The Evolving Landscape of Medical Cannabis

Medical cannabis storage and distribution for clinical trials.

Medical Cannabis, otherwise known as medical marijuana, has grown in prominence in recent years as its potential therapeutic benefits have caught the attention of healthcare professionals and the public. The global landscape is witnessing a shift and indeed evolution in its attitude towards the use of cannabis for medicinal purposes. The legal use of cannabis as a medication varies from country to country with some countries introducing their own legislation with regards to its possession, distribution, cultivation, what medical conditions it is used for and how it is consumed. Its use for medical purposes has now been legalised in many countries across Asia, Europe, Africa and some parts of the USA.

In this article we look at the uses of medical cannabis, its growth in clinical trials and a few of the key players within the industry.

Uses of Medical Marijuana

Medical cannabis is increasingly gaining recognition as a multifaceted therapeutic choice. The prominent constituents within it, namely Cannabidiol (CBD) and Tetrahydrocannabinol (THC), are attracting significant interest due to their potential in addressing a wide array of medical ailments. These components have well-documented attributes that contribute to alleviating pain, reducing inflammation, and promoting muscle relaxation. As such it has been used varyingly across countries for the control of:

  • Chronic Pain: It is believed to be safer than the use of opiods which can be addictive. It can be used as an alternative to non-steroidal anti-inflammatory drugs (NSAIDs) which cannot be used on patients who suffer, for example, from kidney, ulcer or gastro reflux problems.
  • Sickness: The anti-nausea properties of medical cannabis have led to its application in cancer patients undergoing chemotherapy as it has been seen to help treatment-related nausea and vomiting.
  • Parkinsons Disease: The muscle relaxing elements of medical marijuana are believed to lessen tremors associated with Parkinsons.
  • Eating disorders: The cannabis plant’s ability to stimulate appetite can help those with eating disorders or have suffered weight loss as a result of other illness such as cancer or HIV/Aids.
  • Epilepsy: Cannabis use has been known to reduce the frequency and severity of seizures.

The Growth of Clinical Trials

Clinical trials research into the use of medical marijuana plays a pivotal role in unlocking the potential of the plant. Continued research into the application of cannabinoids is essential to gain new evidence and insights into the development of cannabinoid therapy across an increasing number of conditions.

In 2022, according to the National Library of Medicine/PubMed.gov website1, a record number of Cannabis studies were conducted with over 4,300 cannabis specific papers published, the highest figure recorded in a single year.

Whilst many regulators and medical bodies believe that the use of medical marijuana requires further examination and evidence before agreeing to widespread access, many scientists would argue that their interest in studying the plant has increased rapidly in recent years along with their understanding of the plant, its active components, how it functions and the impact it has on not only users, but society as a whole.  They would prefer that more focus is placed on evidence-based discussions and reform policies that represent the knowledge the scientific community has gained.

As medicinal marijuana becomes more mainstream, there is still much research to be done. The characteristics of the cannabis plant are very complex. It contains hundreds of active compounds and how these compounds react can affect the efficacy of the cannabis. How patients react to cannabis therapy differs due to individual reactions to the drug. To address this, scientists are collecting data which will enable them going forward to match specific plant ingredients and treatment options to specific ailments. The consideration of personalised treatments holds the promise of revolutionising medical cannabis therapy and tailoring solutions to individual requirements.

In addition to the need to qualify the plant’s medical success for cannabis therapies, other challenges being faced include regulatory, licensing and legal considerations; the best methods of interpreting clinical, observational and epidemiological studies and assessing the safety of cannabis and any adverse effects resulting from the medication. Looking forward, the exploration of new and emerging cannabis clinical trial designs and where the industry is heading needs further evaluation.

The Use of Medical Marijuana in the USA

With the legalisation of medical marijuana in 38 US states, it’s no surprise that a recent report showed that for the period 2010-2023, the USA conducted more than half of the global cannabis clinical trials registered on clinicaltrials.gov2. Since its approval for medical use in California in 1996 its growing acceptance by the State and public has meant that it has now become a flourishing industry with sales showing an upward trajectory, estimated to reach sales levels of up to $15 billion by 2025.

Its most prominent use has been for pain relief, but it has also been used to treat the symptoms of cancer, glaucoma, AIDS/HIV and multiple sclerosis amongst others.

The usage, laws and prices of cannabis vary across states.  The number of marijuana dispensaries, patients and caregivers can also vary by state as a result of some states having more relaxed laws surrounding the use of medical cannabis and additionally, some have gone so far as to legalise it for recreational use.

Israel – A Leading Importer of Medical Marijuana

Israel’s history with medical cannabis dates back to 1964 when Israeli scientists Raphael Mechoulam and Yechiel Gaoni successfully isolated THC, the psychoactive component of the drug. However, it wasn’t until the early 1990s when it was permitted for use medically to combat chronic pain and other pain-related illnesses.

Today, Israel stands as one of the leading importers of medical marijuana with an estimated 127,000 cannaboid companies importing into the country. The country has the highest rate of cannabis patients in relation to the population and in 2022, imported 33,000 kg of medical cannabis principally from Canada, Portugal and South Africa. In the latter part of 2022, the Israeli Ministry of Health, who oversee imports and are committed to the quality of medical marijuana products, issued new guidelines for the approval of applications for the importation of dangerous drugs such as cannabis for both medical research and use.  Israel is one of only three countries in the world where the government sponsors cannabis research3. This has resulted in many other countries, including the US, relocating their research operations to Israel.

Africa’s Emergence as a Significant Medical Cannabis Producer

In recent years we have seen the emergence of Africa as a key player in the global medical cannabis sector taking advantage of its beneficial climate, low labour costs, and its potential ability to yield multiple crops annually. These unique factors have placed it as a promising centre for the cultivation of high-quality medical cannabis.

With an increasing global acceptance of the medicinal benefits of cannabis, Africa’s appearance in this industry holds significant market potential, with the opportunity for lucrative export prospects, sparking economic growth and societal changes across the region.

The estimated potential for the legal pharmaceutical market for cannabis products in South Africa is in excess of US $5 billion per annum4. The industry offers a great opportunity for job creation, rural development and the alleviation of poverty improving long-standing socio-economic challenges.

One of the early countries in South Africa to cultivate cannabis for medical use was Lesotho in 2008 when legislation was introduced legalising the cultivation and use of medical cannabis. Backed with a supportive Government and benefiting from a good infrastructure, utilities, equipment supply and excellent natural environment, it is now a leading producer of medical cannabis.

With Africa’s potential, it has the capability to be a major player within the medical cannabis industry.

Marijuana clinical trials are set to have a crucial impact on advancing therapeutic treatments for fighting severe illnesses and disease. While the potential economic benefits for the industry are huge, further research will need to be undertaken before nations universally embrace the widespread dissemination of cannabis-based products.

Clinical Trial Logistic Solutions from Oximio

Established in 2004, Oximio’s unwavering commitment to upholding quality standards throughout its entire end-to-end clinical logistics provision, ensures the safety of products and patients. Offering a comprehensive global clinical trial supply chain service we support clinical trials across the globe supported by facilities including depots and bonded warehouses in Europe, Africa and the Middle East. Our extensive partner depot network further expands our capabilities across North America and Asia.

Oximio, South Africa, has recently attained an additional resolution to the SAPHRA Licence. This means it has the capability to support all licensed manufacturers and cultivating farms in the transportation of medical cannabis for exportation from South Africa. Furthermore, it is now able to accept medical cannabis for storage on behalf of local manufacturers and cultivators. You can access the full statement below in our Further Reading.

Further Reading

Oximio, South Africa, attains an additional resolution to SAHPRA Licence, Paving the Way for Medical Cannabis Innovation

 

References:

1, 2 https://cannabishealthnews.co.uk/2023/08/22/report-reveals-countries-leading-cannabis-related-clinical-trials/

3 https://www.usnews.com/news/best-countries/articles/2017-04-11/israel-is-a-global-leader-in-marijuana-research

4 https://theconversation.com/cannabis-industry-plans-for-south-africa-have-stalled-how-to-get-them-moving-again-200602#:~:text=The%20potential%20legal%20pharmaceutical%20market,township%20and%20rural%20entrepreneurs%20farmers.