The future of medical cannabis research is an altogether complicated and exciting conversation. Will plants continue to rule the day? Are isolated molecules the best means of treating particular diseases? Do synthetic cannabinoid drugs hold the answer to efficacy and standardization? At this juncture, only one thing is certain: the outlook includes both plants and pills.
Roger Pertwee, an academic researcher based at the University of Aberdeen in Scotland, believes the future of cannabis will be clinical. As an expert on cannabinoid pharmacology, Pertwee says drugs like Sativex – which was developed in the UK by GW Pharmaceuticals and is comprised notably of a combination of two cannabis-derived cannabinoids – represent the most likely avenue for medical cannabis.
“This market has a great future as, for example, a lot of potential therapeutic uses of cannabis-derived cannabinoids have already been identified,” he says. “I think with regard to cannabis-based medicines, that isolated single compounds, combinations in particular ratios of two compounds, and perhaps also combinations in particular ratios of more than two compounds, could all play a significant role in the future of cannabis drugs.”
Pertwee, who is a co-founder of the International Cannabinoid Research Society and collaborated in the early 90s with famed cannabis scientist Dr. Raphael Mechoulam on the project that led to the discovery of endocannabinoids, says that if cannabis-based medicines are to overcome prejudice by physicians and the public, those drugs will need to be further standardized and proven safe for consumption.
As regulatory environments governing cannabis have become less strict in recent years, scientists like Pertwee have been able to research the plant more freely. The immediate results have been significant. Nearly every week now, new discoveries are being made and innovations implemented that are revolutionizing the science.
One technique that holds promise for the development of cannabis drugs is yeast fermentation. The process, which involves inserting cannabis genes into a yeast genome to create a particular cannabinoid, is being investigated by a number of Canadian labs. Some have already made encouraging discoveries.
Last month, Kevin Chen’s Montreal-based biotech firm, Hyasynth Bio, successfully produced cannabigerol (CBG) and cannabigevarin (CBGV) from genetically engineered yeast. Chen says the process, likened to making beer or wine, could be used to isolate other cannabinoids to treat particular conditions.
“Maybe none of the strains work for certain people, and so how are they going to get access to the medication that they need?” he questions “What we really need is to have this kind of platform that is capable of producing the full range of cannabinoids, not just THC and CBD, and be able to delve into more advanced formulations.”
As the CEO of Hyasynth Bio, Chen says key words like efficacy and dosing are the reason he’s undertaking the research in his lab. He believes that as the industry progresses, medical practitioners will be less reliant on the actual cannabis plant.
“The way that we see this whole industry is that everyone’s going to start thinking less about the plant itself, and more about the actual molecules that are going into it. It’s always been happening on the research side of things,” he says. “In terms of what formulations are possible, it’s about enabling what’s actually possible.”
Har Grover agrees. As the CEO of CannScience, Grover says cannabinoid research is behind other fields not because of a lack of dedicated scientists, but because of regulatory regime restrictions. He sees a specific timeline of five to 10 years for the development of new cannabis drugs that blend different phytocannabinoids and 10 to 20 years for discoveries of pharmaceutical-grade cannabis drugs.
“I think what you’re going to see more of is good cocktails,” he says. “We may not specifically know which ingredient is creating the therapeutic benefit, but we do know that there’s a batch of them that do. So rather than try to isolate them, just working with a batch I think is what’s going to create good progress over the next five or 10 years.”
Jonathan Page, a co-founder of Anandia Labs in Vancouver and adjunct professor at the University of British Columbia, says that marijuana has so far resisted “pharmaceuticalization.” The reason, he believes, is that the pharmaceutical industry responds to regulation and standardization, two ideals that have only recently been accessible to the scientific community studying cannabis.
“When it comes to cannabis as a plant, it is very difficult for the regulators to treat it as they do other pharmaceutical drugs,” he says. “Whether it’s a micro-dose inhaler or patch or pill capsule or something that might not necessarily be smoked herbal cannabis,” he says, “I think the future will move toward pharmaceutical products in the mode of delivery but it’s still a plant-derived mixture that presents all the complexity that the plant produces.”
Credited with leading the team that first mapped the cannabis genome, Page’s mandate is to improve medical marijuana through innovative breeding techniques. As a service provider to the Canadian cannabis industry, Anandia focused on contributing to research efforts that will help bridge the gap between past regulatory restrictions and the current mainstream support of marijuana by many in the scientific community.
“One of the important things about cannabis is that prohibition and restrictions have really inhibited research. And for the huge potential of cannabis to be realized, we have to share data and information and findings freely,” says Page. “This has been the way medicine has been advanced… and that’s really the only way that cannabis is going to advance. Everybody – patients, producers, governments – will benefit when the research is open and shared.”
As one of the leading cannabinoid scientists on the planet, Ethan Russo spent over a decade at GW Pharmaceuticals working on clinical trials of Sativex. Now medical director of Phytecs, a Los Angeles-based company that develops products from natural cannabis compounds, Russo foresees pharmaceutical-grade cannabinoid drugs being developed alongside the advancement of traditional cannabis treatments. The future of the industry, says he, will be one of “parallel tracks.”
“There are people that believe that the pharmaceutical market is going to eliminate all other types of commerce, but I don’t believe that’s the case,” he says. “There are patients that prefer a pharmaceutical-grade product that will have the uniformity of action and quality control behind it. On the other hand, there are going to be patients that have already identified a strain of cannabis that’s helpful to them and they’re going to want to stick with.”