Could cannabis be a ‘silver bullet’ in the fight against the opioid crisis?

UBC research goes viral, although a cannabis company contributes to the university

Source

CBC News 

Adam Miller · 

Posted: Nov 24, 2019

Research into the use of cannabis as a treatment for opioid addiction is in its early stages, but conflicting studies raise questions about its effectiveness. (Blair Gable/Reuters)

A new study suggests cannabis could be a safer and more effective substitute for opioids in the treatment of chronic pain, but can it help fight the opioid crisis?

Researchers at the University of British Columbia and the B.C. Centre on Substance Use conducted over 5,000 interviews with 1,152 people who used heroin and other drugs and reported chronic pain at some point from June 2014 to June 2017.

The participants were largely from Vancouver’s Downtown Eastside, and lead author M-J Milloy said the study aimed to discover “new interventions” that might “lower or address the risk of overdose” in heavy opioid users.

More than 12,800 apparent opioid-related deaths occurred in Canada between January 2016, when the federal government started tracking the data, and March 2019, according to the latest available statistics from the Public Health Agency of Canada.

Milloy said chronic pain is one of the “driving factors” of the opioid crisis, adding that many who can’t get effective pain relief can turn to the black market for opioids.

“This is the population that’s really suffering the worst burden of mortality in the crisis,” he said. “And there’s been some work suggesting that cannabis might be beneficial in the overdose crisis. So we’ve really tried to use our data to figure out if that is true.”

What they found was that daily cannabis use was associated with significantly lower odds of daily illicit opioid use, suggesting cannabis may serve as a substitute treatment in people with chronic pain.

The story went viral online this week and was picked up in publications in Canada and overseas, including the Daily Mail and The Sun in the U.K.

What the articles failed to mention, however, is that Milloy is also UBC’s inaugural Canopy Growth Professor of Cannabis Science.

M-J Milloy was named inaugural professor of cannabis science at UBC last November. (Rafferty Baker/CBC)

While a spokesperson for the university says he receives no funding from any industry group, it is worth noting the cannabis company contributed $2.5 million to UBC and BCCSU for the professorship and research.

Milloy said the fact that his study looked at daily cannabis use raised a “valid concern” about the risk of addiction, but added it’s also linked to therapeutic benefits.

• New UBC pot professor to research potential of cannabis in treating opioid addiction

“A lot of people who are benefiting from cannabis are the people who are using it every day,” he said.

“We are very aware of the risk of harms. And I want to emphasize that none of us think that cannabis is a panacea or a silver bullet to knock out the overdose crisis. What we do think, though, is that it has tremendous potential.”

Conflicting research raises questions

A day after the UBC study was published, researchers at McMaster University published a review of almost 30 years’ worth of data in the Canadian Medical Association Journal that examined the use of cannabis as a replacement drug for people with opioid addictions.

Researchers looked at six studies involving 3,676 participants dating back to 1991 in an effort to determine the effects of cannabis use on opioid addiction during methadone treatment.

• Can cannabis reduce opioid use in addicts?

What they found was starkly different than the UBC study — there is no consensus among studies that cannabis use is associated with reduced opioid use.

“There’s a lot of hype and interest and hope that this could be a replacement. Could this be helping people with chronic pain or with opioid addiction?” said senior author Dr. Zainab Samaan, associate professor of psychiatry and behavioural neurosciences at McMaster.

• Addiction experts decry restrictions on cannabis sales on Vancouver’s Downtown Eastside

“The reality is that there are no good studies or good evidence to show us it’s beneficial.”

The research also found cannabis use did not result in patients with opioid addiction staying in methadone treatment longer.

Challenges to cannabis research

Samaan concedes that studying the positive or negative effects of cannabis is difficult, especially when studying drug users with addictions to multiple drugs.

“When you’ve got a mix of drugs and a population who are already addicted to drugs, it’s really hard to decipher,” she said. “What is the benefit, what is the harm?”

The McMaster study also concludes the overall quality of evidence was “very low,” with “critical issues of inconsistency and imprecision to moderate risk of bias.”

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After Evo, the Lithium Question Looms Large in Bolivia

Redfish

Shortly before the coup against Bolivia’s Evo Morales, his government announced plans to nationalize the highly profitable lithium industry and to deal directly on the international market instead of exporting it at bargain prices to the West.

Global demand for lithium, used to make cell phone batteries, parts of laptops and electric cars, is expected to triple in the next 15 years and guess where the largest reserves in the world are?

After Evo, the Lithium Question Looms Large in Bolivia

http://www.counterpunch.org

by VIJAY PRASHAD

NOVEMBER 13, 2019

Bolivia’s President Evo Morales was overthrown in a military coup on November 10. He is now in Mexico. Before he left office, Morales had been involved in a long project to bring economic and social democracy to his long-exploited country. It is important to recall that Bolivia has suffered a series of coups, often conducted by the military and the oligarchy on behalf of transnational mining companies. Initially, these were tin firms, but tin is no longer the main target in Bolivia. The main target is its massive deposits of lithium, crucial for the electric car.

Over the past 13 years, Morales has tried to build a different relationship between his country and its resources. He has not wanted the resources to benefit the transnational mining firms, but rather to benefit his own population. Part of that promise was met as Bolivia’s poverty rate has declined, and as Bolivia’s population was able to improve its social indicators. Nationalization of resources combined with the use of its income to fund social development has played a role. The attitude of the Morales government toward the transnational firms produced a harsh response from them, many of them taking Bolivia to court.

Over the course of the past few years, Bolivia has struggled to raise investment to develop the lithium reserves in a way that brings the wealth back into the country for its people. Morales’ Vice President Álvaro García Linera had said that lithium is the “fuel that will feed the world.” Bolivia was unable to make deals with Western transnational firms; it decided to partner with Chinese firms. This made the Morales government vulnerable. It had walked into the new Cold War between the West and China. The coup against Morales cannot be understood without a glance at this clash.

Clash With the Transnational Firms

When Evo Morales and the Movement for Socialism took power in 2006, the government immediately sought to undo decades of theft by transnational mining firms. Morales’ government seized several of the mining operations of the most powerful firms, such as Glencore, Jindal Steel & Power, Anglo-Argentine Pan American Energy, and South American Silver (now TriMetals Mining). It sent a message that business as usual was not going to continue.

Nonetheless, these large firms continued their operations—based on older contracts—in some areas of the country. For example, the Canadian transnational firm South American Silver had created a company in 2003—before Morales came to power—to mine the Malku Khota for silver and indium (a rare earth metal used in flat-screen televisions). South American Silver then began to extend its reach into its concessions. The land that it claimed was inhabited by indigenous Bolivians, who argued that the company was destroying its sacred spaces as well as promoting an atmosphere of violence.

On August 1, 2012, the Morales government—by Supreme Decree no. 1308—annulled the contract with South American Silver (TriMetals Mining), which then sought international arbitration and compensation. Canada’s government of Justin Trudeau—as part of a broader pushon behalf of Canadian mining companies in South America—put an immense amount of pressure on Bolivia. In August 2019, TriMetals struck a deal with the Bolivian government for $25.8 million, about a tenth of what it had earlier demanded as compensation.

Jindal Steel, an Indian transnational corporation, had an old contract to mine iron ore from Bolivia’s El Mutún, a contract that was put on hold by the Morales government in 2007. In July 2012, Jindal Steel terminated the contract and sought international arbitration and compensation for its investment. In 2014, it won $22.5 million from Bolivia in a ruling from Paris-based International Chamber of Commerce. For another case against Bolivia, Jindal Steel demanded $100 million in compensation.

The Morales government seized three facilities from the Swiss-based transnational mining firm Glencore; these included a tin and zinc mine as well as two smelters. The mine’s expropriation took place after Glencore’s subsidiary clashed violently with miners.

Most aggressively, Pan American sued the Bolivian government for $1.5 billion for the expropriation of the Anglo-Argentinian company’s stake in natural gas producer Chaco by the state. Bolivia settled for $357 million in 2014.

The scale of these payouts is enormous. It was estimated in 2014 that the public and private payments made for nationalization of these key sectors amounted to at least $1.9 billion (Bolivia’s GDP was at that time $28 billion).

In 2014, even the Financial Times agreed that Morales’ strategy was not entirely inappropriate. “Proof of the success of Morales’s economic model is that since coming to power he has tripled the size of the economy while ramping up record foreign reserves.”

Lithium

Bolivia’s key reserves are in lithium, which is essential for the electric car. Bolivia claims to have 70 percent of the world’s lithium reserves, mostly in the Salar de Uyuni salt flats. The complexity of the mining and processing has meant that Bolivia has not been able to develop the lithium industry on its own. It requires capital, and it requires expertise.

The salt flat is about 12,000 feet (3,600 meters) above sea level, and it receives high rainfall. This makes it difficult to use sun-based evaporation. Such simpler solutions are available to Chile’s Atacama Desert and in Argentina’s Hombre Muerto. More technical solutions are needed for Bolivia, which means that more investment is needed.

The nationalization policy of the Morales government and the geographical complexity of Salar de Uyuni chased away several transnational mining firms. Eramet (France), FMC (United States) and Posco (South Korea) could not make deals with Bolivia, so they now operate in Argentina.

Morales made it clear that any development of the lithium had to be done with Bolivia’s Comibol—its national mining company—and Yacimientos de Litio Bolivianos (YLB)—its national lithium company—as equal partners.

Last year, Germany’s ACI Systems agreed to a deal with Bolivia. After protests from residents in the Salar de Uyuni region, Morales canceled that deal on November 4, 2019.

Chinese firms—such as TBEA Group and China Machinery Engineering—made a deal with YLB. It was being said that China’s Tianqi Lithium Group, which operates in Argentina, was going to make a deal with YLB. Both Chinese investment and the Bolivian lithium company were experimenting with new ways to both mine the lithium and to share the profits of the lithium. The idea that there might be a new social compact for the lithium was unacceptable to the main transnational mining companies.

Tesla (United States) and Pure Energy Minerals (Canada) both showed great interest in having a direct stake in Bolivian lithium. But they could not make a deal that would take into consideration the parameters set by the Morales government. Morales himself was a direct impediment to the takeover of the lithium fields by the non-Chinese transnational firms. He had to go.

After the coup, Tesla’s stock rose astronomically.

This article was produced by Globetrotter, a project of the Independent Media Institute.

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More articles by:VIJAY PRASHAD

Vijay Prashad’s most recent book is No Free Left: The Futures of Indian Communism (New Delhi: LeftWord Books, 2015).

Cannabis was legalized 1 year ago: How is Canada doing?

‘We’re not fully there yet, but the progression is great,’ says legal pot store owner

Source

CBC News 

Laura Sciarpelletti

Oct 14, 2019

The legalization process appears to be working, according to pot industry professionals. But it has its growing pains.  (Richard Vogel/The Associated Press)

One year after legalization, some cannabis industry professionals say they are mostly happy with how British Columbia has rolled out recreational pot.

Tom Ulanowski, president of NextLeaf Labs, a cannabis processing company that partners with cultivators to provide contracting and wholesale services to the industry, says growing pains like licensing issues and product quality issues are to be expected.

“But overall, for something of this magnitude and something as new as this to be done on a federal level, I think its been pretty positive,” Ulanowski said.

• Knowing who uses cannabis is key for public policy, says researcher

Mike Babins, co-owner of Evergreen Cannabis Society, Vancouver’s first retail pot shop, says major challenges for cannabis business owners have been learning to work within the new federal and provincial legal cannabis systems, and dealing with customers who are used to buying pot illegally.

“Every day we get someone coming saying: ‘why should I buy this? I can get ounces from a guy for 100 bucks’ … but when they come back, nine out of 10 say, ‘wow, it’s amazing.’ And they switch,” Babins said.

‘We’re a year past legalization and there are many stores who are still happy to sell unlicensed products at a huge markup and not pay any taxes,’ says Mike Babins, co-owner of Evergreen Cannabis Society. (Darryl Dyck/The Canadian Press)

Licensing

Babins says he often hears on social media that the government is too slow to issue licences for cannabis shops. But he says the system is reasonable.

“I think a big issue is that a lot of people get their information from people who have ulterior motives and are very good at social media.”

Babins says getting a licence is a lot of work, but more often than not it’s the pot shops who drag their heels.

“We’re a year past legalization and there are many stores who are still happy to sell unlicensed products at a huge markup and not pay any taxes. And I understand that. It’s a lot of money that you make that way.”

Ulanowski says some provincial governments, like B.C., have begun to take measures to speed up the licensing process.

• Prairies ‘bright spot’ in Canadian cannabis market as legalization anniversary nears, expert says

“On the federal side, when it comes to licensing and manufacturing, licensing has been a huge bottleneck. It’s taking some companies years to obtain a licence,” said Ulanowski.

He’s says the province has had issues with municipal support.

“I’d like to see the mayors and city councils of various large and small cities in B.C. really embrace this process.”

Ulanowski would like to see B.C. put more resources into getting more licensed pot shops, and for licences to be approved in a timely fashion.

With files from Joel Ballard

Knowing who uses cannabis is key for public policy, says researcher

Source

http://www.cbc.ca

Oct 09, 2019

Studies shows 10% of users consume two-thirds of the weed in Canada

According to the 2018 National Cannabis Survey, men between the ages of 15 and 34 consume the most cannabis in the country. (Jason Redmond/Reuters)

It’s been nearly one year since cannabis was legalized in Canada and a professor at the University of Northern British Columbia says knowing who is using it is important to develop sound policy aimed at reducing cannabis-related harms.

Russ Callaghan, medical professor at UNBC, is the lead author of an article in the forthcoming December issue of the Journal of Drug and Alcohol Dependence that identifies who consumes the most cannabis in Canada.

Callaghan and a team of researchers looked at data from the federal government’s 2018 National Cannabis Survey to find out who are the biggest users and how that should inform public policy.

According the survey conducted prior to legalization — which did not distinguish between legal and illegal cannabis — 10 per cent of people use roughly 66 per cent of the cannabis in Canada. The data also showed  males reported higher use than females and males aged 15-34 were the highest using subgroup.

Callaghan said the usage rates are similar to alcohol statistics which show the heaviest users consume a high proportion of alcohol in Canada.

• Cannabis-related hospitalizations highlight need for education, clinicians say

• Legalized cannabis hasn’t hurt productivity, but most employers don’t allow it at work, survey suggests

‘A large societal experiment’

Possible harms from cannabis use include impaired driving, lung cancer and personal injury, although he noted there is not a lot of evidence yet linking weed to non-traffic related injuries.

“We’ve legalized it so it’s a real large societal experiment,” said Callaghan in a phone interview on CBC’s The Early Edition, adding particular risks associated with edible cannabis products may become evident after they become legal this year. 

The U.S. experience with edible cannabis goods like fruit-flavoured gummies, pictured, include more children ending up in emergency departments after eating them, says Callaghan. Edibles will be legal in Canada later this year. (Brandon Police Service )

With weed, as with alcohol, consumption rates can be influenced by prices and taxation, the availability of stores in a neighbourhood and their operating hours.

The study included a team of researchers from UNBC, the University of British Columbia, the Centre for Addiction and Mental Health (CAMH), and the Canadian Institute for Substance Use Research at the University of Victoria.

A campaign promise kept: Canada’s modestly successful cannabis legalization

Source

theconversation.com

September 23, 2019

The anniversary of Canada’s recreational cannabis legalization arrives Oct. 17, just days before the federal election. Legalization was a Liberal campaign promise from the last election, so it’s timely to review how it’s worked out.

Consumers evidently like legalization. Statistics Canada just reported that July’s recreational sales hit $104 million.

Politicians apparently like it too. It’s an election promise the Liberals kept and that no other party plans to repeal.

But how well has it reduced black market cannabis, as promised?

Increasing legal sales

A government-funded study in 2018 estimated Canada’s total cannabis consumption at roughly 926,000 kilograms annually, or some 77,000 kilograms monthly.

Health Canada says that in June 2018, when only medical usage was legal, licensed producers sold 2,151 kilograms of dry cannabis and 4,652 litres of cannabis oil. That represents around nine per cent of national demand.

In June 2019, by comparison, legal medical and recreational sales totalled 9,976 kilograms of dry and 9,614 litres of oil. That’s about 26 per cent of the market.

So legal sales have roughly tripled. But illegal sales remain the majority.

Legal medical and recreational cannabis monthly sales volumes, combining dry (kilograms) and oil (litres) products. Prepared by author from Health Canada data. Michael Armstrong

By contrast, StatCan seems more optimistic. Its surveys ask users whether they buy at least some cannabis legally. It estimated that number at 47 per cent, or 2.5 million Canadians, for the first quarter of 2019. That’s up sharply from 23 per cent, or 954,000 people, in 2018’s first quarter.

Unfortunately, those estimates aren’t really plausible. The only people who could legally buy cannabis in March 2018 were Health Canada’s 296,702 registered patients. And just 132,975 did so. That implies StatCan’s estimates are three to seven times too high.

So while survey participants reported purchasing legally, they mostly didn’t.

Growing pains

One reason legal sales haven’t done better is a lack of retailers in some regions. British Columbia and Ontario were especially slow to open stores.

Product shortages have posed bigger problems. While there’s ample oil, producers until recently hadn’t processed enough dry products. And legal foods, drinks, vapes and lotions aren’t yet available.

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Read more: Canada’s legalization of weed edibles is another global social experiment

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Those shortages are predictable side effects of the government’s legalization strategy. It chose a regulated pharmaceutical approach, rather than the more hands-off approach many U.S. states have used.

That hands-off approach has several drawbacks, however. Ex-black-market producers don’t always prioritize consumer safety. Some reportedly fudge their product lab tests.

Furthermore, minimal government oversight is worrisome to social conservatives. Almost 80 per cent of California cities banned state-licensed cannabis shops.

But the pharmaceutical approach has its own drawbacks. Rigorous standards prevent existing grow-ops from going legit. Instead, they remain illegal and undercut legal producers’ prices.

Meanwhile, legal producers need time to build facilities and gain experience. That almost guarantees initial product shortages.

It’s understandable the feds chose the regulation-heavy approach. But as I and others have complained, they shouldn’t be denying its limitations.

Head-spinning spin

Already in January, Border Security Minister Bill Blair was implausibly bragging that cannabis supplies were “adequate” and “exceed existing demand.”

Bill Blair

✔@BillBlair

Building on our considerable experience with medical cannabis, and with 147 Health Canada licensed producers, the data is clear: there remains sufficient supply to meet and exceed existing demand.https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/licensed-producers/market-data/supply-demand.html …

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That was despite government data showing legal production met less than a fifth of Canada’s dry cannabis needs that month.

A Newfoundland store even closed due to the shortages.

In March, Health Canada spokespeople similarly said “there is not — as some have suggested — a national shortage.” That was when shortages were keeping Québec’s shops closed three days a week and preventing hundreds of Alberta store openings.

Those premature claims only added to the frustrations felt by retailers and consumers.

However, some other criticisms of the government seem frivolous.

Other complaints

For example, some critics say the government legalized too slowly. Edibles should have been allowed sooner to better compete with black markets, they say.

Unfortunately, that wasn’t realistic. Given limited regulatory resources, it made sense to legalize simpler dry and oil products first. That allowed another year to figure out the rest.

Besides, producers have struggled to supply just two product categories. More categories would have meant more severe shortages.

Conversely, other observers argue legalization went too quickly. They think governments should have resolved problems like product shortfalls and impaired driving before beginning sales.

Again, that’s unrealistic. First, legalization has been discussed since 1972’s Le Dain Report; 46 years isn’t rushing.

A sales clerk helps customers at a retail cannabis store in Manitoba in April 2019. THE CANADIAN PRESS

Second, the government only has four years between elections. Had it moved more slowly, legalization wouldn’t have happened.

Finally, many problems require research to resolve. Since legalization, Health Canada has issued 145 research licences and hundreds more are pending. Studies have already examined grow-op lights, black market financing and alternative retailing strategies.

Canadian compromises

Canada has come a long way since 2001, when the government began the process of legalizing medical cannabis. In a sense, we’re 15 years ahead of Australia and 17 ahead of Britain.

Here, recreational users now grumble about product quality and wasteful packaging. But in the U.K., epileptic children still struggle to access medical cannabis oil.

Yes, legalization has been a muddled mess of compromises and glitches. It still needs years of work. But at least it happened. And it’s taken a bite out of black markets. So it should be considered a typical Canadian success story.

Common questions about CBD health claims for pain and other conditions answered

Doctors weigh the science behind cannabidiol claims

CBC News

Source

Sep 18, 2019 

An oral administration syringe loaded with CBD hemp oil for treating a severely-ill child is shown at a home in Colorado Springs, Colo., in 2014. (Brennan Linsley/The Associated Press)

Cannabidiol, or CBD oil, is promoted for a wide range of medical conditions. Recently, a review for doctors weighed the science behind the claims.

The Clinicians’ Guide to Cannabidiol and Hemp Oils was published earlier this month in the journal Mayo Clinic Proceedings.

CBD is a compound found in the cannabis plant. It is not intoxicating, Health Canada said.

As of October 2018, the sale of dried cannabis, fresh cannabis, cannabis oil, cannabis plants and cannabis seeds are permitted under the the Cannabis Act.

As consumer interest in CBD grows ahead of the Oct. 17 legalization of cannabis edibles, extracts and topicals, here’s a primer to answer common questions about its health claims for seizures, pain and other conditions.

What is CBD approved to treat?

Epidiolex, a purified form of plant-based CBD, is the only CBD-related treatment approved by the U.S. Food and Drug Administration (FDA). It is used to treat severe forms of epilepsy. Epidiolex isn’t listed in Health Canada’s database of medications approved for use in this country.

Health Canada assigns a drug identification number (DIN) to all drug products evaluated and authorized for sale in this country. To qualify, a drug manufacturer needs to provide information including dosing, strength and how it’s taken.

“Currently, there are two cannabis-related drugs that have a DIN and are authorized for sale in Canada,” a spokesperson for Health Canada said in an email.

Nabilone, a synthetic tetrahydrocannabinol, or THC, product is approved to treat nausea. THC is the main psychoactive component in cannabis that gives users a high.

The other drug with a DIN is Sativex, which is manufactured from whole botanical extracts and contains THC and CBD, according to Health Canada. Sativex is added to treatments aimed at relieving spasticity in adults with multiple sclerosis. Spasticity is a muscle-control disorder.

No CBD-specific product has a DIN.

As well, no other “cannabis-related drug (including fresh or dried marijuana or cannabis oil) has been approved to be marketed as a drug for therapeutic use and sale in Canada,” Health Canada said.

What is CBD commonly used for?

There are anecdotal reports from users of CBD helping with certain types of pain, such as nerve-related back pain.

“Chronic pain management continues to challenge patients and physicians alike, and investigation into potential therapies such as CBD and hemp oils is a promising area for the future of clinical pain management for both pain relief as well as addiction management,” Dr. Karen Mauck, an internist at Mayo Clinic, and her co-authors wrote.

Dr. Hance Clarke, director of pain services at Toronto General Hospital who wasn’t involved in the U.S. paper, said he starts by asking patients what symptoms they want to use CBD to treat.

It’s one of the first times in Canadian history where a medication has made it to the population without the science actually leading us there.– Dr. Hance Clarke, director of pain services at Toronto General Hospital

“The evidence has not caught up to the story that’s in the public,” Clarke said. “It’s tricky. It’s one of the first times in Canadian history where a medication has made it to the population without the science actually leading us there.”

The world is looking to Canada for answers on CBD, said Dr. Hance Clarke. (University Health Network)

Physicians need to work with patients to figure out what people are using, the levels in their body and what’s actually helped and what hasn’t.

“The world is looking to Canada over the next five to 10 years,” Clarke said. An evidence-based perspective on cannabis is needed rather than solely industry’s, he said.

Canada’s Arthritis Society said there’s limited clinical evidence so far on the relative benefits and risks of medical cannabis to treat osteoarthritis and rheumatoid arthritis.

CBD now is widely used by people for all kinds of disease, in particular anxiety, panic attack, bipolar disorder, depression. But we don’t know if CBD is really good for these kind of diseases.– Dr. Gabriella Gobbi

In January, research into CBD’s effects on pain and anxiety in lab rats was published in the scientific journal Pain.

“CBD now is widely used by people for all kinds of disease, in particular anxiety, panic attack, bipolar disorder, depression,” said Dr. Gabriella Gobbi, the study’s author and a psychiatrist at McGill University’s faculty of medicine in Montreal. “But we don’t know if CBD is really good for these kinds of diseases.”

Only clinical trials in humans can show if CBD is really effective for an illness, Gobbi said.

In Canada, pharmaceutical companies are sponsoring clinical trials to test CBD products in people.

How do you know what’s in the product?

Depending on what part of the plant is extracted, different components will be present in the oil, the Mayo Clinic authors said. Their list of what clinicians should look for include:

• Manufacturing standards certification, such as pesticide or herbicide testing.
• European Union, Australian or Canadian organic certification.
• Lab testing to confirm cannabinoid levels and the absence of heavy metals.

“We see variations from batch to batch where patients are doing well on something, and potentially the next time they seek that same product, potentially they’re not seeing the same effects,” Clarke said.

A research letter published in 2017 in JAMA  found nearly 70 per cent of CBD extracts sold online were mislabelled.

“A lot of CBD oil can have very little or contain lots of THC, so you must be very careful,” Gobbi said. “We need more quality control.”

What side-effects have been reported?

In larger studies on CBD treatment for epileptic patients, it was associated with drowsiness, decreased appetite and diarrhea in up to 36 per cent of people, the Mayo Clinic authors said, adding the side-effects were less severe and frequent compared with a conventional anticonvulsant medication.

CBD oil products can have very little of the active ingredient or contain a lot of THC, the main psychoactive component in cannabis that gives users a high. (Tijana Martin/The Canadian Press)

The FDA said its review of a marketing application for Epidiolex suggested potential for liver injury associated with CBD.

You can’t just self-treat.– Dr. Gabriella Gobbi

“You can’t just self-treat,” Gobbi said.

What about drug interactions?

The main drug interactions doctors and pharmacists look for are drugs, such as morphine, oxycodone, sleeping pills, antidepressants or antipsychotics, that already make you sleepy, confused or impair co-ordination.

“If you’re taking those medications to begin with and you use cannabis, we’d expect that those side effects would get worse,” said Kelly Grindrod of the University of Waterloo’s School of Pharmacy.

Doctors should look for lab testing to confirm cannabinoid levels when looking for products for patients, researchers say. (Guillaume Payen/SOPA Images/LightRocket/Getty)

People should talk to their physician, nurse or pharmacist to discuss potential drug interactions when determining whether to try CBD.

Maddie Brown, a registered practical nurse and cannabis consultant based in Ottawa, helps patients with medical cannabis prescriptions understand how CBD works and obtain it.

“I’m definitely most concerned about blood thinners,” Brown told CBC Radio’s White Coat, Black Art. “CBD can make Coumadin [a blood thinning medication] more potent.”

The general advice is to start low and go slow, especially if taking medications that are known to interact, Grindrod said.

With files from CBC’s Christine Birak

Green Party leader calls for decriminalization of drugs across Canada

British Columbia

Source

http://www.cbc.ca

Sep 10, 2019

‘If we don’t control it, we will lose people,’ says Elizabeth May

Elizabeth May says she wants to pressure other federal party leaders to commit to harm reduction strategies like a safe drug supply. (Ben Nelms/CBC)

Green Party Leader Elizabeth May says it’s time the federal government declared the opioid crisis a national emergency and decriminalized illicit drugs to prevent deaths.

“This is not a criminal issue. This is a health issue, and we have to adequately support people in our society who are dealing with illness and ill health,” May told Stephen Quinn, the host of CBC’s The Early Edition.

The CBC has asked all federal parties to comment on the issue of a safe drug supply. Conservative Leader Andrew Scheer has declined to comment. The NDP and Liberal parties have not yet provided a response.

During the CBC interview Tuesday morning, May, who is also MP for Saanich-Gulf Islands on Vancouver Island, did not explicitly support the idea that the government should provide a safe supply of opioids, which are increasingly contaminated with fentanyl.

“If we don’t control it, we will lose people,” May told Quinn. “You can die from a very small amount of fentanyl, so our position as the Greens is we have to decriminalize.”

Late Tuesday, May’s spokesperson clarified in an email to CBC that she does in fact support a safe supply, as well as decriminalization of illicit drugs across Canada.

• ‘Make this a federal election campaign issue’: Crowd gathers for forum on Downtown Eastside

People on the front lines of the opioid crisis have long said creating a supply of clean drugs and removing the criminal element will cut down on the number of people dying of overdoses.

May points to findings from a Statistics Canada report that say life expectancy rates in Canada have stopped increasing for the first time in four decades because of deadly overdoses.

She says the overdose crisis has become a public health emergency — one that affects people across the country and across all walks of life.

More than 11,500 opioid-related deaths occurred in Canada between January 2016 and December 2018, according to provincial data gathered by the federal government. In 2018, 73 per cent of those deaths involved fentanyl or fentanyl-related substances.

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May acknowledges Canadians and politicians have been resistant to the idea of government providing illicit drugs to those struggling with addiction. She believes part of the reason is due to the framing of the issue.

“I think we mischaracterize it when we refer to the deaths as overdoses. These are poisonings.”

She adds that the cost of investing further in harm reduction is also a factor in the lack of political will.

The Green Party leader says her party’s election platform will identify new revenue sources to fund mental health and addiction treatment.