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Innovating for the Benefit of Patients in Medical Cannabis (Opinion)

Poor bioavailability formulations in orally delivered medical cannabis have left an innovation gap for patients.

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The medical cannabis industry, though still relatively young, has reached a critical juncture. As it continues to grow, it often follows the "path of least resistance"—adapting and evolving more in response to market demand than to the clinical needs of patients. Since 2017, the industry has largely introduced what could be called “me-too” products: formulations that offer little differentiation or therapeutic advancement.

One of the most overlooked and unresolved issues remains the low oral bioavailability of cannabinoids. According to studies such as Cannabinoid Formulations and Delivery Systems: Current and Future Options to Treat Pain, the bioavailability of orally consumed cannabinoids is approximately 6%—compared to intravenous administration. In practice, this means that 94% of the active compounds are not reaching the bloodstream, diminishing potential therapeutic benefits.

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Why Oral Delivery Still Matters

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While smoking or vaporizing cannabis may offer higher bioavailability, it is generally not preferred in medical contexts. Oral delivery—through oils or capsules—is favored by health care providers due to patient safety, ease of use, consistency, and compliance. But the problem remains: If oral formulations are ineffective at delivering active compounds to the bloodstream, patients are left with underwhelming or unpredictable results.

This is where the industry must turn its focus: innovation grounded in clinical science and pharmacokinetics. Without it, medical cannabis risks remaining a fringe alternative rather than a mainstream medical solution.

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Barriers to True Innovation

One reason for the slow pace of progress is that the market hasn’t demanded it—yet. In many regions, the growth of the sector has been fueled by semi-medical or recreational use, where therapeutic consistency is not the primary concern. This has allowed producers to thrive without significantly improving the core product experience for patients and prescribing doctors.

But that’s beginning to change.

A Case Study in Meaningful Innovation: STENOCARE and ASTRUM OIL

European medical cannabis company STENOCARE has invested in pharmaceutical-grade R&D since 2019. The company’s goal is to develop cannabis oil formulations that directly address the challenge of poor bioavailability.

The company’s work led to the development of ASTRUM OIL, a medical cannabis oil designed to optimize uptake in the body. Collaborating with a team of former Novo Nordisk researchers, STENOCARE conducted a pharmacokinetic study in dogs comparing ASTRUM OIL with a standard medium-chain triglycerides (MCT) oil commonly used in many “me-too” products. The results:

  • 2.6x higher uptake when taken with food
  • 15x higher uptake when taken without food
  • More consistent uptake across subjects
  • Reduced time to peak concentration from two to four hours to just one hour

These findings suggest that ASTRUM OIL not only improves the efficiency of delivery but also offers greater predictability for doctors and patients—a critical factor in medical treatment.

A Path Forward for the Industry

This type of innovation represents a shift from superficial features (like high-THC potency) toward clinically meaningful product performance. It also helps position medical cannabis as a legitimate therapeutic option in line with the rigor expected of the pharmaceutical industry.

What STENOCARE has demonstrated through ASTRUM OIL is that innovation is not just possible—it’s necessary. As more companies commit to scientific R&D and evidence-backed development, we can be optimistic that the next wave of products will be more patient-centric, data-driven, and therapeutically relevant.

Thomas Skovlund Schnegelsberg is the co-founder and CEO of STENOCARE, a publicly traded Danish company that supplies prescription-based medical cannabis oils to patients in the European and Australian markets.

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