Notes from the Medical Cannabis Summit and the fight for drug policy reform in Malta (Part 2 of 3)

The Flag of Malta. Source: Wikimedia

Last month, I attended the Medical Cannabis Summit in Malta. The country wants to become a leader for European medical cannabis innovation, after several policy changes in recent years. In the second of this three-part article I'll dive into some key takeaways from the conference. Check out part one for an explanation of Malta’s medical and ‘recreational’ cannabis policies. Part Three explores how the multi-million euro cannabis market seems to exist in a parallel reality to that of communities on the ground.

 

What is happening with CBD? 

 

The cannabinoid CBD was the flavour of the day at the conference, despite there being hundreds more that are currently under-explored, as highlighted by Dave Charnick, a cannabis industry expert. Dejan Gacov suggested that 15 per cent of opioid markets are being replaced, or can be, by cannabis. I have not been able to corroborate this claim, but studies show that many sufferers of chronic pain are indeed replacing opioids with cannabis.

Its uses are also vast, from treating epilepsy or serving as an alternative to other potent chemicals, such as morphine. As described by Jade Proudman, who started as a patient and is now CEO of Savage Cabbage, “it became quite tragic that I was just in this fog of morphine” which was lifted only with the use of cannabis. 

More discussion arose from the fact that, until now, CBD had been relatively unregulated in Europe, but following a European Commission recommendation, which government’s are usually expected to follow, it is now classified as a Novel Food. This means that cannabis is seen as a food that was not consumed to a significant degree by people before 1997. Therefore, to sell CBD products, they must be tested and classified as safe, with clear labelling. The controversy begins because some of these products, derived from hemp extracts, will have the same “identical chemical profile to hemp-based foods that have been consumed for thousands of years and deemed non-novel”, explained Elliott Rolfe, Head of the Cannabis Law team at Mackrell for Health Europa.

At the same time, country-specific agencies, like the UK's Food Standards Authority, agreed with this guidance but did not confirm how, if at all, they will apply this interpretation of the law. Of course, in the UK’s case, this also creates new questions for legislation, patient and consumer safety and market deregulation pending a Brexit resolution.

 

Regulation, safety and information

 

Commentators from the US point out that the market is so saturated that quality is undermined and it is difficult to make profits. Lizi Jenkins, Head of Technical & Development at Next Gen360, one of the largest e-liquid manufacturers in the UK, explained that people are making CBD in “the back room”, as it is so easy to produce. Her parallel with the current vaping scandals in the US, with six deaths and over 450 reported cases of lung illness tied to vaping, was pertinent.

Regulation is often reactionary, but given the European Union's power, they can play a leading role in creating more robust, yet accessible, controls that allow for markets to flourish while protecting consumers. At the moment, there are not enough complaints about CBD because people do not necessarily know enough to threaten the status quo, and when they do, it is unclear who to complain to. As one speaker questioned, do you turn to the shop where you bought it, even if it is Poundland or Amazon? It is unlikely that they would care.

This question is a complicated one, and if the speakers could not solve it, I cannot pretend to do it in this article. On the one hand, new regulations mean that thousands of beneficial products might be removed from the market pending analysis of their quality, which can prevent access to inoffensive medicines that are already helping patients, leading them to seek products in the illicit market.

On the other hand, Jonathan Liebling, co-founder and director of Patient Advocacy and Support Services, gave a stern warning against blindly trusting all current products. Independent tests showed that products sold in high-street pharmacies in the UK contained 0 per cent CBD, or harmful chemicals or just olive oil, as well as massive differences between batches that can put people at risk. 

It is now hoped that once the CBD bubble bursts and appropriate regulations are in place, we can move on to other cannabinoids and ensure that more research and information for patients will guarantee a higher quality standard. What these ideal regulations actually look like, remains unknown, but at the Summit, it seems that the current ways are more of a complicated and loosely enforced set of rules, rather than a long-term solution. 

 

What’s the deal with hemp?

 

One of my personal highlights was the presentation given by Preet Marwaha, CEO of Blue Sky Biologicals, a leading producer of organic hemp-based cannabinoids. He made compelling arguments about the benefits of turning towards hemp, the name used to classify varieties of cannabis with less than 0.3% of THC. While we often hear about hemp as a construction material or fabric, it was great to understand its more medicinal and recreational values. 

The very definition of hemp created a lively debate, as the 0.3 number seemed arbitrary for many and precisely limited the use of either hemp or higher THC-containing cannabis, in fields that are typically associated with one or the other. For instance, Marwaha mentioned the validity of planting hemp biomass to extract THC for the recreational market, while being able to use the rest of the plant for its other benefits, from nutritional value to the manufacturing of batteries, which would curb the need for lithium, whose extraction is environmentally and humanly unsafe. Marwaha added that the weird ideas will be weeded out, like pillows infused with CBD, but that in the future “your bowl of cereal in the morning is gonna have cannabinoids in it”. 

Marwaha also highlighted the clear need for organisations and companies that sell hemp or other cannabis-derived products to collaborate towards taking advantage of all possible cannabinoids, pushing for better regulations and fostering innovation without compromising quality. However, he fears that this much-needed cooperation is unlikely if we look at how pharma works: “big pharma will have to find a way to work with us, or they’ll just take over everything”.

In different parts of the world, particularly North America where the medical cannabis market has had more time to develop, there is a strong desire to fully take advantage of the plant’s capacity. Every year there is some kind of miracle product, food or vitamin that revolutionises the market, and so far, it seems that we are all spectators of the CBD boom.

While it does have a very wide range of benefits, it will certainly be interesting to see what happens when some of these products have to prove their claims, and once the market convinces manufacturers and buyers that cannabis and hemp can provide more than resistant fabrics, CBD and a THC high.

 

 

This artice is Part Two of a three-part series on cannabis in Malta. Check out Part One. Have a read of Part Three here.

*Massive thank you to Karen Mamo and Andrew Bonello for their contributions to this article and for the super warm welcome in Malta!