Cannabis Health Issue 4

ISSUE 04

Covering cannabis medicine and wellbeing from every angle

I have access to life-changing medicine - but my sister doesn’t

Your Guiding Light

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On all things cannabis medicine and wellbeing

CH-Q4IS04-2508

Why we’ve been refused a prescription on the NHS

The future looks bright for CBD

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WELCOME

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Covering medical cannabis from every angle in print and online.

Cannabis Health is delivered every quarter to people across the UK interested in the potential health benefits of cannabis medicines and wellbeing products. It is supported by an editorial panel of experts.

Our directors and editorial advisors include:

For a free* postal subscription email editor@aspectpublishing.co.uk

Hannah Deacon

For advertising enquiries contact gary@aspectpublishing.co.uk

Hannah successfully campaigned to enable her epileptic son Alfie Dingley to legally receive cannabis medicine.

She continues to campaign to help more families access medicinal cannabis in the UK.

Send your stories and opinions to sarah@aspectpublishing.co.uk

Also on the Cannabis Health team:

Professor Mike Barnes

Mike obtained the first full medicinal cannabis licence in the UK for Alfie Dingley, and has been involved in efforts to assist many others. He is the founder of the Medical Cannabis Clinicians Society.

Sarah Sinclair, Managing Editor | sarah@aspectpublishing.co.uk Gary Wilding, Head of Advertising | gary@aspectpublishing.co.uk Paul Allison, Commercial Manager Nick Cracknell, Publisher Andrew Mernin, Editor-in-Chief | andrew@aspectpublishing.co.uk Paul Newton, Operations and Finance Manager Millie Newton, Social Media Contributors: Joe Roberts, Freya Masters, Johanna Perraudin

For regular updates on all things medical cannabis visit cannabishealthnews.co.uk

WELCOME

Editor's comment The medical cannabis sector has seen some major developments this year, but let’s not forget those at the heart of the issue, writes Sarah Sinclair.

1 November 2018 was a day of celebration. The medication that was saving the lives of sons, daughters, sisters, mothers and friends, was finally made legal in the UK. But more than two years since the landmark law change, still only a handful of NHS prescriptions have been issued.

Patients are still being unfairly criminalised for accessing their medication and dozens of parents are still living on a knife-edge, forced to choose between their family’s livelihood or their children’s health.

Those whose loved ones have severe forms of epilepsy and who have had their lives transformed by cannabis, have spent tens of thousands on their children’s medication in the last two years alone. They’ve begged friends and family for money, sold their homes, pursued legal action and spent the hours that they should have been with their sick children, rallying politicians. But for many of them, a breakthrough feels as far away as it has ever been.

A global pandemic has opened the world’s eyes to the fragility of our health, something those close to chronic illness know only too well, having already spent decades living through their own personal pandemics.

One mum I spoke to recently said that when the coronavirus outbreak hit, people asked her if she was scared - “we’ve been scared every day of Eddie’s life,” she told me. No one should have to choose between bankrupting themselves, watching their child repeatedly hit their face against the floor whilst suffering a seizure, or risk their lives by “washing out” their medication so they’ll be accepted into an NHS trial.

Since our last issue there have been some huge developments in the cannabis industry, from the

European Court of Justice ruling that CBD is not a narcotic, to the UN’s vote to reschedule cannabis and finally recognise its medical potential. But let’s not forget those at the centre of the sector - the patients - for many of whom there’s still a long way to go.

We’ll continue to tell their stories, as well as covering all aspects of this ever-changing industry in the UK and beyond. If you have a story to share we’d love to hear from you.

For more regular content and to sign up for your free subscription to the magazine visit www.cannabishealthnews.co.uk @CannabisHNews @cannabishealthmag Sarah Sinclair, editor, Cannabis Health sarah@aspectpublishing.co.uk

Cannabis Health is produced by Aspect Publishing Ltd, 11 Lansdowne Terrace, Newcastle upon Tyne. Registered company in England and Wales. No. 10109188.

DISCLAIMER: This publication is intended for an 18+ audience. The comments and opinions given by contributors, quoted sources and interviewees are not the views of the editorial team or publisher unless otherwise stated. This is an editorial magazine, not a peerreviewed medical journal. Anyone interested in accessing medicinal cannabis is urged to consult their GP first. Cannabis Health cannot accept liability for any issues or comments raised by individuals featured in this publication.

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CONTENTS

10 NEWS

2 8 G ROW I N G P L AC E S

Industry breakthroughs, CBD scams and calls for cannabis decriminalisation

The UK company posed to become a world-leading cannabis producer

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42 A G R E Y A R E A The “stressed� elephants getting a taste for CBD

4 6 D E D I C AT E D TO C B D The Sisters healing the world through plant-based medicine

CONTENTS

50 UNDER THE SKIN

54 SISTERS INTERRUPTED

How CBD is changing the face of the beauty industry

“I have access to life-changing medical cannabis, but my sister doesn’t” 9

6 2 C A N N A B I S AT 50 Tackling stigma as a ‘surburban housewife’

68 T WO Y E A R S O N Why our children have been refused cannabis medicines on the NHS

NEWS

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‘Confused’ medical cannabis report ignores lack of patient access A Government report into the impact of the legalisation of medicinal cannabis has been criticised for ignoring some of the key issues facing patients.

The Advisory Council for the Misuse of Drugs (ACMD) has published its report on the impact of the rescheduling of medical cannabis in November 2018.

Following the landmark law change, the ACMD was commissioned by the Home Office in February 2019, to conduct a longer-term review of cannabis based products for medicinal use (CBPMs).

Its findings confirm what has been widely reported - that fewer than five NHS prescriptions for unlicensed medical cannabis products have been issued in the last two years, despite an increase in the number of products becoming available.

But the review has been criticised for failing to highlight the ‘significant harms’ caused to patients by this lack of affordable access.

Responding to the report, patient-led advocacy group PLEA (Patient-Led Engagement for Access) said that it was ‘disgraceful’ that the lack of access and the impact this has had on patients was not more prominent.

“We welcome the ACMD’s assessment of the impact of rescheduling CBPMs, including the development of a CBPM patient registry. However, two years on from the

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rescheduling - patients are in desperate need of NHS access,” they commented.

“Thankfully initiatives such as Project Twenty21 are building the evidence base in the interim, but remain inaccessible to patients who are unable to afford private healthcare costs.

“It is disgraceful that the significant harms caused by the lack of patient access are not further highlighted within the assessment.

“We hope that a full review of international approaches to legislation of medical cannabis will lead to access to CBPMs for patients who urgently need them.”

The ACMD recognised that the number of patients obtaining private prescriptions has risen considerably, but its projection that between 149 and 224 have been issued throughout 2020 has been described as ‘way out’ by experts.

The actual figure is thought to be more like 2,500, according to Professor Mike Barnes, in keeping with the rise in the number of import notifications made for medical cannabis to the Medicines and Healthcare products Regulatory Agency (MHRA).

Specialist importers must notify the MHRA of their intention to import unlicensed cannabis medicines into the UK. According to the Government’s figures the number of packs of medicines notified for importation rose significantly from 1,992 to 37,543 between March and November this year, suggesting huge demand in the private sector.

While around 800 patients a year have been prescribed one of the UK’s three licensed cannabis medicines Epidiolex, Nabilone and Sativex - on the NHS, Prof Barnes also pointed out that full extract, unlicensed medicines are ‘far superior’ when it comes to treating conditions such refractory epilepsy.

“Overall, the underlying assumption seems to be that as we have licensed cannabis medicines we don’t really need unlicensed ones,” he said.

“The ACDM, along with NICE and other bodies, don’t seem to realise that full spectrum products are far superior to the available licensed medicines and that is why these are not being used.”

The price of unlicensed cannabis products is said to be ‘high’ compared to that of licensed medicines, but the report doesn’t acknowledge that the cost is thought to have fallen by around three quarters in 2020.

“They should have recommended a thorough health economic appraisal,” added Prof Barnes.

“It suggests that cannabis products are expensive without recognising that the cost has come down about 75 percent this year.

It’s disgraceful that the significant harm caused by the lack of patient access is not further highlighted within the assessment 11

“They have failed to consider that the cost of the product needs to be offset against savings on other medicines such as anticonvulsants, anti-anxiety drugs and opioids.”

Although he agreed with the report’s recommendations that a full review of international approaches to the legislation of cannabis based medicinal products was needed and a patient registry would be ‘crucial’ for assessing the impact of these medicines.

Campaigner Hannah Deacon, whose son Alfie now has an NHS prescription for an unlicensed medical cannabis product, described the report as ‘confused’ and said it failed to make clear the inconsistencies in access.

“Even though three licensed medicines are available access is still very limited,” she said.

“They can only be prescribed for a very limited number of conditions and we know that some CCGs and NHS trusts are not even allowing funding for these medicines.

Hannah continued: “The report also states that individual funding requests (IFRs) have to be made for unlicensed medicines and to get this sort of funding you must prove that the patient is unique or rare in diagnosis, which is incredibly difficult to do with most patients.

“There is, however, an NHS trust in Northern Ireland funding an unlicensed medication for an epileptic child, which isn’t made clear in their report.”

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NEWS

Warnings over CBD scams Consumers are being urged to be extra vigilant following reports of scams by rogue CBD companies.

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Elderly people and those with long-term health conditions are being targeted by ‘unscrupulous’ CBD brands making false claims online.

A number of people have reported having considerable sums of money taken from their bank account after being persuaded to sign up for a free trial by companies claiming to be endorsed by Sir David Attenborough.

Adverts on social media and elsewhere online used photos of Attenborough without permission to promote CBD oil, while also making a number of unsubstantiated medical claims.

One advert stated that CBD is known to ‘support the nutritional health of aging bodies’, while another claims to ‘relieve chronic pain’, ‘reduce anxiety’ and ‘lower blood sugar’.

Pat, 73, (who asked us not to use her surname) told Cannabis Health that more than £160 was taken from her bank after she was taken in by a company called Canzana.

Pat, who has overcome cancer and has mobility issues following a knee replacement, says the advert appeared in her email inbox and the photo of Attenborough caught her attention.

“I’d been thinking about taking CBD for a while after having cancer and prior to that, a knee replacement. All the cancer drugs have really affected my joints and an osteopath recommended I try CBD during my treatment,” she said.

“Due to my profession I wanted to make sure I stayed within the law, so when I saw the picture of David Attenborough, I immediately thought it must be legitimate because he wouldn’t put his face on something that was illegal.”

The company appears to offer people a free sample of CBD oil by asking them to sign up for a trial period, they are then asked to enter payment details to cover the cost of delivery.

“At the time I was slightly worried about having to give them my credit card details, but I thought the worst

that can happen is I might lose the £3 delivery charge,” continued Pat. “I thought how am I ever going to find out about this stuff if I don’t try it? So I took a leap of faith.

“There was no mention of any kind of contractual obligation or further payment.”

Pat’s bank statement shows two transactions of £3.25 and then £4.75 went out of her account on 28 September.

The package arrived the following week containing CBD gummies and a bottle of CBD hemp oil.

But a few days later the same company made a request for payment of £85 and then another for £82, which was stopped by her bank after it raised concerns.

Several other members of CBD user support groups on Facebook also told Cannabis Health that the same thing had happened to them.

A spokesperson for David Attenborough confirmed that the star has no involvement with these companies.

In a statement they said: “Sir David Attenborough has been appalled to discover companies are using his name and image to advertise CBD oil on Facebook and elsewhere online. These are not genuine endorsements and Sir David has had no involvement whatsoever with these products.

“The companies do not have permission to use Sir David’s name or image – Sir David only allows the use of his name and image for marketing in connection with his own programmes and books.”

Mary Biles, a cannabis journalist and author of The CBD Book, warned people to be wary of free trials online saying there is ‘always a catch’.

“People buying CBD for the first time are often in a vulnerable situation and I think it’s disgusting that they are targeted by unscrupulous companies like Canzana using false celebrity endorsements to lure them in,” she said.

“It’s important consumers realise that whenever a CBD

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People buying CBD for the first time are often in a vulnerable situation

company offers some sort of free trial there is always a catch involved and may lead to them being signed up unknowingly to a subscription scheme which may then be difficult to get out of.

“It goes without saying these kinds of companies are highly unlikely to be selling safe, quality CBD products as they clearly have no concern about the wellbeing of their customers.”

Mary added: “For anyone new to CBD, it’s always advisable to choose from companies that are transparent and ethical about where their CBD is sourced, provide detailed descriptions of their products (including certificates of analysis from a third party laboratory for each batch), and make no wild medical claims on their website.”

Meanwhile Sian Phillips, managing director of the Cannabis Trades Association (CTA) confirmed she was aware of the companies in question and urged consumers to be extra vigilant when buying CBD products online.

She commented: “The general public have to be so careful about who they buy their CBD products from.

“Make sure the company you are dealing with makes no medical claims on their website or social media and that they follow MHRA (Medicines and Healthcare products Regulatory Agency) regulations.

“Any company making medical claims is obviously using that to boost sales and that is frowned on by the rest of the industry.”

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In a UK market navigating a ‘Race to The Starting Line’ the 31st March 2021 Food Standards Agency Novel-Food exemption deadline for CBD food supplements, only suppliers with approved applications will be allowed to produce and manufacture cannabis-derived ingredients on a regular, legal and compliant basis.

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It’s not just us recognising the value of retaining as many cannabis compounds in extracts as possible. Experts agree that the cannabis plant has so much more to offer than CBD.

• This would then immediately make those ingredients and subsequent finished products illegal to sell and they would likely be required to be removed from the market without notice.

For example, Professor Mike Barnes, of the Medical Cannabis Clinicians Society, says: “The cannabis plant has over 100 terpenes and flavonoids in addition to cannabinoids. All of these phytochemicals tested so far have some medicinal properties.

• This creates a lot of uncertainty for any company for years to come. Any day might be the day they have to remove their products from sale.

“There is much to learn but there is no doubt that the plant offers real hope of many different health applications in the years to come.”

How BRITISH CANNABIS ensures Novel Foods compliance: • Our CBD ingredients will always be supported by Novel Foods exemption applications; • All of our other cannabis extracts fall outside the scope of Novel Foods; We have perfected methods which are traditional, solvent free, non-selective and 100% natural for these other extractions.

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BRITISH CANNABIS has been working to assure the compliancy of our retail brands with upcoming reformulations in early 2021. All of our products reformulated in this way will be supported and linked to a validated Novel Foods application to protect our customers and also continue to have all of the stringent testing and documentation on product accuracy, purity and safety that we have become to be known for.

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NEWS

‘If no one is pushing, the industry will never move on’ 18

KanaVape founder Antonin Cohen has spoken of his relief that a six-year battle with the European courts has proved victorious for the CBD industry.

The founder of French company KanaVape is celebrating a landmark victory, following a six-year battle with the authorities.

On Thursday 20 November the European Court of Justice (CJEU) ruled that CBD is not a narcotic drug and does not appear to have any ‘harmful effect on human health’.

The dispute between French authorities and the founders of the first CBD vaporizer, KanaVape, has centred around the question of whether restricting the sale of CBD products legally produced in other countries in the EU breaches single market rules.

As in the UK, the extraction of flowers from the cannabis plant is illegal in France, due to the presence of THC. In 2014 French authorities launched legal action against KanaVape co-founders Antonin Cohen and Sébastien Béguerie for importing hemp flowers from the Czech Republic.

The pair were prosecuted in 2018 and given a 16-month suspended sentence and a 10,000 Euro fine.

But the verdict was later overturned by the European

Court of Appeal on the grounds that it may go against the rules of the single market, which allows for the freedom of movement of goods between the 27 member states of the EU. The ruling, by the highest European court, concludes that a member state, ‘may not prohibit the marketing of CBD lawfully produced in other Member States’ when extracted from the whole cannabis plant and ‘not solely from its fibre and seeds’.

The decision is expected to overturn a preliminary conclusion issued by the European Commission (EC) earlier this year that CBD and other extracts from hemp flowers should be classed as narcotics under the UN’s Single Convention on Narcotic Drugs.

Mr Cohen said he was ‘grateful’ that his efforts of the last six years had proved fruitful - not only for him, but the industry as a whole.

“I am very happy and relieved that we have been successful in this case, after what has been a long battle,” he told Cannabis Health.

“I have been lucky to have the revenue to be able to defend

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There were certainly times when I wondered why I was pursuing this

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myself, but the process has been extremely stressful and costly in terms of money, time and energy.”

Mr Cohen, an activist who has been involved in cannabis science since 2008, said his motivation was to see “society progress” and move the cannabis sector forward.

“I had a choice six years ago to say that the products were coming from the whole plant. That decision has led to this victory, which will allow for similar companies to operate in a safer environment,” he continued.

“There were certainly times when I wondered why I was pursuing this, but if no-one is pushing for this clarification, the industry is never going to move on.”

Now CEO of one of Europe’s leading CBD brands, Harmony, Mr Cohen hopes the ruling that CBD is not a narcotic, will urge the EC to proceed with novel food applications and make way for clear regulations.

“The only way to ensure quality standards and good manufacturing processes is through regulations that work with the industry,” he said.

“It’s important now for the EC to harmonise regulation of CBD products on the European market, so we can make sure products are accessible and safe for consumers, but also that companies can benefit from the growth of this industry worldwide.”

He added: “There hasn’t been much good news for the CBD industry in recent years, with a lot of confusion and complexity around regulation, so I’m very excited about this milestone - but there is still a lot of work to be done.”

Eveline Van Keymeulen, head of Allen & Overy’s Life Sciences Regulatory and Cannabis practices, who is assisting Antonin Cohen in the proceedings, commented: “This

long-awaited decision is a landmark decision for the CBD industry in Europe, the development of which has been hindered seriously by the fragmented and inadequate legal framework to date.

“The Court’s decision sets a binding precedent with European reach. Its interpretation of EU law is binding on the European institutions – including the EC – and will require other EU member states to assess their national rules applicable to the marketing of natural CBD in light of the clear criteria provided by this decision. The judgment should therefore lead to more regulatory harmonisation and legal certainty which is indispensable for the further development of the CBD industry in Europe. Most importantly, a clear and proportionate regulation of CBD-based products will ultimate benefit EU consumers.”

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Calls for cannabis to be decriminalised as report finds ‘evidence of no evidence’ 20

A groundbreaking report is threatening to blow up the cannabis issue after finding a lack of evidence to support its criminalisation.

The report, published by the cannabis campaign group Seed Our Future, details the history of cannabis prohibition as based on ideology and racism, and highlights a lack of evidence to support the inclusion of the plant within the Misuse of Drugs Act 1971.

Cannabis is currently controlled as a Class B drug under the Act, meaning it is unlawful to possess, supply, produce, import or export it except under a Home Office licence.

The Seed Our Future campaign submitted FOI requests to police forces across the UK, as well as the Crown Prosecution Service (CPS), the Home Office and the Advisory Council on the Misuse of Drugs (ACMD), asking them to produce evidence for the scheduling of cannabis.

The responses revealed an ‘unequivocal evidence of no evidence’, according to the report.

Campaigners believe the results could have the power to ‘turn the tables’ with police officers supposedly in breach of employment law and possibly several criminal laws if they continue to enforce cannabis laws.

Seed Our Future founder and co-author of the ‘Cannabis and the Law – No Evidence, No Crime?’ report, Guy Coxall, compared it to the PPI scandal and said reparations could cost the Government billions.

“The report proves that there is no evidence to justify cannabis ever having been permitted as a narcotic - we’ve got the evidence that the evidence doesn’t exist,” he told Cannabis Health.

“We are supporting people in courts of law and had one case dropped in August because the CPS couldn’t produce

any foundation evidence. If there is no evidence these court cases are going to collapse and we can actually claim reparations through a civil court.”

He continued: “This could potentially lead to a PPI of cannabis claims, which could cost the Government billions, because potentially everybody who’s been adversely affected by cannabis laws since 1971 could claim reparations for damages.”

The Seed Our Future report was sent to police forces across the UK last week, and on Thursday 5 November, landed in the inboxes of every MP, as well as the Home Secretary, the Secretary of State, the Secretariat for the ACMD, the Attorney General and the Prime Minister.

It calls on them to act immediately to completely remove cannabis from the Misuse of Drugs Act, instructing them that inaction on these findings would result in the ‘implementation of legal action’ for misconduct in public office.

“Our target is for cannabis to be completely removed from all drug scheduling before Christmas,” said Guy. “The Government is not above the law and we are going to fight this as far as we need to.”

West Midlands Police recently said it would be telling its officers to use their own discretion when enforcing cannabis laws, but others have responded by highlighting the fact that they don’t make the laws, only enforce them.

“Two years ago they supposedly legalised medical cannabis but there’s only been three NHS prescriptions in two years. It’s unacceptable when so many people are

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struggling every day,” he continued.

“Even the ACMD said it would take 5,000 men or 20,000 women to not use cannabis to prevent one person getting schizophrenia. It seems completely illogical that dangerous drugs such as tobacco and alcohol are socially acceptable whereas cannabis is the safest drug and helps with over 100 different conditions.

“It should be available to the public. We’re just trying to do the right thing.”

However, the Government’s approach is clear that it must ‘prevent drug use’, ‘support people through treatment’ and ‘tackle the supply of illegal drugs’.

A Home Office spokesperson commented: “Illegal drugs devastate lives and communities.

“Cannabis is a controlled drug and the Government has no plans to decriminalise it. There is clear scientific and medical evidence showing cannabis is harmful and can damage people’s mental and physical health. This was most recently noted in Dame Carol Black’s independent review of drugs published in February.”

In the Independent Review of Drugs, commissioned by the Home Office, Dame Carol Black stated that: “After heroin and crack cocaine, cannabis is the most common drug that results in people seeking treatment.

“Cannabis poses a large number of health risks, including psychological and respiratory disorders, particularly given recent increases in potency.”

Read the full report at www.seedourfuture.co.uk

The report proves that there is no evidence to justify cannabis ever having been permitted as a narcotic

NEWS

‘NHS asking children to come off meds for clinical trials could kill them’ Parents have warned that ‘washing out’ their children’s medication to enter clinical trials could put their lives at risk.

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The parents of children with severe, life-threatening epilepsy say that insisting they come off their medication to take part in NHS trials is ‘unethical’.

It comes after the Department of Health appears to have reversed its position on observational trials, insisting that randomised control trials (RCTs) are held before medical cannabis is made more widely available on the NHS. Following a review into the lack of access held by the Government department last year, the NHS proposed two RCTs and an observational study.

This would take into account cases such as eight-yearold Murray Gray, who has been seizure-free for 18 months since taking medical cannabis.

A programme of two RCTs is now being developed by the National Institute for Health Research, with ministers insisting this is the ‘best course of action’ to build evidence.

These trials would require participants to undergo a ‘washing out’ period beforehand, during which they would have to come off their current medication.

Joanne Griffiths, whose son Ben, 11, has treatmentresistant epilepsy, has seen his condition improve significantly since he obtained a private prescription last year.

However, her local NHS trust and leading children’s hospital, Alder Hey Children’s NHS Foundation Trust, refuses to prescribe the medication until these trials have been carried out.

During a meeting last year lead neurologists and hospital bosses said they were ‘keen’ to be involved in upcoming trials.

However, Joanne was told that Ben and other children who have already had access to THC products, will be offered a ‘wash out’ period to be eligible for the study.

“Asking these children to wash out their current medicines could kill them. It’s putting their lives at risk,” said Joanne.

When Ben was on epidiolex [a drug containing CBD which is prescribed for severe epilepsy] he was having up to 300 seizures a day and was ‘close to death’.

“I wouldn’t swap my child from something that is working to something that possibly won’t,” she continued.

“It’s unethical what they are asking us to do.

“We’ve managed to reduce every single one of Ben’s antiepileptic drugs and he was still having hundreds of seizures. The only thing that is stopping him having seizures right now is cannabis. If we were to remove that from his system he could go back to having hundreds of seizures and could die.”

Elaine Levy’s daughter Fallon, 26, has been taking medical cannabis since 2018. She saw an instant deterioration in her condition when she tried a cheaper oil to help manage the costs.

“Taking these kids off their medicine could see them being blue-lighted to hospital, they could die or just go back to smashing their head against the floor again,” said Elaine.

NEWS

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“They can’t do that to these children and young adults whose lives have been changed so dramatically thanks to medical cannabis.”

She added: “The whole thing is just astonishing, it’s the Hippocratic Oath. You can’t take a person off of something that is working and then give them a placebo instead.”

More than 30 cross-party MPs have now signed a letter to Health Secretary Matt Hancock calling for him to release emergency funding to help families cover the costs of prescriptions until they become available on the NHS. A spokesperson for Alder Hey Children’s NHS Foundation Trust told Cannabis Health they could not comment on individual cases.

They said: “Alder Hey is at the forefront for children’s health research and is a founding partner of the NIHR Clinical Research Network for Children. The Trust will continue to engage in supporting any new, well designed and robust clinical trials that investigate the role of cannabis-based medicinal products in drug resistant paediatric epilepsy.

“All studies take into account safety considerations for all potential recruitment candidates and the safety of all patients remains paramount.”

I wouldn’t swap my child from a treatment that is working; it’s unethical what they are asking us to do

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Why CBD Wellcare’s immuneboosting herbal teas are the perfect brew to blast away the winter blues.

With winter underway, we’re all in need of a cosy drink to fend off the cold right now. And, amid COVID-19 and the usual flu season, many of us are looking for ways to also boost our immune system. CBD-infused herbal tea may well be the perfect tonic.

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The likes of vitamin C, B6 and E are all said to be essential for maintaining a good immune system and there have also been some inconclusive reports that vitamin D can help fight COVID-19.

Whether or not vitamin D does indeed protect against COVID-19, with the nights drawing in, it remains an essential supplement. In fact, according to the NHS, between October and March, the body cannot receive enough vitamin D from sunlight alone and so supplements are becoming evermore popular.

Meanwhile, CBD is also gaining prominence on shopping lists of the health conscious.

A recent report, for example, shows that the global cannabis beverages market size is expected to reach USD 2.8 Billion by 2025.

One cannabis-infused beverage that has been growing in popularity in recent years is CBD-tea, with customers across the globe embracing its calming, warming and soothing properties.

In the UK, CBD Wellcare is pioneering two varieties of CBD-infused teas that also pack in the immunity-building properties of key vitamins.

Its lemon-flavoured CBD tea is enriched with vitamin C, with the unique flavour profile of the tea derived from cannabis terpenes.

The company’s raspberry-infused tea is also enriched, with both CBD extract and vitamin B, which is proven to be good for the heart.

Aside from its range of teas, one of CBD Wellcare’s most popular products, particularly at this time of year, is its cocoa tablet.

This is a CBD-infused tablet that is placed underneath the tongue, with the flavour of the tablet being meticulously crafted to emanate the taste of the much-loved chocolate bar, the Milky Way. CBD Wellcare is a family business, based in Bedford, England. Chris Harris, who runs the company with his wife Julie, was inspired to launch his own venture after using CBD to help treat his son’s health condition.

Harris says: “My son was given lots of different tablets from his GP which came with quite unpleasant side effects. So, around four years ago, we went down the route of CBD and he now no longer takes any medication from his doctor; just a few drops of CBD oil a day.”

Harris says the thing that sets his company apart is its scrupulous testing of all its products, with data collected through the entire process from seed to shelf.

“We test our products before they’re planted in the ground, when they come out of the ground and right the way through the production process.

“Although the CBD industry is booming right now, it has never been about the money for me. It’s because I believe in this marvellous product.” www.cbdwellcare.co.uk

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How CBD is shaping a brighter future across Britain Rachael Wilson, Excite for life founder and YouTube’s CBD Woman, charts the UK’s shifting perception of cannabis products.

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Working in the CBD Industry over the last four years, I’ve seen a shift in people’s perceptions of cannabis. I find that the older generation who once saw cannabis as a drug and bad are now becoming more open minded to its health benefits.

As the owner of Excite for Life CBD shop and CBD Woman on Youtube, I’ve found people especially over the age of 40 are starting to shift their views about cannabis; and embrace it as a health supplement.

Usually they will come to me because they are suffering with their physical or mental health and have heard that CBD can help. Sometimes they mention how they have seen an improvement in someone they love and it seems as though this encourages them and gives them confidence to try it for themselves. Social proof is a big factor in a person’s decision to buy cannabis products.

They often feel cautious and concerned about being high and tell me that I’m their last hope as they have tried everything else.

Pharmaceutical drugs of course have their place - but people are becoming more aware that there are natural alternatives available. Many would prefer to use CBD than taking several different tablets. I usually find, once people speak to me, they understand that CBD will not get them stoned, that it’s completely legal and is just like taking any other vitamin or mineral.

I have always adhered to legislation so all my products are tested at a third party laboratory to show they have no pesticides or heavy metals; and also that they have the correct amount of CBD and are non psychoactive. This

gives my consumers confidence to try it for themselves.

Once people try CBD they understand instantly that they wont get stoned and there are no side effects. They even understand that you can’t overdose on it.

However, it’s evident that there is still a fear around cannabis. Although many are shifting their views there are many who still regard it as a dangerous drug - versus pharmaceuticals that are deemed safe as they are prescribed by a doctor.

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Now, as we have access to a plethora of information on the internet, more people are looking to take responsibility for their own health by exploring new options.

I follow up with all my customers, and over 50 percent notice an improvement straight away.

Some people need to take larger amounts and also need to be assured that it is safe to do so. This is why it is important for me to follow up with people so that I can help them find their CBD sweet-spot. We all have unique bodies and we all need different amounts of CBD. CBD definitely isn’t a miracle cure. And, in some cases, even large amounts of CBD doesn’t bring any noticeable differences. Therefore other changes in lifestyle or medications can be helpful.

It does seem, however, that the government and other business entities still do not want to embrace this wonderful plant.

I understand their needs to be legislation but to suppress this plant so our farmers are unable to grow it or so that we cant grow it ourselves is ridiculous; especially when the industrial hemp plant is non psychoactive and good for our bodies, environment and the economy.

We do need to raise more positive awareness around cannabis. Although more than six million people have tried CBD in the UK, we have a population of over 60 million - so tens of millions haven’t. The stigma around cannabis isn’t helped when our government classifies the non psychoactive hemp plant as a schedule 1 drug.

Yet the government is the biggest exporter of medicinal cannabis. Why is it acceptable for the government to

grow high-THC cannabis, yet, we as a nation, are unable to grow low THC hemp?

Cannabis has so many elements that can be used in a multitude of ways. By classifying it as a drug, we negate the benefits of it being a food supplement, a paper resource, clothing, bio fuel, hemp plastic, hemp concrete and much, much more. I believe the way that we bring more positive awareness is to carry on providing good quality products to people.

Visit Rachael’s CBD shop Excite for Life now at www.exciteforlife.co.uk to claim your special offer.

Buy two products for a 10 percent discount. Buy three and get a 4th free.

Rachael’s YouTube channel is available at: www.youtube.com/c/cbdwoman

I N D US T RY

British medical cannabis company Avida Global has secured multi-million pound investment to move into commercial production next year. Those at the top tell Cannabis Health why they are uniquely placed to take on the sector.

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Growing places

I N D US T RY

In north east Colombia, just below the Andes, the beginning of something potentially groundbreaking is taking root.

With 240 hectares of high grade flat land, abundant water and power and shelter from the mountains, Avida Global’s production facility, La Finca Manizales, is vast in its potential.

The British producer of cannabis oils and isolates founded in 2018, has recently secured £3 million of investment as it moves towards beginning commercial production early next year.

The site is currently home to one football pitch sized greenhouse, but the funding will allow for the installation of two additional facilities and a custom-built post harvest room for drying and extraction. This will take the total growing space to 15,000 square feet - putting it among the top three producers in Colombia in terms of scale.

But this is just the beginning. Avida has a licence for up to 100 acres and at full production the facility will be visible from space, with 30 greenhouses - each one the size of a football pitch - producing around 20 tonnes of pure cannabis oil a year.

If it sounds almost incomprehensible, that’s because it is.

The global cannabis market is growing rapidly - it is estimated to be US$150 billion today and expected to grow to US$272 billion by 2028. But in terms of where it can go, it’s still in its infancy.

With a team of world-class experts, both on the ground and in the boardroom, Avida is set to be among those leading the way.

CEO David Kirby comes from a business background, having worked high up in the likes of Capgemini and Shell, while chief of operations, Carl Haffner, has spent 15 years in horticulture, and chief financial officer, Peter Ryan-Bell, is a former banker who spent 22 years in the financial sector.

Meanwhile, over in Colombia, the team is led by worldclass scientists and agronomists [who act as the go-between for farmers and crop researchers] with the cost of labour allowing the company to recruit a highly-skilled workforce at a fraction of the cost.

“We pride ourselves on producing the very highest quality, but at a very low cost price for what we’re doing,” explains David over Zoom.

“We’ve spent a long time assembling a team of scientists and agronomists who have three to four years experience of medicinal cannabis - in this new market that’s the equivalent of 40 years - they are some of the most experienced in the world.”

Back in the UK, Lord Benjamin Mancroft, is chairman of the company, as well as one of the country’s most knowledgeable parliamentarians on the subject of drug use and an influential advocate for legalisation.

David continues: “It gives us an air of respectability and integrity in this business. There are lots of people jumping on the bandwagon, but the way we’re doing it is with absolute

We’ve spent a long time assembling a team of scientists and agronomists, who are some of the most experienced in the world

integrity, we’re not cutting any corners, quality is absolutely the heart of what we do.”

He adds: “It’s a large investment to get where we need to be, but it will be worth it, because it will position us as one of the global leaders.”

The location and climate in Colombia will allow the team to grow between five and six crops a year, while the computercontrolled greenhouses maintain the right light and humidity, while protecting from environmental factors such as heavy rain and pests.

They also grow hydroponically, using a benign substance, coconut substrate, to ensure there are no added pesticides or nutrients in the flower.

The set-up means Avida can produce a broad spectrum of genetics.

“We will produce very high grade oils, isolates or crystal isolates, but we are not producing end-user products, we’re selling to companies that will produce those items.

“Typically our market will be pharmaceutical, medical and eventually food and beverage companies,” David explains.

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I N D US T RY

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Cannabis is life-changing for people, but you have to use it smartly and it has to go hand in hand with the science because it’s evolving all the time

However, a large part of work will be centred around funding research and working with pharmaceutical companies to create the specific strains needed to treat certain conditions.

Avida’s chief medical officer is one of the leading trauma clinicians in Colombia, currently driving research into the use of cannabis in PTSD. “There’s all sorts of opportunities and we want to get involved in research in Colombia,” adds David.

“We will do more research and have the potential to globally integrate and put some unique products onto the market.”

It is this research which is vital in producing the safest and most effective products for patients, as Dr Inbar MaymonPomeranchik, scientific advisor at Avida and one of the world’s leading experts on medicinal cannabis, points out.

“Medical cannabis came about in the opposite way to other medicines, we are working backwards,” she says, on a separate Zoom call from her home in Israel where she is a scientist and biotech investment consultant.

“We know the cannabis plant is amazing, but we don’t know what molecules are doing what - we know that it helps, but we want to know exactly how it helps - and this is the work that is being done at the moment.

Dr Maymon-Pomeranchik continues: “Just growing cannabis isn’t enough. As a grower you need to know what to grow, how to grow it, where to grow it and how to use it afterwards - that is the most important thing to understand if we want to use it as a medicine. It has to go hand in hand with research and knowledge.”

Working daily with leaders in the sector, Dr MaymonPomeranchik’s insight and research will be vital to Avida moving forward as more evidence is published about the effectiveness of cannabinoids for specific health conditions.

“Everyday we know new things. There is a lot of knowledge that is coming out that is going to help companies like Avida to do the things the right way,” she says, referring to a recent study which showed a rare cannabinoid could be used to treat colon cancer.

“Cannabis is a big word and so is cancer, there are many types of cancer and 144 cannabinoids.

“If I know what type of cannabinoid we need, we can search for a strain that has it and grow it at Avida in order to have our own formulation that we already know works in the laboratory.”

Dr Maymon-Pomeranchik believes that this puts Avida in a strong position to take on the global cannabis market and ultimately improve the lives of patients across the world.

“There are a lot of producers but there are not enough good producers that know how to use the best strain,” she says.

“Having the best team and the connection to science and to research to conduct clinical trials puts Avida in a very good position.

“Cannabis is life-changing for people but you have to use it smartly and it has to go hand in hand with the science, because it’s evolving all the time.”

NEWS

UN gives medical cannabis the green light The United Nations (UN) has voted to reclassify cannabis as a less dangerous drug and recognise its medicinal benefits in a historic moment for the industry.

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A landmark move by the United Nations commission to remove medical cannabis from a list of serious narcotics has been welcomed by the sector.

On 2 December 2020, the UN Commission for Narcotic Drugs, which includes 53 member states, voted on changes in the scheduling of medical cannabis products in international law.

The vote took place in Vienna and considered a series of recommendations from the World Health Organization (WHO) on reclassifying cannabis.

A total of 27 states voted to remove cannabis from Schedule IV of the 1961 Single Convention on Narcotic Drugs, where it was categorised as a dangerous drug with no medicinal benefit, alongside substances such as heroin and cocaine.

Great Britain, along with other European countries and the US, was among those who voted in favour of the rescheduling.

The news has been described as a huge boost for the industry and is expected to pave the way for more global research into the medical benefits of cannabis.

Neurologist and medical cannabis expert Professor Mike Barnes said it was a sign that the world was waking up to the potential of cannabis.

“This is really exciting news for the global cannabis industry,” he commented.

“It frees up individual countries to develop their own

medical cannabis market without the international controls that were previously limiting growth and international trade.”

Prof Barnes added: “This vote finally recognises the medicinal value of cannabis - well done UN.” The commission voted to reject a WHO recommendation to exempt CBD products with less than 0.2% THC from international control, in a move that some have described as ‘disappointing’.

Steve Moore of the Centre for Medical Cannabis said: “We welcome the outcome of today’s vote which will make the process of undertaking clinical research into the therapeutic benefits of medicinal cannabis.

“However, we are disappointed that other WHO proposals have not been supported and will now be working closely with the UK government to ensure that the regulatory framework for the commercial cannabis extract market, particularly CBD, is robust to support the sustainable and innovative market.”

Kyle Esplin, of the Scottish Hemp Association, also said the vote did not go far enough and left those producing synthetic cannabinoids at an advantage.

He commented: “This is a step in the right direction, but considering the racist origins of these laws the changes don’t go far enough, with five of the proposals being rejected and leaving synthetic cannabinoids with a regulatory advantage.”

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CiiTECH: Breaking new ground in cannabis research A joint venture between cannabis research company CiiTECH and top scientists in Israel is leading the way in diabetes and weight-loss studies. Cannabis Health speaks to CEO and founder Clifton Flack to find out more.

In May 2020 CiiTECH labs announced that it had developed a patent-pending breakthrough technology.

Developed together with leading metabolic researcher Dr Yossi Tam and the Hebrew University in Israel, the groundbreaking cannabis formula has the potential to treat non-alcoholic fatty liver disease (NAFLD), obesity and a number of other metabolic disorders.

Having co-founded iCAN Israel-Cannabis and together with his team brought the world CannaTech, we spoke to Clifton Flack about his latest venture.

and his current focus is on uncovering the involvement of the endocannabinoid system in the pathogenesis of obesity and its metabolic complications, with CBD as a prospect for the development of an effective maintenance therapy.

Since its inception in 1964, Yissum has registered more than 10,000 patents covering 3,000 inventions and licensed over 950 technologies, with global business partners including companies such as Novartis, Merck, Intel and Google.

CH: Tell us about your partnership with Dr Tam and the Hebrew University?

Clifton: Working with Dr Tam and ‘Yissum’ the tech transfer arm of the Hebrew University, CiiTECH Labs is leveraging the full potential of Israel’s cutting-edge cannabis innovation.

Dr Tam is head of the Obesity and Metabolism Laboratory

Why is the patent-pending technology significant?

Our patent-pending technology aims to explore the therapeutic potential of CBD in combination with additional cannabinoids in reversing the accumulation of fat thus providing the means for treating or preventing type 2 Diabetes and NAFLD.

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What has your research found so far?

Through CiiTECH’s past and current clinical studies, researchers have identified the cell genes that influence the uptake of fat and secured a provisional patent for the technology of a unique cannabinoid formulation to potentially treat obesity, diabetes and their causes in NAFLD. Recent findings from CiiTECH Labs have revealed the significant role of the endocannabinoid (eCB) system in the development of NAFLD via the regulation of both CB1 and CB2 receptors.

Why is this research important now?

Obesity is reaching epic proportions in Western societies, with more than one-third of US adults now considered to be obese. It has been described as a catalyst for cardiovascular disease, type 2 diabetes and NAFLD. According to the NHS, one in every three people in the UK has early stages of NAFLD. If left untreated, it can lead to liver damage, scarring, and cirrhosis and patients are at a much higher risk of developing more serious conditions including diabetes, high blood pressure and kidney disease.

Why did you choose Israel to carry out this pioneering work?

Israel has been at the forefront of cannabis research for over 50 years and this gold-label institution has the richest history of cannabis breakthroughs and cannabinoid therapy patents in the world.

While the rest of the world was preoccupied with prohibition and propaganda, Professor Raphael Mechoulam and his team of scientists at the Hebrew University in Jerusalem, were working to unlock secrets of the cannabis plant. Prof Mechoulam was the first person to study the endocannabinoid system and isolate the compounds THC and CBD. After finding success as a global cannabis pioneer why did you turn your attention to the UK? After a number of years building the global cannabis community, I saw a huge opportunity in my home country, the UK, where an unregulated CBD industry had begun to explode. With many brands making unsubstantiated claims and mislabeling their

products, I recognised the need for consumers to be protected - and the key to this is research.

CiiTECH developed a proprietary CBD brand PROVACAN, which has formed a number of joint ventures to bring the best of CBD and science to the UK. It continually works with leading formulators and innovators to bring to market the most efficient and cost-effective products and has seen the formation of CiiTECH’s other CBD brands IMPACT and HUGG. How are you preparing for the UK’s Food Standards Authority’s (FSA) Novel Food regulations coming into force at the end of March next year?

The team has taken the necessary steps to ensure we are ready for the new regulations to take effect. We have been working closely with all industry stakeholders to ensure that all our brands adhere to the guidance set forth by the FSA and Novel foods.

Our products comply 100 percent with the stringent EU and UK agricultural directives and we expect all our brands to be ready when the new regulations come into effect next year.

What impact do you think the introduction of the regulations will have on the industry?

The new regulations will clean up the market, getting rid of any products that do not comply with new regulations. This will make all CBD users more confident in what they are buying with more clarity and precise labelling.

What does the future hold for CiiTECH? It is a very exciting time at CiiTECH as we continue to develop new patents, formulations and brands that meet the growing needs of niche markets around the world. Our global expansion tells us that we are doing something right and that our products are filling in a market that is lacking something that consumers need.

Although the landscape will likely look very different this time next year, with the technology, research and expertise we have, CiiTECH is set to be at the forefront of this ever-changing industry.

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NEWS

Thousands apply for medical cannabis exemption card 34

A new initiative which could protect over one million medical cannabis patients from prosecution launched this year with an “encouraging” response from police forces, writes Joe Roberts.

Cancard was founded earlier this year by Carly Barton, a former university lecturer who became the first patient in the UK to be prescribed cannabis after its rescheduling for medical use in November 2018.

Carly uses cannabis to ease the chronic pain she experiences from fibromyalgia, a condition she developed following a stroke in her early twenties.

The scheme seeks to protect patients who use cannabisbased supplements to treat a medical condition. As such treatments remain unavailable through the NHS, only private practices have been able to prescribe medical cannabis - which can come at a significant cost to the patient.

Although Carly was one of the first to access cannabis legally in the UK, the large monthly prescription bill meant she soon had to resort to growing her own and buying cannabis illicitly.

There are approximately 1.4 million people in the UK who regularly consume cannabis for health reasons, who according to Carly, are often “living in fear” of prosecution or arrest.

Since opening for applications on 30 November, Cancard has received over 3,700 submissions with an average of 208 applications per hour on the day of its launch.

The scheme has also received a “really positive” response from the UK police. Following a briefing from the National Police Chief Council, Carly says most of the training packages have been delivered by the police intranet.

“It [training] has been delivered really well by the police,” she says.

“They’ve done a smashing job on communicating it all.

Every officer in the UK should now know about Cancard and should know what to do if they encounter one.

“Patients are reporting to us that they’ve already spoken to PCSOs [Police Community Support Officers] and police in their areas, and found that they are aware of it, they know about it, and they are supportive.

“We’ve also had a lot of emails and calls from individual police authorities and they’ve been really encouraging.

They’ve been getting in touch to say it’s a brilliant idea.”

Unfortunately, it hasn’t been this easy with every police authority. Some have been reluctant, especially those

NEWS

that take a hard line on drug enforcement. And although the organisation has worked with the Home Office to roll out the scheme, according to Carly, it “can’t and won’t” make a statement unless there is an official change to the drugs act.

“What we can do is make changes operationally without making a change to the law,” she adds.

“That can be done in two ways; police discretion and national guidance.

“We were gradually seeing a shift in attitudes before Cancard but I think that there was still a lack of confidence amongst frontline police officers, particularly new staff, in how safe it felt to use their discretion.”

Cancard gives police officers and PCSOs the confidence to use their discretion, as cardholders have been checked to ensure their condition qualifies for a cannabis prescription.

There are two ways of being certified for a Cancard, either through a GP or through self-certification. People can selfcertify by asking their GP receptionist for a copy of their summary of care, a one-page document containing details of previous diagnoses and prescriptions. An email is then sent to their GP to confirm that the individual has the condition which they claim to have on their application.

The self-certification route was put in place to allow people to access the card without it affecting their medical records. Currently, individuals are unable to access NHS mental health services, such as cognitive behavioural therapy, if they have consumed cannabis in the previous three months.

Carly was surprised by the response from GP practices.

“We were anticipating that GPs would be reluctant,” she says.

“But we’ve had literally thousands of GPs confirm patients’ conditions and we haven’t had any that have refused.”

However, Cancard remains a temporary solution and it is hoped that in the future there will not be a need for the scheme.

Carly says: “We need to understand that there are 1.4 million people in the UK who are successfully consuming [cannabis] for their conditions and they’re choosing a natural supplement over potentially harmful pharmaceutical drugs.

“In my case, I’ve been able to come off fentanyl, morphine and benzodiazepines because of cannabis. We can’t ignore that people are getting real benefit from this and we can no longer ignore the evidence that’s coming out of countries with sophisticated medical science.”

She adds: “What Cancard does is answer the question: should these people be criminalised for taking this supplement? I have yet to find anybody who says yes to that question in the police or otherwise.”

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There are 1.4 million people in the UK who are successfully consuming cannabis for their conditions we can no longer ignore the evidence

NEWS

CBD has no adverse effects on health - study A landmark study has shown that long-term exposure to CBD does not appear to have any adverse effects on health.

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The study, which is the first of its kind to examine the toxicity and longterm effects of CBD, has found that it did not demonstrate ‘any degree of acute or life-long toxicity’.

Instead, CBD actually extended the average lifespan and increased activity in later life.

The research was conducted by Spectrum Therapeutics, the medical division of Ontario cannabis company, Canopy Growth Corporation, as part of a commitment to provide the data which is needed to support and influence public policy.

These findings could be instrumental in changing public attitudes and improving access to CBD for patients who use it to help manage a range of symptoms including anxiety and pain.

The study evaluated the solubility, stability, acute toxicity, thermotolerance, and effects on lifespan of CBD in what is thought to be the first long-term toxicity and lifespan research regarding the effects of chronic exposure to cannabidiol.

Acute and long-term exposure studies of CBD at physiologically relevant concentrations were studied in the worm model Caenorhabditis elegans (C. elegans), which is recognised as a valid model for this kind of research on the basis that 60-80 percent of their genes are shared with humans and their short lifespan of two-three weeks makes such studies feasible.

Researchers found that CBD did not demonstrate any degree of acute or life-long toxicity or related liabilities at physiological concentrations.

Instead, it extended the average lifespan up to 18 percent and increased late-stage life activity by up to 206 percent when compared to the untreated controls within the study.

While further research into the life-long use of CBD should be carried out in mammalian models, this study indicates a lack of long-term toxicity at physiologically relevant concentrations.

“Despite widespread use of CBD, no life-long toxicity studies had been conducted to date to determine the impact – or potential impact – of long-term exposure to CBD,” said Hunter Land, senior director of translational and discovery science at Canopy Growth, said: “These results serve as the only CBD life-long exposure data in an in vivo model to date, and the absence of long-term toxicity gives us the evidence we need as an industry to continue researching the potential health benefits for the broader application of CBD.” The study is published in the Cannabis and Cannabinoid Research journal.

Don’t miss out on your free subscription to Cannabis Health!

NEWS

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If you picked up this edition in a CBD shop, doctor’s waiting room or from a friend, make sure you’re on the list for our next edition.

For a limited time only, we’re offering a 100% free, no strings annual subscription to Cannabis Health.

Every quarter you will receive your beautifully presented, expertly written update on the many exciting things happening in the world of cannabis health.

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Covering CBD from every angle

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CBD brand steps up ‘For Murray’ A new CBD company is taking direct action to help eight-year-old Murray Gray access medical cannabis.

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CBD brand Green Active is proving it’s as good as its word with the launch of a new campaign in honour of eight-year-old Murray Gray, who has a severe form of treatment-resistant epilepsy known as Doose syndrome.

Murray, from Edinburgh, has been seizure-free for the last 17 months since he has been taking full extract cannabis oil which he obtains via a private prescription.

But his family struggles to find £1,400 a month to fund his medication, which doctors have refused to prescribe on the NHS. After seeing Murray’s story online, the co-founders of Green Active have pledged to dip into their own pockets to help his family cover the costs.

Since November, customers who shop using the code ‘For Murray’ at the check-out, will see 100 percent of the profits from the sale donated to Murray’s prescription fund.

“When I look at the pictures of these children who have had their lives completely transformed by medical cannabis, I just can’t get behind the reasons why they are not being supported by the NHS,” Green Active cofounder Jo Devall told Cannabis Health.

“It’s frustrating to see that in the country we live in when there’s such astounding evidence to support the actions of these mothers and fathers - they are forced to source this exceptionally expensive medication.”

Jo continued: “We are in a position where we can actually do something, so instead of just scrolling by we’ve decided to take a stand.

“We built the business as a reflection of who we are

and we have one main mandate - principles before profit.

This is our first opportunity to be able to contribute something on a level that’s much greater than ourselves.”

Although the brand is still in its infancy, launching earlier this year, Murray is the first of what Jo hopes will be many more patients that they are able to help.

“We’re not just doing this for a day or a week, it will be something that we continue to drive and as we build awareness hopefully it will inspire other companies to do the same. It’s a good opportunity for the private sector to step in.”

He added: “The ideal scenario is that it’s enormously successful and we generate more money than needed for Murray and can move on to the next person. The bigger scope of what we want to do is bringing more and more awareness of what these families have to face.”

“This is what the company is built for and if we can’t wake up and contribute then there’s no point doing business.”

Murray’s mum Karen Gray said: “I’m very grateful that Jo contacted me and wants to help Murray. It means a lot that other people are invested in keeping Murray seizure free and out of hospital.”

She added: “It is appalling that the government and NHS don’t seem to care as much as Jo from Green Active and the general public.”

Visit the Green Active website and use the code ‘FORMURRAY’ at the checkout - customers will also receive 10 percent off their order.

Find out more at www.greenactive.co.uk/for-murray

@morewithmat

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In times when we all need a little something to take the edge off, UK consumers are waking up to smell the coffee.

How do you take your coffee? Milk? Sugar? CBD? With young professionals looking for something to help take the edge off their workday rituals or ease them into lazy Sunday mornings, since lockdown sales of CBD coffee have shot up.

No longer able to pick up their Starbucks on the office commute, people have had to improve their home brews - and it turns out coffee and cannabis is the perfect combination (who knew?)

“Our sales quadrupled in a month,” says Tristan Adlington, founder of premium CBD brand, Pot Head Coffee.

“It was completely correlated to lockdown, but it was really interesting to see people start experimenting with new ways to brew coffee at home. It was a distraction from the stress and I think it opened their eyes to how much their daily coffee habit was costing them. They could have CBD coffee at home and still save money.”

And the trend has continued now that people have got a taste for it.

Launched two years ago, Pot Head Coffee was one of the first CBD coffee brands, but it has taken a little while for people to understand why you’d mix the two.

“At first people thought it was just an expensive coffee, but consumers are beginning to understand CBD and how coffee is a healthy, easy way to get your daily dose of cannabinoids,” continues Tristan.

“We are used to having a coffee every morning, so it is a good ritual to build your CBD consumption into.”

Each cup is made using organic hemp extract and arabica coffee beans and a serving contains approximately 10mg of CBD as well other cannabinoids.

“Our customers find that the CBD takes the edge off the caffeine – creating an alert, yet calm state to start their day,” says Tristan.

“While it is particularly perfect for a lazy Sunday morning brew, a lot of people use coffee as a mental primer for work and the ritual of making the coffee and sitting down to work is a big part of it too.

“The brand resonates well with people in the creative industries, who find cannabis is actually quite useful for their job when they need to think differently or outside the box.”

Tristan was in the tech industry before setting up the brand and always felt like he had to hide his cannabis consumption.

When he found out a family member was accessing it illicitly to help with a medical condition he started exploring the research and the parallels between coffee and cannabis.

While Pot Head was born out of a bit of fun at first – Tristan and his friends would pair coffee beans and blends to their favourite strains of cannabis. The brand has grown up and is actively trying to educate the public that responsible cannabis use is possible, and maybe even beneficial. Part of this effort is a podcast where Tristan interviews creators, makers and entrepreneurs about their lives, with a very honest focus on their cannabis use.

“The vision is to help grow the UK’s cannabis scene whether it is legal or not. Through our online coffeeshop and our stockists we are creating our own version of the dispensary experience. Eventually we will open our own coffee shop.

“It would also be great to be serving THC coffee,” he adds.

“When cannabis is legalised recreationally here, we’ll be ready for it.”

Head to www.pothead.coffee or @pothead.coffee on Instagram to learn more.

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Taking a natural approach to CBD Alexander Berg once held the record for the most push-ups per minute, with an impressive 101. He achieved the feat just a few years after a life changing injury left him with chronic back pain. The 35-year-old attributes this achievement to his lifestyle choices and CBD regime.

Berg works as the Business Development executive and subject matter-expert at a CBD products company, Share Natur, and is a passionate advocate for the benefits of the cannabis plant.

He had his injury seven years ago at just 28 years old, leaving him debilitated due to the pain. He tried a number of prescribed medications, but the negative side effects became too much to bear.

As pill after pill failed to control his pain, Berg took matters into his own hands, changing his lifestyle in an effort to rebuild his life.

He now lives on a completely plant-based diet and has adapted the way he moves and breathes in order to control the pain. However, above all else, it is cannabis that has made the biggest impact on his life.

He says: “Cannabis is a massive part of my life now. Since

my injury, I have experienced a lot of pain and I have been on many different pills that just didn’t work for me; I lost 30kg of weight in eight months when I started on morphine.

“The cannabis plant changed my life because it opened up doors. It made me feel again and it made me passionate.”

“I’ve experienced a lot of bad things in my life, but I’ve been able to change that by doing things the right way.

I’ve been able to reduce my pain by moving and breathing correctly, eating fruits, getting the right amount of sun and taking CBD and THC. I’ve lowered my pain so much that I can thrive; I’ve never been stronger in my life.”

Share Natur is a Dutch company headquartered in Amsterdam known for using CBD to elevate products in multiple categories, from droppers, capsules and creams to infusing CBD in food and beverages such as water

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“It’s like a symphony orchestra where the CBD is the conductor and the rest of the terpenoids, cannabinoids, flavonoids, terpenes, minerals and fatty acids, are the different instruments”

and gummies. Its products are 100% natural thanks to a number of unconventional processes that aim to bring the company as close to nature as possible.

Rather than using traditional methods for extracting CBD from hemp, such as carbon dioxide or alcohol extraction, Share Natur is one of the only companies in Europe to use cold pressed technology. Compared to conventional hemp oils, cold-pressed products contain a higher volume of the nutrients, natural fats, vitamins and phytocannabinoids from the original hemp plant.

Berg explains: “With CO2 and alcohol extraction methods, companies are using lots of different solvents and emulsifiers. Our cold-pressed solution simply squeezes cannabinoids meaning they remain more in-tact but still gets rid of the acid bindings of the CBD.” The company says this technique improves bioavailability, which means more CBD is absorbed into the body. A normal CBD oil has an absorption of 3 to 5% of active CBD in your bloodstream within 190 min, but with Share Natur’s range of carriers, which are also cold-pressed, the absorption can be increased dramatically. Their new bioavailability studies is released start next year.

“You are not what you eat,” Berg says. “You are what you absorb, so bioavailability is very important. If you don't have a very healthy lifestyle or if you are stressed, this tool can help you get in balance quicker than normal.”

In addition to its CBD oil, Share Natur has also developed something called HempCap, a CBD powder derived from hemp. The powder is micro-encapsulated meaning it can be fully dissolved into water without affecting the taste.

Encapsulation involves surrounding small particles with a coating. In the case of HempCap, this coating is from proteins. When the product reaches the stomach, the only thing the body needs to do is break down these proteins to fully release the compounds within the hemp. According to Share Natur, the result of this process is an effect that is fifty-two times greater than that produced by nonencapsulated CBD products.

Berg says: “The amazing thing about bringing the CBD to

your stomach is that CBD will be broken down differently than in your liver. Some of the CBD will convert over to something called THC Delta 8.

“THC Delta 8 is not very psychoactive, as THC Delta 9 is, but it has all the other properties and benefits of Delta 9.

“You can convert the CBD into THC Delta 8 and something called 11-Hydroxy-THC which is very suitable for sick people, specifically those with cancer, because it reaches the cells and penetrates them quicker and brings all the other cannabinoids with it.”

Share Natur is looking for new ways to further enhance the effectiveness of CBD. Playing a key role in this push is the ‘entourage effect’, which was discovered in 1998 by the Israeli cannabis expert, Dr. Raphael Mechoulam.

This theory claims that the many and varied compounds found in the cannabis plant, including CBD, THC, terpenes and flavonoids, work together to produce therapeutic effects. In other words, the combination of cannabinoids has more benefits when consumed together than separately, commonly known as an isolate.

Share Natur has created a range of products called Full Spectrum, which combines the various compounds found within industrial hemp. This includes a tiny amount of THC, which Berg says helps reduce the time it takes for the cannabinoids to reach the cells.

“We are developing new products where the CBD can be read by the body quicker,” Berg says. “We have found that if we don't change the cannabinoids and if we have the complete solution of the terpenes as well as CBD and other compounds, they will help each other.

“It's like a symphony orchestra where the CBD is the conductor and the rest of the terpenoids, cannabinoids, flavonoids, terpenes, minerals and fatty acids, are the different instruments. Hence we call these products Full Spectrum, but with our unique processing techniques we also develop Broad Spectrum products fully omitting THC ” Find out more about Share Natur at sharenatur.com or follow them on Instagram @sharenatur

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A grey area of CBD knowledge CBD is widely thought to relieve stress and anxiety in humans - but what about elephants? Cannabis Health talks to veterinarian Dr Agnieszka Czujkowska, who is leading a groundbreaking project to find out.

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Warsaw Zoo caused a stampede of media coverage this summer when it announced it was going to be testing the effects of CBD on its elephants.

The Hemp for Elephants project, which is thought to be the first study of its kind, aims to determine whether regular doses of CBD oil will reduce stress levels in the animals. If it proves to be successful, the zoo hopes to roll it out to other large mammals in its care, with giraffes, polar bears and rhinos all next in line.

But first, the eyes of the world will be on Fredzia, Fryderyk and Buba - the three elephants at the centre of the Polish zoo’s experiment.

The trio were thought to be the perfect candidates, when the zoo was approached by Polish CBD company Dobrekonopie earlier this year.

Veterinarian, Dr Agnieszka Czujkowska, who is leading

the project told Cannabis Health: “There’s always going to be an indication with elephants because they are really social creatures and they live in very complicated social groups.

“Elephants sometimes have various conflicts with each other – sometimes it’s the weather, sometimes it is caused by a changing environment – there are many factors that can make an elephant feel uncomfortable and stressed.”

After the death of Edna - the head of the zoo’s elephant herd - Fredzia was having trouble adjusting to her new position as the leader of the pack.

Dr Czujkowska said: “It’s not that there is an emergency in the group right now, because that would be the worst time to conduct this experiment, but we did have some changes. After our oldest elephant Edna died, they had to adjust to a new situation. Fredzia has always wanted to

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We have the people and we have the skills; we would rather work harder and give something natural a try, than just put them all on Prozac.

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dominate and now she can, she’s in control of the other elephants, so there is a little bit of stress involved.”

This combined with the fact that the elephants are in a small group, are well trained and the zookeepers know them all well, means it should be easier to monitor their behaviour during the project.

A pilot study was carried out first to measure the amount of cortisol, the hormone produced in the bodies of humans and animals in stressful situations, in the elephant’s saliva and determine which time of day it was highest.

For the study itself, CBD hemp extracts will be mixed in with the elephant’s food or administered directly into their mouth at regular intervals.

Dr Czujkowska and her team will begin by following the guidance around dosage in horses - around 40-50 drops every six hours - and will then adjust this for each elephant throughout the project, collecting samples of their blood, feces, saliva and urine to monitor the levels of cortisol.

“When you conduct an experiment like this, you have to have full control over the group,” she said.

“This is easy in the elephants because the keepers know them really well and they can catch the tiniest differences in their behaviour.”

She added: “We will expand into others such as giraffes, polar bears and rhinos.

“But these are wild animals and the problems that you have to solve are completely different from those in domesticated animals.”

Dr Czujkowska is hopeful that CBD could provide an alternative option to the strong pharmaceuticals that

large animals are currently treated with.

“We have a whole pharmacy full of different drugs, but they are not natural and these drugs really change the animals’ behaviour,” she said.

“There are many antipsychotic drugs and true narcotics that you can use in elephants if you don’t have any other choice. For example, if you have to sedate or anaesthetise the animal or it’s a dangerous animal and you cannot approach it, or it has a huge wound that you have to clean every day and it’s not going to cope with the pain.

“Otherwise I think we should look for something natural, and CBD is a very potent substance so why not try it?

Dr Czujkowska continued: “We would rather work really hard through a lot of enrichment to manage the behaviour in the group and try CBD oils than just put them all on Prozac. That is not the solution.

“We have the people, we have the skills so we would rather work harder and give something natural a try, than just go for the easy option.”

The Hemp for Elephants study will be a long-term project, with Dr Czujkowska not expecting to be able to make the first conclusions until around one year down the line.

The study will also have to take into account environmental changes such as weather conditions and other outside factors that may impact on the elephants mood and behaviour.

“We might see that CBD solves some of our problems, maybe not all of the and maybe there will be some side effects. I don’t know and that’s the exciting part of the project,” she said.

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CBD in the animal kingdom The use of CBD in animals is a growing area of interest and the internet is bursting with anecdotal evidence to suggest how it could help our furry friends - although so far the science to back it up is relatively thin on the ground.

In humans, cannabis is widely-thought to help relieve symptoms such as anxiety, chronic pain and to reduce seizures. Given how close we are to our pets, it was only a matter of time before people started to explore how it could be used to treat similar health concerns in the animal kingdom.

A study by Dr Stephanie McGrath at Colorado State University gave 14 dogs two daily doses of CBD oil for 12 weeks and the results showed a significant decrease in the number of seizures over this period.

Meanwhile, Californian company Phyto Farmacy is marketing CBD oils for pain relief in farm animals, particularly horses.

A review of cannabis in veterinary medicine published last year by Dr Joshua Hartzel reported that although it has not seen the same advances as human medicine, there are now several university-based, clinical studies examining CBD from hemp extracts to measure its safety and pharmacokinetics, including the effect of hemp oil extracts on osteoarthritis and epilepsy.

The review concluded: “Due to the nearly universal distribution of the endocannabinoid system in all

chordates, and in many invertebrates, the same or similar beneďŹ ts of cannabinoids found in humans also can be applied to most veterinary species.â€?

Despite concerns around treating animals with cannabis, a study published by the Veterinary Information Network showed that 80 percent of dogs that were given CBD to help relieve pain and anxiety experienced no adverse effects.

However, the British Veterinary Association is reluctant to support CBD use in animals until more evidence about its impact emerges.

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The Sisters who make CBD Nestled in the Central Valley, California, is not your typical convent, but the women there are no less dedicated to their cause. Sarah Sinclair met the nuns on a mission to heal the world through plant-based medicine.

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When the US congress passed a bill in 2011, which - to some interpretations - declared pizza a vegetable, an outraged Kate Meeusen, declared herself a nun. She didn’t realise at the time what she was signing up for.

Kate had a high-flying career, travelling Europe as a business consultant in deregulating industries, but after a devastating divorce a few years earlier, had moved to California as a single mother-of-three.

Feeling let down by the men in her life, she craved the peace and quiet of a life in the country, somewhere she could ‘heal’. But equally determined to create work and leadership opportunities for other women, she turned to the most promising deregulating market in her new home state - the cannabis industry.

Kate founded a non-profit cannabis collective in 2010, delivering cannabidiol medicine to terminally-ill patients and developing teas and tinctures so they could experience its effects without needing to smoke it.

The calling came soon after.

“I thought I was just being sarcastic and sort of giving a finger to the establishment, to how messed up things were,” Sister Kate says, talking to Cannabis Health from the Central Valley.

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We’ve built a community here where we are really trying to better ourselves and the world around us.

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“I had no idea the journey it was going to take me on.

At the time it was just a costume I had pulled out.”

The Sisters of the Valley was formed in 2014, with a mission statement to help as many people in the world access their medicine, as responsibly as possible.

She explains: “In 2014 I started to form the principles of what this new-age religion would look like.

“We decided we would be religious about women in business ownership. Women have been used for free labour for thousands of years, so we don’t allow volunteers or any unpaid work to happen under our roof.”

The Sisters of the Valley CBD now has franchises - or enclaves - in countries across the world, including the UK [Brother Matt is based in Southampton], with 22 active sisters and seven Brothers.

The colourful journey of how Sister Kate learned how to grow cannabis from black market dealers - and was shot at protecting her crop - has even featured on a Netflix documentary Breaking Habits.

Today there are eight Sisters based in California, of which three or four will live at the ‘convent’ at any one time.

“The women come to me,” says Sister Kate.

“My philosophy was that I would take in whoever came and I’ve been very successful in attracting women - many of whom already have a healing calling in them.

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“Our message is a holistic one, we’re not doctors or scientists. We believe CBD is good for you.”

They might not be religious in the traditional sense, but the Sisters live a spiritual life, following the six basic principles, Solace, Obedience, Living Simply, Activism, Chastity and Ecology (SOLACE) and wearing veils to ‘protect their energy’.

They live and work around the cycles of the moon with all the products handmade by the women, set on the new moon, and bottled under the full moon.

They eat meals together and take part in communal prayers, but most of their work is carried out individually; from growing the crop, to making the medicine, to marketing and delivering their range of CBD-infused products worldwide.

“We believe in a depth of power that is greater than what we see,” says Sister Kate.

“We believe that the energies around the medicine have to be protected and that we’re here to protect them.

“In this day and age there is so much over communicating.

“Our number one thing is that we want a harmonious place to work, we value a quiet environment and separate solo work.

“We do everything we can to keep a monastery-like feeling in place.”

But she adds: “We do a lot of fun stuff too, because we don’t want to be working all the time.”

In their free time they might be out hiking, on bike rides, or taking part in group art or music sessions (during the coronavirus lockdown they all took up learning a musical instrument).

“We’re all aspiring to the six-hour work day and aim to spend our late afternoons doing art or music together,” she says.

The women come from a variety of backgrounds and vary in age, from Sister Kate who is 60, to Sister Quinn, who, at 24, is one of the youngest.

She joined the enclave just over a year ago and now works with them part-time alongside her job as an analyst at the University of California Merced.

“When I first heard about the Sisters I thought it was amazing that they were here in the Central Valley,” says Sister Quinn.

“After I graduated I was so broke I reached out to them on Instagram and started working as Sister Kate’s assistant - I started wearing the veil soon after, they didn’t even have to convince me.”

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Sister Quinn had begun using cannabis as a teenager, to help manage the symptoms of her ADHD but now uses it to treat anxiety, insomnia and chronic back pain, among other ailments saying she never uses anything else.

But it was the community that the Sisters have created that really won her over.

“It’s amazing to have people love you unconditionally,” she continues.

“My family did their best but they didn’t really give me what I needed emotionally.

“Being young, I’m not used to people being interested in my ideas, but the Sisters have helped me grow as a person.

I’ve gained a lot more self-respect and self-awareness.”

Despite some surprise at first, her friends and family were mostly supportive about her decision to join the enclave, she says: “I’ve always paved my own way and I’m never going to fit in with the status quo, so most of my friends support me because they know how I am - I think they’re happy that I’ve found a home.”

She seems sure she’s found her ‘forever home’ and is even dreaming up a retirement plan in which she will lead her own enclave one day.

“We’ve built a community here, where we are all really trying to better ourselves and the world around us, it’s amazing” she adds.

“I’ve been a lone wolf for a long time, so it’s nice to finally have a pack. I never realised how much I was missing.”

Find out more at www.sistersofthevalley.org.

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Getting under our skin CBD is changing the face of the beauty industry, but are the benefits more than just skin deep?

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From retinol and hyaluronic acid to charcoal masks and snail mucus - the beauty industry knows we’ll put almost anything on our skin in the search for a flawless complexion.

But one ingredient which appears to be living up to the hype is CBD. The CBD skincare market has exploded in recent years as more evidence comes to light of the cannabinoid’s antiinflammatory effects. And with the industry projected to generate £734m in annual sales by 2024, those in the field predict this is a trend that will continue to snowball.

Leading UK CBD brand Love Hemp, has seen its cosmetic range - which includes a 300mg body salve and cellulose fibre face mask - prove particularly popular with consumers and CEO Tony Calamita expects to see a great deal more products entering the market in the coming years.

“Consumers are focused on health and wellbeing now more than ever and CBD is a large part of this market, as one of the fastest growing product categories in the UK,” he told Cannabis Health.

“Topical CBD and CBD-infused skincare products are quickly making their way into skincare and self-care routines across the UK and as consumers become more invested in natural beauty and skincare, and I don’t see this slowing down anytime soon.”

Tony continued: “The benefits of CBD and skincare have been well documented, with many leading skincare companies beginning to incorporate it into their products.

Combining the spirit-lifting properties of the hemp plant alongside natural skincare ingredients can only mean good things for the skin.”

“I expect CBD-based products will continue to grow in

Skin conditions can affect people’s appearance, their self-worth and how they enter into romantic relationships - it can have a devastating impact on their whole life

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popularity and we’ll see a lot of new products enter the market.”

While a handful of big-name beauty brands have cottoned on - The Body Shop released its CBD range in recent weeks - an industry report published by Prohibition Partners earlier this year found that it is actually the smaller brands which are driving the developments in the CBD beauty market, while multinational companies remain wary of its legal position.

One such UK brand is The London Botanists, which recently launched an organic skin balm containing CBD, rosehip and shea butter, which is said to be safe for even ‘the most sensitive of skin’.

“The skincare trend has already begun, but I believe it is only going to get bigger and bigger,” said founder Chloe Lawrence-Green, who launched the brand after struggling to find all-natural products on the market.

She added: “CBD applied directly to the skin has been found to have significant soothing properties helping minimise issues related to skin sensitivity, including redness and reactivity.”

Taking it one step further, the world’s first beauty industryendorsed CBD facial is coming to the UK in October, along with its first full range of cosmeceutical CBD products.

The Grass Roots Facial, which it is hoped will soon be available in salons up and down the country, is a five step treatment which can be personalised to target certain conditions including acne, rosacea, sensitive, pigmented and ageing skin.

Although not yet available for general retail, the Grass Roots range includes seven products designed to replace the client’s skincare regime, avoiding the additional steps and expense that come with adding more products to an existing routine.

The facial and product range will only be available in salons where beauty therapists have completed the required training course, so they are able to educate their clients about CBD. Although it’s still early days, Grass Roots founders believe that the benefits of CBD could have huge implications for how skin concerns are treated, with CBD-infused products reportedly being used by those with conditions such as eczema, acne and psoriasis.

Co-founder Zoe Wilkinson said: “Doctors often prescribe strong ointments for skin conditions like psoriasis or eczema, but if we can treat these conditions with something natural, before going down the medical route then that will transform how we use skincare.”

Until recently the interest in cannabis extracts and their potential benefits for the skin has been predominantly

Doctors often prescribe strong ointments for psoriasis and eczema.

If we can treat these conditions with something natural it would transform how we use skincare

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cosmetic, but last month Sapphire Medical Clinics opened the UK’s first medical cannabis dermatology service for patients with hard-to-treat skin conditions.

For the first time, doctors can now offer cannabisbased treatments to patients with rare and challenging conditions who have not responded to conventional therapies.

Consulting dermatologists at the clinic told Cannabis Health this could ‘dramatically change’ how health professionals treat skin disorders such as atopic eczema, genital psoriasis and allergic contact dermatitis.

While scientific evidence into the efficacy of cannabis in treating skin conditions is limited, it is thought that its anti-inflammatory properties could help reduce inflammation in a wide range of conditions including discoid lupus erythematosus and scarring alopecia.

“There is evidence that CBD has anti-inflammatory effects but there is still a lot of work to be done in terms of determining efficacy,” said Dr Richard Watchorn, a dermatologist based at Imperial College Healthcare NHS Trust.

“The numbers involved in the studies are not what we

would usually work with, so at this moment in time the evidence base is in its embryonic stages, but there’s enough to show that it is promising.”

The Sapphire Medical dermatology service will play a vital role in collecting this much-needed data. Participating patients - treated with either topical or systemic therapies - will be entered into a registry where doctors will record their symptoms and any improvement in their conditions to help inform future studies.

Serious skin conditions can have a devastating impact on people’s lives, affecting everything from their sleep to work life and personal relationships.

“If you’re living with chronic itching or chronic pain, it can affect your sleep, your ability to be productive in your work and therefore your job prospects,” Dr Watchorn explained.

“Skin conditions can affect people’s appearance, their selfworth and how they enter into romantic relationships - it really can be devastating for their whole life.”

He added: “Being able to access a new treatment, even one that doesn’t have a huge evidence base at this time, but that will hopefully in the future, is very exciting.”

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‘I just hope it will happen in my sister’s lifetime’ Siblings Chelsea and Tamsin Leyland both have epilepsy, but only one of them has access to life-changing medical cannabis.

DJ and activist Chelsea, tells Sarah Sinclair about the fight to save her sister.

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Chelsea Leyland had always been the ‘healthy’ sibling.

Growing up she saw her elder sister Tamsin rushed in and out of intensive care, having been diagnosed with intractable epilepsy as a baby.

The condition had already been a part of Chelsea’s life for as long as she could remember, when she started displaying symptoms herself aged 14.

“At the time no one knew them to be symptoms,” says Chelsea over Zoom, from her home in New York.

“I noticed when I was in the car and the light would come through the trees and flicker on my eyelids that I would get a strange sensation in my head, and I started to have what I now know are myoclonic jerks in the morning.

“They would happen more frequently when I was tired and on school days where I was feeling a little bit more stressed.”

The symptoms worsened and at the age of 15, Chelsea was diagnosed with juvenile myoclonic epilepsy (JPE).

She and Tamsin both carry a mutation in the CPA6 gene, often identified in certain forms of epilepsy.

“I was always the cognitively healthy sibling, so it was a real shock for me and my family, because we had been on this emotional roller coaster with my sister,” she says.

“To go through life believing there is nothing wrong with you, to then find out that you have this horrific condition that you’ve seen your sibling suffer with was very challenging.”

She was put on a number of anticonvulsant drugs, but although they did improve her condition the side effects were debilitating. Throughout her late teens and 20s, she experienced insomnia, extreme depression, anxiety and hyperactivity. She describes it as living in ‘fight or flight mode’.

“My nervous system was a complete mess,” Chelsea says.

But on the outside, she was carving a successful career as a DJ and model. She had moved to New York and was becoming well-known in the fashion crowd, with friends in high places and a huge following on social media.

Chelsea was at the Glamour Awards, listening to women give empowering speeches about their philanthropic work, when she realised she wanted to use her platform for something positive.

There was never any doubt about what that would be.

“I had been working in what felt like quite a superficial world for some time,” she says.

“I remember hearing all of these incredible female speakers who were committing their life to being of service. I went home that night and thought I have to use my platform for something good and what else to feel drawn to, but epilepsy?

“There’s a stigma about epilepsy and the way I was brought up was to keep it ‘hush hush’.

“I was in the fashion world and there were ways I could bring a different colour to the conversation, so it wasn’t

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just doom and gloom, which was how it felt when I was growing up.”

And so she turned her Instagram account - which now has more than 61K followers - into a platform for her activism.

“I didn’t have a million followers, but I did have a platform and a voice, and that could be powerful,” she adds.

Chelsea discovered cannabinoids around four years ago (medical cannabis was legalised in New York in 2016), through Sanjay Gupta’s famous CNN film about Charlotte Figi and how CBD was treating her intractable epilepsy.

“It was mind-blowing to watch,” she says.

“I had seen my sister having daily seizures for so long that it was hard to comprehend that a little bit of plant oil could be an efficacious form of treatment.”

But when she tried CBD through a friend and cannabis activist, she noticed its effects instantly. After six months of using cannabis, against her doctor’s and family’s wishes, she weaned herself off all of her pharmaceutical drugs.

She uses a full spectrum cannabis oil, containing a oneto-one ratio of THC and CBD, and has now been seizure free for three and a half years. She has even reached the point where she is able to take the occasional day off from medication completely.

“To say cannabis has kind of transformed my life is an understatement,” says Chelsea.

“It was already such an incredible gift that I was able to wean off pharmaceuticals, but now to get to a point where my body is in such balance that I’m able to miss a day is quite remarkable.

“It’s quite painful to imagine what life would be like without it. I still struggle everyday living with this condition. Even though I’m not having seizures, there are so many other elements of epilepsy that one has to battle with daily.”

She adds: “I felt like I couldn’t cope when I was on the medication, but cannabis allows me to feel like everything is going to be okay in those moments.

“It doesn’t just treat my seizures, it also helps my sleep, stress, digestion and anxiety. It’s a very dynamic medicine.

“My life would not be in such a good place without it.”

This is a truth that, sadly, Chelsea and her family know too well.

Her sister Tamsin, now 37 and living in an NHS facility for people with severe epilepsy in the UK, does not have access to this life-changing medication, despite it being legalised in 2018.

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These patients are someone’s mother, father, daughter, sibling; it shouldn’t matter how old they are, we still want to keep them alive

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Clinicians believe there is a good chance that medical cannabis would improve Tamsin’s quality of life, as she shares the same genetic mutation at Chelsea. But until doctors are able to prescribe it on the NHS, she will never know.

“It’s hard to articulate how unbelievably frustrating it is,” says Chelsea.

“It’s absurd that we are in this position where vulnerable patients like my sister - who we are struggling to keep alive - can’t access a plant extract, which could potentially be a life-saving form of treatment, due to her geographical postcode.

“Tamsin has severe brain damage from having seizures since she was a baby.

“We’re not looking for a miracle as a family, we’re just looking for some relief, and potentially a better quality of life.”

Chelsea’s activism has naturally transitioned into medical cannabis advocacy.

For the last two years she has been working on the documentary, Sisters Interrupted, which began life as an exploration of the medical cannabis space but ended up an intimate tale about two sisters and what it looks like when one is prevented from having the medicine she needs.

“Even though Tamsin is five years older than me, there was a time where I mentally outgrew her, so she almost feels like a little sister,” Chelsea says.

“As she is living in the body of an adult there’s less concern, but we need to remember that these patients are someone’s mother, someone’s father, someone’s daughter, someone’s sibling.

“It shouldn’t matter how old they are, we still want to keep them alive.”

Having started work on the documentary before the UK law change, Chelsea says it was a ‘big moment’, but ended up leaving her feeling ‘defeated’ and ‘disheartened’.

“We were celebrating that day, we really believed that our hard work and the work of all of the advocates who had come before us, had paid off - but it ended up being anticlimactic,” she says.

“I’m a fighter by nature, so it fuelled the fire and we realised this was going to be a much bigger fight than we thought.”

Chelsea might be a fighter, but she is also a realist and after more than three decades of watching her sister suffer, she admits that the fight is exhausting.

“Am I losing steam? Honestly, some days it feels like I am and I wish I could say otherwise,” she admits.

“But I am still fighting and just hope that it will happen in my sister’s lifetime.”

She adds: “In an ideal world, the outcome of the film would mean access for my sister, and of course on a wider scale, that everybody that could benefit from cannabis has access to a safe, standardised product.

“But even if we can’t change policies, at the very least I hope that my sister and I sharing our story will touch the lives of other people and help anyone struggling with this condition, feel that they’re not alone.”

Sisters Interrupted is due to be released soon.

Follow @cbd4epilepsydoc and @chelsealeyland Twitter for updates and visit www.separatingthestrains.com

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INSIGHT

Cannabis and IBD - not just a gut feeling?

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Mounting evidence suggests that medical cannabis can relieve symptoms of inflammatory bowel disease (IBD) - but what role does it have to play in treatment? Sarah Sinclair reports.

“For seven or eight years cannabis was a lifeline for me. I really don’t know if I’d be here without it,” says Alex Fraser.

“It’s not that the disease would have killed me, but that it was so awful that I might have taken my own life if I hadn’t had the relief from cannabis.”

He adds: “I don’t say that lightly. It’s such a horrific disease that people do, especially when diagnosed young, sadly take their own life.

“It’s that severe and there’s that much pain.”

Alex, 29, was diagnosed with Crohn’s Disease 10 years ago. He was already using cannabis recreationally when he started to see an improvement in his symptoms.

Without it he could find himself rushing to the toilet up to 12 times a day. But the cannabis reduced this drastically, as well as easing his pain and nausea, boosting his appetite and helping him to sleep. All of which had a knock on effect on his overall quality of life.

“Cannabis allowed me to have a good quality of life despite having difficulties with the disease. It certainly didn’t eliminate my symptoms but it did help me cope,” he says.

“I think people underplay that aspect of cannabis, joking about the munchies, but without any appetite I would have lost a lot more weight and become much more unwell as a result.

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“It’s so important to have a good sleep and three meals a day, especially when you’ve got such a serious illness.”

In 2014 Alex’s disease was manageable enough for him to form the United Patient Alliance, advocating for better access to medical cannabis, and went on to become involved with the End Our Pain movement, supporting the campaigns of Billy and Charlotte Caldwell and Hannah Deacon and Alfie.

He would later find cannabis to be a saviour for his mental health, after having surgery and a colostomy bag fitted as a result of his Crohn’s in 2017.

“It was certainly something I struggled to come to terms with and cannabis was a lifeline for me afterwards in helping with my mental health and anxiety,” he admits.

Since the surgery Alex’s Crohn’s Disease has been in remission and he now has a full-time role as patient access lead with Grow Pharma, a UK based supplier of unlicensed cannabis medicines.

Through his work he speaks to dozens of medical cannabis patients every day and believes there is a wealth of anecdotal evidence to support the use of cannabis in IBD patients.

“I speak to hundreds of patients now, at various different points with their cannabis use and I do talk to a lot of people with Crohn’s Disease as well,” he says.

“Some use cannabis and some don’t, but nearly everyone I have spoken to who has tried it says they have had some benefit from it.

“It seems to be fairly consistent that it helps with symptoms of pain, nausea, sleep, appetite and mental health.”

While he believes there are a small number of gastroenterologists prescribing medical cannabis in the private sector, many patients will receive a prescription for the pain-related symptoms.

He adds: “I would love to see more research into it and more IBD specialists being aware of and understanding the endocannabinoid system and how these medicines work.”

Dr. Timna Naftali, a gastroenterologist at the University of Tel Aviv, was the first person to explore the effect of medicinal cannabis on inflammatory bowel disease (IBD) and has studied its impact on both Crohn’s and Ulcerative Colitis patients.

Writing in the ‘Overview of cannabis based treatment in Crohn’s disease’ published earlier this year, Dr Naftali noted that the plant has ‘therapeutic potential’ that ‘must not be neglected’ suggesting that it can have a ‘significant’ improvement on symptoms.

Her most recent study of 50 patients with Crohn’s Disease, reported that those who received medical cannabis - of a ratio of four to one CBD/THC - saw their symptoms improve over a period of eight weeks.

Patients reported less diarrhea, reduced abdominal pain,

Patients taking cannabis say they have less abdonimal pain, less diarrhea and can reduce the amount of steroids they are taking

an increase in their appetite and an overall better quality of life, she says.

“Patients taking cannabis say they have less abdominal pain, less diarrhea and can reduce the amount of steroids they are taking.

“They all say sleep much better, have a better appetite and generally feel better,” Dr Naftali explains.

However, there was no change in the actual inflammation caused by the disease.

“The study not only looked at clinical data, but patients underwent a colonoscopy before and after,” she continues.

“What we observed is that while patients felt better there was no endoscopic change - the inflammation inside remained as it was before.”

To date there have only been three small placebo controlled studies on cannabis in IBD patients, two of which showed ‘significant clinical improvement’ but no change in markers of inflammation.

Despite being initially sceptical about the role of cannabis in medicine, it was a patient who unknowingly convinced Dr Naftali to carry out her own research.

One day out of the blue a particularly symptomatic patient stopped turning up to her clinic. When she returned a year later she revealed she had been using cannabis and her symptoms had stopped.

“This was just one case, so I wasn’t terribly convinced,” she says.

INSIGHT

“Later I had a patient who was very symptomatic, she was limited in what she could eat and couldn’t go out of the house for longer than an hour, because he would have to rush to the toilet.

“I suggested she try cannabis and she came back next time and had eaten an apple - this is someone who didn’t eat anything but boiled chicken and soup for 10 years.”

Dr Naftali now believes that cannabis does have the potential to treat inflammation, but research is still in its infancy and more studies are needed to investigate the effects of the various cannabis compounds.

“We need a lot more research. If you look at the animal and lab studies, it seems that cannabis does have the potential to cure inflammation, but these studies have not yet been translated to human trials,” she says.

“Cannabis has so many different compounds. I’m sure if we managed to isolate the right active ingredients and found the right way of taking it, it could turn out to be a useful treatment.”

In Israel, the Ministry of Health permits the use of medical cannabis for patients with Crohn’s Disease who meet certain criteria, including not responding to any alternative biologic treatments.

But until more research is conducted, Dr Naftali is hesitant to prescribe, seeing its role as largely a last resort.

“The main role that cannabis can have at the moment is either as a bridge for a period until more effective medicines work, or for those who have such severe disease that they don’t respond to any other medicine,” she adds.

“30 years ago we knew we had no better treatments, I would have said this is wonderful. But now we have six different types of biologic treatments that will reduce the inflammation in the first place so patients will not need the symptomatic treatment.”

“Currently we know that cannabis is very useful for symptomatic improvement, but it cannot replace the real anti-inflammatory treatments.”

Considerable developments have been made in biologic and autoimmune treatments for IBD since Alex was diagnosed.

He decided not to try biologics when they were first offered to him in 2014, but feels that maybe he may have felt differently if he had had a better, more open relationship with his doctor.

“At the time I was resistant to using biologics and immunosuppressant drugs and you could say that was the wrong decision as I ended up having surgery at the end, but had I been able to receive cannabis through a doctor, I would have trusted them with other potential treatments as well, he says.

“My doctors knew nothing about cannabis and so my trust in the healthcare system waned, because I was treating myself better than they were treating me.”

“Now we have more research into those drugs I can see that actually they are having some very positive effects, but I do think there’s a role for cannabis there, at least for symptom control.”

Another 45-year-old Crohn’s Disease patient, who asked not to be named, has found using just CBD products has helped him manage his symptoms.

“I suffer from extreme tiredness, severe pain and have to use the bathroom at least 20 times a day,” he says.

“To manage the pain I always used Tramadol, which was the only painkiller that helped.”

He has been using CBD for three months and has been able to come off painkillers for the first time. It has also helped him manage the anxiety that comes with IBD. “Crohn’s makes you live an anxious life, nervous about where you’re going and what you are doing,” he continues.

“It has a big impact on work as a business owner and employer, It makes you nervous and I worry all of the time about falling ill.

“Within 48 hours of taking my first drops, I felt less anxious, had a night’s sleep for the first time in months and was at a point where I didn’t need my Tramadol as my pain settled.”

Dr Naftali is currently investigating where CBD on its own can relieve symptoms in patients, but expects it may not be enough to have a noticeable impact.

“If this is effective, it would be perfect, because it’s a really safe substance and there’s no central effect, but I have a feeling that you need more than just CBD. “If you look at my previous experience with patients it seems that the plant extract with some THC works better than the pure CBD.” Alex also found that while using CBD on its own had some positive effects in relieving his anxiety and stress, it wasn’t as effective as full extract cannabis.

He adds: “I’ve tried cannabis products of all kinds and while CBD definitely has a role to play, as an anti-inflammatory, I don’t think it’s powerful enough to control Crohn’s Disease on its own.”

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“I just medicate to hoover” 62

Lorna Bland had never been drunk - let alone high - when she became one of the first recipients of a medicinal cannabis prescription in the UK. She tells Sarah Sinclair what it’s like tackling stigma as a ‘suburban housewife’.

“There is a perception of the type of person who consumes cannabis, and I’m everything that that kind of person is not,” says Lorna Bland, a 57-year-old housewife, who lives in Surrey with her husband, and has raised two grown-up children.

“I discovered cannabis in my 50s. I was of the generation where it was perceived to be a bad thing. I’ve never been drunk, so I certainly had no interest in getting high which is what I associated with consuming cannabis.”

She adds: “I’ve had to adjust my mindset to the idea that this isn’t a dangerous thing, it is a therapeutic medication.”

Lorna was one of the first UK patients to receive a prescription for medicinal cannabis following the law change in 2018.

She has been living with fibromyalgia for more than a decade, diagnosed in 2007 after a year of unexplained pain and chronic fatigue.

“Fibromyalgia is living with a level of pain that other people cannot imagine,” she says.

“It’s 24/7 pain, in 100 percent of my body, 100 percent of the time. Every movement I make has a pain reaction to it and it does make life really quite unbearable.”

There’s is no specific medication to treat fibromyalgia, so instead Lorna was prescribed various heavy duty pharmaceuticals to manage the pain, including amitriptyline, gabapentin and pregabalin, which robbed her of a month of her life, she says - “I was on another planet.”

With nothing else available to her, Lorna describes being “abandoned” by the NHS and began exploring CBD, but it wasn’t enough to relieve her pain.

She resisted cannabis - despite some persuasion from her two children - until it was rescheduled in 2018. She went to see a pain specialist and became the first patient he had prescribed medicinal cannabis for.

“We learned about it together and I was more than willing to be his guinea pig,” she says.

“That first prescription cost me £1,032 for three months worth of flower, which was for dry vaping.

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“I later realised that it was not going to be the right method for me and that I needed something that was a bit more discreet.”

Lorna admits that she feared what people would think, particularly her neighbours who she had to warn not to be alarmed by the smell - but she needn’t have.

“The response from family and friends was incredible,” she says.

“The neighbours said ‘all we want is for you to be well’ and my mum who’s in her 70s could not have been more supportive.

“The people I worried the most about telling were my inlaws, but they actually offered to pay for the prescription.”

Lorna eventually moved onto an oil which is more effective and actually cheaper. Her prescription now costs £80 pounds for a 30ml bottle of oil, which will last seven weeks. It works out at £50 a month, or £1.60 a day.

“I appreciate that I’m in a very fortunate position to be very well supported by my husband to be able to go down the private prescription route,” says Lorna.

“I struggle sometimes with the fact that I know so many patients can’t afford it but I think it’s important to get the message out there that it is possible to get cheaper medication.

“It goes without saying that I should be getting this on the NHS, but I think because I’m paying for the treatment, I’ve got that financial investment so I tend to invest much more in myself as well.”

Before taking medical cannabis Lorna would be able to take an average of around 1,000 steps a day - over 18 months later she can do anything up to 10,000 and is out for a walk every day with the dogs.

“It has absolutely transformed my life,” she says.

“I’m not pain-free and I’m not cured. I’m never going to be back to how I was but I now have some quality to my life that has been missing for all these years.”

Despite having to give up her job with a charity that she loved after her diagnosis, she has been able to continue the work in the voluntary sector which means so much to her.

“I went through a period of grief following diagnosis, adjusting to the fact that life was not going to be the same as it was before, but I believe in having a positive mindset so for me it was about finding the things that I could do rather than focusing on the things that I couldn’t,” she says.

Having volunteered since the age of 15, Lorna has spent many years specialising in bereavement care, receiving a BBC award in recognition of her work supporting families of stillborn babies, and was a major incident responder for the Grenfell fire and London terror attacks.

More recently she also helped launch advocacy service

I’m not pain-free, I’m not cured, but I now have some quality to my life that has been missing for all these years

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PLEA (Patient-Led Engagement for Access), to challenge the inequalities in access to cannabis-based medicinal products in the UK. “PLEA has really pushed me to do things I would never have imagined doing, purely because I wanted to help other patients,” says Lorna.

Although she describes herself as a ‘private person’, she is using her platform to tackle the stigma still attached to cannabis consumption in society.

“For me the whole point of going public was to destigmatise it,” she says.

“I don’t meet the mould - I am a middle-aged suburban housewife - I’m not living an extraordinary life, I’m not trying to climb mountains or run marathons, I just medicate in order to hoover.”

Lorna adds: “It’s important that we are represented.

We’re just ordinary people trying to live ordinary lives - and not once in all of this have I ever been high.”

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Seeding the future 64 64

The hemp industry has the potential to boost the economy, create jobs and tackle climate change but we need to act fast, say those behind the first UK Hemp Manifesto.

Britain’s greatness was built on a thriving hemp industry.

In the fifteenth and sixteenth centuries, during the reigns of King Henry VIII and Queen Elizabeth I, hemp was so valuable, it was illegal not to grow it - people even paid their taxes with it.

Now Britain is being left behind as the rest of the world cashes in on the hemp renaissance.

These are the views outlined in the UK’s first Hemp Manifesto, put together by experts in the field, including the British Hemp Alliance, Beyond Green and Unyte.

The document makes a compelling case for the as-yet untapped potential of hemp here on British soil. It is calling on the government to recognise and promote hemp as an essential environmental crop and to make the change in policy necessary for the industry to thrive.

The manifesto was delivered to Number 10 in September and was welcomed by Cabinet Minister, former environment secretary and self-proclaimed reformed environmentalist, Michael Gove following talks with campaigners about how hemp could help the British climate.

“The hemp manifesto solves a lot of our UK issues right now,” said Beyond Green’s Sam Cannon, who co-authored

the manifesto with the British Hemp Alliance.

“It will boost the economy, tackle green initiatives, create jobs and support the farming industry with a plant that is sustainable and not harmful.

“This has the potential to sort out issues that are directly affecting the people of this country. It’s mind-boggling why they haven’t moved on it already.”

The global hemp industry was worth $4.6 billion in 2019, and is expected to grow to $26.6 billion by 2025.

In 2018, China made almost $1.2 billion in hemp sales, followed by the US at $1 billion, and all of Europe at $980 million.

Here in the UK the hemp sector is still relatively non-existent.

The manifesto reports that whilst hemp cultivation is growing throughout Europe (33,000 hectares in 2016) the UK lags behind with barely 850 hectares.

“There are so many barriers to growth in the UK and while the rest of the world is opening up to hemp as agricultural crop and seeing a huge renaissance, we are still very far behind and missing out on a lucrative new industry,” said Rebekah Shaman, managing director of the British Hemp Alliance.

INSIGHT

“We haven’t looked at hemp as an agricultural crop since 1993 when they gave out the first hemp licences.

“This is the first time there has been a manifesto that very clearly lays out what needs to happen.

“It is offering a new perspective of hemp as an essential agricultural and environmental crop for future generations.”

Under current legislation hemp is not considered an agricultural crop and farmers must apply for a licence from the Home Office. This requires every farmer to provide an enhanced DBS check and for every new field grown, a new licence has to be applied for.

These are then awarded in April, too late for hemp farmers to prepare for the seasonal crop.

In addition, while hemp is under the Home Office, farmers are unable to access any funding or support from the Department for Environment, Food and Rural Affairs (DEFRA) or the National Farmers Union (NFU).

The flower and leaf of the plant, which contain the cannabinoids, are then prohibited from being used, reducing any potential return they can make on it.

This is despite the fact that CBD products can be legally imported into the UK - a market which is currently worth £300 million and growing.

The manifesto calls for the Government to remove hemp as a controlled substance from the Misuse of Drugs Act 1971, permitting the use of the whole plant and to remove all Home Office licencing restrictions.

It also advocates for the descheduling of all derivatives, extracts, cannabinoids, and seeds of the whole hemp plant, as long as those portions of the plant remain below the THC threshold.

“We’re asking the Government to recognise the importance of this crop in a post-Brexit, coronavirus landscape and remove those crippling barriers,” said Rebekah.

Sam, who alongside Rebekah led the Seed the Future campaign earlier this year to raise awareness of hemp, added: “We can import CBD products from other countries but farmers in the UK have to destroy the leaves. If they were allowed to use them it would become a viable crop for them because of the potential return that they can get on it.”

He continued: “Hemp will bring new innovation to farming, inspiring a new generation of young farmers to come through into a cool industry, that’s sustainable and can do so much good.”

Then there’s the small matter of the climate. The UK has signed up to the Paris Agreement on Climate Change,

pledging to become Net Zero by 2050. The manifesto highlights how hemp could have a huge role to play in helping reach those targets.

Growing four metres in just four months, hemp requires little or no pesticides and absorbs 15 tonnes of CO2 per hectare - 25 times that of the equivalent size rainforest.

Rebekah said: “The Government has signed up to these green initiatives and here is a crop that could potentially support them in meeting their targets and yet they’re not recognising that there’s a potential solution here.”

But we need to act fast. With the rest of the world already ploughing on with production, we risk becoming importers of hemp rather than producers, according to Rebekah.

“Five years down the line America and other countries will be so far in the innovation and manufacturing process that we won’t be able to catch up,” she said.

“This is about highlighting this as a profitable crop that everyone should be able to benefit from - the farmers, the rural economy and small businesses that want to sell products to feed their families.

“The hemp boat is in the port and if we don’t act now to remove the barriers it will be too late.”

The manifesto also asks that the Government dedicate a proportion of the green jobs plan, promised by Chancellor Rishi Sunak in his Green Jobs Summer 2020 Statement, to the hemp industry.

“The ideal scenario is that Gove comes back and organises a sit-down with the Prime Minister and says let’s stop mucking around,” added Sam. “Let’s be the entrepreneurs that this country is thought to be. We should be allowed to drive this forward and let the hemp industry thrive.”

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Going green Three CBD companies spoke to Johanna Perraudin about their journey to be more ecologically responsible - and the challenges they had to overcome along the way.

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As concerns for the planet have never been higher – with 29 countries breaking temperature records between May and August 2019 and the year 2020 almost certain to be ranked among the four warmest years on record, more and more companies are trying to minimize their impact on the environment.

Hemp itself can be considered sustainable in comparison with other crops.

Being a resilient plant, it does not require any chemicals such as herbicides or pesticides to grow. It is usually grown outside, with no electricity and very little water required - less than a third of the water needed for cotton.

Hemp has also low carbon emissions and is able to capture emissions from the atmosphere.

Unlike other crops which can dry out the soil, hemp puts nitrogen back in and loosens it, creating a good environment for other plants to grow afterwards.

So, if hemp can be considered environment-friendly, how can CBD businesses be ecologically responsible too?

We spoke to Christina, co-founder of Essench, a UK brand selling vegan, cruelty-free and ethically produced products. Since 2019, Christina and co-founder Jennifer, have been determined to be as ecologically responsible as possible.

“As a business we are using nature’s creations, so it is only fair to give back to nature,” says Christina.

They carefully choose the ingredients they use, ensuring their products do not contain any palm oil and are made in the UK using Christina’s own formulas.

To reduce their carbon footprint and strengthen quality control on their ingredients, Essench’s founders are determined to grow their own plants and extract their own oils such as lavender and sunflower oils within two years.

However, due to British legislation they cannot grow and extract their own CBD oil, a major stumbling block in their objective to reduce their carbon footprint.

In the UK, hemp can only be grown to harvest its seeds and stalks and the flowers must be immediately destroyed.

This means that CBD companies must go through a UK laboratory which imports hemp flowers from Europe or North America.

This is highly problematic given that imports are a major part of the UK’s carbon footprint, with around half of it coming from emissions released overseas to satisfy UKbased consumption.

Christina and Jennifer took part in the Seed the Future protest on 19 July. Protesters congregated in their own areas and as a symbolic gesture, planted a hemp seed in a pot to contest the legislation around cannabis production.

“In the UK, the minute you put a hemp seed in a pot, you can be prosecuted for cultivation,” says Christina.

“Because of the stigma around hemp, the legislation does not allow us to produce it, even though hemp can provide so many things.”

Another challenge Essench met in its effort to be environment-friendly was packaging.

In 2019, they decided to get rid of all the plastic in their packaging. However, it ended up being harder than they thought. They did find eco-friendly alternatives such as glass for their creams and scrubs, but couldn’t find any satisfying solutions for their dropper bottle pipettes.

Even greener options, such as bamboo, were coated with plastic on the inside.

“There should be a lot more companies getting involved in packaging solutions,” Christina adds.

“At the moment, eco-friendly options are very limited and very expensive for a small company like ours.”

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For Zero Waste Week, which took place from 7 - 11 September 2020, Essench launched its first zero-waste product. The serum comes in a glass bottle and when empty consumers can order a refill that will come in an aluminium bottle. Essench then pays the postage for the bottle to be sent back, sterilised and used again. Its goal is to expand this to other products such as oils.

Alex Hunter, CBD Centre’s director, has also made sure to incorporate ecology into his objectives.

CBD Centre provides raw organic products for customers to make use of it as it is, or to create their own products.

“You can actually make a lot of products yourself; you don’t need a lot of special ingredients,” says Alex.

“It will also probably be cheaper and better for you as your own products won’t contain any preservatives.”

CBD Centre has instructions for creating CBD butter, oil and a vegan smoothie on its website, and Alex hopes to publish a book of recipes so that his customers can make their own products.

“It will be a way to offer an alternative to people with the aim of avoiding mass production, processing and the environmental implications that are associated with these,” he adds.

CBD Centre also worked hard to find a suitable solution for the environmentally-friendly packaging.

All of its products are made from reusable or recyclable materials and you can see how to recycle each product on their website.

Its wax pots are made from untreated bamboo, which is biodegradable, although the inner plastic needs to be removed and recycled locally. Its oil bottles are made of glass which can be recycled locally, bamboo which can go into the compost bin, and plastic for the dropper which can go into the plastic recycling bin.

Unfortunately, its flower pouches cannot be recycled locally. However, customers can send them back and the team will forward them to a company to be turned into fuel used for boats, machinery, and land vehicles.

Just like Essench and CBD Centre, Green Active struggled with its packaging. Business development manager Jo Devall, described the process of finding eco-friendly alternatives as “frustrating and challenging.”

The Green Active team spent six months working on finding the right packaging.

“It was an incredible learning experience for us and completely cemented our commitment to providing environmentally friendly packaging. The issue we faced was cost,” he says.

They had opted for vegan and vegetarian friendly inks, 100 percent biodegradable packaging and 100 per cent recycled materials. Unfortunately, the initial cost was – and still is – too high for them.

We aren’t perfect, but generally the people in this industry have a deep desire to benefit those around us “For Green Active it has been a case of working out what we can do now and what we will do later,” says Jo. Although they cannot afford it at the moment, they are still determined to find a 100 percent environmentally friendly packaging.

“Whilst we make incremental changes to ensure a sustainable future, it is vital that cannabis companies like ours stay focused on the longer-term goals of the company,” Jo continues.

“When we come across a problem, to learn and develop, we focus on our why. Why are we doing this? Why does it matter? When we focus on the why, the ‘how’ we will achieve it, closely follows.

“When your ‘why’ is strong enough, people will always figure out ‘how’ to do it, and this applies as much for sustainable businesses practices as it does with anything else.”

For the delivery, the company opted for Royal Mail.

Although it is one of the most expensive options, they appreciated Royal Mail’s dedication to become carbon neutral.

All their products are derived from certified Cannabis Sativa L. which is grown to organic standards within the EU. Their supplier’s farms are fit for an organic stamp approval, but they continue to batch test for heavy metals, pesticides, and herbicides, nonetheless.

When asked what one piece of advice he would give to CBD companies beginning their journey to become a greener business, Jo says: “Be humble. Accept that you may not get things right every time, you may not make the right call at the right time and that’s okay.”

“It’s important to remember that behind the brand name, company, title, there is just a human surrounded by more humans,” he adds.

“We aren’t perfect entities but generally the people that join this industry have a deep, unshakable desire to benefit those around us and when you have that outlook it’s acceptable to make mistakes with the right intentions.”

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Two years on: What happened to our prescription bid?

S P EC I A L R E P O R T

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It's been two years since medical cannabis was legalised in the UK, but dozens of severely epileptic children and young people still don’t have access to an NHS prescription.

Sarah Sinclair spoke to their families to find out why.

S P EC I A L R E P O R T

On 1 November 2018 medical cannabis campaigners celebrated.

The treatment that was saving the lives of their loved ones was finally legalised in the UK, after months of rallying politicians, national TV appearances and telling their stories to the press.

No one thought that two years on they would still be fighting.

Since the law change, less than five NHS prescriptions have been issued and parents have spent tens of thousands of pounds funding their child’s medication each month. Some have sold their homes, risked everything pursuing legal action and spent the hours that they should have been with their sick children calling for change.

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Leading UK charity Epilepsy Action has now joined forces with families from the End Our Pain campaign to urge the Government to act on its promise for easier access to cannabisbased medicines.

In an open letter to Prime Minister Boris Johnson, the families of 25 children and young people, have pleaded with him to intervene in what has become a ‘matter of life and death’. It comes after they learned Mr Johnson had sent a congratulatory letter to the mother of a child who is believed to be only the third person to receive an NHS prescription after a two-year fight.

In the letter, the Prime Minister said he ‘sympathised deeply’ with those suffering from drug-resistant epilepsy and ‘completely understands’ the importance for patients to have access to the most effective treatments on the NHS.

S P EC I A L R E P O R T

Here, seven families reveal the blocks they have come up against in their fight for medical cannabis.

Bailey It’s November 2018. A then 16-year-old Bailey, is in the high dependency unit at his local hospital having another seizure. His mum, Rachel Rankmore and dad, Craig Williams, have been up for 48 hours straight monitoring their son in case the unimaginable should happen.

A consultant neurologist chooses this moment to ask the family if they want to have a conversation ‘about the other stuff?’

Bailey has been taking hemp oil for two years but despite making huge improvements at first, his condition has plateaued. He is now having hundreds of seizures a day. He needs full extract cannabis oil.

Bailey has a rare form of epilepsy known as Lennox Gastaut Syndrome. For most of his life he has had to wear a crash helmet to protect his head from drop seizures and being blue-lighted to hospital has been a weekly occurrence.

Before he tried Charlotte’s Web CBD, doctors told Rachel and Craig there was nothing more they could do for him.

“The hospital offered to give us Epidiolex [a drug containing CBD which was approved for use in the UK last year], but we knew we needed full extract cannabis oil,” remembers Rachel.

“I asked them why they wouldn’t prescribe when they knew there was nothing left for Bailey to try.

“At first they said it was because THC would ‘damage his brain’, but when I pushed them the answer I got was that they helped write the BPNA (British Paediatric Neurology Association) guidelines and couldn’t go back on them.”

BPNA guidance for clinicians says that products with ‘higher proportions of THC (>0.2%) have no randomised controlled clinical trial evidence of safety or efficacy’ in children and young people with epilepsy.

It adds that clinicians should not feel ‘under pressure’ to prescribe cannabis-based medicines until they have undergone clinical trials.

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Rachel asked for a second opinion from another neurologist at the hospital. Again, the answer was no.

Bailey has had a private prescription for medical cannabis for two years now. He has had no emergency trips to the high dependency unit and has been able to reduce his antiepileptic drugs. He is attending school, engaging in conversations, playing computer games and going out with his support workers. As Rachel says, Bailey is “living his best life” for the first time in 19 years.

But his prescription is only afforded through donations from his friends, family and followers - and due to coronavirus restrictions they have been unable to hold any fundraising events this year.

Rachel has been told by a hospice that when he inevitably ends up in hospital with uncontrollable seizures the only line of treatment available would be pain management.

“They would write my son off rather than give him a prescription for a medicine that has proved to work for him,” she says.

“Our son’s life is in danger because the guidance has failed him.”

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Our son’s life is in danger because the guidance has failed him

Murray 72

Karen Gray was also told by her consultant that he wouldn’t prescribe full-extract cannabis for her son Murray, eight, due to the BNPA guidelines.

Murray, who has Doose Syndrome has been seizure-free for 18 months since he started taking full extract cannabis oil.

He looks unrecognisable to how he did before. He is speaking, attending school and no longer needs the use of a wheelchair.

But when his case was referred to the Refractory Epilepsy Specialist Clinical Advisory Service (RESCAS) it was recommended that he be weaned off the oils and put back on Epidiolex.

Karen says she has always accepted the consultant’s decision not to prescribe, but refuses to take him off his current medication, when epidiolex had previously left him in epileptic status and confined to a hospital bed.

“There was no way I was going to change anything when Murray has been seizure-free since June 2019,” she says.

“I asked for the RESCAS decision to be appealed so I could pursue a shared care agreement [as two other children have, which allows them to access their prescription through the NHS].”

Murray’s consultant recently resigned from his care claiming the ‘stress of the situation’ was putting him under too much ‘strain’.

In a letter which Karen received ‘out of the blue’ he said he has been finding it ‘difficult to deal with’ her requests for Bedrolite and Bedica (which have a higher strain of THC) and claims the demand was having a ‘serious impact’ on him.

Murray is now under the care of the complex epilepsy team, made up of several neurologists, who have said they would consider putting Murray’s case to RESCAS again in six to 12 months.

“That’s another six to 12 months of us funding his prescription ourselves,” says Karen, who currently struggles to find £1,400 a month for Murray’s medicine.

“We can’t afford this long-term but we’re terrified that if we take him off it he will start having seizures again.”

Ben The lack of clinical trials is an explanation which Joanne Griffiths has heard often.

She is also trying to pursue a shared care agreement for her son Ben, 11, but is fighting a losing battle. She first asked for full-extract cannabis following the law change in 2018 but says she got ‘a flat no’.

“I was told they had a clear policy that they were not going to prescribe these drugs until more trials were done,” says Joanne.

“They constantly quoted the BPNA guidance.”

She and her husband considered going down a judicial route but decided it would be better to work with the doctors who had cared for Ben - who has had severe epilepsy, cerebral palsy and autism - all his life.

“We were eventually discharged with a letter saying we had asked for THC products that were ‘illegal to prescribe’ which they weren’t,” she continues.

“Every child is different but Ben wasn’t being treated as an individual.”

A year down the line Joanne has just received a letter from the Greater Preston Clinical Commissioning Group (CCG) declining her funding request for a shared care agreement between Ben’s GP and private neurologist, as it was ‘contrary’ to policy and no grounds for ‘clinical exceptionality’ were found.

Joanne is now considering legal action.

“It’s the only thing I can do,” she says.

“They know that Ben has got no other treatment line left.”

Charlie One family taking the same risk is Matt and Ali Hughes, parents to three-year-old Charlie.

Before they discovered cannabis medicine last May, Charlie, who was diagnosed with West syndrome at 10 weeks old, was having up to 120 seizures a day. Now they are down to between 10 and 20.

The couple are seeking a judicial review of National Institute for Health and Care Excellence (NICE) guidelines which prevent doctors in the NHS prescribing medical cannabis, and leave them forced to fund the £1,200 prescription each month themselves.

NICE has acknowledged the need for more research into the use of medical cannabis and supports NHS England’s call to collect evidence from randomised controlled trials and observational studies.

But the guidelines state that until there is clear evidence of the safety and effectiveness of cannabis-based medicinal products, specialist doctors need to consider individual patient circumstances and the risks and benefits in choosing treatments.

Matt and Ali will argue that the existing evidence - while mostly anecdotal and low quality - should be enough to support doctors to prescribe full extract cannabis oil for severe treatment-resistant epilepsy.

If they are successful the guidance could be redrafted, which they hope would give some doctors the confidence to write the prescription.

“I’ve spoken to clinicians that say they would prescribe if they could but I think there is a feeling that if they step out of line, their trust will block it anyway,” Matt told Cannabis Health.

“A lot of clinicians are prescribing it privately, just not on the NHS. So why is it fine for children to take it privately but for the NHS we need all this extra evidence?”

Zak In 23-year-old Zak’s case, it wasn’t that his doctor didn’t accept that the evidence was out there, rather they ‘didn’t have time’ to read it.

“I’ve asked our consultant several times why they won’t prescribe on the NHS. They always say that the research hasn’t been done to prove that it’s safe,” says Zak’s dad, Benedict Lamb.

“As parents we’ve become quite knowledgeable about the subject. Over the last 15 years in Canada and Israel there have been several published studies. I told them all the research exists, but they said they didn’t have time to read it.”

Benedict feels lucky in a way, even though Zak has Dravet Syndrome and is severely disabled, he has responded well to Epidiolex, where many children do not.

Age 15, doctors told the family he only had six to 12 months to live. But thanks to the medication, eight years on Zak is very much alive, attending a specialist college and continuing to make improvements.

CBD saved Zak’s life, but he still has seizures, and with every one there is a risk that he might not come back from it.

“Every time they have a seizure, it comes with the risk of more damage to the brain, nervous system or even death,” says Benedict.

“When he was younger Zak used to have very serious fits on a regular basis, but thankfully that’s stopped since he was put on Epidiolex.

“Although he still has seizures, they are all around the three minute mark, which means that he doesn’t end up in hospital.

He adds: “We’re in a much better place than we were, but he hasn’t got any better. The goal for all of the parents in the group and beyond is for our children to be seizure-free.”

It is hoped that an oil with a higher concentration of THC will help to control Zak’s seizures and he is due to trial a new product, which has been generously funded by the pharmaceutical company for six months. But then what?

“They could turn around and say its X amount,” says Benedict.

“And then we’re faced with balancing the financial stress against our child’s health.”

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Eddie

Fallon

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“It’s all about the money,” according to Fallon’s mum, Elaine Levy.

If anyone should know it’s Elaine. She was forced to sell her house to fund her daughter’s medical cannabis prescription, with the financial pressure of finding the £2,200 each month leaving her “broken” - both emotionally and financially.

The family are now staying at Elaine’s sister’s flat, with no idea how long it will be until they can look to find a place of their own.

Fallon, 27, who has had Lennox–Gastaut syndrome since the age of four, went from being ‘zombie-like’ on a cocktail of antiepileptic drugs and barely able to leave the house, to enjoying a full day out with her family for the first time thanks to medical cannabis.

Elaine says Fallon’s former consultant, who is one of the country’s leading epilepsy specialists, has tried ‘every way he can’ to help them.

“When we got the letter from NHS England to say we could have medicinal cannabis, Bedrolite was on the tarif as one of the drugs we could have,” she says.

“He wrote the request out there and then, but within half an hour he had received a response refusing it.”

Elaine has tried Fallon on a cheaper oil but it wasn’t as effective and she couldn’t bear to watch her daughter falling over and “smashing her face on the floor” several times a day.

It was even suggested that she film Fallon falling over when she runs out of medication, as his may help build her case.

But Elaine believes that the “excuses” about a lack of evidence, are just masking the real problem - that medical cannabis is too expensive to fund on the NHS. “There is so much evidence - we are the evidence,” she says.

“It’s not about the guidelines, it's about the money. The NHS has not got the budget for it. Too many people would need it and they would be inundated.”

Elaine adds: “My consultant said to me in his own words when I left his office for the last time, if it was ‘£5 a bottle I would be prescribing it for everyone who needs it with intractable epilepsy’ - which says it all really.”

Back in 2018 Ilmarie Braun still had hope. She was alongside campaigners such as Hannah Deacon and her son Alfie, who were tirelessly fighting for the law change.

“For a while it all moved fast and things felt really positive, it felt like we were being listened to,” she says.

Ilmarie and her husband Alex met with MP Nick Hurd, who at the time was setting up a panel of specialist epilepsy experts to deal with cases ‘just like Eddie’.

Eddie, five, was given a diagnosis of West syndrome at seven months old. He spent the first years of his life on up to five different types of antiepileptic drugs until his parents tried him on Hayley’s Hope CBD from America.

As he was weaned off the pharmaceuticals, with no deterioration in his condition, they saw his personality emerge for the first time.

But the CBD alone wasn’t enough to control Eddie’s seizures.

His pediatrician agreed to put an application in to RESCAS, but it was refused on the grounds that it wasn’t written by a neurologist and Eddie hadn’t yet tried Epidiolex (despite the fact it hadn’t yet been approved for use in the UK).

When he started to plateau on the Epidiolex, they again asked his doctors for a prescription of full extract cannabis oil. Their consultant took the request to the drugs and therapeutics committee, where a panel of eight said no, unanimously.

By this point, the family had obtained a private prescription from a neurologist in London and according to Ilmaire, the

S P EC I A L R E P O R T

the panel felt it would have been “immoral” to ask them to write him one on the NHS. “They all claim to have every sympathy with us, we get all these different people saying ‘we really feel for your family and what you’re going through’ - but they don’t,” she says.

Ilmarie accepts the fact that theirs was a small hospital and staff didn’t feel they could be the first to prescribe when specialist centres such as Great Ormond Street were not.

She finds it harder to accept that the Government could do something to alleviate some of these families’ suffering, but chooses not to.

“There’s a huge amount of politics involved. Matt Hancock promised that he would help us and he hasn’t,” she says.

“Our doctors won’t even tell us whether our kids are going to be teenagers. We don’t know how long we have and yet they’re telling us we need to worry about possible psychosis later on down the line, it makes no sense.

“We don't know what the future holds, but we know it's not going to be easy. We’re angry that the Government won’t do something to alleviate that.”

Ilmarie speaks for many when she says a breakthrough feels as far away as it ever did.

“There’s a real mismatch between what was promised and what the reality is,” she adds.

“This is not what anyone was campaigning for.”

There’s a real mismatch between what was promised and what the reality is. This is not what anyone was campaigning for

What the Department of Health said: The Department of Health is said to be ‘working closely’ with NHS England-NHS Improvement (NHSE-I) and the National Institute of Health Research (NIHR) to establish the clinical trials needed to ‘develop the evidence base to support further commissioning decisions’.

It adds that NHS funding decisions follow ‘clearly developed procedures’ that ensure the fair distribution of funding, prioritising medicines that have proved their safety, quality and efficacy. The latest NICE guidelines demonstrate a ‘clear need’ for more evidence to support prescribing and funding decisions, as the majority of THC/CBD products are unlicensed and have not demonstrated clear evidence of their ‘safety, clinical and cost effectiveness’.

RESCAS was established to support clinicians to ‘optimise treatment’ of refractory epilepsy but the service is ‘advisory only’ and the responsibility remains with the patient’s neurologist.

“We sympathise with patients dealing with challenging conditions and the decision on whether to prescribe medicinal cannabis is ultimately one for clinicians to make,” said a Department of Health and Social Care spokesperson.

“Since the law changed, two cannabis-based medicines have been made available for prescribing on the NHS for patients with multiple sclerosis or hard-to-treat epilepsies, where clinically appropriate. This follows clear evidence of their safety, clinical and cost effectiveness.

“However, more evidence is needed to routinely prescribe and fund other treatments on the NHS and we continue to back further research and look at how to minimise the costs of these medicines.”

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SCIENCE

Peering into the void:

Inside the endocannabinoid system That refreshing wake-up feeling. The rumble in your stomach. The stress-busting power of a deep breath. These momentary passages of everyday life are part of the body’s response to the myriad of molecular interactions going on internally, invisible to the human eye, writes Freya Masters.

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The complex cell-signalling endocannabinoid system encapsulates these very interactions, mediating multiple processes at work in your body right now – from the immune response to metabolism (the chemical reactions of life).

The endocannabinoid system comprises three major components; the endocannabinoids themselves, the enzymes which break down endocannabinoids and receptors – all interacting in a network of neural pathways and cells.

It is believed that the endocannabinoid system has a crucial role in “essentially all human disease.”.

The compound cannabidiol or ‘CBD’ (derived from the cannabis plant) has an interesting part to play in the system, with therapeutic potential for a variety of neurological disorders.

Endocannabinoids are molecules synthesised in the body (endo meaning ‘in’). Their aim is to bind to specific cell-surface receptors and exert a range of physiological effects in the body. For example, stimulating that familiar growl of hunger.

The major endocannabinoids which have been characterised in-depth are anandamide and 2-arachidonoylglyerol (2-AG).

THC is the psychoactive substance in cannabis plants.

Cannabidiol, first synthesised in 1965, can be perceived as THC’s sensible older sibling. While you might not think it is quite as exciting as THC in its effects, I hope to change your mind.

In fact, the cannabis plant has over 60 cannabinoids which are similar to endocannabinoids such as 2-AG. Both CBD and 2-AG are neurotransmitters – chemical messengers which transmit a signal to a key target cell in order to elucidate an effect. Although the exact number is unknown, there are over 200 neurotransmitters in the human body.

The principle purpose of a neurotransmitter is to activate its target receptor. The resulting physiological effect depends on the chemistry of the receptor itself and the specific biochemical pathways involved.

For instance, the neurotransmitter serotonin (also known as the ‘happy’ chemical) binds to 5-hydroxytryptamine (5-HT) receptors, thus regulating a number of processes including memory and learning and muscle contraction.

How exactly does a neurotransmitter such as serotonin reach its target receptor? How does neurotransmission of CBD work after ingestion? To understand this a little more, we will need to dive down to the level of the cell itself…

Cells in the human body come in an array of shapes and

SCIENCE

sizes and have various components, from the controlcentre (the nucleus) to the protein-making machines (known as ribosomes) to the cell surface membrane, which is decorated with receptors. The gaps between cells are known as synapses. Those synapses which use chemical messengers are called chemical synapses.

A neuron is a vital cell of the nervous system, with the ability to transmit information to other cells in order to bring about an effect.

Imagine you are standing on the surface of a neuron cell body – the portion of the neuron which contains its nucleus. Stretching before you is a longer extension of the neuron, the axon.

If you gaze into the distance, you can see that this axon starts to divide into a multitude of branches. These are the axon terminals.

Curious, you walk down the axon until you stand right at the end of one of these vast branches.

Do you dare to peer down into the void, the synaptic cleft?

The neuron on which you stand is ‘presynaptic’ (situated before the synapse). Towering before you is a portion of a gate-like protein (called a voltage-gated calcium channel) with the remainder embedded in the cell surface membrane below you.

You notice that there are more of these gate-like proteins along the other edges of your axon terminal (and all over the axon terminals adjacent to yours). If you look through this voltage-gated calcium channel and across the gap, you can just make out the postsynaptic neuron.

Suddenly, you feel a trembling in the cell beneath you and turn around to see the surface of the long axon behind you rippling, with the rippling coming closer by the second! You hold on to the side of the calcium channel to brace yourself as this rippling reaches the surface below your feet.

Remember the ‘information’ that neurons transmit? This information is an ‘action potential’ or ‘nerve impulse’ (imagined as the ‘rippling’ depicted here) – an electrical signal which will stimulate the calcium channel. In turn, this will enable positively charged atoms known as calcium ions to flow into the neuron.

Fascinated, you watch the channel’s shape shift and alter, clinging on to its side as the influx of calcium ions passes you. There is another trembling in the cell membrane below you and you lie flat, looking over the edge of the axon terminal.

Because of the influx of calcium, sphere-like portions of the membrane – called vesicles – can now release small molecules into the synaptic cleft directly beneath you.

These small molecules are neurotransmitters – perhaps serotonin.

You watch as the molecules diffuse across the synapse and bind to receptors dotted along the surface of the postsynaptic neuron. In binding to these receptors, the neurotransmitters are able to stimulate another nerve pulse down the postsynaptic neuron.

Now you know how neurotransmitters normally travel between neurons, it will be easier to understand how our particular group of neurotransmitters – the endocannabinoids like 2-AG of the endocannabinoid system (or cannabinoids

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SCIENCE

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like CBD) – do so. The way in which endocannabinoids reach their target receptor occurs in a backwards manner, through retrograde signalling.

Indeed, the activation of a postsynaptic neuron by a nerve impulse stimulates endocannabinoids to diffuse across the synaptic cleft to bind to receptors of the presynaptic cells. The receptors bound by anandamide or 2-AG bind are the cannabinoid receptors.

Specifically, these are cannabinoid receptors 1 and 2 (CB1 and CB2), which were first discovered in the nineties.

While CB1 is situated abundantly in the Central Nervous System (CNS), CB2 is expressed much more in both the Immune and Peripheral Nervous Systems.

The activation of these two receptors by endocannabinoids has numerous implications for cellular physiology (the activities in the cell which keep it functioning) or cell motility, to name only a couple.

In the last three decades, the endocannabinoid system has been the most studied retrograde system of neurotransmission, with plentiful facets of research seeking to unravel the sheer complexity of the overall system.

While we know the system has implications for multiple physiological processes – from mood regulation to neuroprotection – there is a vast number of unknowns in this area. For instance, although there is a whole collection of evidence presenting the components of the endocannabinoid system as anti-cancer targets, the complex interplay of this system with other biological

pathways makes progress challenging, with rigorous testing required.

CBD has been shown to possess anxiolytic (ability to reduce anxiety) antipsychotic (for management of psychosis) and neuroprotective (aiding preservation of neuronal integrity) properties, with the potential to treat several health conditions such as schizophrenia, depression or Parkinson’s.

There is a need for further controlled clinical research on the use of CBD in these areas and its role as an adjunct therapy – given in addition to an existing therapy for a condition such as epilepsy in order to increase effectiveness.

Interestingly, CBD binds to neither CB1 nor CB2 receptors – it is thought that it may instead interact with a receptor not yet discovered.

Additionally, it has been proposed that CBD could alter how endocannabinoids interact with CB1/2.

As you read this, research scientists are peering into the synaptic cleft – the void of the unknown – to elucidate the therapeutic potential of the endocannabinoid system and compounds like cannabidiol.

Perhaps next time you feel that niggling rumble of hunger, your thoughts will wonder down to the unseen world of the cell – to the tiny neurotransmitters whizzing across those synaptic clefts in a series of complex biological interactions which might just tell you that it’s time for lunch.

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