Standardized Cannabis And Pain Management

[in vivo]

Standardized Cannabis and Pain Management

A. Paul Hornby

Hedron Analytical Inc.Canada

 

1. Introduction

We began our journey researching cannabis as a medicine roughly twelve years ago and

have been astounded time and time again at the profound effectiveness of the plant. In this

chapter we will describe the usefulness of cannabis in pain management. In so doing we will

be describing the whole plant medicine such as is dispensed in compassion clubs and medical

marijuana dispensaries here in British Columbia, Canada and similarly in California and

other parts of the world where cannabis has become legal as a medicine.

 

We treat cannabis as the herbal medicine that it is. What we do; is apply high tech

instrument analysis of the plant and scientific method to members using cannabis

therapeutically in attempts to unravel the truth of its efficacy and safety. We have set up

research departments, collected membership data, run literally thousands of chromatograms

and worked closely with persons with chronic pain at local dispensaries and cannabis clubs

here in British Columbia for many years.

 

What we will describe in the chapter is primarily repeated observation of members of

medical marijuana dispensaries who routinely use cannabis to deal with pain. Of the clubs

we have worked with over the years most of their members are using cannabis for pain

management. Often greater than 70% of the members surveyed will be using cannabis for

this purpose. This holds true for medical dispensaries here in B.C. as well as for California,

Holland and Switzerland (1). Simply put, most persons frequenting medical cannabis

dispensaries are there for pain management.

 

Many of the people we have worked with over the years have been terribly broken up,

either in car accidents, on the job injuries, infection (Reiter’s syndrome), surgeries or cancer

therapy, plus many other causes, that lead to 24/7 chronic pain. As if the pain isn’t bad

enough, often cycling with the pain is mood disorder, such as depression, attention deficit

disorder and anxiety.

 

When it is difficult to put on a jacket, climb a flight of stairs or tie shoelaces, normal life is

affected and the individual adjusts by changing their life style in attempts to relieve pain.

These adjustments can often bring on anxiety (not being able to go out) or depression

(relating to friends and family) since now the person’s lifestyle is not as it used to be…now it

is ruled by pain.

 

For those dealing with pain it often becomes a fulltime job: monitoring, medicating, resting,

exercising, eating, going to bed, take on new meaning when one is in pain. Constantly

seeking relief from “the banging drum,” as quoted by Dr. Mel Pohl (2), being the top

priority for those who suffer. Relief from pain leads to a new quality of life that, in turn,

breaks the cycle of chronic pain syndrome.

 

Cannabis allows new quality of life for many suffering from chronic pain.

Having access to the member’s data allows determination of; how much cannabis they’re

using daily, in what form (smoke able or edible), what strain is preferred, their ailment, etc.

This accumulated data is used to take perspective on the cannabis use of the membership of

the individual clubs and to track various individuals included in studies.

 

We have spent five years with our laboratory serving the quality control and

standardization needs of one such dispensary, and the past two doing similar duties and

research at a second. In all of this time we maintain close association with the members who

use cannabis therapeutically for pain, tracking their symptoms with questionnaires,

interviews, pain charts, emails, etc.

 

We have found a psychology that prevails at these dispensaries; they’re friendly, nonviolent,

people whom all seem to be willing to take part in the scientific research that is

being carried out. No shortage of volunteers. And many have sustained and continue to

deal with disabling injuries that have dramatically affected their lives and families.

 

Currently we have joined with five medical dispensaries in our local area and are initiating

Randomized Controlled Trials (RCT) with roughly one hundred volunteer subjects together

taking part in the placebo controlled trial. Our focus will be arthritic pain and we look

forward to publication before the end of 2012.

 

http://cdn.intechopen.com/pdfs/32438/InTech-Standardized_cannabis_and_pain_management.pdf

[Wild Bill]

Standardization seems impractical. There are so many different strains and so many phenotypes of each strain.

 

In addition, even among the same strain and pheno there are differences created by growing conditions.

Take two cuts off of the same plant, grow one inside under lights and grow the other one outside, you'll see a difference.

 

If a strain is taken from the wild in one area of the world and introduced to another area it will eventually take on the characteristics of those strains native to the area where it was introduced.

 

This is one of the reasons the mainstream medical community gives against medical use of cannabis, every dose isn't the same. It's also one of the reasons it's sometimes difficult to find a strain that works for your particular ailment.

 

There are probably an infinite number of combinations possible between the various cannabinoids, terpenes etc.

 

The cannabis plant is not like our standard pharmaceutical medicines. It is not a single ingredient magic bullet, it's more like a whole pharmacy.

[in vivo]

I appreciate your participation.

 

I don't think anyone would dispute the notion that the combined total of all of the compounds in cannabis is greater than the sum of their parts. At the same time, there are compounds that have been identified as having varying therapeutic properties. With the information that's currently available we can certainly increase the therapeutic value delivered to patients by making more educated guesses in regards to cannabinoid based therapies.

 

I think a layman could establish a processing regiment that would result in a relatively standardized concentrate from chemovars grown under similar conditions. It might not be of much use to a patient that smokes of vaporizes cannabis, but if you're utilizing oral, sublingual, or topical applications, I can see benefits to standardizing doses.

Edited September 13, 2013 by in vivo

[Wild Bill]

I think a layman could establish a processing regiment that would result in a relatively standardized concentrate from chemovars grown under similar conditions. It might not be of much use to a patient that smokes of vaporizes cannabis, but if you're utilizing oral, sublingual, or topical applications, I can see benefits to standardizing doses.

 

You can standardize the dose within a particular strain, but a dropper full of tincture made with 1 pint of alcohol and 1 ounce of White Widow will not give you the same effects as a tincture made with 1 pint of alcohol and one ounce of Hash Plant.

 

Even within the same strain a weeks difference in harvest time can make a difference in potency. And you can't really harvest by how long they have been growing due to environmental factors, sometimes the same strain will take longer to grow to the same point.

Edited September 13, 2013 by Wild Bill

[in vivo]

I agree completely.

 

I'm interested in pairing compounds from different chemovars. For instance, I only have one plant that I can isolate CBD from. But what if the terpene profile from another plant added to it would deliver more medicinal value? A person would need to have relatively standardized doses in order to explore those types of possibilities. 

Edited September 13, 2013 by in vivo

[Shaun485]

A report released in the Canadian Medical Association Journal has suggested that medical marijuana could be utilized to alleviate the actual painful muscle contractions a result of multiple sclerosis. It might likewise lessen other muscle spasms.

[trichcycler]

please explain the process of "isolating CBD"?

[in vivo]

I've not played with isolating cannabinoids. I should have said procure rather than isolate. One process for isolation is described here (page 45):

 

https://openaccess.leidenuniv.nl/bitstream/handle/1887/12297/Thesis.pdf?sequence=1#page=45

[GregS]

As far as I'm concerned, trying the different strains and effects are part of the fun.