April 7th, 2021
Top medical experts share the research they're relying on now in their clinical practice, a view of what’s coming next and what it means for patients and healthcare professionals.
Part 1: Cannabis & Headache
JMCC Group Chair & CEO Diane Scott introduces session moderator Professor Mike Barnes, Professor of Neurological Rehabilitation, University of Newcastle, UK., who is also a consultant neurologist and cannabis physician. Following Mike’s opening comments, he introduces Dr. Evan Lewis, Director, Toronto Neurology Centre and JMCC Chief Medical Advisor. Dr. Lewis takes us through current thinking on the role of the endocannabinoid system (ES) in headaches and migraines, and how cannabis, specifically THC, can help to re-balance the ES and reduce frequency and severity. He also reviews current and emerging research and suggests that it could apply to other types of headache while also reducing opioid use by frequent sufferers.
Part 2: Cannabis & Epilepsy
Moderator Professor Mike Barnes, Professor of Neurological Rehabilitation, University of Newcastle, UK., introduces Dr. Richard Huntsman, Associate Professor, Pediatric Neurology at the University of Saskatchewan, who begins with a review of key studies on the use of medical cannabis products for the treatment of childhood epilepsy. Then, Dr. Huntsman shares some emerging developments in treatment, including the use of purified CBD vs CBD-enriched extracts and the exciting anti-convulsant potential of other cannabinoids and terpenes. Looking at future research, he highlights the need for a better understanding of why some children respond so much better to cannabis treatment than others, the exploration of new cannabis compounds and new treatments for adults.
Part 3: Cannabis & Pain
Moderator Professor Mike Barnes, Professor of Neurological Rehabilitation, University of Newcastle, UK., introduces Dr. Elyad Davidson, Director of the Pain Relief Unit at Israel’s Hadassah Hebrew University Medical Centre and Medical Advisor to JMCC. With pain representing a majority of medical cannabis prescriptions in most jurisdictions (over 60%), Dr. Davidson begins by explaining the many kinds of pain humans suffer, how often they are intertwined, and how numerical and other pain scale assessments are “asking the wrong question” because pain is such a complex sensation. He highlights how, in such a complex area, clinicians must learn from their patients how different cannabis treatment compositions, doses and forms of administration are affecting them, and take this information “back to the lab” to understand why. Dr. Davidson also offers a critique of the International Association for the Study of Pain’s recent review of 57 cannabis and pain studies, and questions how IASP came to its conclusion that “there is a lack of sufficient evidence to endorse the general use of cannabis for the treatment of pain”, since it based its review on an “ancient view” of cannabis, with no examination of particular cannabinoids, doses, routes of administration, pain conditions, analgesic outcomes and other factors.
Part 4: Cannabis & Substance Use Disorder
Moderator Professor Mike Barnes, Professor of Neurological Rehabilitation, University of Newcastle, UK., introduces Dr. Shelley Turner, Founder & Chief Medical Officer of Ekosi Health Centres, who is regarded as a trailblazer in Canada’s medical cannabis community, specializing in cannabinoid therapies for addiction, sleep, mood disorders, and chronic pain, with over 20,000 patient interactions. Through analyses of patient histories, Dr. Turner illustrates how substance use disorders must be treated along with the underlying mental and physical health conditions that often gave rise to the addiction by asking not "why the addiction?” but “why the pain?”. Dr. Turner also discusses how using comprehensive diagnostic tools to identify genetic, environmental, inter-generational trauma and other factors can lead to better treatment, including replacing opioids with cannabis and other therapies, and describes her organization’s research work in harm reduction and genomics.
Part 5: Cannabis & Cancer
Moderator Professor Mike Barnes, Professor of Neurological Rehabilitation, University of Newcastle, UK., introduces Dr. Andrew Feifer, a Surgical Oncologist at Trillium Health Partners’ Fidani Cancer Centre in Ontario, who runs through the solid body of evidence attesting to the efficacy of cannabis with cancer symptoms and treatment-induced side effects, such as pain, anxiety, appetite loss, etc. Dr. Feifer then moves on to highlight some of the most exciting new research, including pre-clinical studies with phytocannabinoids, endocannabinoids and synthetics to modulate multiple aspects of tumour development, and the effects shown on various gene pathways, “the primary movers and shakers” in cancer tumour biology. He also notes early research that points to the possibility that some endocannabinoids may be early bio-markers for some types of cancer, and the preliminary findings on the general anti-neoplastic effects of phytocannabinoids, with the promise of terpenes being the newest “undiscovered country” in research.
Part 6: Cannabis in Palliative Care
Moderator Professor Mike Barnes, Professor of Neurological Rehabilitation, University of Newcastle, UK., introduces Dr. Paul Daeninck, a medical oncologist and palliative medicine consultant with CancerCare Manitoba and the Winnipeg Regional Palliative Care Program. Dr. Daeninck points out the historically high use of cannabis among cancer patients in particular (e.g., 43% in one 2018 study) to deal with issues such as anxiety, chemotherapy-induced nausea and loss of appetite, pain and sleep issues, and the natural carry-over of cannabis to palliative and supportive care. He shares results from several studies showing improvements in most symptom areas as well as chemo-induced peripheral neuropathy, significant reported increases in quality of life and major reductions in opioid use. Dr. Daeninck also discusses new research including the pan-Canadian Cannabis for Cancer-Related Symptoms (CAFCARS) Phase II study using a range of cannabis extracts vs a placebo, and resources that he and colleagues have produced for patients and healthcare professionals to facilitate discussion about cannabis use in palliative care.