Concord, N.H. — PRESS RELEASE — On Thursday, the New Hampshire Senate passed a bill in a voice vote that would allow patients and caregivers to grow a limited supply of cannabis. SB 420 will now proceed to the House of Representatives, which has passed similar legislation in the past with strong majority support.
SB 420 would allow possession of three mature plants, three immature plants and 12 seedlings for each patient. Under current law, home cultivation is classified as a felony. There are now more than 8,000 Granite Staters that are enrolled in the state’s therapeutic cannabis program. This bill is critically important because many patients are unable to afford dispensary products, which are not covered by health insurance. For some patients, home cultivation is simply the best, most affordable option.
Last year, the New Hampshire House and Senate passed a similar bill that would have allowed patients and caregivers to grow a limited supply of cannabis. Gov. Chris Sununu vetoed the bill. The House voted to override his veto, but the Senate fell three votes short of doing so.
Matt Simon, New England political director at the Marijuana Policy Project, said, “This bill presents Gov. Sununu with a great opportunity to continue his evolution on cannabis policy. Patients all over New Hampshire are benefitting from cannabis as an alternative to opioids, but many are unable to afford the expensive products that are available at dispensaries. Home cultivation is a cost-effective option that is available to patients and adults in all neighboring jurisdictions, and there is no good reason it should remain a crime for patients in the ‘Live Free or Die’ state.”
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CBG: A New(er) Option for Cancer Treatment?
Preliminary studies show promise of a non-intoxicating stem cell cannabinoid against cancer cell lines in both isolated and synergistic drug preparations.
The research on the anti-palliative effects of cannabinoids, namely THC, has produced pharmaceutical options like Marinol that have been on the market since the mid-80s and remain available to patients with intractable chemo-related nausea and vomiting. However, recent research suggests that cannabinoids may do more than treat the symptoms associated with conventional cancer therapies; some cannabinoids may kill cancer cells altogether and with a low risk of side effects or damage to healthy cells.
Recent pre-clinical studies have found that one such phytochemical component, cannabigerol (CBG), may be exceptionally efficacious against a number of cancer cell lines, and without the risk of intoxication.
CBG is the precursor to all other cannabinoids, including THC, CBD and CBC. CBG in its raw form, cannabigerolic acid (CBGA), develops within the plant’s cells when two organic compounds produced by the plant, olivetolic acid (OA) and geranyl pyrophosphate (GPP), combine. CBGA then is secreted into trichomes before it converts into the three major cannabinoid lines: THCA, CBDA, and CBCA, otherwise known in their more studied, “activated” forms as THC, CBD and CBC.
Unlike THC, CBG doesn’t have any great affinity for activating CB1 receptors, thus it doesn’t create a classic cannabis high in consumers—though its psychoactive efficacy may help treat certain mood disorders, including anxiety and depression. However, much like other cannabinoids, CBG does engage with the endogenous cannabinoid system both directly and indirectly, as well as through a number of peripheral pathways in the body.
Deactivation, or antagonism, of the ion channel TRPM8 (Transient Receptor Potential Cation Channel subfamily Melastatin member 8), otherwise known as the “cold and menthol receptor”, is one such mechanism of action for CBG. Irregular expression of this receptor is implicated in the initiation and progression of tumors, including prostate, melanoma, breast adenocarcinoma, bladder and colorectal cancers. Currently, the strongest evidence for CBG anti-tumor therapy via the TRPM8 channel is supported by research into colon cancer cell lines.
CBG Studies on Colorectal Cancer
A number of studies have pointed to CBG’s efficacy against colorectal cancer via TRPM8 antagonism including a 2014 paper published inCarcinogenesiswhich described potent in vivo action that promoted apoptosis (programmed cell death), improved oxidative stress responses, and reduced cell growth in colorectal cancer cells. The study found that these results were independent of CBG’s engagement with other TRP receptor channels and were improved by CB2 receptor deactivation, the endocannabinoid receptor predominately associated with immune system response. Inversely, activation of CB2 receptors has been linked to colon cancer progression which suggests that cannabinoids whose primary mechanisms of action lie outside of canonical cannabinoid receptors, like CBG, may prove most effective, according to the study’s authors.
CBG isn’t alone in its cytotoxic effects on colorectal cancer; its raw form has also demonstrated promising early results. A 2018 paper published in Cannabis and Cannabinoid Research observed CBGA-rich cannabis extractions were also involved in cytotoxic activity on in vitro colon cancer cells, indicating the presence of additive effects with combined cannabinoid ratios in the presence of minute amounts of other cannabis compounds like terpenes, specifically in relation to preparations rich in both CBGA and THCA. The THCA-rich fraction was found to be moderately effective, but efficacy improved significantly with the addition of CBGA. Furthermore, both neutral (THC and CBG) and acidic forms of these cannabinoids displayed cytotoxicity, but the acidic forms were less active on normal colon cell lines thereby elucidating their potential for chemopreventative activity against noncancerous colorectal growths associated with a greater risk of developing cancer, according to the study. These results on mixed ratio applications strengthen previous research that demonstrated CBG botanical extracts to be more active at TRPM8 than pure CBG.
Breast Cancer
The therapeutic potential of cannabinoid synergy, known as the Entourage or Ensemble Effect, was also discussed in a 2018 study that examined activity against breast cancer cell lines. Referencing extensive preclinical data that demonstrated cannabinoids can trigger antitumor responses in various forms of cancer, the authors found that botanical drug preparations rich in CBG, THCA, and THC were more effective than THC alone in cell culture and animal models.
While THC displayed some efficacy by elevating immune and antioxidant responses through activation of CB2 receptors, the authors described the importance of non-cannabinoid receptor pathways in the improvement of botanical drug preparations activity against cancer cells, especially in cancer types that inherently express low to undetectable levels of cannabinoid receptors. For these types, a 2005 study published in The Journal of Immunology described how THC and other cannabinoids whose primary mechanism of anti-tumor action appears to rely on canonical cannabinoid receptor engagement may not be as effective as cannabinoids that engage through peripheral pathways, like CBG.
Stomach, Bone, and Gastrointestinal Cancers
Cannabics Pharmaceuticals, a U.S. company with research facilities in Israel, specifically focuses on the development of cannabinoid therapies for cancer treatment and its conventional therapy side effects. In recent headlines, the company announced preliminary findings that further elucidate the anti-tumor potential of CBG and the potential for cannabinoid synergy in cancer treatments.
In pre-clinical work that looked at human stomach and bone cancer cell lines in vitro, CBG was found to be more effective than its acidic form, CBGA, against diseased cells. Additionally, investigators demonstrated the potency of both CBG and CBC (cannabichromene) against gastrointestinal cancer cells. Here, both cannabinoids were shown to induce significantly higher rates of cancer cell death compared to other cannabinoids and suggest the need for further investigation into synergistic efficacy.
Other Areas Worthy of Investigation
The potential of CBG to regulate inflammatory and oxidative mechanisms across numerous receptor sites bodes well for its use against a plethora of pathologies. In fact, in a GW Pharmaceuticals patent application, the company provided a large list of diseases and conditions where they felt CBG research was warranted:
"...pain (including but not limited to acute pain; chronic pain; neuropathic pain and cancer pain), neurodegenerative disease (including but not limited to Alzheimer's disease; Parkinson's disease; amyotrophic lateral sclerosis; Huntington's disease; multiple sclerosis; frontotemporal dementia; prion disease; Lewy body dementia; progressive supranuclear palsy; vascular dementia; normal pressure hydrocephalus; traumatic spinal cord injury; HIV dementia; alcohol induced neurotoxicity; Down's syndrome; epilepsy or any other related neurological or psychiatric neurodegenerative disease), ischemic disease (including but not limited to stroke; cardiac ischemia; coronary artery disease; thromboembolism; myocardial infarction or any other ischemic related disease), brain injury or damage (including but not limited to traumatic brain injury is taken from the group: diffuse axonal injury; concussion; contusion; whiplash or any other traumatic head or brain injury), acquired brain injury (including but not limited to stroke; anoxic brain injury; hypoxic brain injury or any other acquired brain injury), age related inflammatory or autoimmune disease, cachexia (including related conditions such as AIDS wasting disease, weight loss associated with cancer, chronic obstructive pulmonary disease or infectious diseases such as tuberculosis), nausea and vomiting, glaucoma, movement disorders, rheumatoid arthritis, asthma, allergy, psoriasis, Crohn's disease, systemic lupus erythematosus, diabetes, cancer, osteoporosis, renal ischemia and nephritis."
This long list is no surprise when considering the primary role of the endocannabinoid system as a regulator of balance within bodily systems for optimal health and wellness.
Other promising cancer-related research for CBG includes a 1996 investigation that demonstrated the cannabinoid’s “significant antitumor activity” against mouse melanoma cells and that same team’s 1998 discovery of the cytotoxic effects of CBG at high doses against human oral epithelial carcinoma cells. As seen in colorectal cancer cell lines, TRPM8 receptors may also play a role in epithelial carcinogenesis as these menthol receptors have also been found in human epithelial cells. The implication of TRPM8 in the growth and progression of pancreatic cancer should not be discounted and its potential as a molecular target for prostate cancer has already been suggested by scientists.
The deactivation of overactive TRPM8 receptors by CBG is not the only mechanism of action to consider when it comes to cannabinoid-based cancer therapies. Another attractive molecular target for CBG’s anti-inflammatory and antioxidant benefits is through potent activation of the peroxisome proliferator-activated receptor gamma, or PPARγ. These nuclear hormone receptors play an important role in regulating inflammation, glucose metabolism and cancer. In a 2017 review of PPAR receptors as potential drug targets for cancer therapy, investigators noted that PPARγ activation inhibits tumor progression and increases tumor suppression. Research from 2013 published in Cell Death and Diseasedemonstrated the efficacy of THC, another PPARγ agonist, against in vitro and in vivoliver cancer cell lines. With THC’s risk of unwanted intoxication, CBG and mixed-cannabinoid preparations should be further studied for their efficacy against liver cancer development and progression.
While human trials have not yet been published on the potential efficacy of CBG against various forms of cancers and there is a great deal more to understand before therapeutic pharmaceutical treatments are developed, scientists are chomping at the empirical evidence bit. More importantly, understanding cannabinoid potential, even in its investigational infancy, can help consumers better navigate the products currently available on the market to fit their needs. By actively engaging with receptors in the body implicated in the development and progression of a number of cancer cell lines, as well as playing a vital role in regulating the body’s own natural defense systems without fear of intoxication, research suggests that CBG holds enormous therapeutic promise moving forward.
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Missouri Licenses Six Seed-to-Sale Cannabis Businesses
The licensees will use their technology platforms to track medical cannabis from the seed or immature plant stage through the product’s sale at a dispensary.
The Missouri Department of Health and Senior Services (DHSS) has awarded six seed-to-sale tracking companies licenses to operate in the state’s forthcoming medical cannabis market.
The licensees are MJ Freeway, Bio-Tech Medical Software, Swin, Artemis Agtech, Validated Housing and Retail Innovation, according to The Motley Fool.
Two companies, Leaf Logix Technologies and Canna Botanicals, were denied licenses, the news outlet reported.
The licensees will use their technology platforms to track medical cannabis from the seed or immature plant stage through the product’s sale at a dispensary.
Missouri legalized medical cannabis in 2018 and has worked quickly to license the nascent industry. DHSS issued testing lab and cultivation licenses in December, and awarded manufacturing and dispensary licenses last month.
The state had approved roughly 25,000 medical cannabis cards as of late January.
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Oklahoma’s First Year of Medical Cannabis Licensing, Revenue Exceeds Expectations
Eighteen months after legalization, 8% of Oklahomans have a medical cannabis card and the state has licensed more than 2,200 dispensaries.
It’s been 18 months since Oklahoma launched its legal medical cannabis program, and licensing and revenue have both exceeded initial expectations, according to a Cherokee Phoenix report.
Roughly 8% of adults have a medical cannabis card, the news outlet reported, and the state has licensed more than 2,200 dispensaries, which means there is one for every 1,786 residents, or one for every 100 card holders.
The state has issued 4,757 total cultivation, processing and dispensary licenses to date, Cherokee Phoenix reported, and only 770 have not been renewed.
The Oklahoma Tax Commission has reported that medical cannabis sales reached $345 million in 2019, according to the news outlet, and the state collected $55 million in total tax revenue.
New Frontier Data has rated Oklahoma as the second-most saturated market behind New Mexico, Cherokee Phoenix reported, due to minimal financial obstacles and a lack of qualifying conditions—doctors can ultimately decide whether to prescribe cannabis on a case-by-case basis.
The Latest CBD Research: Q&A with Alice O’Leary-Randall
O’Leary-Randall dispels common CBD myths and outlines what current research suggests about the therapeutic properties of CBD, drug-to-drug interactions and best clinical practices for medical professionals.
The CBD industry’s explosive growth is quickly outpacing science, but with the passage of the 2018 Farm Bill, research has begun in earnest, and more is being known about the benefits of this now common cannabis compound and its uses.
Alice O’Leary-Randall has been on the forefront of the medical cannabis movement ever since her late husband, Robert C. Randall, became the first person in the U.S. to legally receive medical cannabis. Now the editor-in-chief of Mary’s Medicinals publications, O’Leary-Randall frequently writes and speaks on the issue. Here, she outlines some common CBD myths, as well as what current research suggests about the therapeutic properties of CBD, drug-to-drug interactions and best clinical practices for medical professionals.
Cannabis Business Times: What are some common CBD myths that have been dispelled through research?
Alice O’Leary-Randall: I think the most common one that I hear is that you can use CBD because that way you won’t fail the drug test at work. That’s a big one, and that is not true. There’s just enough THC in there that if you’re using it on a regular basis, like taking capsules every day or something like that, the THC can build up in the liver and thus into your bloodstream eventually and can skew a drug test.
The idea that CBD can heal things. Realistically, CBD treats symptoms. It doesn’t heal disease. I think that’s really important for people to understand that distinction.
CBT: What is currently known about CBD and drug-to-drug interactions?
AOR: There’s a growing amount that’s known. The good news is that CBD is a relatively benign substance, and that extends to the drug interactions, as well. But there is always that one individual who has really different reactions—contraindicative reactions—to drugs. I have a friend who looks at the word THC and she’s high. Give her a little bit of THC and she just becomes a mop—it’s amazing to me. But similarly, prescribed medications to her are also a really big issue because they just don’t react in the same way as they do in other people.
So, it’s a really good question because not only are we still on the cutting edge of finding out how CBD interacts with other medications, but there’s also a whole lot that isn’t known about medications that are already available. It’s a two-way street; it demonstrates our lack of knowledge on both fronts.
CBT: What does current research suggest about the therapeutic properties of CBD?
AOR: It’s a really exciting area because there’s a lot of research going on—not here in America, sadly, but certainly in Israel, Europe and Brazil. I think what we’re finding is this cannabinoid, like so many cannabinoids, has properties that can be tailored to the individual to make it an extraordinary medication.
If this science pans out where they’re looking down into the submolecules of humans and how drugs interact with those submolecules—if that research pans out with what the suppositions are—we’re going to have really incredible medicine in the next 20 to 30 years. A physician will be able to pick a little bit here, a little bit there, take a little bit of CBD, a little bit of CBG, a little bit of THC, and make a tailor-made concoction for the individual. I think that’s what’s most exciting in terms of cannabinoid research in general. People are really getting down to the smallest snippets, and there’s even something inside of us that they call “snips,” these tiny little things that collect cannabinoids and can have a tremendous impact on your health.
The problem is, we’re all a little different, and we’ve already known that cannabis affects everybody a little differently. CBD is no different. It has some very broad properties, such as anti-inflammatory, which are being supported by current research coming out of Israel, primarily, and to a certain extent, Germany. But it also has this deeper potential that I think is going to be really, really exciting in coming years.
CBT: What are some best clinical practices that doctors should implement regarding CBD?
AOR: I think there are two categories of clinicians that we have now. There are those who understand cannabis, who have embraced it wholeheartedly, or they’re not embracing it and they’re sick of their patients coming in the door and saying, “Well, doctor, I’ve been hearing about this CBD stuff from my friends,” and their answer is usually, “Well, go to the clinic,” if you’re lucky enough to live in a state that has a medical cannabis clinic.
If you’re lucky enough to have clinicians who are embracing it, the most common practice for cannabis clinicians in today’s world is you start low and you go slow. It’s almost becoming singsong at this point—everybody knows it. But it’s really important because a medical cannabis patient’s approach to using cannabis is 180 degrees from the recreational user. The medical cannabis patient doesn’t need high THC content, for the most part. There are some that do, but for the most part, they don’t. And cannabis clinicians understand that. They understand that they can start with very small amounts and get as effective relief as they want from it, or as the patient wants from it.
I think one reason that a conventional doctor has yet to educate himself or herself relative to cannabis [is because he or she] still has that Cheech and Chong vision in his or her head, that this elderly patient sitting in front of them is going to be high as a kite on THC. They don’t understand that that really is not necessary. You can get a therapeutic effect with the smallest amount of cannabis in some cases, and that’s true to CBD as well, if it’s well-produced CBD. That’s an important thing that needs to be brought out here—we’re talking full-spectrum CBD and not juiced-up hemp oil, if you will.
If you’re lucky enough to have a cannabis clinician, use them because your regular doctor isn’t there yet, for the most part.
CBT: What do you hope attendees will bring back to their business from your session at Cannabis Conference 2020?
AOR: I would hope that the attendees recognize that there is help out there for the medical cannabis patient, and it would be really nice if the industry as a whole, from the cultivator up through the dispenser, embraces that. The American Cannabis Nurses Association, as well as the Society of Cannabis Clinicians, are two racehorses available to the industry that are not being well utilized. I think this is probably going to be my big point more than anything, that the medical cannabis industry needs to start partnering more, in my opinion, with those clinicians who are actively engaged in treating patients and who want to help patients pick out the proper medication for them. There’s a ton of American Cannabis Nurses who would love to be affiliated with dispensaries, be available as a hotline or be available in the dispensary one day a week [or] two days a week to consult with patients and help them tailor their medical cannabis experience, but the dispensaries haven’t been real open to that, and that needs to change. There needs to be more cooperation between the industry and the clinicians.
Editor’s Note: This interview has been edited for style, length and clarity.
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Melissa Schiller
