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Whole Plant Cannabis Doesn’t Fit the Healthcare Industry Mold

Moreover, this [Epidiolex] is a purified form of CBD. It’s being delivered to patients in a reliable dosage form and through a reproducible route of delivery to ensure that patients derive the anticipated benefits. This is how sound medical science is advanced.

-- FDA Commissioner Scott Gottlieb, M.D. (June 25, 2018)[1]

This statement by FDA Commissioner Scott Gottlieb helps illuminate why government – as well as many in the healthcare industry – are so averse to cannabis in flower or other whole plant form: Whole plant cannabis is simply not a form of medication that reflects “sound medical science,” that is, it is not a purified form that can be reliably dosed.

Origins of Medication Standardization

The idea that active ingredients in medication should be isolated and purified is not a new concept. The idea dates back to ancient times, to the Greek physician Galen (c. 130–c. 200 AD). Yet, it wasn’t until the 1800s that active compounds were actually first isolated. The ability to isolate and purify individual compounds radically changed how plants were used in medicine. Henceforth the healthcare industry insisted on the exclusive use of isolated and purified compounds in healthcare – rather than whole plant medicines – for three reasons:[2]

  1. Accurate dosing of medications,
  2. Elimination of toxic effects due to impurities in plant product, and
  3. Synthesis of related compounds for use in other valuable drugs.

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Cannabis Is Reaching its Me Too Moment

I was just listening to the Brave New Weed podcast discussion (Episode 51) about the wrangling going on in New York regarding cannabis legalization. Two different threads in the discussion peaked my interest. One thread discussed the idea that many people in New York – especially in upstate counties – are against legalization of cannabis; this is the Just Say No To Drugs contingent. Politicians will be reluctant to legalize cannabis, if they think this contingent is large enough, and if politicians will lose their vote by voting for legalization. Another thread discussed how big cannabis companies in New York submitted a proposal containing a clause that outlawed homegrown cannabis. This was a clear power-grab by established cannabis companies.

As I listened to the discussion, and these two threads in particular, it occurred to me that cannabis is reaching its Me Too moment. 

Before the Me Too Movement had gained momentum, there had always been grassroots movements against sexual harassment. I consider the issue of sexual harassment to be a component of the fight for equality, which has been brewing probably since Adam and Eve left the Garden of Eden. Yet, even with the presence of grassroots movements, companies had always gained more by paying off accusers – even if it meant a bit of bad press – than by firing powerful people in the company for engaging in harassment. The fact was the negative costs to companies of any social condemnation paled in comparison to the benefits of retaining valuable employees. 

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Overview of How the Endocannabinoid System Works

So how does the Endocannabinoid System (ECS) in our bodies work? To understand this, we first have to understand some basics about cells and cell-to-cell communications.

Cells

cell is the smallest unit of life. Cells are often called the "building blocks of life." Our bodies are comprised of trillions and trillions of different cells, approximately 32.7 trillion cells in all, of more than 200 different types

Cells Cluster

Each cell has a particular function to perform. At the same time, however, cells cluster to form tissues, organs, and body systems, where they work together with other cells to serve larger functions (see Figure 1)

Figure 1: Cell Clusters

1 cell clusters

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Introduction to the Endocannabinoid System

I’m a researcher. Just over two years ago, I was introduced to the subject of medical cannabis. My quest was to understand how cannabis works in our bodies to provide medicinal benefits. It’s been a little over two years since I started my research, and I’ve learned quite a bit. 

The more I’ve read, the more overwhelmed I’ve become at how extraordinarily complex the human body is. Our bodies are the product of millions of years of evolution, and it shows. Our bodies are like tremendous orchestras, with more instruments in our bodies (cells) than there are stars in the sky. And not only are there brass and string and percussion instruments – akin to our circulatory and digestive and immune systems – but within each system there are scores of sub-systems. Within the wind instruments are numerous flutes and oboes and clarinets and saxophones and bassoons. 

The average human body contains about 33 trillion cells of about 200 different types, 100,000 miles of blood vessels, and 640 skeletal muscles. Every day, the average adult takes over 20,000 breaths, experiences 100,000 heartbeats, processes about 200 quarts (50 gallons) of blood through the kidneys, and filters out about 2 quarts of waste and water. 

Read more: Introduction to the Endocannabinoid System

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