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Higher THC Percentages Are Finally Coming To Pharmacies In Uruguay

Written by Johnny Green on . Posted in Policy.

One of my biggest cannabis public policy pet peeves is when governments institute THC percentage caps on products, primarily due to the negative impact it has on the suffering patients that desperately need cannabis products containing higher amounts of THC. I extend my distain for THC percentage caps to the adult-use industry because whether people realize it or not, many suffering patients obtain their medicine via the adult-use industry when possible, including in Uruguay where low-THC percentage limits have been in place jn pharmacies since legal sales began in 2017.

Uruguay first passed a national adult-use legalization measure back in 2013, making it the first country on the planet to do so since the dawn of prohibition. The historic legalization measure provided for various ways for consumers to obtain cannabis, including private clubs and home cultivation. It also provided for eventual legal sales through pharmacies for two varieties of cannabis flower, “alpha” and “beta” flower. Both options have a THC level of less than or equal to 9% and a CBD level of greater than or equal to 3%. Thankfully, a third option is on the way, and the cannabinoid limits are much more favorable.

“Gamma” Cannabis Flower

Juan Ignacio Tastás, the executive director of the Institute for the Regulation and Control of Cannabis (Ircca), announced recently that Uruguay is set to launch a third variety of cannabis to be sold through pharmacies. The new variety is called “gamma” and will contain a THC percentage that is less than or equal to 15%, and a CBD percentage that is less than or equal to 1%. The new option is expected to be available to consumers in Uruguay starting around December 20th.

To put things into perspective, cannabis flower that tops 30% THC is common in many legal states in the U.S. and in Canada. For some consumers, anything less than 30% is often deemed as not being strong enough. For patients in particular, especially those that suffer from chronic and severe pain, high-potency cannabis flower is an optimal form of medicine.

A huge benefit of adult-use legalization is that patients don’t have to jump through all of the hoops of a medical cannabis program to obtain their medicine. In Uruguay, they simply have to be of legal age and go to a licensed pharmacy that sells adult-use cannabis. However, that only works out if the pharmacy actually sells cannabis that is strong enough to help the suffering patient.

An Evolving Model

Part of the reporting out of Uruguay indicates that yet another strain, a fourth option, is being considered for pharmacies, with a potential release date being next December. No details seem to be available regarding what cannabinoid levels will be involved. It’s definitely possible that an option with an even higher level of THC could be involved, however, without any details surfacing I suppose it’s also possible that it could be a low-THC, high-CBD strain. We will all just have to wait and see.

One thing that is clear is that Uruguay’s adult-use cannabis regulation model, the first one in the history of the world at a national level, is still evolving. That in itself provides a learning moment for other countries that are exploring which components to include and exclude for their legalization frameworks. Lawmakers and regulators in those countries need to approach cannabinoid level limits objectively. By doing so they will no doubt realize that THC percentage limits do not serve any actual scientific purpose, but rather, are born out of reefer madness and as a result they should never be a part of any sensible cannabis public policy.

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Cannabis Pilot Program Delayed Until At Least 2024 In The Netherlands

Written by Hazel Norman on . Posted in Policy.

Historically, the Netherlands served as the international leader when it came to cannabis in many ways, particularly Amsterdam. It was no secret that people flocked from all over the globe over the course of many years to partake in coffeeshop cannabis offerings.

Had the Netherlands embraced cannabis more in recent years, it would have made it nearly impossible for any other country to take its title, and the country would be reaping the economic benefits from a booming cannabis industry. However, that is not the case.

While cannabis reform has spread to other countries, including in Europe, the Netherlands has not experienced similar activity. If anything, attempts were made to limit cannabis commerce, although unregulated cannabis sales still thrive throughout the country, especially in Amsterdam.

The Netherlands was set to launch a cannabis commerce pilot program, similar to what is being pursued in Switzerland and Denmark. Unfortunately, the launch of the pilot program has experienced several delays, and it appears the delays will continue to pile up. Per NL Times:

Health Minister Ernst Kuipers said that the experiment in regulated cultivated cannabis will be postponed again. He expects that “as it stands now” only legally produced cannabis will be able to be sold in coffeeshops in eleven municipalities in 2024, and that it is not possible to launch the project during the second quarter of 2023 as previously announced. He does want to try to begin with a “start-up phase” in a smaller number of municipalities.

According to the minister, the implementation of the cannabis experiment is “extremely complicated” and he understood that to be the reason why it has been postponed several times. The first hurdle is the paperwork: arranging locations, obtaining permits and arranging a banking license has turned out to be very complex.

A cannabis pilot program involves allowing local jurisdictions to permit limited adult-use cannabis commerce with the goal of collecting information and data at the local level to give national lawmakers more insight when crafting national laws and regulations.

Of course, an adult-use cannabis legalization pilot program is only useful if it actually launches. At this point, even 2024 doesn’t seem certain for a program launch in the Netherlands. Meanwhile, the push for national legalization continues elsewhere. It will be interesting to see what the cannabis policy landscape looks like in Europe by 2024.

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Israeli Cannabis Study Finds Improvements In Patients With Treatment-Resistant Fibromyalgia

Written by Frank Schuler on . Posted in Science.

Fibromyalgia is a condition involving widespread musculoskeletal pain. The condition is accompanied by feelings of fatigue, lack of sleep, memory issues, and mood swings. It is estimated that as many as 1 out of every 20 people on earth suffers from fibromyalgia.

Women are much more likely to be diagnosed with fibromyalgia compared to men, with roughly seven times as many women suffering from the condition compared to men. Women between the ages of 20 and 55 are particularly susceptible to being diagnosed with fibromyalgia.

Pharmaceutical prescriptions, including anti-depressants, are common treatments for fibromyalgia, although most if not all of them can yield very undesirable side effects. Fortunately, cannabis provides a safer alternative to many pharmaceutical drugs, and a recent study in Israel found it to be effective. Below is more information about it via a news release from NORML:

Holon, Israel: Cannabis treatment is associated with quality of life improvements in patients with treatment-resistant fibromyalgia (FM), according to the results of a prospective cohort study published in the journal Pain Practice.

Israeli researchers evaluated cannabis’ efficacy in a cohort of 30 patients diagnosed with fibromyalgia. All of the study’s participants had previously failed to respond to conventional pharmaceutical treatments. Investigators assessed patients’ quality of life, general health, and physical health following 30 days of cannabis treatment.

They determined: “Cannabis treatment … showed a marked improvement in general quality-of-life by 1.97 points out of a 5-point score and enhanced general health by 1.83 scores. Cannabis treatment also improved the physical health domain score by 1.5 points. Further examination of the physical health subdomains showed a reduction of 1.67 points in pain and discomfort, pain and fatigue (1.57), and an improvement of 2.13 points in activities of daily living.”

The authors further acknowledged that cannabis use was also associated with improvements in patients’ self-esteem, mood, memory, and concentration.

“This study suggests that cannabis treatment shows short-term improvement in quality of life through its influence on pain, sleep, and physical and psychological domains,” they concluded. “Further studies are still indicated to understand this potential and its long-term beneficial impact.”

Survey data reports that fibromyalgia patients frequently consume cannabis for therapeutic purposes, and several recent observational trials have affirmed its safety and efficacy in this population. A recent review of the relevant literature, published in 2021, concluded, “[T]he use of cannabinoids and cannabis carries limited side effects in the treatment of FM, and they can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted.”

Full text of the study, “The role of cannabis in treatment-resistant fibromyalgia women,” appears in Pain Practice. Additional information on cannabis and FM is available from NORML.

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Will Luxembourg Ever Pass A Legalization Measure?

Written by Hazel Norman on . Posted in Policy.

Back in 2018 the potential for legalization to occur in Luxembourg seemed fairly strong, with the coalition government including cannabis legalization in its coalition agreement that year. At the time, no European country had ever passed a nationwide adult-use cannabis legalization measure. Luxembourg seemed poised to make history.

Of course, multiple years have gone by and yet cannabis prohibition remains the law of the land in Luxembourg. If/when Luxembourg ever passes an adult-use legalization measure, it will no longer be the first to do so on the continent, as that ship already sailed in Malta late last year when lawmakers passed a limited legalization measure that permits home cultivation, and eventually, private non-profit cannabis clubs.

Not only has Luxembourg failed to pass a legalization measure, what was originally proposed in the coalition agreement has since been watered down quite a bit, with the latest version of legalization floating around Luxembourg political circles only involving home cultivation and use, which is obviously more akin to Malta’s legalization model versus something like Canada’s or what is currently being proposed in Germany.

And yet, even that limited legalization model seems to be facing uncertainty at the moment. Per excerpts from Le Quotidien (translated to English):

The judicial authorities are calling for a “thorough review” of the bill which aims to legalize the cultivation and consumption of cannabis at home. From beginning to end, shortcomings are detected.

The list of “difficulties and incongruities” highlighted in particular by the general prosecutor’s office is long: contradictions, unequal treatment, lack of clarity, oversights, serious error of logic or even the door wide open to abuse.

In short, the Minister of Justice, Sam Tanson, is sent back to his studies. The first Advocate General, Serge Wagner, is the most severe. He calls for a “thorough review” of the text, which is not ready to be put to the vote of the deputies anytime soon.

As I previously touched on, Malta has already passed a legalization measure that is somewhat similar to what is being floated in Luxembourg, with adult households being able to legally cultivate up to four plants. If Malta can make it work, why can’t Luxembourg?

As with every country in Europe that is holding cannabis reform discussions, they are not doing so in a vacuum. Germany is pursuing a legalization plan that is exponentially more robust compared to what is currently being floated in Luxembourg, and the two countries obviously share a border.

The opposition arguments being made in Luxembourg are already flimsy to say the least, and after legalization moves forward in neighboring Germany, those arguments will become even less tenable.

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Shops Can No Longer Provide Cannabis Smoking Spaces In Thailand

Written by Hazel Norman on . Posted in Policy.

Thailand is a very interesting place when it comes to cannabis public policy. Earlier this year, in June, Thailand made a historic cannabis policy shift and implemented a plan that allows every household in the entire country to sign up to legally cultivate low-THC cannabis plants. Thailand’s policy change marked the first time in the history of the world that such a public policy was implemented at a national level.

Since June, Thailand has seemed to struggle with finding its ‘cannabis policy identity’ and many members of the government have tried hard to push back on public perception that cannabis is legal for recreational use in Thailand. In an attempt to thwart recreational use of cannabis, Thailand’s Ministry of Public Health has announced new policies. Per Bangkok Post:

Ganja-smoking shops are deemed illegal now that the Ministry of Public Health’s new announcement declaring flowers of marijuana plants to be a herb requiring strict control has taken effect, the ministry warned on Wednesday.

The controlled herb announcement, dated Nov 11, was announced in the Royal Gazette last Wednesday and took effect the following day, said Dr Thongchai Lertwilairatanapong, director-general of the Department of Thai Traditional and Alternative Medicine (DTTAM).

In addition to the prohibition of shops providing smoking spaces, the new changes involve prohibiting cannabis sales to people under 20, to students of any type, and to pregnant or breastfeeding women. Sales are also now prohibited through vending machines and via the internet. The new changes signal a turnabout of sorts for Thailand’s government to some degree.

Thailand’s Public Health Minister previously indicated that there is no plant limit for the government’s cultivation program and Thailand gave away over 1 million cannabis seeds directly to households to help them cultivate cannabis. The government is even giving out low-interest loans to help aspiring cultivators get their operations started.

Thailand previously launched an app to help streamline the process of people signing up their households to cultivate cannabis. An FAQ public service announcement effort was launched to help people understand the law and cultivation program. As we previously reported, a broad spectrum of government agencies in Thailand previously entered into an agreement to do their part to push Thailand’s emerging cannabis industry forward.

With all of that in mind, the scrambling going on right now in Thailand seems a bit bizarre. After all, a country can’t embrace cannabis and also demonize it at the same time. It will be interesting to see if more changes come to Thailand in the coming months.

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Cannabis Benefits Headache Patients According To New Canadian Study

Written by Frank Schuler on . Posted in Science.

Headaches are one of the most common health conditions that people suffer from around the globe, with the severity and frequency of headaches varying from person to person. For some people, headaches are rare and when they do occur they go away fairly quickly after a short amount of time, often without the assistance of medication.

However, for many other sufferers, headaches can be frequent, severe, and over-the-counter medications are not enough to help reduce the pain and suffering. For folks in the latter group, a recent study out of Canada provides some hope, with researchers finding that headache patients frequently report benefits from using cannabis. Below is more information about it via a news release from NORML:

Alberta, Canada: Patients suffering from headache disorders frequently experience relief from the use of cannabis, according to survey data published in the Canadian Journal of Neurology.

Researchers surveyed 200 patients associated with a tertiary headache clinic in Calgary regarding their use of cannabis products. (Cannabis is legal in Canada for both medical and adult use.)

Over one-third of respondents (34 percent) acknowledged currently engaging in the use of cannabis. Of these, 60 percent perceived cannabis to be effective at reducing the severity of their headaches, while 29 percent said it mitigated headache frequency. Subjects most frequently reported consuming liquid cannabis preparations or inhaling cannabis flowers.

“The findings of this survey document patient’s perceived benefit of cannabinoids in the management of headache,” authors reported. “The results of this exploratory survey will aid neurologists and headache specialists in understanding the current trends in use of cannabis products in more severely affected headache patients and inform treatment parameters when designing controlled studies of cannabis in this setting.”

Numerous other surveys similarly report that those suffering from migraines often turn to cannabis for symptomatic relief, and many patients say that it is more effective than prescription medications. A recent literature review of 12 previously published studies involving 1,980 participants concluded that cannabis preparations likely provide for the prophylactic and abortive treatment of migraines.

Full text of the study, “Cannabinoid use in a tertiary headache clinic: A cross-sectional survey,” appears in the Canadian Journal of Neurology. Additional information on cannabis and migraine is available from NORML.

 

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Germany’s Health Minister To Commission ‘An Expert Opinion’ To Help EU Legalization Push

Written by Johnny Green on . Posted in Policy.

What I would give to be a fly on the wall in the room where private cannabis policy discussions are being held between European Union (EU) leadership and Germany’s Health Minister Karl Lauterbach. Health Minister Lauterbach has actively lobbied the European Union for its general approval of a German adult-use legalization plan ever since he presented a legalization proposal to the German federal cabinet back in late October. Various information has surfaced regarding legalization discussions with the EU in recent weeks, with the latest revelation involving Minister Lauterbach reportedly seeking an ‘expert opinion’ to help with the legalization push.

Health Minister Lauterbach presented a plan over a month ago that involves legalizing the possession of up to 30 grams of cannabis in Germany, as well as legalizing the cultivation of up to three cannabis plants in adult households. The plan was an evolved version of a previously leaked plan, and more changes could occur between now and a formal introduction of an actual bill. Arguably the most consequential provision of the legalization plan that was presented in late October involves removing cannabis from Germany’s narcotics law. Minister Lauterbach has made it clear that he wants to obtain EU permission for the plan prior to it being formally introduced and considered by lawmakers.

What Will An ‘Expert Opinion’ Involve?

According to Zeit, Minister Lauterbach is bringing in an expert opinion to help make the case for legalization to the EU. “Confidential talks with the EU Commission show that “very good arguments” are needed to convince them of the path they have taken,” stated Minister Lauterbach according to reporting from Zeit. From what I can tell, no announcement has been made regarding who will be providing the expert opinion or what it will include.

“We need good arguments when it comes to cannabis: We commission an expert opinion, develop a draft law at the same time and have it examined by the EU. This should show how we ensure quality, limit consumption & protect children. I am convinced of it.” Minister Lauterbach stated earlier this week regarding the latest wrinkle in the ongoing German legalization saga.

Logically speaking, one of two things is going on right now. Either the EU truly wants to learn more about Germany’s legalization plan, at which point help with crafting additional “very good arguments” via an expert or experts would be helpful. Or, of course, the other possibility is that the EU is trying to drag its feet and slow down the process by seeking ‘more information’ knowing that any amount of information will not change the EU’s opinion. Being that the EU hasn’t weighed in either way for better or worse, all we can do is sit and wait, although I do think that it’s worth asking an obvious question – what arguments can be made to the EU that haven’t already been made regarding the harms of cannabis prohibition and the benefits of legalization and regulation?

Calls To Speed Up The Timeline

Coupled with Minister Lauterbach’s announcement that he is seeking assistance in crafting arguments for the EU was a reiteration that the formal introduction of a legalization measure will not happen by the end of the year. Rather, a formalized draft of the law should be ready for private circulation by the end of the first quarter of 2023, and ‘if things go well’ and the EU blesses the effort, the formalized measure will be introduced in the second half of 2023. That timeline is sure to disappoint many legalization supporters, including supporters that are members of the Bundestag.

“Minister of Health Karl Lauterbach must now draw up a draft law for #Legalisierung from #Cannabis and present it promptly – waiting for #EU and remaining inactive is not an option! As the rapporteurs responsible, we are making that clear once again today.” previously stated Kirsten Kappert-Gonther (Greens) on Twitter (translated from German to English). Kirsten Kappert-Gonther was joined in her call for urgency by Kristine Lütke MdB (FDP).

“Minister of Health @Karl_Lauterbach must not remain idle until the #EU commission has given its feedback! He must submit a #Gesetzentwurf for #Cannabis legalization by the end of the year – so that the controlled release is implemented quickly and does not come until the end of 2023!” stated Kristine Lütke MdB previously on Twitter (translated from German to English).

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Cannabis Associated With Improved Quality Of Life for Tourette Syndrome Patients

Written by Frank Schuler on . Posted in Science.

It is estimated that roughly 0.5-1% of the world’s population has been diagnosed with some level of Tourette Syndrome, although the actual rate of people suffering from the condition could be greater due to gaps in identification and treatment in some parts of the world.

According to the National Institute of Neurological Disorders and Stroke, “Tourette syndrome (TS) is a neurological disorder characterized by sudden, repetitive, rapid, and unwanted movements or vocal sounds called tics.” Currently, there is no cure for the condition.

Various treatments for Tourette Syndrome exist, with common ones being dopamine blockers, Botox injections, ADHD medications, anti-depressants, and anti-seizure medications. Everyone of those treatments can yield possible side effects. Fortunately, a recent study in Israel found that cannabis may help. Below is more information about it via a news release from NORML:

Tel Aviv, Israel: Tourette syndrome (TS) patients’ who consume cannabis products report significant improvements in their quality of life and reduce their intake of prescription medicines, according to data published in the journal Cannabis and Cannabinoid Research.

Israeli researchers assessed patients’ symptoms immediately prior to and following six months of cannabis treatment. Study participants generally inhaled THC-dominant cannabis flowers, though some patients also consumed extract formulations.

Researchers reported, “A statistically significant improvement in quality of life, employment status, and [a] reduction in the number of medications was found, with a statistically significant number of patients reporting improvements in OCD and anxiety symptoms after six months of treatment.” The authors also identified improvements in motor and vocal tic severity, but they acknowledged that these changes were not statistically significant.

Few patients reported experiencing adverse effects from cannabis treatment. Most commonly reported side effects were dry mouth, dizziness, and fatigue.

“Our findings suggest that medical cannabis may be an effective and safe option to improve comorbidities and quality of life in TS patients,” authors concluded. “Medical cannabis effectiveness should be further evaluated in large-scale randomized clinical trials.”

TS patients frequently report gaining symptomatic relief from cannabis, and several human trials have identified positive results in cohorts using either oral THC or inhaled cannabis.

Full text of the study, “Use of medical cannabis in patients with Gilles de la Tourette’s Syndrome in a real-world setting, appears in Cannabis and Cannabinoid Research. Additional information on cannabis and TS is available from NORML.

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Malta To Start Accepting Cannabis Club Applications By February

Written by Johnny Green on . Posted in Business, Policy.

Malta made continental history late in 2021 when lawmakers passed Europe’s first nationwide adult-use legalization measure. Prior to legalization passing in Malta, the only two other countries that had previously passed national legalization measures were Uruguay in 2013 and Canada in 2018. However, unlike its predecessors, Malta’s legalization model does not provide for sales through pharmacies, storefronts, and for-profit delivery services. Rather, Malta’s legalization model will be built on non-profit cannabis clubs, applications for which people can start submitting as early as February 2023.

Despite legalization’s passage in Malta late last year, there are still no legal means by which to purchase legal adult-use cannabis products. Whereas consumers have a buffet of options from which to make cannabis purchases in Canada, and to a lesser extent Uruguay (residents only), consumers in Malta have continued to wait until the regulatory framework is set up for non-profit cannabis clubs. Thankfully, there appears to be some progress on that front.

Accepting Applications In 2023

The non-profit cannabis club model is not a new concept. Barcelona, where we co-host the world’s largest cannabis super-conference every year along with Spannabis, is home to numerous private cannabis clubs where people can acquire cannabis as well as consume it in a social setting. Uruguay is also home to hundreds of private cannabis clubs, although Uruguay has implemented a regulated system for cannabis clubs compared to Spain where clubs still operate in somewhat of a grey area of the law.

In Malta there will only be two legal sources for adult-use cannabis. One of them is home cultivation. Adult households in Malta can cultivate up to four plants, per the law that was passed late last year. The other source for adult-use cannabis will, of course, be cannabis clubs. However, clubs cannot exist without first having a license, and generally speaking a license cannot be obtained until there is an application and approval process set up. That last part is reportedly finally happening in February 2023 in Malta.

“The Authority for the Responsible Use of Cannabis will be in a position to start accepting applications for cannabis club licenses by next February, according to Parliamentary Secretary Rebecca Buttigieg.” stated Malta Today in its domestic coverage. Malta’s Authority for the Responsible Use of Cannabis will oversee the non-profit sector, including the cannabis club application process. Leonid McKay is currently the executive chair of the authority.

What About The European Union?

Currently, an adult-use legalization measure is looming in Germany, with the nation’s Health Minister Karl Lauterbach currently lobbying the European Union to gain approval prior to formally introducing the measure so that lawmakers in Germany can officially consider it. While some lawmakers in Germany have called for the measure to be introduced immediately, the Health Minister appears to still be seeking EU approval first, at least for the time being.

An obvious question that international cannabis observers are asking on social media and beyond is why is Malta legalizing without so much European Union involvement compared to Germany? It’s a straightforward question that yields some fairly complicated answers. The less complicated answer is that Malta’s legalization model is far more limited than what is being proposed in Germany. Lawmakers in Germany are proposing a nationwide adult-use market where legal purchases will be made at storefronts, similar to what is going on in Canada but on a much larger scale. Malta will have non-profit clubs where people can acquire cannabis, but only if they are members and membership will be limited in many ways I’d assume.

The more complex answer is that Germany’s Health Minister is likely pursuing a strategy that will save legal and political headaches down the road. If the European Union gives its blessing to Germany’s plan, then it largely thwarts potential legal challenges from other EU member nations and mitigates some of the probability of German legalization becoming a political punching bag for cannabis prohibitionists. EU approval would be a final answer in many ways, and while challenges would likely still be pursued, it would be nearly guaranteed that legalization would overcome any challenges if EU approval was granted prior to a legalization measure’s introduction. With that being said, the EU presumably realizes that the decision on Germany will set a precedent, and a big one at that, so it’s not a decision that will be made hastily. The longer it takes for the decision to be rendered, the louder the calls will become within Germany’s borders for lawmakers to hit the gas pedal. In the meantime, the framework for Malta’s limited legalization model will continue to develop.