British company GW Pharmaceuticals has been testing cannabis extracts for the past few years, and now has clinical evidence that certain formulations reduce the mortality rate of people with glioblastoma multiforme (GBM), a form of brain cancer that typically kills patients within two years. Results of the ‘phase 2 proof of concept study’ were announced Feb. 7.

Combined with temozolomide, the current medication used to treat GBM, patients’ median survival was more than 550 days, compared to 369 days without the cannabis treatment. The CBD (cannabidiol)-THC (tetrahydrocannabinol) treatment helped produced an 83 percent one-year survival rate, compared with 53 percent for non-cannabis patients.

Prior studies had shown that a CBD-THC combination “led to a synergistic reduction in the viability of U87MG glioma cells,” and the “co-administration of temozolomide with THC and CBD had further synergistic effects, causing a significant reduction in cell viability.”

In their press release, GW noted that there is substantial oncologic research on cannabinoids to treat several forms of cancer, with 15 publications on the positive effects on tumor growth and suppression – especially in promoting autophagy, or “the process of regulated self-degradation by cells.”

“We believe that the signals of efficacy demonstrated in this study further reinforce the potential role of cannabinoids in the field of oncology and provide GW with the prospect of a new and distinct cannabinoid product candidate in the treatment of glioma,” said CEO Justin Gover.

GW can be said to be one of more respectable pharma companies. Instead of actively fighting cannabis legalization – as U.S. companies have done by funding anti-pot propaganda prior to state ballot initiatives – GW is embracing the power of cannabis.

GW Pharma is on the verge of securing approval for a cannabis-derived drug called Epidiolex to treat children with severe epilepsy. It will file for approval this year in the U.S. and the U.K. Trials have shown “high statistical significance” in helping patients, some of who suffer 80 severe seizures a day.

Of course, we already know through countless examples that the administration of CBD or other types of cannabis oil stops seizures in their tracks for children suffering with epilepsy. It’s why a Colorado company has produced a nasal cannabis spray that repeatedly stops seizures within 20 seconds.

While many states now acknowledge this reality and are legalizing cannabis extracts for seizures, Epidiolex has the potential to offer an effective treatment nationwide. It will also put the absurd classification of cannabis and its derivatives as a Schedule 1 drug to the ultimate test.

2. Marijuana Recreational use

Generally i2P is not promoting the use of marijuana for recreational use, particularly when smoked, because many of the chemicals that are contained in marijuana leaf are similar to those contained in tobacco, including some chemicals known to cause cancer.
Colorado, a US state that has legalised recreational use, is also keeping a close watch on the outcomes in a public health sense.
The government of that state has set up an oversight committee to monitor the health effects (including adverse events) and they have published a report for the year 2016.
The following is an extract from its introduction and the link provided will find the full report that publishes useful information for pharmacists.
Please note that some of the beneficial health outcomes from medical cannabis are not apparent in the recreational form, particularly when smoked.
Heat generated by smoking marijuana converts all benign THC cannabinoids to the psychoactive THC form and this is concerning in some ways as it may deliver high doses of THC depending on what plant strain has been used.
Overall reports show no real increase in adverse events.

“When Colorado became one of the first two states in the nation to legalize retail marijuana, the Colorado Legislature mandated that the Colorado Department of Public Health and Environment (CDPHE) study the potential public health effects of marijuana.
Though medical marijuana has been legal in Colorado since 2000, it was largely viewed as an individual doctor/patient decision outside the scope of public health policy.
However, the legalization of retail (non-medical) marijuana and the potential for greater availability of marijuana in the community prompted a closer look at potential health effects on the population at large.

Legalized retail marijuana presents a paradigm shift, grouping marijuana with other legal substances like alcohol, tobacco and prescription drugs, as opposed to illicit drugs like cocaine and heroin.
As with alcohol, tobacco and prescription drugs, misuse of marijuana can have serious health consequences.

The standard public health approaches to alcohol, tobacco and prescription drugs are to monitor use patterns and behaviors, health care use, potential health effects, and emerging scientific literature to guide the development of policies or consumer education strategies to prevent serious health consequences.
This report presents information on marijuana use patterns, potential health effects and the most recent scientific findings associated with marijuana use, with a key objective of helping facilitate evidence-based policy decisions and science-based public education campaigns.”

Access this link:
Executive Summary – Health concerns related to Marijuana use 2016

3. Australian Advisory Council on the Medicinal Use of Cannabis

On 23 December 2016, the Minister for Health and Aged Care at that time, Sussan Ley, said that the new Australian Advisory Council on the Medicinal Use of Cannabis is a vital component of the Government’s Medicinal Cannabis Scheme.

“I’m pleased that Dr Southcott has agreed to chair the Council and bring his expertise as a doctor to this important Australian Government initiative for patients and their doctors to have access to a safe, legal and reliable supply of medicinal cannabis products for the management of painful and chronic conditions,” she said.

“This new Council will look at all aspects of patient healthcare, cannabis therapies, related research, palliative care and patient advocacy.

“The formation of the Council follows on from the introduction of the new medicinal cannabis legislation in early 2016 and the commencement of the Medicinal Cannabis Scheme from October this year.” Australian Advisory Council on the Medicinal Use of Cannabis
The Medicinal Cannabis Scheme is the result of extensive consultation between the Federal Government and State and Territory authorities in the development of regulations and security protocols for the cultivation, production and manufacture of medicinal cannabis. 

Dr Andrew Southcott is a medical practitioner and a former Member of Parliament who held the positions of Shadow Parliamentary Secretary for Health and Wellbeing and Regional Health Services and Shadow Parliamentary Secretary for Primary Healthcare.

The Council is expected to sit in February of 2017 for its initial meeting and will be in place for two years.
More information about the Australian Advisory Council on the Medicinal Use of Cannabis and its membership will be available shortly on the Office of Drug Control website.

Recently, this advisory council met and Professor James Angus AO, Dean of the Faculty of Medicine at the University of Melbourne, agreed to be the new Chairman for the Advisory Council.
A full list of members is shown below, but significant for pharmacy is the appointment of pharmacist Michelle Lynch to the council as a representative of the pharmacy profession.
Michelle Lynch BPharm, MPS, MAICD  is PSA National Vice President and joined its Board in January 2014.

She has been a pharmacist since 1996 and has worked in hospital and community pharmacy, and as a consultant for an independent specialist consulting firm that specialises in medication management and pharmacy services.

She is the National Hospital Pharmacy Manager at Ramsay Health Care.

Her Board responsibilities include:

• Chair, Finance, Audit and Risk Management Committee
• Member, 6CPA Working Group

And she is also a member of the APF Editorial Board.
And i2P would add that Michelle would appear to be well-qualified to represent the pharmacy profession for what is believed will be a significant opportunity for pharmacy, if managed correctly.

The Council’s expert members will be expected to provide specialist, balanced and timely advice to the Government on a range of issues, but i2P would contend that while this is a reasonable starting-point, there does not appear to be any representative for existing users and existing growers – an information resource that should be tapped.
While this may be seen as giving recognition to a group of people who have been deemed to be operating outside of the law in the past, it is now obvious that the laws that have existed have been draconian at best and certainly not good legislation.
These two groups have been instrumental in publicising the benefits of the natural versions of medical marijuana (CBD oil etc) and would constitute a wealth of knowledge that would not necessarily be available to current council members.
So if this council is genuine in its desire to provide the medicinal benefits of marijuana to all Australian patients, it might consider an approach to the Hemp Party to appoint a suitable delegate, and a grower representative such as Lucy Haslam from her United in Compassion group – both very knowledgeable resources and great advocates for the medical benefits of marijuana.

While some access to medical marijuana is available through the Special Access Scheme, it is either synthesised (with side effects not seen in natural forms) or is derived from genetically modified plants.

The real benefit to Australia lies in assisting local producers to develop suitable plant strains for ideal cannabinoid content, allowing the natural versions to be marketed at the lowest possible cost with non-psychoactive forms regulated as Schedule 3 recordable substances through pharmacies and research grants established to educate pharmacists as to the appropriate THC/CBD proportions suitable for various chronic conditions.
This translates into investment in Australian primary industry, manufacture, jobs in the industry, professional opportunities for pharmacist specialists and a potentially massive reduction in the PBS costs to taxpayers.
This may not occur if politicians give in to global pharma lobbying initiatives which are already inhibiting local opportunity.

Michelle, with her APF position would be an ideal person to create this type of project by preparing some sort of monograph for CBD oil so that the APF version could then be utilised by pharmacists, particularly compounding pharmacists who could develop suitable formats and combinations tailored to patient need.
The following persons are current council members:

Name	Organisation	Role
Professor James Angus	Chair of Victorian Independent Medical Advisory Committee on Medicinal Cannabis	Chair
Emiritus Professor Anne Tonkin	Chair of South Australian Medication Advisory Committee	Deputy Chair
Ms Liz Callaghan	Palliative Care Australia	Patient group
Professor Richard Chye	St Vincent’s Hospital	Palliative care and pain
Dr Ian Freckelton QC	University of Melbourne	Law / former member of the 2015 Victorian Law Reform Commission Review
Professor Wayne Hall	University of Queensland	Toxicology (drugs) / Also advising the Queensland Government
Dr Chris Hayes	Faculty of Pain Medicine – Australian and New Zealand College of Anaesthetists	Pain specialist
Ms Carol Ireland	Epilepsy Action Australia	Patient group
Professor Jennifer Martin	University of Newcastle	Pharmacology
Ms Michelle Lynch	Pharmaceutical Society of Australia	Pharmacy profession representative
Ms Ria Pryce	Centre for Medicinal Cannabis Research and Innovation	NSW Government nominee
Dr Morton Rawlin	Royal Australian College of General Practitioners	Medical profession representative
Dr Simon Walsh	Australian Federal Police	Chief Scientist
Dr Phil Wright	NSW Department of Primary Industry	Chief Scientist / cultivation
Professor Helen Zorbas	Cancer Australia	Patient group