Friday 28 February, 2020

CAP President: T&T 'perfect' for medical cannabis research

Trinidad and Tobago is ‘perfectly positioned’ to begin medical cannabis research, according to the President of the Caribbean Association of Pharmacists, Dr Marvin Smith.

Dr Smith, who is lobbying in the Bahamas for approvals to carry out medical cannabis research, said due to the Trinidad and Tobago’s diverse population, state-of-the-art medical and agricultural facilities, optimal climate and soil, the country only stands to benefit from launching research into medical cannabis.

In an interview with LoopTT, Dr Smith, however, was clear that the issue of medical cannabis research stands apart from the decriminalisation of cannabis for personal use.

We’re trying to get as much information on the issue out there as possible. We are trying to see how we can advocate for research and let the science dictate how we move ahead with this.

“We’re looking at marijuana from the perspective of medicinal use and from that end we’re asking people to have an open mind and look at whether this substance has potential to treat various diseases.”

Dr Smith said Trinidad and Tobago has several advantages in developing cannabis research which can benefit not just the country but the region as a whole.

“You have, at the UWI, one of the major schools of pharmacology in the Caribbean, you have some of the world’s best researchers. The UWI does great research and you have the training and facilities. Trinidad, more than any other place (in the Caribbean), has an opportunity to really push the research aspect of this.”

“You have the medical facilities, you have access to a fairly diverse population (for test subjects), you can look at ethnic differences without having to bring in additional candidates.”

“You are already heavily engaged in agricultural research, your botanical scientists there, your doctors and nurses are there, everything is already set up.”

“In fact, you are probably more ready than anyone else,” he said.


Cannabis research in the Caribbean, for the Caribbean

Dr Smith said Caribbean researchers, at the moment, must travel to the US in order to carry out studies on medical cannabis, using American test subjects, however, he said in order to fully assess the effect on Caribbean patients, research should be carried out within the Caribbean region.

How the body is impacted by the various metabolic processes is different and varies from person to person in various ways. It can be different based on race, on ethnicity and many other different things.”

“The Caribbean people are diverse but they also have some commonalities so we really want to press the issue of how these substances might impact on the health of Caribbean people.”

“There are so many studies that are Euro-centric and American-centric. But we’re treating people, not case studies. We want to have research that’s inductive in the Caribbean, for the Caribbean,” he said.

Dr Smith added that the strains of cannabis found in the Caribbean vary from the strains being used in other studies which come from other regions.

“Marijuana’s recorded clinical effects are also said to be strain-specific so we also want to look into that to see what can be done with the strains that are commonly found in the Caribbean.”

Dr Smith added that in the Caribbean, where access to medical care is difficult, medical cannabis can create a cheaper, more viable solution.

“In a region where people suffer for access to medical care…in some count,ries economics is the obstacle to health care. Now we have other avenues for treatment, and if we can empower countries to produce their own medical treatments, it can alleviate the problem.”

“Thirdly, there’s the economic issue…we’re spending almost half a billion dollars on health care and health care products in this region. A fair amount of that is due to pharmaceutical products and over-the-counter products.”

“If we can do something that is naturally produced, that can be grown in all of our territories, this produces an economic solution that we need to look at,” he said.


The case for cannabis

Dr Smith said science is still uncovering the range of illnesses which can be treated with medical cannabis drugs.

Studies have shown that CBDs (cannabinoids) have been proven to work in various disease states.

- Cancer: Cannabinoids (the active ingredient in marijuana) has been shown in animal studies to kill tumor cells and tumor growth.

- Alzheimer’s: Marijuana works to prevent Alzheimer’s by blocking the formation of beta amyloid plaques that are a cause of the disease, according to 2006 research from the Scripps Institute.

- Seizures: As a muscle relaxant and antispasmodic, marijuana has been shown to be a very effective treatment for many types of seizures.

- Migraines: Doctors in California report they have successfully treated more than 300,000 people with migraine headaches for whom standard medicine could offer no relief since medical marijuana was legalized in the state.

- Multiple sclerosis: Marijuana stops the neurological effects and muscles spasms of the invariably fatal disease.

- Irritable bowel syndrome and Crohn’s disease: Marijuana has been shown to relieve the symptoms of these debilitating conditions by stopping nausea, cramping, abdominal pain and diarrhea.

- Premenstrual syndrome (PMS): Marijuana blocks the cramping associated with PMS, much in the same way it works for the digestive problems above.

(Sativex (Nabiximols), developed by British biopharmaceutical company GW Pharmaceuticals, is used to treat multiple sclerosis. It is the first natural cannabis plant derivative to gain market approval in any country. It's currently in various countries worldwide.)

- Glaucoma: Marijuana’s effects on this disease of the optic nerve that can cause blindness. Extensive research shows marijuana lowers the pressure in the eye, relieving pain and even reversing the condition.

- Tourette’s syndrome: This neurological condition is characterized by tics, grimaces and involuntary movements. Marijuana has been shown to reduce or even eliminate the spasms.

- ADD and ADHD: Marijuana has been shown to be at least as effective as the prescription drug Ritalin without any of the negative side effects associated with the drug. 

Additionally, a survey of patients who used both opioids and cannabis for pain found that participants reported a higher satisfaction rate with cannabis than with opioids, with less addictive tendencies, according to a 2017 study published in the journal Cannabis and Cannabinoid Research.

In the US, two FDA-approved drugs, dronabinol and nabilone, contain THC and treat nausea caused by chemotherapy and increase appetite in patients with extreme weight loss caused by AIDS.

The United Kingdom, Canada, and several European countries have approved nabiximols (Sativex®), a mouth spray containing THC and CBD. It treats muscle control problems caused by Multiple Sclerosis.

Dr Smith said that like all drugs, there may be negative side effects, hence the need for proper research and development.

“There may be negative effects but with the proper controls and procedure guidelines, these can be eliminated or reduced, and we do like every other medicine. If you take this, please observe the proper precautions, notify your doctor, etc. We want to see it treated like every other medication once it passes the process and approvals, just like every other medication,” he said.


Medical cannabis in the Caribbean and the world

Dr Smith pointed out several countries which have already allowed for the importation or development of medical cannabis, such as Jamaica, which recently launched Kaya Farms, the Caribbean’s first medical cannabis facility.

Antigua and Barbuda, as well as St Vincent and the Grenadines, announced plans to decriminalise marijuana for personal use, while the Cayman Islands already allows for the importation of cannabis oil.

The herb has also been decriminalised in the US Virgin Islands, Bermuda and Puerto Rico.

Other countries which have decriminalised marijuana include the Netherlands, Canada (medicinal use only), Australia (for medical or scientific purposes), Belgium (up to three grams), Belize (up to 10 grams), Bolivia (up to 50 grams), Colombia, Spain, Uruguay, and some US states, among others.

The drug can also present a significant source of revenue - the US state of Colorado recently announced tax earnings of over US$500 million from marijuana sales alone.

Dr Smith said that the potential for Caribbean patients through this naturally produced drug cannot be ignored.

Let’s take away our preconceived notions, let’s forget everything we’ve seen in and heard as it relates to weed, this is not about the recreational use, this is about medical research."

“Let’s ask ourselves, are we getting healthier or are we getting sicker? If so, do we want to walk away from something that might pose the answer to a lot of the issues that are plaguing us in the Caribbean, in terms of our health, particularly when it involves something that is natural?”

“We should not allow the conversation about marijuana to be hijacked by groups that are only concerned with recreational use. It is a medicine. Let’s walk it through the process, and be confident that if we do recommend it to our patients, or not recommend it as the case may be, that we do it based on research and facts.”

“As the Caribbean, let’s not sit around and wait for the US and Europe to develop this, let’s take the lead in this,” he said. 


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