cannabinoids

What is Medical Cannabis

What is Medical Cannabis (Cannabis Based Medical Products)

What is Medical Cannabis? What is it used to treat?

Cannabis Based Medical Products (CBMPs) or Medical Cannabis are medications derived from the cannabis plant, containing cannabidiol (CBD) and/or Tetrahydrocannabinol (THC – which is the psychoactive substance in cannabis). In the UK medical cannabis has been legal since 2018 for the treatment of psychological, neurological, and chronic pain conditions as well as, palliative and/or end of life care: for sake of brevity a full list of conditions treated in the UK is highlighted in eligibility section of this website.

What’s the eligibility criteria?

With cannabis based medical products (CBMPs) being unlicenced, the census would be for patients to evidence unmet clinical needs i.e., their health is not improving despite having ongoing treatment or interventions via conventional healthcare services. It is important for all patients to recognise that due to cannabis containing a psychoactive substance, for the safety of potential patients, if you have any of the diagnosis listed in the exclusion criteria, you will not be eligible. We would advise these patients to liaise with their consultants at the NHS and explore an alternative treatment method to support their health needs.

Patients have a right to a second opinion, provided they do not have any counterindications listed in the exclusion criteria below. Patient’s must be over 18 years of age.

Exclusion Criteria?  

Like all medications, CBMPs is not advisable to use if you struggle from one of the following: –

  • Suffer with high BP (If this is not stable)
  • History of psychosis
  • Diagnosis of schizophrenia
  • Heart condition (Which has NOT been stable for 6+ months)
  • Pregnant or breast-feeding

What are the side effects of medical cannabis?

Side effects of CBMPs include:

  • Drowsiness
  • Confusion
  • Imbalance
  • Euphoria
  • Diarrhea
  • Dry mouth
  • Anxiety and/or Depression
  • Heart Palpitations
  • Psychological Dependence
  • Tolerance
  • Cannabis hyperemesis syndrome (CHS)

Adverse reactions include:

  • Headaches
  • Migraines
  • Nausea
  • Vomiting
  • Diarrhoea

If you experience an adverse reaction, it is important that you report your symptoms to the MHRA via yellow card, who are the medicines and healthcare products regulatory agency. To report a yellow card, please follow this link and fill out the form: Yellow Card | Making medicines and medical devices safer (mhra.gov.uk). It is also vital that you inform your clinic, to ensure this medication is not prescribed to you again in the future.

Cannabis dependence:

Cannabis dependence is known clinically as cannabis use disorder, and user’s of any form of medicines, including medical cannabis are prone to psychological dependency.

Signs of Psychological dependence include:

  • Not using medications as prescribed -> using more than required or larger dosages and/or more frequently
  • Withdrawal
  • Developed a tolerance and require more
  • Failed repeated attempts to control or stop use
  • Physical or psychological concerns related to use (i.e., respiratory concerns or fluctuation in mood)
  • Missing relevant appointments or work to use
  • Craving for purposes other than prescribed

If you experience any of the following, please get in touch with your prescriber, so that they may manage this concern accordingly.

Cannabis Hyperemesis Syndrome (CHS)

Cannabis hyperemesis syndrome, also known as cannabinoid hyperemesis syndrome, can affect people who are exposed to prolonged, high doses of cannabis: this can also occur with medical cannabis use.

Signs of Cannabis Hyperemesis Syndrome include:

  • Intense nausea and vomiting
  • Projectile vomiting (can happen without warning, up to 5x an hour)
  • Extreme Diarrhea
  • Lack of appetite
  • Weight loss

Although this is uncommon, if you experience any of the following, please reduce use or stop where possible and urgently alert your prescriber. If symptoms are uncontrollable, please seek urgent medical intervention as you are at risk of dehydration.

Monitoring BP / Warfin prescription

Medical cannabis can for some people cause heart palpations, it is important that people with a history of high blood pressure or a heart condition to be mindful of this, particularly those on warfarin as cannabis can impact the liver enzymes, interacting with other medications. It is important that you work alongside your GP and relevant health care professionals to adequately address your heart.

If you are someone who meets this criterion, regularly monitoring your blood pressure would aid in ensuring your safety and enables you to appropriately reach out for support.

Blood pressure guidance:

Low 90/60 or below Inform GP and clinic, if unwell seek medical attention
Ok 90/60 – 140/90 Continue to monitor – update clinic at FUP appointment
Raised 141/91 – 179/119 Raised, monitor and inform GP and clinic
High 180/120 or more Significant risk, needs urgent review – update GP and clinic

 

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Water Activity: A Guide for Medical Cannabis Producers

Water Activity: A Guide for Medical Cannabis Producers 

Introduction

As the global demand for medical cannabis continues to surge, the attention to quality control measures becomes increasingly critical. One such parameter gaining prominence in the cannabis industry is water activity (aw). This blog delves into the multifaceted role of water activity, extending beyond its conventional association with edibles and food safety. Specifically, we explore its impact on microbial stability, storage stability of harvested buds and extracts, its correlation to product quality attributes, and its implications for shelf life. Additionally, we discuss its current inclusion in state regulations and emphasise the need for a holistic understanding of water activity in the cannabis industry.

The Theory of Water Activity

Water activity is not a novel concept but is deeply rooted in the fundamental laws of thermodynamics, as per Gibb’s free energy equation. It represents the relative chemical potential energy of water in a system, measured by the partial vapour pressure of water in a headspace at equilibrium with the sample. This comprehensive understanding helps differentiate water activity from moisture content, with water activity providing a more accurate indication of microbial, chemical, and physical stability in cannabis products.

Water Activity and Microbial Safety

Microbial contamination poses a significant threat to cannabis products, leading to allergic reactions, respiratory complications, or food borne illnesses. Water activity serves as a critical control point for preventing microbial contamination, dictating the ability of microorganisms to grow and reproduce. While moisture content is an extensive property related to purity, water activity is an intensive property directly influencing microbial growth limits. Establishing water activity below 0.63 aw is crucial for ensuring shelf stability, preventing the growth of pathogenic bacteria and moulds that could compromise product safety.

Water Activity and Chemical Stability

Water activity is not only a guardian against microbial growth but also a determinant of chemical stability in cannabis products. Processing biomass and edibles to water activities below 0.63 aw mitigates the risk of microbial spoilage but doesn’t guarantee unlimited shelf life. Chemical degradation, such as tetrahydrocannabinolic acid (THCA) loss due to decarboxylation, becomes a pertinent concern. Water activity influences reaction rates, with lower water activity correlating with minimised chemical degradation. The hygrothermal time model is a valuable tool for predicting reaction rates and establishing the ideal water activity range for maximising shelf life while minimising chemical degradation.

Water Activity and Storage Stability

Harvested cannabis must be adequately dried to facilitate storage and transport. Water activity below 0.63 aw is essential to prevent mould growth, particularly in dried biomass. Adequate packaging, with good moisture barrier properties, becomes imperative to preserve water activity levels during storage and transport.

Water Activity and Regulations

While water activity is recognised for its role in ensuring the safety and stability of cannabis products, its inclusion in state regulations varies. States like Nevada, California, Oregon, and Washington have incorporated water activity testing requirements into their regulations. Additionally, ASTM standards have been established to standardise water activity testing in the cannabis industry, emphasising its importance in maintaining product quality and safety.

Conclusion

In the dynamic landscape of the medical cannabis industry, water activity emerges as a versatile and indispensable parameter. Its influence extends from microbial safety to chemical stability, storage stability, and overall product quality. For medical cannabis producers eyeing the UK market, understanding and controlling water activity is not just a standard to maintain but a strategic move to ensure the longevity, safety, and efficacy of their products. As the industry continues to evolve, embracing the multifaceted significance of water activity will undoubtedly set exporters apart, fostering a reputation for excellence and reliability in the global market.

References

  1. D.S. Reid, Water Activity in Foods (Blackwell Publishing and the Institute of Food Technologists, Ames, Iowa, 2007) pp. 15–28.
  2. A.J. Fontana, Water Activity in Foods (Blackwell Publishing and the Institute of Food Technologists, Ames, Iowa, 2007) pp. 155–171.
  3. M.S. Tapia, S.M. Alzamora, and J. Chirife, Water Activity in Foods (Blackwell Publishing and the Institute of Food Technologists, Ames, Iowa, 2007) pp. 239–271.
  4. L. Beuchat, J. Food Prot.46(2), 135–141 (1983).
  5. W. Scott, Adv. Food Res.7,83–127 (1957).
  6. National Cannabis Industry Association. https://thecannabisindustry.org/ncia-news-resources/state-by-state-policies/. (June 2019).
  7. H. Lueng, Water Activity: Theory and Applications to Food (Marcel Dekker, Inc., New York, New York, 1987) pp. 27–45.
  8. B.P Carter, R.M. Syamaladevi, M.T. Galloway, G.S. Campbell, and S.S. Sablani, Proceedings for the 8th Shelf Life International Meeting, U. Klinkesorn, Ed. (Bangkok, Thailand: Kasetsart University, 2017) pp. 40–45.
  9. H. Eyring, J. Chem. Phys.4, 283 (1936).
  10. The What, How, and Why of Water Activity in Cannabis. https://www.cannabissciencetech.com/view/what-how-and-why-water-activity-cannabis/ (December 2023).
  11. Water Activity And Cannabis. https://aqualab.com/en/knowledge-base/webinars/water-activity-and-cannabis/ (December 2023),

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Dosing Guidance for Dry Herb Vaporising

Dry herb vaporising offers a precise and efficient way to consume cannabis, allowing users to experience the therapeutic benefits of cannabinoids and terpenes without the potential harms associated with smoking. To ensure a safe and enjoyable vaporising experience, it’s essential to understand the boiling points of various terpenes and cannabinoids and how they impact the effects of cannabis.

Importance of Temperature Control
Temperature control is a critical aspect of dry herb vaporising, as different compounds in cannabis vaporise at specific temperatures. By adjusting the temperature, users can target specific cannabinoids and terpenes to customise their experience.

Boiling Points of Common Cannabinoids

Cannabinoid Boiling Point (°C)
THC 157°C
CBD 160-180°C
CBG 52-65°C
CBN 185°C
CBC 220°C
THCV 220°C

Boiling Points of Common Terpenes

Terpene Boiling Point (°C)
Myrcene 167°C
Limonene 176°C
Pinene 155°C
Linalool 198°C
Caryophyllene 130°C
Humulene 198°C
Terpinolene 185°C
Bisabolol 329°C
Eucalyptol 176°C
Guaiol 167°C
Nerolidol 161°C
Phytol 160°C

Dosage and Temperature Recommendations:

Cannabinoid / Terpene Temperature Range (°C) Potential Effects and Benefits
THC 157°C Euphoria, Relaxation, Pain Relief
CBD 160-180°C Anti-inflammatory, Anxiolytic, Anticonvulsant
CBG 52-65°C Neuroprotective, Anti-inflammatory, Potential Antibacterial Effects
CBN 185°C Mild Sedation, Potential Sleep Aid
CBC 220°C Anti-inflammatory, Potential Antidepressant Effects
THCV 220°C Potential Appetite Suppressant, Anticonvulsant
Myrcene 167°C Sedating, Relaxing, Potential Anti-inflammatory Effects
Limonene 176°C Uplifting, Mood-Enhancing, Potential Antioxidant Effects
Pinene 155°C Alertness, Memory Enhancement, Potential Bronchodilator
Linalool 198°C Calming, Stress-Reducing, Potential Analgesic Effects
Caryophyllene 130°C Anti-inflammatory, Potential Gastro-protective Effects, No Psychoactive effects
Humulene 198°C Anti-inflammatory, Potential Appetite Suppressant
Terpinolene 185°C Uplifting, Potential Antioxidant and Anticancer Effects
Bisabolol 329°C Calming, Potential Anti-inflammatory and Antioxidant Effects
Eucalyptol 176°C Potential Anti-inflammatory and Analgesic Effects
Guaiol 167°C Potential Anti-inflammatory and Antioxidant Effects
Nerolidol 161°C Calming, Potential Sedative and Anti-fungal Effects
Phytol 160°C Potential Antioxidant and Anti-inflammatory Effects

Dosage Recommendations
Dosage for dry herb vaporising depends on several factors, including individual tolerance, desired effects, the potency of the cannabis strain and prescriber’s guidance. Start with a low dose and gradually increase until the desired effects are achieved.

Safety Considerations
Always use a reputable vaporiser with accurate temperature controls to ensure precise dosing and avoid combustion. High temperatures (above 230°C) may produce harmful by-products and should be avoided.

Conclusion
Dry herb vaporising provides a customisable and controlled method of cannabis consumption. Understanding the boiling points of cannabinoids and a wide range of terpenes allows users to fine-tune their experience and target specific effects. Start with low temperatures and dosage, gradually increasing as needed, to enjoy the full potential of cannabinoids and terpenes while minimising potential adverse effects.

Disclaimer: The information provided in this context is intended for general informational purposes only and should not be construed as medical advice under any circumstances. It is essential to consult with a qualified healthcare professional or medical practitioner before making any decisions or taking any actions related to medical treatment or dosing. The content here does not replace professional medical guidance, and any reliance on the information presented is at your own risk. We strive to maintain accuracy and up-to-date information; however, we do not warrant the completeness, reliability, or validity of the information provided. Therefore, we disclaim any liability for any adverse outcomes or damages arising from the use or misuse of the information mentioned here. Always seek personalised medical advice from a licensed healthcare provider for your specific medical condition or situation.

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Hexahydrocannabinol (HHC): Exploring the Potential Medical Applications of this Novel Compound

Hexahydrocannabinol (HHC) Structural Formula
Hexahydrocannabinol (HHC) Structural Formula

Introduction

In the rapidly advancing field of medical cannabis, researchers and manufacturers continuously explore new cannabinoids with the potential for therapeutic benefits. Hexahydrocannabinol (HHC), a lesser-known compound found in cannabis plants, has attracted attention due to its unique properties and potential medical applications. This comprehensive blog post aims to provide medical cannabis patients and academics with an in-depth understanding of HHC, including its definition, pros and cons, sources, manufacturing processes, and potential medical uses.

What is Hexahydrocannabinol (HHC)?

Hexahydrocannabinol (HHC) is a naturally occurring cannabinoid found in cannabis plants. Structurally similar to delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis, HHC features a slightly altered molecular structure. Like other cannabinoids, HHC is derived from cannabigerolic acid (CBGA), the precursor molecule for various cannabinoids in the cannabis plant.

Pros of Hexahydrocannabinol (HHC)

  1. Therapeutic Potential: Preliminary research suggests that HHC may possess therapeutic properties, including analgesic (pain-relieving), anti-inflammatory, and anti-anxiety effects. Further studies are necessary to investigate its potential in treating specific medical conditions.
  2. Alternative to THC: HHC provides an alternative for patients who may experience adverse effects or discomfort associated with high levels of THC consumption. It may offer a more balanced and subtle psychoactive experience while potentially reducing THC-related side effects.
  3. Novel Cannabinoid: HHC expands the range of cannabinoids available for researchers to explore, contributing to our understanding of the complex chemistry of cannabis and its medicinal applications. It presents an exciting opportunity to uncover new therapeutic possibilities.

Cons of Hexahydrocannabinol (HHC)

  1. Limited Research: As a relatively new cannabinoid, scientific research on HHC remains limited. This lack of comprehensive studies makes it challenging to fully assess its safety profile, potential side effects, and long-term impacts. Further research is needed to evaluate its efficacy and safety in various medical contexts.
  2. Regulatory Status: The legal and regulatory status of HHC may vary across different jurisdictions. It is crucial for patients and consumers to adhere to local laws and regulations regarding the use and possession of HHC-containing products. Engaging in transparent and open communication with healthcare professionals is essential.

Sources of Hexahydrocannabinol (HHC)

HHC can be found in cannabis plants, albeit in relatively low concentrations compared to other cannabinoids like THC and CBD. It is primarily obtained through specialized cultivation techniques and genetic selection to enhance HHC production in specific cannabis strains. Cultivators employ careful breeding strategies to optimize the production of this unique cannabinoid.

Manufacturing Hexahydrocannabinol (HHC)

The manufacturing process for HHC involves several crucial steps, including extraction, isolation, and purification. Here is a detailed overview of the process:

  1. Extraction: The initial step involves extracting the desired cannabinoids, including HHC, from cannabis plant material. Common extraction methods include solvent-based techniques such as hydrocarbon or ethanol extraction. These methods help separate the cannabinoids from the plant material, resulting in a crude extract.
  2. Isolation: Following extraction, the crude cannabinoid extract undergoes further purification to isolate HHC. Techniques like chromatography, crystallization, or distillation are employed to separate HHC from other cannabinoids and impurities present in the crude extract. The specific isolation method may vary based on the desired purity and intended application of the HHC.
  3. Purification: To obtain a high-purity form of HHC, additional purification steps are necessary. Filtration techniques, solvent removal, and further chromatographic separations can be employed to remove residual impurities and enhance the purity of the HHC isolate.
  4. Formulation: Once the purified HHC is obtained, it can be incorporated into various delivery systems such as oils, tinctures, capsules, or topical products, depending on the desired application and patient needs. These formulations enable convenient and precise dosing for medical cannabis patients.

Potential Medical Applications of Hexahydrocannabinol (HHC)

While research on HHC is still in its early stages, several potential medical applications have been proposed based on the known effects of cannabinoids. These potential applications include:

  1. Pain Management: HHC’s analgesic properties may make it a potential candidate for managing chronic pain conditions. Further research is needed to evaluate its effectiveness in different pain syndromes and compare it to existing treatments.
  2. Inflammation: Studies suggest that HHC might possess anti-inflammatory properties, which could be explored in the treatment of inflammatory conditions such as arthritis and inflammatory bowel disease (IBD).
  3. Anxiety and Mood Disorders: HHC’s potential anxiolytic effects may offer benefits in managing anxiety and mood disorders. Further research is necessary to explore its efficacy, safety, and optimal dosing regimens.
  4. Neurological Disorders: Given the complex interaction between cannabinoids and the endocannabinoid system in the brain, HHC could be investigated for its potential in neuroprotective and neurodegenerative disorders like epilepsy, multiple sclerosis (MS), and Parkinson’s disease.

Conclusion

Hexahydrocannabinol (HHC) represents a novel cannabinoid that holds promise for therapeutic applications within the field of medical cannabis. While research on HHC is still limited, its potential benefits and unique properties warrant further investigation. Medical cannabis patients considering the use of HHC-containing products should consult healthcare professionals and adhere to local laws and regulations. As scientific knowledge expands, a better understanding of HHC’s advantages, drawbacks, and optimal medical applications will emerge, contributing to the advancement of cannabis-based therapies.

Sources

  1. Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344-1364.
  2. Navarro, G., et al. (2020). Cannabigerol action at cannabinoid CB1 and CB2 receptors and at CB1–CB2 heteroreceptor complexes. Cannabis and Cannabinoid Research, 5(1), 66-75.
  3. Hazekamp, A., et al. (2016). Cannabis—From cultivar to chemovar II: A metabolomics approach to cannabis classification. Cannabis and Cannabinoid Research, 1(1), 202-215.

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A Table To Help Manage ECS

Understanding the Endocannabinoid System

Introduction

The endocannabinoid system (ECS) plays a crucial role in maintaining balance and homeostasis within our bodies. It consists of a complex network of receptors, endocannabinoids, and enzymes that interact with cannabinoids found in cannabis plants. For medical cannabis patients in the UK, understanding the ECS is essential for maximising the therapeutic benefits of cannabis-based treatments. In this article, we will delve into the intricacies of the endocannabinoid system, its functions, and how it relates to medical cannabis.

The Endocannabinoid System: An Overview

The ECS is composed of three primary components: endocannabinoid receptors, endocannabinoids, and enzymes. The two main receptors within the ECS are CB1 and CB2 receptors. CB1 receptors are primarily found in the central nervous system, while CB2 receptors are predominantly located in the immune system and peripheral tissues. Endocannabinoids, such as anandamide and 2-arachidonoylglycerol (2-AG), are naturally occurring compounds produced within our bodies that bind to these receptors. Enzymes, specifically fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), break down endocannabinoids once their purpose is served.

Functions of the Endocannabinoid System

The ECS plays a vital role in regulating numerous physiological processes, including:

a. Pain and Inflammation: Activation of CB1 receptors in the central nervous system can help modulate pain perception, while CB2 receptors in the immune system regulate inflammation and immune responses.

b. Mood and Stress: The ECS influences mood regulation by interacting with neurotransmitter systems. Activation of CB1 receptors has been associated with the alleviation of anxiety and depression symptoms.

c. Sleep and Appetite: The ECS is involved in the regulation of sleep-wake cycles and appetite. CB1 receptors in the hypothalamus and limbic system influence food intake and energy balance.

d. Memory and Learning: The ECS is implicated in memory formation and neuroplasticity. CB1 receptors in the hippocampus and cerebral cortex contribute to these cognitive functions.

Medical Cannabis and the Endocannabinoid System

Medical cannabis, containing cannabinoids such as tetrahydrocannabinol (THC) and cannabidiol (CBD), interacts with the ECS to exert its therapeutic effects. THC binds to CB1 receptors, producing psychoactive effects and influencing pain perception, appetite, and mood. CBD, on the other hand, has a low affinity for both CB1 and CB2 receptors but modulates the ECS indirectly by interacting with other receptor systems. CBD has shown promise in reducing seizures, managing pain and inflammation, and aiding with anxiety and sleep disorders.

Optimising Medical Cannabis Use in the UK

For medical cannabis patients in the UK, optimising the use of cannabis-based treatments involves several key considerations:

a. Strain Selection: Different cannabis strains contain varying ratios of cannabinoids and terpenes, each with unique therapeutic properties. Working with a healthcare professional or pharmacist experienced in medical cannabis can help identify the most suitable strains for individual conditions.

b. Dosage and Administration: Accurate dosing is essential to achieve desired therapeutic effects while minimising side effects. Patients should start with low doses and gradually increase until they find their optimal dosage. Various administration methods, such as inhalation, oral ingestion, and topical application, offer different onset times and durations.

c. Monitoring and Adjusting: Regular monitoring of symptoms and side effects is crucial to evaluating treatment efficacy. Adjustments to dosage, strain, or administration method may be necessary to optimise therapeutic outcomes.

A Table To Help Manage ECS

Optimising Your Endocannabinoid System (ECS): A Comprehensive Guide on Evidence-Based Interventions →

Conclusion

Understanding the endocannabinoid system is fundamental for medical cannabis patients in the UK seeking effective relief from various conditions. By comprehending how the ECS functions and interacts with cannabinoids, patients can make informed decisions about strain selection, dosing, and administration methods. Additionally, working closely with healthcare professionals ensures safe and personalised treatment plans. The evolving landscape of medical cannabis research may further enhance our knowledge of the ECS and unlock new possibilities for therapeutic interventions in the future.

References:

  1. Pacher, P., & Kunos, G. (2013). Modulating the endocannabinoid system in human health and disease: successes and failures. The FEBS Journal, 280(9), 1918–1943.
  2. Pertwee, R. G. (2008). The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. British Journal of Pharmacology, 153(2), 199–215.
  3. Russo, E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and Clinical Risk Management, 4(1), 245–259.
  4. Zuardi, A. W. (2008). Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Revista Brasileira de Psiquiatria, 30(3), 271–280.

More Cannabis Science

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