O Canada-Part Deux

Those zany Canadians are at it again!  Yesterday, the Canadian government announced that it will invest almost $47 million (Canadian) over the next five years in a cannabis education and awareness campaign.

According to a press release,  the campaign will include “factual and evidence-based information on the health and safety risks of cannabis use and drug-impaired driving. The campaign will build on ongoing social media efforts, advertising and interactive events to engage youth on the facts.”

The goal of the campaign is to provide Canadians, especially young adults and youth, with clear factual information so that they understand how cannabis could affect them.  A critical part of the initiative is to equip parents and teachers with factual evidence-based scientific information so that they can have meaningful discussions with young Canadians about the risks of cannabis use, especially drug-impaired driving.  To that end, this fall, Public Safety Canada will launch an initiative to inform citizens about the dangers of drug-impaired driving.

Because medical cannabis is legal nationwide  in Canada (and recreational use is soon to follow)  making an investment in cannabis education and awareness makes sense.  An informed and educated public ought to reduce some of the anxiety and possible dangers associated with cannabis use.

Perhaps, the US ought to follow Canada’s lead and make similar investments to educate the American public about medical and recreational cannabis use. At present, the amount of misinformation far outweighs the facts. This is extremely troubling since tens of millions of Americans are currently regular cannabis users.

 

The Number of Legal Cannabis Jobs in the US Grew Over 20% Last Year

While the data are difficult to come by, a recent survey by Leafly (1) determined that the number of legal fulltime Cannabis jobs in the US grew from 122,814 job in 2016 to roughly 149,304 in 2017; a gain of 22%. Of course, not all of these jobs are directly related to Cannabis cultivation and production. These estimates include electricians, plumbers, greenhouse builders, insurance brokers, software developers, realtors and bankers.

Not surprisingly, the growth of legal US Cannabis jobs was not uniform throughout the country (8 states and the District of Columbia have legalized recreational adult Cannabis use and medical Cannabis and 23 medical Cannabis only).

Among the recreational use states, Alaska exhibited the greatest job increases (252%), followed by Maine (100%), and Nevada.  Florida (1,743 %) and Hawaii (1,692%) were the clear leaders in the medical cannabis states. It is important to note that percentages can be deceiving because they don’t represent raw job numbers. For example, if Nevada had 2 full time Cannabis jobs in 2016 and 4 in 2017 that would represent a 50% annual increase. To that point, the actual 2017 job leaders in the recreational use states are California (47,711), Colorado (26, 891), Washington State (26,556) and Oregon (10,843). Likewise, medical cannabis state job leaders in 2017 were Michigan (12,515), Arizona (6,520), Illinois (1,352) and New York (1,341).

Because of legal and political ramifications, the actual number of jobs in the US Cannabis industry is very difficult to quantify. That said, the number of full time jobs is certain to rise as the industry continues to mature in recreational use states.  Likewise, as more research and information about the therapeutic use of Cannabis become available (and mainstream physicians buy into these effects), the number of jobs in the medical cannabis will also grow. However, the 22% increase in the number of fulltime cannabis jobs over the past year suggests that the industry continues to remain strong despite an uncertain political and legal future.

References

  1. https://www.leafly.com/news/politics/cannabis-jobs-count-legal-marijuana-supports-149304-americans?mc_cid=071453b259&mc_eid=510390e56d Accessed September 13, 2017

Who’s Who In the World of Publicly Traded Cannabis Stocks

While the number of publicly traded Cannabis companies is relatively small, the so-called  US Marijuana Index has been created so that people who invest in the stock market know which companies are worth investing in.  The US Marijuana index is complied by the Marijuana International Corporation.

Unlike high flying biotechnology, tech and healthcare company stocks that trade on major stock indices like NASDAQ and the New York Stock exchange, most of the stock issued by companies that comprise the Marijuana Index is traded on the over-the-counter or OTC market.

At present, the marijuana index has a market cap over $5 billion and is equally weight among 20 companies that have at least 50% of their revenues generated from the cannabis or hemp industries.  A list of the companies and their market caps that comprise the US Marijuana Index can be found here.

As of April 2017, the US Marijuana Index delivered an annual return of 35.6% as compared with the 12.47% returns of the S&P 500 index.  This suggests that investment in Cannabis company stocks may be a good bet.  That said, the uncertainty of the Trump administration’s stand on the legal US recreation and medical Cannabis industries should also be considered (at least for long term investing strategies).

Given the chaos of the Trump administration and Jeff Sessions tenuous job security, many people remain high (pun intended) on investing in the Cannabis industry.  However, like any other stock investment, investment in companies that comprise the US Marijuana Index can be risky and not for the feint of heart!

Commercializing Cannabis-Derived Pharmaceuticals: Legal and Regulatory Challenges

The current regulatory and legal landscape for cannabis and cannabis-derived products is extremely difficult and fraught with numerous challenges. For example, in the US, cannabis and products derived from it (including hemp) are federally classified as Schedule I drugs according to the US Controlled Substances Act (1). This means that cannabis and its products have been deemed to have “no currently accepted medical use in treatment in the US” (heroin and LSD are also schedule I drugs), are harmful and consequently, are illegal (2).

Not surprisingly, its Schedule 1 classification has seriously hindered cannabis research in the US and made it extremely challenging for drug companies developing cannabis-derived pharmaceutical products (3). However, over the past decade or so, 29 states including the District of Columbia have enacted legislation that permits some form of cannabis consumption for medical purposes (4). Yet, despite this, cannabis and products derived from it remain illegal at the federal level and during interstate transport (even between states where medical marijuana has been legalized) is illegal and criminally punishable (2).

The confusion regarding cannabis use at the state and federal levels has given rise to two distinct types of companies that are attempting to commercialize cannabis (and products derived from it) for medicinal purposes. The first of these are commonly referred to as medical marijuana or medical cannabis companies. Typically, products from these companies are botanical extracts or actual plant materials derived from specific cannabis strains with anecdotally-reported medicinal properties that can be topically applied, ingested, smoked or vaporized. Patients require a “prescription” (card) from a state-licensed physician to obtain medical marijuana and it can only be used in states that permit consumption of cannabis for medical purposes. It is important to note, that while a prescription is required for medical cannabis use, these products do not require human clinical testing for safety, tolerability and efficacy (like other prescription drugs) prior to their sale in states where medical marijuana is legal.

In contrast with medical marijuana companies, biopharmaceutical companies including GW Pharma, Zynerba, Insys, Kannalife, Aphios and others (Table 1) are committed to developing cannabis-derived pharmaceuticals using conventional US Food and Drug Administration regulatory approval pathways. UK-based GW Pharma is the clear leader in cannabis-derived pharmaceutical space—its flagship product Sativex®, a plant extract, has been approved as a treatment for cancer-related pain and MS spasticity in 27 countries outside the US (5).

While the business case for developing pharmaceutical cannabis-derived pharmaceuticals is a sound one, the time and cost necessary for regulatory approval will be much greater than that for commercializing medical marijuana. At present, the United State Food and Drug Administration (FDA) has signaled a willingness to review new drug applications for cannabis-based pharmaceuticals (6). However, the agency has yet to issue definitive guidance for regulatory approval of these products and to date has not approved any application for cannabis-based products (6). Nevertheless, garnering FDA regulatory approval for cannabis–derived pharmaceuticals may offer several competitive advantages over numerous medical marijuana products that currently dominate the US market.

First, the average cost per patient of Sativex® to treat MS spasticity in countries where it has been approved has been estimated to be roughly $16,000 (6). Several studies indicate  (7, 8) that the high price of Sativex® will make it unlikely to be considered cost effective by regulators in countries with government-mandated national formularies like the UK, Ireland and Australia. However, this should not be an impediment in the US market because the federal government does not set drug prices and third-party payers dictate formulary placement and set drug reimbursement rates.

Second, unlike medical marijuana (which as previously state is a Schedule 1 drug), FDA approved cannabis-based pharmaceuticals like dronabinol and nabilone have been classified or reclassified as Schedule 2 (opioids) or Schedule 3 (codeine) drugs (5, 9). Federal regulators are likely to apply the same scheduling criteria to the next generation of FDA-approved cannabis-derived pharmaceuticals like Sativex® and others. Rescheduling will effectively allow these products to compete with medical marijuana because unlike medical marijuana—which is legal in only 29 states and cannot be transported across state borders—approved cannabis-derived pharmaceuticals can be legally prescribed, sold and used in all 50 states and US territories.

Finally, and perhaps most importantly, physicians may be inclined to prescribe FDA-approved cannabis drugs as compared with medical marijuana because they have been evaluated in human clinical trials and officially deemed to be safe and effective treatments for specific therapeutic indications.. In marked contrast, medical marijuana can be prescribed and sold in states where it is legal without going through any formal drug review process. While this is unlikely to interfere with possible therapeutic benefits offered by medical cannabis questions concerning product safety, effectiveness and reproducibility about these products are likely to continue to  arise until industry best practices are implemented and standardized.

References

  1. https://www.deadiversion.usdoj.gov/21cfr/21usc/812.htm  Accessed July 17, 2017
  2. https://www.dea.gov/druginfo/ds.shtml  Accessed July 17, 2017
  3. https://www.brookings.edu/wp-content/uploads/2016/06/Ending-the-US-governments-war-on-medical-marijuana-research.pdf  Accessed July 17, 2017
  4. http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881 Accessed July 17, 2017
  5. https://www.gwpharm.com/products-pipeline/sativex  Accessed July 17, 2017
  6. https://www.fda.gov/newsevents/publichealthfocus/ucm421163.htm  Accessed July 17, 2017
  7. Pharmacoeconomic NCF. Cost-effectiveness of Delta-9-tetrahydrocannabinol/cannabidiol (Sativex®) as add-on treatment, for symptom improvement in patients with moderate to severe spasticity due to MS who have not responded adequately to other antispasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy. 2014. http://www.ncpe.ie/wp-content/uploads/2013/01/Summary-v1.pdf.
  8. Lu L, Pearce H, Roome C, Shearer J, Lang IA, Stein K. Cost effectiveness of oromucosal cannabis-based medicine (Sativex(R)) for spasticity in multiple sclerosis. PharmacoEconomics. Dec 1 2012;30(12):1157-1171.
  9. https://www.deadiversion.usdoj.gov/fed_regs/rules/1998/fr1105.htm  Accessed July 17, 2017

What is Dabbing and Why Is It So Popular?

Dabbing is a relatively  new method of delivery that involved placing a small amount of Cannabis extracts or oils—a dab—onto a heated surface (usually titanium or quartz and known as a “nail”) and vaporizing it on contact. Like vaporization, cannabinoids pass directly from the lungs to the bloodstream and produce immediate effects.  It is important to note, that dabbing can accommodate only Cannabis extracts or oils not actual Cannabis flower or plant material.

Dabbing requires a delivery device  colloquially  known as a “dab or oil rig” (Fig. 1)

Fig 1.  A dab rig.  Source: You Tube Video

In a recent paper entitled “Tracking Dabbing Using Search Query Surveillance: A Case Study in the US” Zhang et al. (1) found, that based on the volume of Google searches from  2004-2015, dabbing is rapidly growing in popularity among US Cannabis users (Fig. 2).

Fig. 2.  National trends for dabbing-related Google searches in the US, 2004-2015. (from Zhang et al)

The researchers also found a coincidental increase in the number of searches associated with e-cigarettes or electronic nicotine delivery systems (ENDS; Fig. 2)

The average dabbing searches were significantly higher in states in which medical and recreational Cannabis were legalized as compared with states with only medical Cannabis legalization ( P=.02)  [Fig. 3].

Fig. 3.   Map of raw searches for dabbing in the US, 2004-2015. (from Zhang et al)

While it is not clear why dabbing has become increasingly popular, it is likely that this delivery methods offers Cannabis users with doses that are higher in delta-9-tetrahydrocannabinol (THC) and other cannabinoids.  Interestingly, the authors suggest that dabbing surpassed Cannabis edibles and smoking in the middle of 2013 as the preferred alternative form of Cannabis consumption.

Despite its growing popularity, dabbing is not without risk.  This will be the subject of another post!

REFERENCES

  1. Zhang Z, Zheng X, Zeng, DD, Leischow S. Tracking dabbing using search query surveillance: a case study in the United States.  J. Med Internet Res. 2016; 18:e252.

The Cannabis Science Blog: Providing Cannabis Users With Science-based Facts, Information and Data

The medicinal properties of Cannabis (aka pot, weed, etc) for treating cancer-related pain, glaucoma, nausea and vomiting and many chronic medical conditions are well established and scientifically documented. To date, over 28 US States and the District of Columbia have enacted legislation that permits some form of Cannabis consumption for medical purposes. In addition, five states have made Cannabis use legal for recreational purposes.

Industry analysts estimate that the existing Cannabis market (legal and illegal) is already as big a business as coffee, wine, chocolate and Indian gaming with roughly $30-$40 billion ((https://mjbizdaily.com) in annual consumer spending. Industry analysts estimate that as much as one in five dollars is spent on legal Cannabis and its products (http://bit.ly/2j2rMNp). At present, roughly 90% of Cannabis use is recreational and approximately 36% of Americans report mixed medical and recreational use (http://bit.ly/2jc3pO3).

According to Bloomberg News (http://bloom.bg/29kNwR8) the size of the US legal Cannabis market including cultivation, drug distribution/delivery and related services is currently estimated to be $7.2 billion with expansive growth expected over the next decade. Further, a 2016 report “The State of Legal Marijuana Markets” from the ArcView Market Research Group (https://arcviewgroup.com/), projects that annual US legal recreational and medical marijuana sales may reach almost $23 billion by 2020. Not surprisingly, this has unleashed an unprecedented flurry of private investment into the legal Cannabis market. This, in turn, has spurred creation of thousands of medical and recreational Cannabis start ups mainly focusing on industrial cultivation, packaging, distribution and sales (dispensaries) and delivery devices/paraphernalia.

While the actual size of the Cannabis media/communication/information market is unknown, New Frontier Data (https://newfrontierdata.com), a Cannabis analytics company, estimates that 4 in 10 Americans have tried Cannabis and approximately 183,000 million have legal access to medical marijuana in the US and Canada. Further, according to the National Academy of Sciences Engineering and Medicine, Cannabis is the most popular drug in the US, with an estimated 22.2 million Americans ages 12 or older using Cannabis in the past 30 days (http://bit.ly/2jc3pO3).

Finally, a 2016 report from Marijuana Business Daily (http://bit.ly/2j2rMNp) estimates that there are currently between 21,000-33,000 businesses (medical dispensaries/recreational stores, wholesale growers, infused product manufacturers, testing laboratories and ancillary services) that support the Cannabis industry.

Although a recent National Academy of Science Reported found that over 10,000 scientific articles about Cannabis have been published over the past decade or so,  much of this science-based news,  information and data is not available or interpretable by most Cannabis users.   To wit, the goal of the Cannabis Science blog is to provide Cannabis users with the latest science-based news and information about “all things Cannabis.”