Medicine or madness?

There are plenty of benefits to cannabis oil, but it’s not a miracle drug, writes Chai Brady

The controversial cannabis plant is known to have many uses other than the illegal varieties, but sometimes it’s difficult to separate quackery from truth, especially with so many products purporting to be miracle cures.

Many parents shudder at the thought of their children or loved ones succumbing to illicit drug use, and it subsequently becoming a destructive element affecting their lives. Even the word cannabis has negative associations for many and is seen as a gateway to more serious and destructive narcotics.

Therefore, it’s not surprising one of the most contentious issues being discussed worldwide is whether cannabis has medical benefits, and if so, what can it treat.

But cannabis oil does not cause the same psychoactive effects as the form of cannabis that contains THC, and is illegal. Cannabidiol, or CBD, is a chemical extracted from the cannabis plant and is legally sold in Ireland.

Makers of CBD-based products, as well as some medical professionals, believe that it has health benefits for those suffering anxiety, insomnia, chronic pain, glaucoma, epilepsy and more.

However, CBD has not been authorised as a medical product by the Health Products Regulatory Authority (HPRA) of Ireland. They submitted a scientific review after a request by the Minister for Health two years ago which stated there was an absence of scientific data to demonstrate the “effectiveness of cannabis products”.

They did not rubbish CBD however, which many still assert is brilliant for treating conditions such as epilepsy in particular.

Seizures

The case of Noreen O’Neill, whose son Michael suffers from seizures, came to prominence last year when she wrote to Minister Simon Harris asking him to legalise cannabis for medicinal use in Ireland. She said CBD oil had helped control her son’s seizures, and asked that it be made part of the treatment options available for people like Michael.

It may be some time before there is enough clinical evidence for the HPRA to make a decision on whether it’s a medical product in Ireland, but in the meantime, there are people actively using CBD to help with several conditions.

For a professor of pharmacology and therapeutics in NUI Galway, this in itself raises issues. Prof. David Finn, co-director of the Centre for Pain Research, has concerns about how CBD oil is marketed, as well as the health benefits of certain CBD products.

Speaking to The Irish Catholic, Prof. Finn says: “A lot of the time one doesn’t know the precise composition of those cannabis oils or CBD oils, so the products that are being sold in health food stores, and which some patients are getting online, we don’t really know with certainty what the percentage of cannabidiol, or CBD, in those products is.

The contaminants could be anything from general impurities to fungicides aimed to tackle the fungal infection cannabis plants can sometimes be prone to.

“So that presents a problem because we can’t really say whether it’s likely to be efficacious or not if we don’t know with certainty what the composition is.

“So one message that I would have is that patients need to consult with their doctor before they start taking these products and they need to be assured that they know and their doctor knows the composition of what they’re taking and also that it’s safe and free from impurities – that it’s gone through some quality assurance process, because these products aren’t yet subject to medical regulation.”

Although discovered in 1940 the structure of CBD was only made clear in the 1960s, with Prof. Finn saying a “reasonable body of work” has been done on it over the years.

“What I would say is that there is some evidence for efficacy of cannabidiol in specific condition, and those specific conditions are probably pain, particularly inflammatory pain, anxiety and epilepsy now more recently – particularly childhood epilepsy – those are probably the three frontrunners for which there’s most evidence of efficacy, coming either from studies in animal models of disease, or from clinical trials in human patients,” he says.

Although research so far is still “fairly limited” and more trials and research are needed, he added, there’s an “evidence base” that it will produce the desired results in relation to certain conditions.

Prof. Finn says: “But one needs to consider then how much cannabidiol is actually in these products that are being sold as cannabis oil. In addition there are drug companies that are developing purer forms of cannabidiol.”

Contamination

The actual drug itself, laying aside fears of contamination, can have some minor negative effects.

According to Prof. Finn if there isn’t contaminants it’s “unlikely to be harmful in that scenario because cannabidiol from what we do know is a relatively safe drug”.

“There’s some mild adverse effects so I would advise that patients only take cannabidiol or cannabis oil after seeking their doctor’s advice.”

The mild adverse effects are believed to be sedation, gastrointestinal issues like diarrhoea or nausea and possibly some drug-drug interactions as well. This means cannabidiol may have an impact on the way the body deals with other drugs.

In the US, where CBS oil still exists in legal grey areas with laws governing its use changing from state to state, there’s expected to be an increase in its production.

Showing up in all sorts of wellness products, the industry is now worth hundreds of millions of dollars. In fact, hemp, made from cannabis plants and used for making textiles, construction supplies, food and beverages, is expected to boom in the US. President Trump signed legislation last year legalising the widespread growth of industrial hemp, which is used to produce CBD oil.

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The US Food and Drug Adminis-tration (FDA) last summer approved a very pure form of CBD produced by a UK-based pharmaceutical company to treat certain types of epilepsy in children, called epidiolex.

Asked whether he thinks Ireland will give the green light for doctors to prescribe CBD-based treatments, Prof. Finn said: “As a prescription drug I do think it will be in the form of epidiolex…given that the FDA have now approved it I think other countries will follow suit and I wouldn’t be surprised if Ireland was to approve it in the future.”

A question some may ask is why there hasn’t been a large clinical study already published that investigates its benefits that Ireland’s regulatory authorities could already get behind.

Irish scientists announced plans eight months ago to explore how CBD and other elements of the cannabis plant can be used to reduce seizures.

There are 10,000 people in Ireland that are believed to be resistant to current drug treatments for epilepsy, meaning they could have numerous uncontrolled seizures every day. The research is being led by an Irish biopharmaceutical company called FutureNeuro, the SFI Research Centre for Chronic and Rare Neurological Diseases based in the Royal College of Surgeons and GreenLight Medicines.

In a press release Dr Colin Doherty of the FutureNeuro Centre said: “The use of cannabis to treat epilepsy offers a tantalising new horizon for severe disabling seizures. The mechanism by which CBD exerts its antiepileptic effects is currently unknown, and this impactful research will help to provide clinical evidence of its long-term efficacy, as well as data on any long-term side effects.”

Perhaps it’s just a matter of time before its uses become more widespread and the question mark over CBD’s efficacy will disappear. But for many this budding industry and new derivations of CBD products are more than welcome – but don’t be duped by unregulated and potentially harmful products.