Disturbed thinking, delusions and sometimes even hallucinations are all typical symptoms of a psychosis. That CBD can have an influence on the brains of people suffering from psychotic episodes has now been discovered by British researchers at King’s College using imaging techniques.  

A 19-member control group and 13 psychosis patients were participants in the double-blind study in England. Symptomatic subjects received their regular antipsychotic medication. Brain activity of all participants was monitored using magnetic resonance imaging (MRI) technology.  

 Normalization of activities in prefrontal and medio temporal brain areas  

 The symptomatic subjects received a placebo on individual days, and the researchers were able to determine deviating activities in the prefrontal and medio temporal brain areas compared to the control group. In addition, the hippocampus and striatum of the non-psychotic participants interacted less strongly. A brain activity similar to the healthy control group could be shown in the symptomatic group after the administration of 600mg CBD.  

Based on these findings, the authors of the study conclude that CBD is effective in treating psychotic symptoms. However, final conclusions cannot yet be drawn due to the small number of participants. There is also a lack of studies on the long-term effects of CBD consumption. Therefore, the researchers call for more extensive studies in connection with CBD and psychoses and other neuropsychiatric diseases.  

Source:   

O’Neill A, Wilson R, Blest-Hopley G, Annibale L, Colizzi M, Brammer M, Giampietro V, Bhattacharyya S. Normalization of mediotemporal and prefrontal activity, and mediotemporal-striatal connectivity, may underlie antipsychotic effects of cannabidiol in psychosis. Psychol Med. 2021 Mar;51(4):596-606. doi: 10.101   

Good news for pharmacies and patients: CanPharma GmbH’s medicinal cannabis can now be purchased through pharmaceutical wholesalers. 

For the pharmaceutical company, the cooperation with the wholesaler is a step in the right direction: “We are pleased that we are expanding our distribution channels throughout Germany,” says Stefan Jacker, Managing Director of CanPharma GmbH, “this improves the direct availability of our pharmaceutical cannabis varieties and increases the service for pharmacies and patients.”   

CanPharma aims to provide seriously ill people with optimal treatment with medicinal cannabis and to supply pharmacies with standardised and high-quality products. A therapy with medicinal cannabis increases the quality of life in many chronic diseases such as cancer or multiple sclerosis.   

The company is currently planning to expand its product portfolio – primarily with products with a high CBD content. This will give CanPharma an even broader product range.   

The pharmaceutical company CanPharma launched several discount contracts with statutory health insurance funds at the beginning of the year. The contract with the health insurance provider GWQ has been in effect since the beginning of January, and the cooperation with IKK Classic has been in place since February 1st. Further agreements with payers to improve the supply of medical cannabis are already planned. This makes CanPharma one of the first cannabis companies to conclude a discount contract.   

 According to CanPharma, discount contracts with medical cannabis aim to put the supply of patients with certain cannabis-based medicines on a secure footing and at the same time increase economic efficiency. In addition, the aim is to simplify the time-consuming reimbursement process: Currently, therapy with pharmaceutical cannabis requires approval by the health insurance fund before doctors are allowed to issue the corresponding prescriptions.   

Discount agreements are not uncommon for other medicines, but they are new for cannabis-based products. Stefan Jacker, pharmacist and managing director of CanPharma GmbH: “Cannabis-based pharmaceuticals have so far not had the status they deserve in the therapy of seriously ill people. We hope that the new agreements will lead to better acceptance of cannabis and to more trust within the medical profession. The cost-effectiveness of this adjunctive therapy option plays a role in this – and we are actively addressing the issue.”  In this context, an existing discount agreement with medicinal cannabis has no effect on the so-called therapeutic sovereignty: “No patient should be switched. What matters to us is that in a cannabis therapy, the products are prescribed that are on the one hand individually tailored to the patient’s therapy needs, and on the other hand economical and of course of the best pharmaceutical quality. The patient’s well-being has the highest priority for CanPharma,” emphasises Stefan Jacker.   

The discount contract between CanPharma and IKK Classic covers the prescription of three cannabis extracts. The agreement with GWQ goes a bit further and also provides for the prescription of cannabis flowers. GWQ is a health insurance provider that represents various statutory health insurance funds, such as numerous company health insurance funds.   

CanPharma GmbH has already been on the market since July 2020 with various prescription medicines such as medicinal cannabis flowers, and in May 2021 three different cannabis extracts were added.   

About CanPharma 

CanPharma GmbH is a pharmaceutical company with a wholesale and manufacturing licence and a comprehensive portfolio of medicinal cannabinoid products. We aim to become a leading European pharmaceutical company and to improve the quality of life of patients by providing advanced products. Our manufacturing partners meet the highest pharmaceutical quality standards, the EU GMP/GACP guidelines. CanPharma supplies pharmacies throughout Germany with high quality products and CanPharma supplies pharmacies throughout Germany with high-quality products and educates professionals and patients about the professional use of medicinal cannabis.   

As a pharmaceutical company, the well-being of patients is our top priority. This is also our highest priority in the debate on the legalization of cannabis. 

If cannabis is legalized, it is essential that the health of patients is protected and that they continue to have safe access to their medicines and comprehensive information. The high-quality standards of the preparations, the continuous availability of medicines with a stable effect profile as well as the eligibility for reimbursement by the health insurance companies must remain unaffected in order to be able to continue to guarantee patients this therapy option.  

It should continue to be ensured that seriously ill patients who are interested in cannabis therapy have access to trained medical counselling and receive detailed information. Counselling by a medical professional as well as in the pharmacy remains an indispensable cornerstone of therapy with medicinal cannabis, even if the plant and its active ingredients are released for recreational use. 

We welcome the fact that destigmatisation of cannabis, as a result of legalization and the accompanying information, will make it easier for patients to deal with the subject in their environment. Furthermore, we expect that with the increasing abundance of information, new patients will also have easier access to this new therapy option. As the general acceptance increases and medical cannabis also meets with more trust among doctors and pharmacists, the security of supply for patients increases, as does more detailed information by prescribers. 

In order to protect the consumer, we consider it a priority to provide constant information about recreational use. Topics such as the effects of the active substances, possible risks and side effects, dangers of co-medication, addiction potential, effects on the ability to drive and operate heavy machinery and other topics should be known to possible consumers. Consumers should be empowered to make a decision based on sound information. We expect that with legalization, addiction prevention will be promoted and adequately funded. 

We welcome the dispensing of cannabis for recreational use at the pharmacy or pharmacy annex. Pharmacists have the necessary expertise to advise consumers on the safe use of cannabis. CanPharma clearly positions itself here as a reliable partner of pharmacies. 

CanPharma GmbH and its partner network ensure a stable supply of patients through high-quality products and the continuous education of those affected as well as the further training of specialized personnel. If cannabis is legalized, we see it as our task to ensure the safety of consumers through education and training. 

Potential for further future growth in the European cannabis markets  

The pharmaceutical company for Cannabinoids CanPharma GmbH is joining forces with Australian pharmaceutical company Health House International. This strong partnership provides Health House with access to the highly valuable German medical cannabis market. CanPharma has a global player in Europe and Australasia on its side through the merger, which provides the German company with a solid basis for future growth both domestically and internationally. In addition, Health House gives CanPharma access to products that the pharmaceutical company can also bring to market in Germany. 

CanPharma holds the highest pharmaceutical licences (GMP) from the German regulatory authorities, which allow the company to import, manufacture and distribute cannabinoid-based products in both flower and extract form. CanPharma has been importing and distributing dried cannabis flowers in Germany since 2019. In May 2021, the company launched cannabis extracts under its own brand. CanPharma is in an ideal position to benefit from the continued growth in prescription numbers in Germany.  

The partner company, the Barcelona-based Kalapa Clinic, remains part of the group. Kalapa was the first counselling centre for medical cannabis to be established in Europe. It advises healthcare professionals and patients on the appropriate use of cannabis-based medicines for the treatment of various indications. With its headquarters in Spain, Kalapa Clinic is in a strong position to expand into the Spanish market as soon as legislation allows.  

CanPharma’s management team consists of industry specialists with years of experience in the cannabis industry. As part of the acquisition, CanPharma’s founder, Dr Henrik Sprengel, will remain CEO of CanPharma and has been appointed to the board of Health House International. Prior to founding CanPharma, he was CEO of the company’s founder Grupo HS3, which successfully launched several international projects in various industries with a focus on the internet and technology. CanPharma’s current CFO, David Attwood, will be appointed Group CEO of Health House and will assume overall responsibility for the group’s operations.  

Health House International is an international pharmaceutical wholesale company specialising in the distribution of medicinal cannabis products in Australasia, the UK and Europe, among other markets. The company currently distributes more than 11 medicinal cannabis products throughout Australasia. Through its wholesaler and controlled drug licences, the company supplies medical cannabis and general pharmaceutical products to pharmacies, hospitals, government agencies, veterinarians and other wholesalers in Europe.  

For more information, please visit https://healthhouse.com.au/  

“The partnership with Health House has the potential to position us as a market leader in Europe – a fast-growing medical cannabis market with the greatest global potential. We believe CanPharma is in a position to gain access to the growing number of patients in Germany, offer a broader range of products and expand medical education,” explains Dr Henrik Sprengel, co-founder and CEO of CanPharma. “This model, coupled with Health House International’s expertise, global networks and reputation, will drive our development and enable us to expand the company’s footprint across Europe.”   

David Wheeler, Director of Health House, adds: “We are delighted to officially welcome the CanPharma team to the Health House Group, where they will play a leading role in the future growth of the company. By leveraging CanPharma’s licenses, product offerings and expertise, we are expanding our market reach and strengthening our position as a global leader in the distribution of medical cannabis products.”  

About CanPharma  

CanPharma GmbH is a pharmaceutical company with wholesale and manufacturing licenses and a unique portfolio of medical cannabinoid products. Our mission is to become a leading European pharmaceutical company and to improve the quality of life of patients* by providing advanced products. Our manufacturing partners meet the highest pharmaceutical quality standards, the EU GMP guidelines. CanPharma supplies pharmacies throughout Germany with high-quality products and educates professionals and patients about the professional use of medicinal cannabis.  

For more information, please visit https://www.canpharma.eu/de/  

See also:

https://twitter.com/healthhouseint/status/1427067005929201667?s=20

https://www.linkedin.com/feed/update/urn:li:activity:6832832553448177664

Contact  

Clemens Jacker  

Marketing Director  

CanPharma GmbH  

clemens.jacker@canpharma.eu 

Chronic sleep disorders are extremely stressful. Productivity and health are impaired because those affected cannot recover sufficiently at night. In a double-blind study the effect of medicinal cannabis on chronic sleep disorders (chronic insomnia) was investigated for the first time by an Australian research team.

The result: A cannabis extract with the cannabinoids tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) is an effective and safe therapy for chronic insomnia.  

Two-week cross-over study with cannabis extract and placebo in 24 sufferers with chronic insomnia 

At the Centre for Sleep Research at the University of Western Australia 24 patients with an average age of 53 years took part in the randomised, placebo-controlled cross-over study. In this study sleep behaviour without medication was monitored for a fortnight with an activity monitor worn on the wrist and with sleep diaries. The participants recorded how long they fell asleep, how long they slept, the quality of their sleep and how restful their sleep was. In addition the researchers carried out a polysomnography in the sleep laboratory, whereby the body functions of the sleeping person were observed during one night. Afterwards the 24 participants were randomly assigned to the cannabinoid or placebo group, whereby neither the patients nor the researchers knew whether they were taking placebo or cannabis. The two-week study phase was followed by a week without medication before the patients switched to the other group. Monitoring was also done using a sleep diary, activity tracker and polysomnography. The researchers used an oily extract containing THC, CBN, CBD and terpenes as a cannabis-based medicine. The placebo extract contained the same terpenes but no cannabinoids. The participants took the medication sublingually, i.e. under the tongue, one hour before bedtime every day. After four days the dose could be doubled after medical consultation. In order to determine possible side effects, the researchers contacted the participants during the first days and after dose increases.  

Side effects disappear overnight or quickly after awakening 

Two-thirds (67%) experienced mild side effect but these largely disappeared overnight or shortly after awakening. The most common were dry mouth and dizziness. Only one subject discontinued the study due to adverse effects, therefore data from 23 patients were analysed. Caution should be exercised in elderly patients and those with a psychiatric history as hallucinations and dizziness are problematic. 

Medical cannabis shortens the time it takes to fall asleep and extends sleep time 

The sleep diaries of the study participants showed clear improvements in sleep: sleep duration increased. When taking the placebo extract, this averaged 5.06 hours and climbed to 6.11 hours with medicinal cannabis. Cannabis was thus able to extend sleep duration by a good hour. The time to fall asleep was also 38.1 minutes with cannabis, compared to 46.9 minutes with placebo. Those affected fell asleep 8.8 minutes faster on average with the cannabis drug. 

The measurements by means of activity monitor and polysomnography also proved improvements: Under placebothe sleep duration was 6.52 hours according to the measuring devices and increased by 33.5 minutes to 7.07 hours when taking the cannabis extract. Thus the participants who took cannabis reached the recommended sleeping time of about 7 hours for adults. 

Improved sleep quality and recovery 

The participants also rated sleep quality and restfulness on a scale from 0 (very poor or not rested) to 4 (very good or very rested). As a result the patients rated sleep quality as 2.5 and restfulness as 1.2 without taking medication and under placebo.  

Both ratios improved with the cannabis extract to 1.8 for recovery and 3.2 for sleep quality. Those affected slept better with medicinal cannabis and woke up more refreshed. Another positive effect is that the assessed cannabis extract does not influence the duration of sleep stages. 

At what point are sleep disorders chronic? 

6 to 15 percent of the population has to struggle with chronic sleep disorders that occur in the form of difficulty falling asleep and/or sleeping through the night. If the complaints appear on more than 3 nights a week and persist for longer than 3 months, experts speak of chronic insomnia. While patients with insomnia need more than half an hour to fall asleep, patients with insomnia wake up at night and stay awake for more than 30 minutes or wake up very early in the morning (more than 30 minutes before the desired wake-up time). 

Larger studies needed 

The scientists concluded that medicinal cannabis can be an alternative for chronic sleep disorders. However studies with larger groups of people are needed to clearly prove the effect and to inspect the optimal dosage.  

Sources: 

More and more patients with chronic pain are using the non-psychotropic cannabinoid cannabidiol (CBD) to relieve their pain. A survey of patients in America showed that cannabis-based medications and CBD reduced chronic pain in a large proportion of them. In addition, these medicines help to reduce the use of opiate-based painkillers.

Survey in seven pain clinics in America

A total of 253 patients from seven pain centres in Southern California were interviewed. The average age of the patients was 45.4 years. They were invited to participate in the survey through posters and flyers.

62 % of the respondents (152 people) already had experience with CBD products. Back pain was the most common type of pain with a share of 67.3 %. This was followed by nerve pain (46.7 %) and neck pain (44.7 %). In about half of the cases (56.3 %), the psychotropic and pain-relieving tetrahydrocannabinol (THC) was also contained in the cannabis product.

Chronic pain conditions treated included:

• Back pain
• Neuropathic pain
• Neck pain
• Migraine
• Limb pain
• Fibromyalgia

The CBD products were taken in different ways. The most common was by inhalation (62.9 %), followed by edible cannabis products (54.3 %) and oral cannabis tinctures (52.3 %). Some of the respondents had experience with several forms of administration.

The delivery forms used included:

• Inhalation or smoking
• Edibles
• Oral tinctures
• Topical cannabis preparations (cream, ointment, oil)
• Capsules
• Spray

Less pain for most people affected

For 59% of the respondents, CBD products help to alleviate their chronic pain. In addition, around 68 % of the patients were able to reduce the dosage of other painkillers. 53.7 % of the respondents were even able to reduce the intake of opiate painkillers.

In the survey, those affected were also asked about experiences in their surroundings, i.e. from friends, family members and acquaintances, regarding the use of CBD products. The result was positive, as 78.1 % of the respondents stated that they knew people who had successfully treated complaints with CBD. The results regarding tolerability were also quite positive. Only about 7 % of the respondents reported undesirable side effects.

A huge 91.9% of respondents said they wanted to learn more about the medicinal uses of CBD.

The state of research on CBD for chronic pain

There is still much research to be done on the treatment of chronic pain with CBD. However, it is already known that CBD has a low abuse potential. CBD even has rather the opposite effect. An American study in 2019 showed that Epidiolex®, a CBD-containing drug, can reduce addiction pressure and anxiety in patients with heroin addiction.

For chronic pain, especially neuropathic pain, recent data suggests that the cannabinoid THC has a greater analgesic effect than CBD. In 2020, another American study showed that chronic pain patients were able to reduce the dosage of their opiate painkillers after being treated with CBD for 8 weeks. THC and CBD-containing medications can therefore support pain relief.

More studies are needed in the future to find out whether CBD is an effective treatment alternative for the different kinds of pain disorders. In addition, the differences between CBD isolates and full-spectrum extracts need to be further investigated.

Source:

Schilling JM, Hughes CG, Wallace MS, Sexton M, Backonja M, Moeller-Bertram T. Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients’ Perspectives and Attitudes. J Pain Res. 2021;14:1241-1250

https://doi.org/10.2147/JPR.S278718

According to estimates, up to nine million people in Germany suffer from migraines. Women are affected more often than men. Although migraine is one of the most common neurological diseases, its causes are not yet fully understood.

By definition, migraine is a type of headache in which there is a temporary functional disorder in the brain. This results in increased nerve excitability. In addition, more pain-triggering neurotransmitters are released in the brain, so that the vessels in the brain temporarily become inflamed.

The symptoms of migraine are expressed by an attack-like, pulsating and often hemiplegic headache. Often, sufferers also experience vegetative symptoms such as nausea/vomiting and sensitivity to noise or light.

About 15 per cent of sufferers also suffer from an aura phase, which occurs before the actual headache. In a few cases, there is no headache after the aura phase. Symptoms in the aura phase include flashes of light, double vision, blinding sensations, visual field defects, speech disorders and/or motor disorders. Perceptual disturbances are also possible, such as disturbances of the sense of colour or a magnification/reduction of objects.

Migraine: treatment and therapy options

According to the German Neurological Society (DGN) and the German Migraine and Headache Society (DMKG), painkillers such as ibuprofen, ASA, naproxen and diclofenac are effective for mild and moderate migraine attacks.

Triptans are used for severe migraine attacks, but their use is often accompanied by unpleasant side effects.

In the search for new treatment options, cannabinoid-containing medicines have increasingly become the focus of scientific attention in recent years. Various studies suggest that cannabinoids, especially cannabidiol (CBD) could be helpful in acute migraine attacks. This assumption is also supported by various experience reports and surveys.

New survey among migraine patients

Researchers at the University of Colorado in Boulder (USA) conducted an online survey with 161 migraine patients who have legal access to cannabis. The aim of the survey was to investigate the pattern of cannabis use and the associated improvement in migraine.

Seventy-six per cent of participants endorsed the use of cannabis to treat their migraines and 70 per cent of participants used over-the-counter painkillers as well as triptans in addition to cannabis.

The results state that migraine patients who used cannabis reported more severe attacks compared to patients who did not use cannabis. Compared to painkillers, cannabis was significantly more effective, according to the participants.

In the end, the researchers state that migraine patients experience a high degree of symptom relief through the use of cannabis. Future studies are needed to determine the cannabis forms, potencies and dosages that are most effective in treating migraines, they say.

Source:

Gibson LP, Hitchcock LN, Bryan AD, Bidwell LC. Experience of migraine, its severity, and perceived efficacy of treatments among cannabis users. Complement Ther Med. 2020 Nov 20;56:102619. doi: 10.1016/j.ctim.2020.102619. Epub ahead of print. PMID: 33227352.
https://pubmed.ncbi.nlm.nih.gov/33227352/

Two important judgments within a very short time create movement in the cannabis industry. Firstly, at the end of November, the ruling of the European Court of Justice (ECJ) provided clarity with regard to the sale of CBD products. This states that, according to the current state of scientific knowledge, cannabidiol (CBD), other than tetrahydrocannabinol (THC), does not appear to have psychotropic effects or harmful effects on human health.

Last week, the United Nations Commission on Narcotic Drugs (CND) officially recognised cannabis as a substance with “medical benefits”. Before that, cannabis was considered to be a substance with no or very little benefit. The Commission on Narcotic Drugs thus follows the recommendation of the World Health Organisation (WHO).

The Commission on Narcotic Drugs then voted by 27 votes in favour, 25 against and one abstention to classify cannabis as a substance with medical properties.

According to a media report, Yann Bisiou (assistant professor at the University of Montpellier-III and expert in drug law) made a statement on this historic reassessment:

“This is the first time since 1916 that cannabis has been recognised at international level as being of therapeutic interest. For a century, international conventions on drugs have consistently emphasised that this substance is dangerous and has no medical benefit whatsoever. In 2020, the UN declares that the opposite is true”.

Jürgen Neumeyer from the industry association Cannabiswirtschaft commented on the reclassification as follows:

“Following this international impulse, we expect to see worldwide facilitation in the handling of medical cannabis. We very much welcome this, as importers, growers and distributors can expect less bureaucratic hurdles in the future”.

Way to legalisation?

The decision of the Commission on Narcotic Drugs does not yet pave the way for legalisation of cannabis in the EU member states. Cannabis is still listed as a substance that must be strictly controlled, no longer in the highest category IV with heavy drugs like heroin, but still in subgroup I together with drugs like cocaine and methadone.

However, experts believe that the re-evaluation of cannabis could be a small step towards relaxation. Further developments remain to be seen, however.

In Deutschland bleibt der Besitz von Cannabis strafbar. In vielen Bundesländern werden die Ermittlungsverfahren jedoch häufig wegen Geringfügigkeit eingestellt.

In Germany the possession of cannabis remains a criminal offence. But, in many federal states, investigations are often dropped on the grounds of insignificance.

Sources:
https://www.gentside.de/gesundheit/uno-erkennt-medizinischen-nutzen-von-cannabis-an_art20477.html
https://www.dw.com/de/vereinte-nationen-bewerten-cannabis-neu/a-55807237

Professor Thomas M. Clark of the University of Indiana, while conducting the meta-analysis, found that cannabis use correlated with a decrease in various cancers, including head, neck and lung cancer and cancers associated with obesity. However, Clark also found that cannabis use was associated with a slight increase in testicular cancer.

Despite the interesting results, Clark says that these are not necessarily conclusive. This is due to the fact that the data sets were very heterogeneous. There were also not enough data sets for many types of cancer.

Risk factors for cancer types

Clark also noted that cannabis users tended to show a low rate of obesity. Obesity is a known risk factor for many cancers. He also noted that most cannabis users have a low rate of inflammation. This is also a risk factor for cancer. This finding is supported by previous research that has already shown links between cannabis use and a reduced risk of inflammation.

The results also showed that cannabis users tended to have improved insulin resistance and thus a lower risk of diabetes than non-users. This association could also contribute to a reduced risk of cancer. This is because poor insulin resistance and diabetes are associated with a higher risk of cancer, as well as faster cancer growth.

As a conclusion, Professor Clark summarised:

“The current analysis does not support the average recreational use of cannabis as an effective stand-alone cure for cancer. However, the results suggest that cannabis therapy added to established cancer treatment regimens not only significantly improves the quality of life of cancer patients, but could also improve the effectiveness of treatment without stimulating tumour growth”.

Clark added that cannabis use could potentially reduce the cancer-related death rate in the USA (around 600,000 people die of cancer every year). However, the available data would give little confidence in this conclusion. This is because there seem to be different responses among cancers. There would also be little or no data available for many cancers.

In addition, Clark notes that although a relationship between cannabis use and cancer can be proven, a causality cannot. Therefore, caution should be exercised in interpreting the data.

Source:
https://www.liebertpub.com/doi/10.1089/can.2019.0095