The Business of Medical Cannabis T

he Barbados International Business Association in reviewing global business trends has identified that the business of medical cannabis is an industry that could be beneficial to Barbados. The current legal framework in Barbados would need to be amended to permit business opportunities from this area and this is currently receiving the attention of the Government of Barbados.

We interviewed two leading experts on medicinal cannabis, Steve Naraine and Dr. Damian Cohall, in order to understand the drug, its medicinal uses and business opportunities.

Introduction to the Cannabis plant

1.What is the Cannabis plant?

The Cannabis plant refers to a single species, Cannabis sativa, along with any of three subspecies of the flowering plant, ssp. indica, ssp. sativa, and ssp. ruderalis.

2.What makes cannabis plant such a topical plant?

The Cannabis plant has bioactive compounds with health-based properties. The medicinally relevant compounds within the Cannabis plant are known as phytocannabinoids. There are approximately 120 phytocannabinoids identified in the plant and the two most popular bioactive compounds are delta-9tetrahydrocannabinol (THC) and cannabidiol (CBD).

Usefulness

3.Where did its use originate?

The use of Cannabis sativa dates to 3000 BC on the continents of Asia and Europe.

4.What is medical cannabis?

Medical cannabis refers to the use of the whole, unprocessed Cannabis plant or its basic extracts or derivatives of phytocannabinoids to treat symptoms of illness and other conditions.

5.How do the phytocannabinoids produce their health-based effects?

The phytocannabinoids bind to cannabinoid receptors, CB1 and CB2, in the endocannabinoid system (ECS) in the central nervous system. These receptors can also be found at peripheral sites in the body. The ECS is activated naturally by endocannabinoids such as anandamide. The ECS is involved in a variety of physiological processes including appetite stimulation, analgesia and pleasure sensation, and the modulation of the immune system, mood and memory.

Medical properties of THC/CBD

6.What medical uses have been associated with the use of cannabinoids?

The USFDA has approved four cannabinoid compounds for their medicinal properties.

•Epidiolex (CBD) for the treatment of epileptic seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in patients 2 years of age and older

•Marinol and Syndros (Dronabinol [synthetic THC]) for therapeutic uses in the United States, including for the treatment of anorexia associated with weight loss in AIDS patients

•Cesamet (Nabilione [synthetic THC]) for nausea and emesis associated with cancer chemotherapy

There has been culpable evidence, which shows the usefulness of cannabinoid therapy in chronic, neuropathic and cancer related pain, spasticity related to Multiple Sclerosis or Paraplegia and appetite stimulation in cancer patients.

7.How is medical cannabis administered?

Medical cannabis can be administered by a variety of formulations which may include vapours, tinctures, oromucosal sprays, oral forms, transdermal patches, ointments and suppositories.

Medical Cannabis Industry

8.What are the most important guiding principles for the development of local medical cannabis industry?

•A local cannabis industry must be people-centered to ensure protection of patient and public safety;

•It should be guided by differentiating between medical cannabis and recreational cannabis use;

•Research and evidence-based approaches are important to ensure the best care to patients while reducing risks associated with therapy;

•The supply chain must be secured to maintain the integrity of the product, enable traceability and limit diversion to black markets.

9.What opportunities are present in a local medical cannabis industry?

A local medical cannabis industry must prioritise patient and public safety. It should be regulated to confirm efficacy and safety for consumption by authorised patients. These are some of the opportunities of a local cannabis industry:

•Efficacious and safe drugs will be accessible by patients who need the medicine;

•There will be opportunities for businesses to manage the supply chain from licensed suppliers to licensed dispensaries and retailers;

•Barbados is known as a global services hub in the Eastern Caribbean and will benefit by providing intellectual property, banking and other business solutions to help build the sector;

•The University of the West Indies, Cave Hill, will benefit through research to optimize the development of local cultivars and efficacious and safe products. The university could also benefit from the delivery of educational programmes to industry players, from growers to quality assurance specialists;

•Potential tax and other income generation for the Government from its regulatory and licensure policies and procedures for the industry;

•A potential source for developing alternative energy by the use of the biomass of cannabis after extraction; and

•A textile and garment industry from the post extracted raw material

10.What are the potential niche markets in the global value chain that can be capitalised?

Potential niche markets in the global medicinal cannabis value chain may include intellectual property on improvements or innovations of various aspects of the current value chain and treatment modalities. These can be further categorised as follows:

•Propagation of Barbadian medicinal cannabis cultivars;

•Standardization and amelioration of registered Barbadian cultivars;

•Synthesis of value added medicinal products through novel techniques such as biosynthesis;

•Using innovation to improve extraction of cannabinoids;

•Development of products with new treatment modalities; and

•Medical tourism which is supported by the local tourism product and cannabis based treatments

11. How can the Barbadian public benefit from the medicinal cannabis industry?

•Through access to other therapeutics classes of drugs for illnesses;

•By direct employment in businesses derived from the supply and value chain enterprises;

•Small farmers could cultivate through cooperatives and community-based enterprises to compete with other established suppliers of raw material to meet product demand; and

•Indirect benefits may be derived from net inflows into the Barbados’ economy and an improved quality of life

Steve Naraine is the Founder and Chief Scientific Officer of Colombian Company, CannaVida SAS. He is also the Founder of AEther Research Corp.

Dr. Damian Cohall is a Senior Lecturer in Pharmacology and Deputy Dean (Preclinical) in the Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus.

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