolaurin, a potent antiviral, antibacterial and anti-protozoal substance. Monolaurin, being a monoglyceride, can destroy lipid-coated viruses including measles, influenza, HIV, herpes and a number of pathogenic bacteria. Although it ‘targets’ the liver and gets processed there (metabolism), you can avoid this happening with your infusion/blend, and the ensuing metabolism of the cannabinoids (e.g. Δ-9-THC metabolises into Δ-11-THC in the liver), by a process commonly known as ‘pre-loading’. Consuming a large spoonful of coconut oil around half an hour before dosing with capsules occupies the metabolising enzymes and allows cannabinoids to enter the bloodstream and go about their business, as they are meant to, before going back to the liver.

Hempy Honeytongue,
Cannabis as Medicine and More – Its Your Life


 

According to Dr Dustin Sulak, dosage is the key factor in achieving the most benefits from Cannabis. After following thousands of patients using Cannabis therapeutically for eight years, he observed that dosing Cannabis is unlike any therapeutic agent to which he was exposed during medical training. A basic understanding of the key characteristics of Cannabis dosing can empower one to make the most of this incredibly versatile, safe and effective herb, Dr Sulak said. Some patients effectively use tiny amounts of Cannabis, while others use incredibly high doses. Dr Sulak has seen adult patients achieve therapeutic effects at 1 mg of total cannabinoids daily, while others consume over 2,000 mg daily. And while a 2000-fold dosing range is unusual for a medication, researchers have failed to kill monkeys at doses even 300 times higher than the highest dose Dr Sulak observed in the clinic.

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Within this unusually broad dosing range, Cannabis exhibits an unusual relationship between the dose and the expected response.  For most medications, a higher dose will result in a stronger therapeutic effect and a higher likelihood of adverse effects; this is described as a monophasic dose-response relationship. Cannabis simply does not follow this pattern. For most Cannabis consumers, gradually increasing their dose will at first result in stronger effects; but after a certain point (unique to each individual), subsequent dosage increases can result in weaker and weaker therapeutic effects.  Consumers who continue to increase their dosage to very high levels can often reclaim some or all of the previously lost benefit, and sometimes find additional therapeutic effects not achieved at the lower doses. Of course, ultra-high doses are much more expensive and can produce some unwanted side effects.

Most patients do much better at the lowest effective dose. For many Cannabis users, this means that less can be more. In a study of 263 opioid-treated cancer patients with poorly controlled pain, the group receiving 21 mg of combined THC and CBD each day experienced significant improvements in pain levels, more so than the group that received 52 mg daily. The group that received 83 mg daily reduced their pain no better than placebo, but experienced more adverse effects. How is this possible? The Endocannabinoid System (ECS) is a sensitive, highly tuned physiologic infrastructure designed to maintain balance at a cellular level. When the cannabinoid receptors become overstimulated by high doses of Cannabis, the cells pull the receptors inside, where they are either recycled or degraded. As cannabinoid receptor levels diminish, the effects of Cannabis will diminish as well, even (or especially) in the face of dose escalation.

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This is known as tolerance-building, something that many regular Cannabis users have experienced. The term therapeutic window describes the range between the lowest effective dose and the dose that produces unwanted or intolerable side effects. People who have little or no experience using Cannabis typically have a very narrow therapeutic window, while regular users develop a wider therapeutic window. This is due to the fact that individuals build tolerance to the various effects of Cannabis at different rates and most build tolerance to unwanted effects faster than desired effects. Cannabis also has the ability to produce opposite (or bidirectional) effects in different people, with different strains, and at different dosages. For example, anxious people who take Cannabis may relax while non-anxious people who take the same dose can become anxious.

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The same dose of two different varieties of Cannabis can cause opposite effects – one might be an awakening strain and the other might put you to sleep. CBD and THC have many overlapping therapeutic qualities, including relief of pain, anxiety, seizures and nausea, although they work via different mechanisms of action. When combined, CBD and THC can enhance each other’s benefits while reducing unwanted effects. By adding CBD to THC, the therapeutic window becomes even wider. Consumers should know, however, that the total dose of cannabinoids needed to treat a symptom or condition will also likely increase. For example, in a study of 177 patients with cancer pain, one group received an oral spray of THC, while another group received an oral spray of combined THC and CBD at an approximate 1:1 ratio. Both groups were allowed to gradually increase their dose until they experienced satisfactory relief.

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The THC group ended up using an average of 27 mg daily, while the CBD+THC group used close to 60 total mg daily, but the CBD+THC group had a superior reduction in pain. Some patients do well with ultra-high doses (hundreds or thousands of milligrams daily). THC consumers have to slowly work up to these high doses, but many patients can quickly reach high doses of CBD without adverse effects. On the other hand, ultra-low doses can be extremely effective, sometimes even more so than the other extreme. Most people are surprised to learn that the therapeutic effects of THC-dominant Cannabis can be achieved at dosages lower than those required to produce euphoria. Cannabis microdosing, taking a dose for the purpose of improving heath and productivity, has been gaining popularity across many legal jurisdictions.

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People report better mood, reduced anxiety, improved focus, enhanced resilience to stress, less pain (and/or less bothersome pain) and other benefits without any adverse effects. Most consumers find 1-5 mg works well. Some emerging evidence even suggests a practice like this could be protective against damage of a heart attack or brain injury. For new Cannabis users, Dr Sulak abides by an old adage: “Start low, go slow, and don’t be afraid to go all the way”. Dr Sulak has  developed an easy- to-follow program to help find the optimal dose, along with other useful resources available on Healer.com. If you’ve not tried non-inhaled delivery methods such as tinctures or sprays, and haven’t experimented with the combination of CBD and THC, Dr Sulak suggests both endeavours will help you continue to unlock the full power of this incredible herb.

Adapted from Most THC and CBD oil goes to waste in your body—here’s whyA Physician’s Perspective on Optimal Cannabis Dosing with Guidance for the use of medicinal cannabis in Australia: Overview and Granny Storm Crow’s List Phytocannabinoids 2015-2019 

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Safety/Toxicology Profiles of Extraction Solvents

Solvent safety in Cannabis extraction must not be underestimated. The harsh toxicology  of naphtha and other solvents led to their decline. Consumers and extractors want safe solvents and inhalation of airborne vapours is a major consideration. In the United States, Acute Exposure Guideline Levels (AEGL) are published by the National Academies of Science to help measure the toxicity of certain airborne chemicals:

  • AEGL-1: airborne concentration that causes discomfort in the general population; effects are transient and reversible
  • AEGL-2: airborne concentration that causes irreversible or serious health effects in the general population
  • AEGL-3: airborne concentration that causes death or catastrophic health effects in the general population

Airborne chemicals are usually reported in parts per million (ppm). Different time periods of exposure are also tracked, namely 10 minutes (min), 30 min, 1 hour (h), 4 h, and 8 h. The Occupational Safety and Health Administration (OSHA) and the American Conference of Governmental Industrial Hygienists (ACGIH) also publish limits for certain airborne chemicals. Cannabis extractors must also be aware that flammable vapours can cause cataclysmic explosions. Lower explosive limit (LEL) refers to the lowest concentration of vapour (as a percent of volume in air) required to spread fire given an ignition source. The extractor may not experience any negative health effects with levels of vapour capable of igniting. Monitoring vapour levels, using closed-loop extraction systems and testing for residual solvents are fundamental. Below is American data for the four most common Cannabis extraction solvents:
Image result for butane cannabis extraction

Butane (C4H10)

Hydrocarbon solvents are petroleum-derived organic compounds composed of carbon and hydrogen molecules. Butane is perhaps the most common hydrocarbon solvent in Cannabis extraction today.

Overall Toxicity: Low

  • 10-min AEGL-1: 10,000 ppm
  • 1-h, 4-h, and 8-h AEGL-1: 5,500 ppm
  • 10-min AEGL-2: 24,000 ppm
  • 30-min, 1-h, 4-h, and 8-h AEGL-2: 17,000 ppm
  • 10-min AEGL-3: 77,000 ppm
  • 30-min, 1-h, 4-h, and 8-h AEGL-3: 53,000 ppm

Symptoms: Drowsiness and slowed speech; pulmonary distress; unconsciousness; central / peripheral nervous system and cardiac effects; brain damage.

Flammability: Extremely flammable

  • LEL: 1.9% (or 19,000 ppm)

Notes: Requires Class I Division I set-up, per National Fire Code. Butane may cause  severe brain damage in developing foetuses. Vaporising residual butane in Cannabis oils produces cancerous byproducts.


Image result for propane cannabis extraction
Propane 
(C3H8)

Propane may be the second most common hydrocarbon solvent used in Cannabis extraction. Some extractors combine propane and butane.

Overall Toxicity: Low

  • 10-min AEGL-1: 10,000 ppm
  • 30-min AEGL-1: 6,900 ppm
  • 1-h, 4-h, and 8-h AEGL-1: 5,500 ppm
  • AEGL-2: 17,000 ppm (all time periods)
  • AEGL-3: 33,000 ppm (all time periods)

Symptoms: Vertigo; burning sensation; nausea; fever; respiratory distress; central nervous system depression; cardiac sensitisation (e.g., cardiac arrhythmia).

Flammability: Extremely flammable

  • LEL: 2.3% (or 23,000 ppm)

Notes: Requires Class I Division I set-up. Air displacement and asphyxia are a significant concern.


Image result for ethanol cannabis extraction
Ethanol 
(C2H6O)

Many extractors use ethanol (aka ethyl alcohol, or simply alcohol) as a standalone polar solvent; others use ethanol as part of post-processing (i.e., winterisation).

Overall Toxicity: Low

  • OSHA regulatory limit: 1,000 ppm (8-hour time weighted average)

Symptoms: Eye and skin irritation, headache, sensation of heat; rapid inebriation and narcosis; vomiting; lung irritation and injury; liver and kidney damage; central nervous system depression.

Flammability: Highly flammable

  • LEL: 3.3% (or 33,000 ppm)

Notes: Requires Class I Division I set-up. The consumption of alcohol is associated with various forms of cancer and severe brain damage to foetuses; acute/chronic vapour exposure may pose similar dangers.


Image result for carbon dioxide cannabis extraction
Carbon Dioxide 
(CO2)

Extractors modulate the temperature and pressure of CO(to sub- or super-critical states) to extract phytochemicals from Cannabis. COis ubiquitous in the natural world and present in fresh air at roughly 300 ppm (0.03%).

Overall Toxicity: Very low

  • OSHA regulatory limit: 5,000 ppm (8-hour time weighted average)
  • 10-min ACGIH limit: 30,000 ppm

Symptoms: Personality changes; reduced cognitive performance; flushed skin; vision impairment; hyperventilation/respiratory stimulation; asphyxiation and convulsions; unconsciousness; respiratory failure; circulatory arrest; coma.

Flammability: Non-flammable

Notes: Carbon dioxide is odourless and readily displaces oxygen. Unconsciousness can occur within one minute of over-exposure. Accumulation of COin the blood is known as hypercapnia.

Adapted from Safety/Toxicology Profiles of Extraction Solvents

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