When Cannabis is the Only Option

March 30, 2017
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By Sven Hosford / Contributor

Some entrepreneurs in medical cannabis are in it for more than just the money.

An entirely new kind of industry began two decades ago when California legalized cannabis for medicinal purposes. Many people assumed the medical cannabis industry was just a thin cover for recreational use, which it often was. This Wild West start drew a certain type of people to the industry. The advocates and entrepreneurs willing to build an industry selling an illegal plant as medicine are the business equivalent of extreme sports athletes — people that thrive on risk and adrenaline.

As the medical research demonstrating the efficacy of cannabis began to mount and the list of ailments for which it provided patients real relief grew, that thin cover began to thicken. The endocannabinoid system was discovered shortly before the green rush began in California, and as researchers began to understand how it functioned, physicians were able to at least make a more educated guess about how to use cannabis as medicine. 

Word of the new science spread quickly among families dealing with conditions like epilepsy and traumatic brain injuries. As it did, another kind of advocate and entrepreneur appeared — people with a formidable will forged from a parent’s love of their child, a child who is suffering. Parents of children for whom cannabis is the only effective medicine have become a force of nature in the industry. 

Necessity is the Mother of an Entrepreneur
One such force of nature is Janel Ralph. She had no intention of being an entrepreneur, let alone in such a sketchy industry. That changed with the birth of a daughter she named Harmony. “About seven years ago, my third and youngest child was born with an extremely rare genetic condition called Lissencephaly,” says Ralph. “There are only 700 children worldwide who have this condition. It’s also known as ‘smooth brain’ as the outside of her brain is completely smooth. It did not develop in utero due to a missing chromosome.” 

Ralph said that this type of genetic disorder is considered a traumatic brain injury, as her daughter is missing a large portion of her brain, which causes epilepsy. She explains, “Not just any epilepsy, but intractable epilepsy. You get the diagnosis of intractable if you fail three epilepsy drugs and none of them can stop the seizures from occurring. The chances of you having a pharmaceutical medicine that can give you any type of control over the seizures drops to under 5 percent, basically next to nothing.”

Ralph described the horror of watching her daughter have hundreds of seizures a day, even while taking five strong antiepileptic drugs. She spoke calmly about hearing the news every parent dreads. “When she was almost four, the doctors said there was nothing more they could do. They were pretty much out of options at that point. They were talking to us about hospice. That’s when I started researching cannabis.”

Education Leads to Advocacy
Ralph quickly became active in the fight for CBD legislation in South Carolina, where she and her family live. The hemp bill that passed in 2013 removed all strains with less than 0.3 percent THC from the definition of marijuana, allowing her to purchase it legally in the state. The problem then became supply. As parents connected, an underground network formed to search for safe, legitimate sources of non-psychoactive, full-spectrum hemp oil. They started testing what they could find.

“We were way overcharged for products that weren’t even fit for human consumption,” Ralph says. “Products were grossly mislabeled.” She describes a supposedly reputable company that sent samples to parents in states without testing facilities. When Ralph tested samples from other parents, they found straight THC and no CBD.

“That’s when I decided to get into this industry. We had found a two-week supply one time that had provided almost immediate relief. I knew what she needed.” 

Making Safe Medicine
Today, Ralph is CEO and president of Palmetto Synergistic Research, which grows and processes a non-GMO, organic strain of cannabis under the Industrial Hemp Research Pilot Program run by the Kentucky Department of Agriculture (KDA). “We produce a full-spectrum cannabis oil from the hemp plant,” she says. “We have very specific genetics that we grow, federally compliant under the KDA’s program in Kentucky. Those genetics are all 18 percent or higher in CBD.” 

The oil is not a cure. Like many of the conditions for which cannabis is used as medicine, there is no cure for Harmony. What the oil provides for parents and children like Ralph’s is a much more manageable quality of life. A handful of seizures is more manageable than hundreds a day.

Many people wonder what they would do if their child got sick. Ralph does not need to wonder. She became a titan in a brand new industry. More importantly, she found the surest way to provide clean, safe, high-quality, full-spectrum CBD hemp oil for her daughter and children across the country. Has it been worth it? “We’ve had a 95 percent reduction in seizures and have removed almost 90 percent of her pharmaceuticals,” Ralph says with a small smile.  

Janel Ralph’s products can be ordered through PalmettoHarmony.com. She can be reached at janel@palmettoharmony.com


 

What is Cannabis?

Some facts from TheAnswerPage* on Cannabis treatments for ALS, Epilepsy, Multiple Sclerosis, and more.

Q: What is Cannabis?

A: Cannabis is a genus of flowering plants that includes multiple subspecies. One species is Cannabis sativa. Scientists have identified over 400 chemical compounds produced by the cannabis plant. More than 65 of these compounds are unique to the cannabis plant, and they are called cannabinoids (or phytocannabinoids). Examples of phytocannabinoids include delta -9- tetrahydrocannabinol (THC), tetrahydrocannabivarin (THCV), cannabidiol (CBD), cannabichromene (CBC), and cannabigerol (CBG). 

Q: What are phytocannabinoids?

A: THC and the analogues of THC derived from the cannabis plant that interact with endocannabinoid receptors or otherwise affect the endocannabinoid system are called phytocannabinoids. Phytocannabinoids have pharmacological activity due to their receptor-based effects on the endocannabinoid system. Additional pharmacological effects, such as anti-inflammatory mechanisms may be non-receptor mediated.

Q: THC and CBD are the most commonly occurring cannabinoids in cannabis. What distinguishes them structurally?

A: THC and CBD are structural isomers. They are both 21 carbon- containing phytocannabinoids and share an identical chemical formula, C21H30O2. However, the way that the atoms are arranged in the two molecules is different. There is an oxygen-containing closed ring in THC that is open in CBD. Dissolved in a solution, through a process known as ‘isomerization’ involving heat and acid, the two compounds can be interconverted chemically.

Q: Do cannabinoids modulate ALS-related pain?

A:  Pain is a common symptom of motor neuron disease, and patients suffering from ALS generally report suffering from significant pain, which is sometimes a neglected aspect of this disease. In ALS, pain is considered to be largely a consequence of immobility and its related complications and, more rarely, neuropathic pain. Considerable progress has been made in understanding the role of cannabinoids in the modulation of pain. In the context of ALS, modulation of the cannabinoid system could have a great potential since pain present in ALS patients involves a large inflammatory component in the CNS.

Q: According to the National Multiple Sclerosis Society, more than 2.3 million people are affected by MS worldwide. What is the clinical evidence for cannabis therapy in multiple sclerosis?

A: There is evidence that cannabis-based medicine can significantly reduce spasticity, pain, and cause a subjective improvement in sleep quality compared to placebo in clinical trials. Cannabis-based medicine can also result in an objective improvement in mobility and bladder dysfunction. The undesirable side effects observed are often mild and well-tolerated.

Q: Do clinical studies suggest that cannabis-based medicine can alleviate cancer pain?

A: In animal models, cannabinoids have been shown to be synergistic with opioids in reducing pain. A small pharmacokinetic interaction study of vaporized cannabis (900mg of 3.56 percent THC herbal cannabis with no CBD), administered once on days 1 and 5, and t.i.d on days 2 - 4 in 21 chronic pain patients on sustained-release morphine (10) or oxycodone (11) showed no significant effect on opioid plasma concentrations when cannabis was added but did suggest increased analgesia. A RCT of nabiximols in 359 cancer patients with poorly controlled pain despite a stable opioid regimen found that the sublingual preparation at 4 sprays (10.8 mg THC and 10 mg THC), 10 sprays (27 mg THC and 25 mg CBD) or 16 sprays (43.2 mg THC and 40 mg CBD) daily for 5 weeks decreased pain and sleep disruption.

Q: Is the endocannabinoid system involved in human epilepsy?

A: Yes. There are defects in the endocannabinoid system in persons with epilepsy. In one study, 12 patients with newly diagnosed temporal lobe epilepsy had lower levels (p < .01) of anandamide in CSF as compared to controls. In tissue removed from 30 patients undergoing epilepsy surgery, the levels of CB1 receptor messenger RNA were lower in some excitatory nerve endings as compared to the specimens obtained post mortem from persons without epilepsy. It was also noted that in the epilepsy patients, there was reduced expression of diacylglycerol lipase a, the enzyme that synthesizes 2-AG in postsynaptic neurons. (Recall that 2-AG is a fully efficacious agonist of both CB1 and CB2 receptors.)

Q: Do cannabinoids impact antiretroviral therapy-related nausea?

A: Cannabinoids, such as dronabinol as well as non-pharmaceutical preparations, are commonly used by HIV and AIDS patients in an attempt to counter nausea caused by antiretroviral therapy. A single study among 88 individuals used a visual analogue scale to measure changes in nausea and found that nausea was reduced by 22 percent among those randomly assigned to dronabinol (2.5mg TID), compared to 7 percent in those assigned a placebo (p<0.05).


*Excerpts from the TheAnswerPage’s AMA PRA Category 1 CME™ accredited educational courses covering the endocannabinoid system, phytocannabinoids, the administration of cannabinoid medicines, the physiological and cognitive effects of cannabinoid medicines, the therapeutic uses of cannabinoid medicines and much more. Physicians, nurses, pharmacists, and qualifying health care providers can earn up to 22.5 CMEs by attending the 2017 World Medical Marijuana Business Conference & Expo on April 21-22 in Pittsburgh. Visit CompassionateCertificationCenters.com for more information.
Article from Edible Allegheny at http://edibleallegheny.ediblecommunities.com/food-thought/when-cannabis-only-option
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