Weed Ed | What exactly is medical marijuana, and how will Jamaica develop the requisite medical standards?

"A really awesome thing happened to me three months ago," said Mary Jane* as she told the story of how marijuana changed her life. "I started using CBD oil for my pain management and now I'm 95 per cent pain free."

The 57-year-old pharmacist and entrepreneur from Montego Bay damaged her spine in a car accident in 1997, which led to degenerative disc disease. She underwent surgery in 2001 but since then has lived in chronic pain associated with her condition.

The simple motion of opening and closing her hands sent needlelike sensations shooting throughout her entire body. Doctor-recommended drugs were ineffective and carried side effects.

Then three months ago her search for an alternative medicine led her to CBD oil, an extract from the ganja plant. Jane consumes the oil by vaporising it. She medicates three times daily, taking between 10 and 15 puffs each session.

"When I feel the pain or the anxiety returning I know it's time for another medication," she added.

Jane's story reflects both the life-changing applications of medical marijuana and the importance of that medicine being validated for patient use.

Medical marijuana refers to the use of the cannabis plant to relieve symptoms or treat ailments. Marijuana contains more than 100 active compounds, but the two most researched cannabinoids are THC and CBD.

CBD has been the front runner in treating ailments as it does not have a psychoactive effect on the patient like THC.

As marijuana becomes more accepted in the arena of traditional medicine, its cultivation, curing, storage, packaging and application must be governed by a universally accepted set of standards.

The plant, and its by-products, must display the highest levels of safety and quality, particularly given its controversial nature.

PROMISED LAND

While there are no globally accepted guidelines yet for using marijuana as medicine, Israel is the industry's 'Promised Land' as it has long pioneered medical marijuana research and innovation.

Israel began its research in the 1960s at the Hebrew University of Jerusalem led by Professor Raphael Mechoulam, the man credited for discovering the THC cannabinoid. Today, the university holds numerous intellectual property patents for medical cannabis.

All this has been possible due to Israel's well-coordinated ecosystem of cannabis researchers, farmers, entrepreneurs, pharmaceutical industry and government policies.

Local regulators are in the process of developing a similar multi-agency approach that will include the Cannabis Licensing Authority (CLA), the Ministry of Health, the Bureau of Standards Jamaica, cultivators, academia, pharmaceutical council, scientific labs and the cannabis companies. There are, however, some glaring contradictions.

Since the amendment to the Dangerous Drugs Act in 2015 allowing for the establishment of a medical ganja industry, the Ministry of Health has maintained a cautious stance when it comes to treating ailments with marijuana.

The ministry requires that all medicinal cannabis products are registered with its offices, and has said it does not support smoking cannabis or consuming edibles for medicinal or therapeutic purposes.

There is also the issue of the Food and Drugs Act and the Pharmacy Act, which have not been amended to support ganja's decriminalisation. "Therefore, any company that is currently selling cannabis products for medical and therapeutic purposes is in breach", said a release from the health ministry.

TESTING

But for patients like Jane and numerous others, CBD oil, even without approval from the health authorities, has been a life changer. Jane not only vaporises but supplements with CBD tablets and uses topicals infused with CBD to treat her acne and eczema.

Jane's oil, which was manufactured overseas, would have gone through a series of tests to ensure the product exhibits a high degree of quality and safety standards.

Carole Lindsay is the chief analyst at the Caribbean Toxicology Unit (CARITOX) at the University of the West Indies, the island's leading laboratory for cannabis testing.

She said the potency test of THC and CBD ranks at the top of the list of mandatory assessments as this has a direct correlation to the dose when physicians are writing a prescription.

The terpene profile is also determined to understand the synergistic effect with the cannabinoids. Terpenes are what give marijuana its distinctive flavour and aroma.

When it comes to safety, screening is done for pesticides, mycotoxins, heavy metals (leached through the soil), yeast and mould (caused by too much moisture and poor storage), residual solvents (used to extract oils) and shelf life.

Lindsay said since the start of the year, CARITOX has screened more than 300 samples, and that local cultivators and herb houses receive a certificate of authenticity.

CULTIVATION

"One way to ensure marijuana can withstand medical scrutiny is growing the plant by standards that meet ethical and moral values which will guarantee the safe consumption of the herb and its derivatives," emphasised Dr Machel Emanuel, principal investigator of the Life Science Cannabis Research Group at the UWI, Mona.

He says when using the cannabis plant for medical and therapeutic applications, the replicability and consistency of the cannabinoids and terpenoids are paramount to the consumer and the integrity of the medical industry.

One of the ways to guarantee genetic consistency is through the process of asexual propagation. By cultivating from plant cuttings, instead of seeds, he is able to replicate the exact genetics as the parent plant.

Cultivating marijuana from seeds brings about genetic variation through cross-pollination.

Dr Emanuel and his team also observe strict post-harvest best practices aimed at preserving the trichomes: the crystal-like glands located on the plant that house the terpenoids and cannabinoids.

Dr Emanuel says he wants his research to influence the decision-making of local policymakers establishing the industry standards.

"Policy decisions should be guided by research. This will ensure we can have some quality control and guarantee that cannabis coming from this island, to be exported, meets a certain aesthetic and organoleptic quality that the consumer can identify with," he said.

While recreational marijuana use currently accounts for roughly two-thirds of marijuana spending globally, it is expected to swing in favour of medical use as more research findings are published, more countries adopt a medical marijuana framework, and more people, like Jane, are healed.

Researchers have just begun to scratch the surface of truly understanding ganja's healing properties. American investment firms, however, have taken a keen interest in the industry's economic potential and over the past four years have invested more than US$50 million to fund cannabis research, agriculture and tech innovations in Israel.

"The real value (of the industry) is in medical marijuana and the protocol from cultivation to medical application is significant," Dr Emanuel pointed out. "Being able to administer a particular plant that will deliver a particular relief, that's where the value is."

*Name changed on request.