Cannabis: Current Trends and Research Emily Leuer January 21, 2020
Agenda • Vireo Health Overview • Cannabis: Hemp vs Marijuana • Minnesota Medical Marijuana • How Cannabis Interacts with the Human Body • Cannabinoids • Terpenes • Formulating with Cannabis
Vireo Health Overview
Vireo Health • On track to be in 11 states • Minnesota Medical Solutions • Pennsylvania Medical Solutions • Maryland: MaryMed • Ohio Medical Solutions • Vireo New York • Rhode Island, Arizona, Massachusetts, Nevada, New Mexico, & Puerto Rico • Headquartered in Minneapolis • For more information: https://vireohealth.com/
Cannabis: Hemp vs Marijuana
Hemp vs Marijuana • 2018 Farm Bill legalized farming of industrial hemp • Surge of CBD products since the change • Biologically, they are the same plant • Hemp: ≤ 0.3% THC (dry basis) • Marijuana: > 0.3% THC • Typically 5-20% THC
FDA Stance on CBD • “It is currently illegal to market CBD by adding it to food or labeling it as a dietary supplement” • “Some CBD products are being marketed with unproven medical claims and could produced with unsafe manufacturing processes” • For more information: • https://www.fda.gov/news-events/public-health-focus/fda-regulation- cannabis-and-cannabis-derived-products-including-cannabidiol-cbd • Or, Google FDA and CBD
Medical Marijuana Products • Testing protocol varies by state, but in general, medical products are tested for the following: • Potency • %THC, %CBD • Heavy Metals • Arsenic, lead, mercury, chromium, cadmium • Pesticides • Residual solvents • Ethanol, hexane, pentane • Microbials • Salmonella, coliform, yeast, mold, aerobic bacteria, gram negative bacteria
Minnesota Medical Marijuana
Qualifying Conditions
Changes to MN MMJ in August, 2020 • New delivery methods • Water-soluble cannabis powder • Orally dissolvable lozenges and mints • New qualifying conditions • Chronic pain • Macular degeneration • More dispensaries • Vireo: Woodbury, Blaine, Burnsville, Duluth • Leafline: Willmar, Mankato, Golden Valley, Rogers
How Cannabis Interacts with the Human Body
Endocannabinoid System • The human endocannabinoid system was discovered in the 1990s • The endocannabinoid system exists to retain homeostasis • The endocannabinoid system is very old (500 MM years +) and exists in all vertebrates • Receptors were originally thought to only exist in the brain but have since been discovered throughout the body • Muscle, organs, blood vessels • Plays a role in many processes • Sleep, stress, pain, mood, immunity, appetite, memory Source: UCLA Health Cannabis Research Initiative
Cannabis and the Endocannabinoid System • Different cannabinoids bind with different endocannabinoid receptors • THC works similarly to a neurotransmitter naturally produced in the human body call anandamide • Both THC and anandamide interact with CB1 receptors • Anandamide may also affect pain and provide a sense of euphoria • May be responsible for “runner’s high” • Endorphins cannot cross the blood-brain barrier whereas anandamide can • Also found in chocolate • There are potentially over one hundred cannabinoids in marijuana and over three hundred terpenes, each of which may interact individually within the human body or synergistically (aka the entourage effect)
Cannabinoids Sources for this section: Leafly.com Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads, E.B. Russo& J. Marcu, 2017
Acid Form vs Neutral Form
THCA – Tetrahydrocannabinolic Acid • Does not produce euphoric effects • Preliminary research shows…. • Anti-inflammatory properties • Neuroprotective • Anti-emetic properties
THC: Tetrahydrocannabinol • Does produce euphoric effects • Interacts with CB1 and CB2 receptors • Short-term effects from THC • Relaxation, sedation, pain relief, memory impairment, hunger, anxiety • Currently used as treatment for: • Nausea, appetite loss, insomnia, pain management, etc • Studies show it may have 20x the anti-inflammatory power of aspirin and 2x hydrocortisone
CBDA – Cannabidiolic Acid • A study in 2008 showed CBDA may act as a COX-2 inhibitor • May be able to be used as a substitute for NSAIDs • May have better bioavailability than CBD • May have anti-convulsant properties • May have anti-depressant properties
CBD: Cannabidiol • Low affinity for CB receptors but may possess CB1 and CB2 independent mechanisms • Shown to have anticonvulsive, anti-inflammatory, antioxidant, and antipsychotic effects. • Currently used to treat the following: • Epilepsy and seizure disorders • Crohn’s disease • Multiple sclerosis • PTSD • Anxiety • Pain/inflammation • Alzheimer’s • Huntington disease
CBG - Cannabigerol • Current research involving mice shows: • May be effective in treating glaucoma • May decrease inflammation in inflammatory bowel disease • May protect neurons with Huntington’s disease • May help to fight cancer cell growth • May be a non-psychoactive appetite stimulant • A study from 1975 shows CBG supports GABA uptake inhibition greater than either THC or CBD and provide muscle relaxation effects • A 2011 study showed CBG was effective against MRSA
CBC - Cannabichromene • Appears to interact with CB2 receptors but not CB1 • May be a powerful anti-cancer agent • May help with inflammation • May have a synergistic effect with THC on inflammation • May fight acne • May work with THC and CBD as an anti-depressant
THCV - Tetrahydrocannabivarin • May be both agonistic and antagonistic on CB1 receptors • May suppress appetite • A 2007 study showed THCV lead to weight loss, lower levels of body fat, and increased energy in mice • May help regulate blood sugar levels and help with diabetes • May reduce occurrence of panic attacks • May help with Alzheimer’s • May stimulate bone growth
CBN - Cannabinol • Breakdown product of THC • Some studies show it has sedative properties when combined with THC • May have anticonvulsant properties • May be anti-inflammatory • May have antibiotic properties • May be effective against MRSA • May show promise against psoriasis in topicals
Terpenes Source for this section: Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads, E.B. Russo & J. Marcu, 2017
ß-Myrcene • Current research shows • Anti-inflammatory • Also found in • Sedative • Mangoes • May cause “couch-lock” effects in • Hops some cannabis chemovars • Bay leaves • A 2014 study suggests myrcene • Lemongrass works synergistically with THC and • Eucalyptus CBD offering neuroprotective • Cardamom antioxidant effects • Flavor • Green mango
ß-Caryophyllene • Current research shows • Anti-inflammatory • Cardioprotective • Also found in • Neuroprotective • Black pepper • Hepatoprotective • Cloves • Gastroprotective • Basil • Antimicrobial • Oregano • Cinnamon • Flavor • Spicy, warm
α-Pinene • Current research shows • Anti-inflammatory • Bronchodilator • Also found in • Antibiotic against MRSA • Pine • Acetylcholinesterase inhibitor • Juniper • May counteract memory loss • Rosemary association with THC • Flavor • Piney
Linalool • Current research shows • Anti-anxiety • Also found in • Sedative • Anti-depressant • Lavender • Analgesic • Rose • Anticonvulsant • Basil • Neroli oil • Flavor • Soapy
D-Limonene • Current research shows • A 2006 study with mice showed limonene to have strong anti- anxiety effects • Stimulating effects • May inhibit cancer cell • Also found in proliferation • Citrus peels • Antioxidant • Flavor • Citrus
Formulating with Cannabis Source for this section: Nanoparticle- and Microparticle-Based Delivery Systems, D.J. McClemets, 2015
Cannabis Extracts are Lipids • Lipids dissolve easily in solvents (ethanol) and other lipids (MCT oil, beeswax, etc) • Lipids do not mix well in water
Creating an Emulsion • Mechanical means • Homogenizer • Ultrasonicator • Chemical means • Surfactant/emulsifier • Liposomes
Creating an Emulsion - Homogenization • Feed enters the homogenizer via high pressure • The feed is forced through small spaces • This results in smaller lipid molecules • Multiple passes may be required
Creating an Emulsion - Ultrasonication Photo source: ScienceDirect.com
Creating an Emulsion - Surfactants • Surfactants help stabilize an emulsion by lowering the surface tension between two liquids • Many different types • Nonionic: tween, span, quillaja extract • Anionic: SLS, DATEM, CITREM • Cationic: lauric arginate • Zwitterionic: lecithin Photo source: integratedhealthblog.com
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