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Multiple Sclerosis Watch Time: 22 mins

touchEXPERT BRIEFING Implications of unregulated cannabis on MS care

Watch a leading neurologist discuss the differences between unregulated and regulated cannabis, including thoughts on the future of medical cannabis in multiple sclerosis (MS).

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Dr Allen Bowling interviews
Special considerations for unregulated cannabis products

Dr Allen Bowling discusses the differences between regulated and non-regulated medical cannabis. 

He details how unregulated medical cannabis products frequently contain contaminants and the special considerations of regulated cannabis products in terms of storage, labelling and staff knowledge.

Regulated cannabis products are FDA-approved or seeking FDA approval. Unregulated cannabis products are not FDA-approved nor seeking FDA approval. There are currently no FDA-approved cannabis products for MS in the USA.

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Interview Questions

In this interview, we asked Dr Allen Bowling the following:

  • What potential contaminants are there in unregulated cannabis products from a dispensary?
  • Please could you describe the special considerations of regulated cannabis products in terms of storage, labelling, and staff knowledge?
 
Dr Allen Bowling interviews
Regulated versus unregulated cannabis products

Dr Allen Bowling discusses the differences between regulated and non-regulated medical cannabis.

He details special considerations for unregulated cannabis in terms of storage, labelling, and dispensary staff training. 

Regulated cannabis products are FDA-approved or seeking FDA approval. Unregulated cannabis products are not FDA-approved nor seeking FDA approval. There are currently no FDA-approved cannabis products for MS in the USA.

view bio and disclosures
2/3 Next Interview
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Interview Questions

In this interview, we asked Dr Allen Bowling the following:

  • How do unregulated products differ from regulated products?
 
Dr Allen Bowling interviews
The future of cannabis

Dr Allen Bowling discusses special considerations for unregulated cannabis products for patients with multiple sclerosis and spasticity, and the future of regulated and unregulated medical cannabis for multiple sclerosis.

Regulated cannabis products are FDA-approved or seeking FDA approval. Unregulated cannabis products are not FDA-approved nor seeking FDA approval. There are currently no FDA-approved cannabis products for MS in the USA.

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Interview Questions

In this interview, we asked Dr Allen Bowling the following:

  • What impact do special considerations for unregulated cannabis products have for patients with multiple sclerosis and spasticity?
  • What do you think the future of regulated and unregulated cannabis is for multiple sclerosis?
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Overview & Learning Objectives
Overview

Unregulated medical cannabis may contain contaminants, may be stored inconsistently, have variable and inaccurate labelling, and be recommended rather than prescribed by non-physicians compared with rigorously tested FDA-regulated cannabis.1–8 We have interviewed a leading physician on the specific differences between regulated and unregulated medical cannabis, and future opportunities for regulated medical cannabis for persons living with multiple sclerosis.

Learning Objectives

After watching this activity, you should understand that:

  • Unregulated medical cannabis can contain many contaminants, in addition to being stored inconsistently, having variable and inaccurate labelling and being dispensed by untrained staff1-8
  • By contrast, FDA-regulated cannabis products are rigorously tested, the exact composition is known, and is accurately labelled and prescribed by physicians7
  • There is an unmet need for FDA-regulated medical cannabis with established dosing, safety, and efficacy data
About Dr Allen Bowling
Dr Allen Bowling

Neurology Care, Englewood, CO, USA

Allen Bowling, MD, PhD, is a multiple sclerosis specialist in Denver, CO, USA, and is currently Director of the NeuroHealth Institute and Clinical Professor of Neurology at the University of Colorado.

Disclosures: Royalties: Springer Publishing; Research/consulting/advising/speaking: Bristol Myers Squibb, EMD-Serono, Genentech, Genzyme, Greenwich Biosciences, Inc., and Novartis.

References
References
  1. Thomas BF, ElSohly M. The analytical chemistry of cannabis. Amsterdam: Elsevier Inc. 2016; 37–65. Available at: www.sciencedirect.com/book/9780128046463/the-analytical-chemistry-of-cannabis (accessed September 4, 2020).
  2. Busse FP, Fiedler GM, Leichtle A, et al. Lead poisoning due to adulterated marijuana in leipzig. Dtsch Arztebl Int. 2008;105:757–62.
  3. Haug NA, Kieschnick D, Sottile JE, et al. Training and practices of cannabis dispensary staff. Cannabis Cannabinoid Res. 2016;1:244–51.
  4. McKernan K, Spangler J, Helbert Y, et al. Metagenomic analysis of medicinal Cannabis samples; pathogenic bacteria, toxigenic fungi, and beneficial microbes grow in culture-based yeast and mold tests. F1000Res. 2016;5:2471.
  5. McPartland J. Adulteration of cannabis with tobacco, calamus, and other cholinergic compounds. Cannabinoids. 2008;3:16–20.
  6. Raber JC, Elzinga S, Kaplan C. Understanding dabs: contamination concerns of cannabis concentrates and cannabinoid transfer during the act of dabbing. J Toxicol Sci. 2015;40:797–803.
  7. Russo EB. Current therapeutic cannabis controversies and clinical trial design issues. Front Pharmacol. 2016;7:309.
  8. Vandrey R, Raber JC, Raber ME, et al. Cannabinoid dose and label accuracy in edible medical cannabis products. JAMA. 2015; 313: 2491–3.
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