With other entrepreneurs, Diehl is betting that the expanding U.S. legalization of cannabis for medicinal use will boost sales of the company’s products to treat everything from skin cancer to
multiple sclerosis (MS).
At the moment, 33 states and the District of Columbia have declared
medical marijuana legal; in D.C. and 10 states — Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, and Washington —
recreational use is also allowed, even though the federal government still considers marijuana in all its forms illegal.
Boxes of “Healer” CBD/THC cannabis drops await distribution at the Kind Therapeutics.
Internationally, Canada is now the world’s largest legal marijuana market, having legalized its cultivation and sale in October 2018 through the
Cannabis Act. Uruguay became the first country to fully legalize marijuana in 2013, with sales permitted in local pharmacies.
Last month, Israel became the third country — along with the Netherlands and Canada — to
allow the export of medical cannabis.
Tikun Olam, which has given MariMed exclusive rights to produce its cannabis products in Maryland, is among Israel’s top cannabis producers.
“The laws are constantly changing, so it’s difficult to get an accurate number. But this is going to be a $70 billion industry in coming years,” said Diehl, whose family has been a major Maryland fruit and vegetable distributor for nearly half a century. “When the state legalized cannabis in 2016, my friends said I needed to get into this business too, so I jumped in full throttle.”
The U.S. Food and Drug Administration (FDA) made history when, in June 2018, it approved a first marijuana-derived therapy to treat any disease. In this case, the cannabidiol was
Epidiolex — developed by Britain’s
GW Pharmaceuticals — to be given to patients with
Dravet and
Lennox-Gastaut syndromes, both severe forms of epilepsy.
“This FDA ruling speaks volumes,” Diehl said. “They’re saying, ‘guys, cannabis is not just for people who want to get high. This is a real medicine that can help everyone, including children.’”
Hype vs. data
Data from two trials, in Italy and the Czech Republic, support the idea that GW’s Sativex is effective in treating moderate to severe spasticity. The oromucosal spray is a formulated extract of the cannabis plant, and has been approved in Australia, Canada, Israel, and more than a dozen European countries.
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| Michael Castleman examines baby marijuana plants. |
For those with
cystic fibrosis, cannabis — in its edible but not smoked form —
improves appetite, a key consideration since CF patients are often undernourished. Marijuana’s anti-inflammatory properties may also help reduce inflammation in the lungs, although its overall effects on those with CF remain to be seen.
A recent
studyjointly conducted by the nonprofit group and Northwestern University found that 80 percent of Parkinson’s patients report using cannabis, and 95 percent of neurologists have been asked to prescribe medical marijuana. But only 23 percent of doctors have received formal education on the subject.
“Having worked as a clinician for the past decade in Colorado — a state at the forefront of medical marijuana use — it is clear that people with Parkinson’s and their families are intensely interested in the potential of marijuana and cannabinoids in helping manage
symptoms and other aspects of the disease,” Benzi Kluger, MD, a professor at
University of Colorado Hospital and co-chair of the upcoming conference, said in a recent
press release.
“To date, there is more hype than actual data to provide meaningful clinical information to patients with Parkinson’s.”
Legal and financial obstacles
This is an extremely regulated industry. In Hagerstown, the premises are under constant surveillance, all plants are accounted for, and all 61 employees had to pass a criminal background check before joining Kind Therapeutics.
Castleman, one of those employees, is happy to show off Room 205, which contains around 400 cannabis plants in living soil. Down the hall is Room 212 — the drying room — which contains upwards of 2,000 plants. Here they hang for exactly 21 days, at exactly 60 percent relative humidity.
The entrance to the Hagerstown, Maryland, facility.
We’re doing a slow cure on the flowers,” Castleman said. “A lot of companies do a ‘fast dry’ where they crank the temps up to 70 degrees and have everything dry in five days. But that degrades the integrity of the flower. Our system preserves the trichomes and increases the terpene profile.”
In partnership with Tikun Olam, Kind Therapeutics opened a seed-to-sale dispensary — known as
First State Compassion — in Wilmington, Delaware, in 2015. MariMed also operates in Rhode Island, Massachusetts, Illinois and Nevada, and along with
GenCanna produces hemp in Kentucky.
Because medical marijuana isn’t legal nationwide, Kind Therapeutics cannot do its banking with Wells Fargo, Bank of America, or any other multistate bank in the U.S. Instead, it’s turned to Severn Saving Bank, a local institution, for about 90 percent of its financial needs.
Medical regulation is another issue.
“In some states, if you have a prescription for opioids from your doctors, you can take it to any marijuana dispensary and get cannabis instead,” Diehl said. “Yet doctors are still pushing opioids, and a lot of them are scared to touch cannabis because of the federal ban.”
Looking to the future
Maryland, Diehl said, still needs to allow for cannabis in a variety of edible forms, like gummy bears or fruit chews, because many chronic disease patients don’t want to smoke. “So they’re making food on their own” like brownies and cookies, she added, and they don’t know the concentrations to do it right.
Baby marijuana plants at the Kind Therapeutics cultivation facility.
Ryan Crandall, MariMed’s chief production officer and a veteran of the computer software industry, thinks it crucial that cannabis products be affordable as well as effective. For example, a 100 mg bottle of “Healer” tincture costs $32 and lasts one to two weeks.
“It’s a premium product at a very economical price point, because we want to get this medical product into patients’ hands economically,” he said.
Another product, known as
Rick Simpson Oil (RSO), is named after the Canadian cannabis activist who developed it. RSO is notable because it’s a full-plant extract that contains higher levels of THC.
“The lion’s share of people using RSO are getting incredible medical benefits from it, and I’ve met two people in the last month alone who are on maintenance doses and have been cancer-free for years,” Crandall said. “One patient with stage 3 lung cancer was given six months or less to live. He was on chemo and his doctor recommended an RSO regime. He believes the thing that’s keeping him cancer-free is RSO.”
More than 83,000 patients are now registered with the
Maryland Medical Cannabis Commission, which entitles them to buy cannabis products at an authorized dispensary. Yet Diehl said it’s been an uphill battle to persuade county authorities to approve new dispensaries around the state — though the landscape does appear to be changing as medical cannabis gains national acceptance.
“A lot of counties just treat us as a CVS now, which is how it should be,” Diehl said in a reference to the U.S. pharmacy chain store. “Some people are still completely opposed to it, and scared that it’s an illegal drug. They don’t want dispensaries in their back yard, but things change when it hits home, when someone they love gets sick and this is going to benefit them.”
Even so, she said, “I don’t want to have it come to that just to get them on board.”
https://parkinsonsnewstoday.com/2019/02/07/medical-marijuana-can-help-everyone-says-director-at-maryland-cannabis-facility/
