W8 Cannabis (AG)

Question 1

What is Cannabis?

Answer 1

It is a plant that is made up of more than 400 chemical constituents, including…
* Cannabinoids
* Terpenoids
* Phenolic compounds
* Nitrogenous compounds
* Amino acids
* Steroids
* Hydrocarbon

70 of these chemical constituents have potential for medical use
American term= marijuana

Question 2

Cannabis chemovars:

Answer 2

Most accepted viewpoint- Monotypic genus which consists of a single species- cannabis sativa

Sativa, Indica, Ruderalis

subspecies= sativa and indica
sativa- taller, pale green colour

Question 3

Cannabis breeding:

Answer 3

• Plants are distinctly male or female
• Therefore, cannabis plants are predisposed to outcrossing as opposed to self-pollination, which is the primary means of fixing desirable traits in other species
• Selective breeding of cannabis as a source of seeds, fibre and drugs
• Understanding the inheritance of chemical phenotype (chemotype) for the most clinically relevant cannabinoids has been central to modern medicinal cannabis and hemp breeding.

3 main chemotypes

Question 4

Phytocannabinoids e.g. THC and CBD
What are they responsible for?

Answer 4

Cannabidiol (CBD)
- Responsible for the calming characteristics of cannabis.
- It is not regulated under the Drugs Misuse Act and is classed as a medicine.

Tetrahydrocannabinol (THC)
- Responsible for the intoxicating effects of cannabis.
- Classified as a Class B drug.

Question 5

Cannabis-based product types?

Answer 5

Psychoactive use
Alimentary use
Medicinal yses
Fiber use
Other uses

Question 6

Medicinal cannabis products:

Answer 6

1. Cesamet and Canemes
   -cont nabilone
2. Marinol and Syndros
   -cont dronabinol
3. Sativex
   -cont nabiximols
4. Epidiolex
   -cont cannabidiol (plant-based CBD)

Question 7

Cannabis preparations:

Answer 7

• Raw cannabis
• Magistral preparations
• Standardised cannabis

These are variable in THC/CBD composition

Question 8

Cannabis based medicinal products
Current practice:
Who should prescribe?

Answer 8

Initial prescription of cannabis-based medicinal products (excluding nabilone, Sativex and CBD) must be made by a specialist medical practitioner (a doctor included in the register of specialist medical practitioners [the Specialist Register]. They should also have a special
interest in the condition being treated.

Question 9

What are some cannabis-based product types?

Answer 9

Edibles
E-liquid
Non-prescription products

(not licensed)

Question 10

Consumer products containing CBD are safe? (for info)

Answer 10

• Consumer products containing CBD are sold directly to consumers in high-street shops and online without a prescription
• They include food and cosmetic
  products
• They are available in different over-the-counter formulations

Question 11

Are edible cannabis-containing products safer than other forms?

Answer 11

No
Ingestion vs inhaling:
Ingestion/eating has a delayed onset of drug effect

Question 12

Are Consumer products-containing CBD safe?

Answer 12

Studies have shown that:
* They may contain traces of THC
* They may contain unclaimed contaminants and adulterants
* They can interact with medicines!

Analysis of applications submitted to EFSA showed uncertainties related to:
* CBD interactions and biological effects
* The CBD matrix and its effect on the substance’s bioavailability
* The impact of long-term consumption
* Impact on the liver, the reproductive and endocrine systems
* Oral intake of CBD sometimes causes diarrhoea, vomiting, nausea, GI discomfort, or
constipation in humans; the reason for this is not well-understood
* CBD may have neurological, psychiatric, and psychologic effects due to CBD’s
interaction with molecular targets and signalling pathways
* Genotoxicity?

Question 13

Are Consumer products containing CBD addictive?

Answer 13

THC content and its impact

Question 14

Consumer products containing CBD are not intoxicating?

Adverse effects due to a conversion of CBD to THC in the gut?

Answer 14

This was a rumour. Studies showed that this conversion does not occur.

Question 15

Consumer products containing CBD are regulated?

Answer 15

• EFSA regulations
• UK FSA regulations
• Novel food products

Question 16

Consumer products containing CBD have numerous health benefits?

Answer 16

No, this is clever marketing and online news article
Not enough evidence to believe this. Not completely safe either due to their side effects

Question 17

Is Hemp seed oil is the same as CBD oil?

Answer 17

Hemp seed oil
* Made from the seeds of the plant
* It contains no active CBD or any other cannabinoids or terpenes
* Sometimes hemp seed oil is used as a carrier oil for CBD oils

CBD Oil:
* Is made from the unfertilised flower of the plant
* It contains high concentrations of CBD and related cannabinoids
* CBD oils are the primary medicinal preparation of the hemp plant

Question 18

Summary:

Answer 18

• Consumer products containing CBD have questionable safety
• Consumer products containing CBD may contain intoxicating cannabinoids
• Consumer products containing CBD are regulated before they are marketed
• Hemp seed oils are different from CBD oils
• Research is needed to confirm health benefits of the cannabis plant constituents

Question 19

Test your knowledge - Example SAQ
Consumer products containing CBD are becoming very popular and are widely sold in health food shops.
1. Comment on the safety of these products, highlighting whether they can be addictive and whether they have health benefits.
2. Comment on how they are regulated?

Answer 19

1. They have a lot of side effects. There is not enough evidence of their health bemefits and we do not know if there are long-term side effects
2. Regulated by 3 regulatory companies
   EFSA regulations, UK FSA regulations and Novel Food Products