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Medical Cannabis: Whole Plant vs. Pharma/Isolates

There are three different forms of medical cannabis currently available in select regions:

  • Pharmaceutical cannabis products: Plant-derived or synthetic isolates that have passed through clinical trials and received FDA-approval.
  • Cannabis isolates: Cannabis-derived isolates that have not been FDA-approved.
  • Whole plant cannabis extracts: Cannabis-derived extracts that contain a variety of compounds from the plant.

Synthetic vs. Isolate vs. Distillate vs. Extract

There are many different methods used to process cannabis and obtain its active ingredients. As far as cannabis users are concerned, the primary difference between the various processes is: which components from the original plant remain in the final extract?

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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