Doctors find Medical Cannabis Effective for Cancer, Pain, and many other Conditions but News Downplays the Results.
The Ohio Medical Marijuana Control Program published an annual report with results of physicians who recommend Medical Cannabis. 648, that’s the number of Ohio physicians actively certified for the program. The program permits 25 medical conditions that qualify for Cannabis treatment in Ohio. One of the key questions of from the report asks physicians, “How satisfied are you with the effectiveness of medical marijuana in treating your patients with the qualifying conditions”. The Physicians were asked to rate each condition with “Satisfied”, “Neutral”, “Dissatisfied”, “Other”, and “Not Applicable”
An article by Laura Hancock in Cleveland.com puzzles me. Although the results of this report are overwhelmingly positive, for some reason the story downplays it. It identifies that 59.4% of physicians were satisfied with the effect of Cannabis on chronic or intractable pain, 53.5% were satisfied with its effectiveness for cancer patients, 50.8% were satisfied for fibromyalgia and 50.3% for post-traumatic stress disorder patients. The results were much better. Only 65% of the doctors responded to the survey. If the percentage of respondents are calculated, 91% of physicians who saw patients with pain were satisfied with the results, 82% for cancer, and 77% for both fibromyalgia and PTSD. Out of the doctors seeing patients with Sickle Cell, 82% were satisfied with Cannabis. Prior studies indicate only 65 % of patients are satisfied with traditional treatment for Sickle Cell and 75% seeking alternative treatments. For every condition in this report, physicians were more satisfied than dissatisfied with Cannabis as treatment. Even for less responsive conditions, like Huntington’s Disease.
Dr. Ryan Marino, Case Western University toxicologists and addiction medicine specialist notes, “There is little evidence in the US about the effectiveness of marijuana”. When asked about the report, he backtracks and qualifies his answer by saying, “I think those conditions are anecdotally what people report success with,” and adds, “the low dissatisfaction rates are likely due to marijuana’s relative low risk.
Dr. Solomon Zaraa, president of Compassionate Cleveland, a medical Cannabis practice sees the survey results as like his own experience. He sees many chronic pain patients who prefer not to depend on opiates. He also sees PTSD patients who are less reluctant to enter therapy after they use Cannabis.
Rather than downplaying, the results of this report, we should shout it from the mountain tops. It’s promising that doctors of patients who use Cannabis are satisfied with the results. However, the stigma of Cannabis continues to be an adversary to real-world evidence. As a response, we must keep publishing survey results such as this. And as a follow up, we should probably find out what the patients themselves think of using Cannabis.
Advances in Cannabis Cancer Research
I evaluated a couple of patients this week treating cancer with Cannabis and looked at recent news to see what progress is being made in Cannabis cancer research.
Early-stage research suggests that Cannabis-derived medicines could be effective in treating various cancers.
Although those of us in the Cannabis industry may already be aware of this, the medical community is just coming around to accepting the idea.
Recent experimental treatments and small-scale clinical trials in Europe are showing the efficacy of medicinal Cannabis formulations.
THC has primarily been used in cancer treatment for palliative care, to relieve nausea, and stimulate appetite. However, early-stage research is suggesting that Cannabis, which is more than THC, is also a highly effective treatment for killing cancer cells.
So, how does it work?
Pre-clinical studies have shown that cannabinoids reduce cancer cell growth and disrupt the blood supply to cancerous cells, including brain tumors, breast cancers and prostate cancer, among others.
With, potentially, hundreds of naturally occurring constituents, there is no one magic medical Cannabis bullet in cancer treatment. Cutting edge work using artificial intelligence (AI) is being carried out to analyze Cannabis plant genetics and to determine the best combination of cannabinoids, terpenes, flavonoids, and other constituents to target and optimize the treatment of various cancers. It’s a many-to-many puzzle; many active ingredients to treat many types of cancers.
In pre-clinical studies, Cannabis cancer treatments can be tested through either 2D or 3D cell culture testing. 3D cell cultures allow researchers to recreate specific pathological environments The improvement in 3D cell culture technology has led to the generation of models that encompass more physiological and tissue-specific micro-environments,
Despite advancements in pre-clinical testing, the key to gaining full acceptance in the medical community is real human data from clinical trials. Currently, there is a small-scale clinical trial on glioblastoma (a brain cancer) in the UK and another trial on liver cancer in the Netherlands.
Scientists are also assessing the role of ‘personalized medicines. Personalized medicine recognizes that we are all physiologically unique and uses individualized DNA sequencing to target treatment. Personalized medicine is already used in the traditional treatment of cancer.
Combined,. the analysis of AI, 3D Cell Cultures and personalized medicine present a huge opportunity for medical Cannabis and the treatment of cancer.
The lifetime prevalence of post-traumatic stress disorder (PTSD) ranges from 6.1 to 9.2 percent of the general population. Does past trauma cause trouble sleeping? Yes.
A new Israeli study published in the Journal of Anxiety Disorders assesses the association between PTSD, Medical Cannabis use, and sleep. After a traumatic experience, 80-90% of people suffer from sleep disturbances. Nightmares and frequent or early awakening are common. People with sleep disturbances caused by PTSD are likely to worsen their PTSD, potentially experiencing suicidal ideations, inflicting self-injury, and becoming disabled.
Some pharmaceutical medications are effective for improving sleep in people with PTSD. However, research on Cannabis use and PTSD is limited. There’s some evidence that THC reduces the occurrence of nightmares and improves sleep quality in patients with PTSD. As well, some animal studies indicate that CBD improves sleep. Typically, studies evaluate low dose, single molecule extracts or synthetic cannabinoids. However, Cannabis is more than THC or CBD.
A recent study by Dr. Sue Sisley examined the effects of smoked Cannabis flowers and PTSD. The study was randomized, double-blinded, and placebo-controlled. However, it didn’t demonstrate any improvement in sleep. How could this be? The accounts of thousands of patients Cannabis can’t be wrong. Dr. Sisley’s study involved participants who are long term Cannabis users. During the study, they reported Cannabis withdrawal symptoms, indicating that the controlled dosage of the study was likely too low.
The Israeli study was conducted differently. Rather than control the amount used, participants were asked to keep a diary of their daily Medical Cannabis use. On average the Cannabis used by participants had higher THC levels (18%). As for the conclusion, Medical Cannabis users demonstrated a shorter time to falling asleep, less nightmares, and less early awakening. Furthermore, those who used Cannabis with a higher CBD content were less likely to wake up early.
Randomized, double-blind, placebo-controlled trials are generally considered the gold standard in single agent pharmaceutical drug discovery. However, the study of herbal Cannabis needs a paradigm shift. Real world Cannabis users have never relied on single agent cannabinoids in controlled fashion. Their herbal Cannabis use ranges widely from a few puffs to consuming a full gram or two. These contrasting studies highlight an important conclusion about Cannabis research. Controlled trials are not the best way to initiate studies on Cannabis. Non-interventional studies where participants are permitted to dose themselves have more external validity, meaning they reflect what is happening in the real world.
Herbal Cannabis has helped patients with PTSD tremendously; particularly those with insomnia and nightmares. Studies are best used to understand how herbal Cannabis works not if it works. Real world evidence, like the Israeli study, demonstrates that Cannabis works.
Cannabis for Tourette's
A syndrome is a collection of symptoms that frequently occur together. Tourette’s Syndrome is characterized by sudden, repetitive, rapid, unwanted movements or vocal sounds called tics. Many people associate Tourette’s with outbursts of obscene or socially inappropriate words. Although only one third of people with Tourette’s make obscene remarks. Those who have outbursts find it difficult to deal with public places, school, work, or even home. Just getting through the day can be excruciatingly difficult. Doctors previously thought that Tourette’s was a psychological disorder. Today, most scientists agree that Tourette’s is a neurological disorder with unknown causes.
Tics come and go over time. They first appear between the ages of 5 and 10, usually in the head and neck area. Motor tics typically appear before vocal tics or outbursts. The tics usually get worse in the early teen years and become more controlled by the late teens or early 20s. Tics worsen with excitement or anxiety and improve during calm or focused activities. Imagine trying to calm your excitement or anxiety as a teenager.
Canadian researchers performed a double-blind, randomized, placebo controlled, cross-over study of nine people with Tourette’s. In prior studies, patients had reported a reduction in tic severity, improved sleep, and improved mood after using Cannabis. This study controlled the type of Cannabis and dosage used. Each participant vaporized ¼ gram of either Type I, II, III, or placebo Cannabis flowers once every two weeks. The Type I Cannabis had only 10% THC, Type II had 9% each of THC and CBD, and Type III had 13% CBD with very little THC. Four different survey scales were used to assess the frequency and severity of the tics after Cannabis use.
The Type I (or 10% THC) flowers worked best. Type II (or 1:1 ratio THC and CBD) were a little less effective than Type I. Type III CBD flowers did not have any significant effects. Type I and II Cannabis improved urge for tics, symptoms of distress, and overall well-being. Type I flowers also had more cognitive and psychological adverse events. The researchers admitted that it was difficult to draw conclusions from a small sample of participants.
MediCann has evaluated a handful of patients with Tourette’s. Their ages range from 18 to 46. On average, they smoke ½ gram of Tyle I Cannabis (closer to 20% THC) 3-4 times per day. Some just smoke 1 time per day and others may smoke up to 8-10 times per day. One patient, the 18-year-old, tried a CBD tincture without success and is next planning to try a 1:1 THC-CBD tincture. Outside of the 18-year-old, they all report improved symptoms with Cannabis use.
When it comes to Cannabis, collecting real-world data complements traditional study design. Non-interventional studies of Tourette’s demonstrate significant improvement with Medical Cannabis. The studies illustrate a wide range of dosage and variable experiences with Cannabis. They highlight that Cannabis is not a one-size fits all medicine.
“Medical Students Have Little Knowledge About Cannabis, Study Finds,” an article published in Cannabis Health by Joe Roberts describes a study about medical student Cannabis education in the US
Researchers from Nova Southeastern University and Florida Atlantic University published the results of a qualitative study on the perceptions of Cannabis by medical students in Florida. The goal of the study was to identify themes shared by the students that may be helpful in designing future curricular on Medical Cannabis. This study was one of the first to use qualitative interviews to explore student perspectives on Medical Cannabis
Qualitative studies focus on the “why” rather than the “what”. They use semi-structured questions in a natural setting to create an in-depth conversation and understanding of the topic. In this study, a total of 83 medical students in eight focus groups were questioned through ZOOM. The questions were designed to get an understanding of 1) beliefs about the therapeutic benefit of Cannabis 2) general knowledge about Cannabis and 3) the potential role of the physician. Each focus group lasted between 60 and 75 minutes.
Most of the medical students were in favor of re-scheduling Cannabis to something less than Schedule I. Most were able to name a symptom or condition that might benefit from Cannabis. And only a few could name a health condition that was contraindicated or had no benefit with Cannabis use.
Students did have concerns about the potential for Cannabis addiction and long-term effects. Most said their source of information came from friends and family or through social media. The two medical schools did not have courses on Cannabis or the Endocannabinoid System.
The students were able to identify conditions, including cancer, AIDS, pain management, irritable bowel, multiple sclerosis, and others., that might benefit from Cannabis. They also expressed concerns about the potential harms of Cannabis. “A lot of people recommend chilling out with Medical Cannabis,” said one student, “but it actually can evolve into a panic attack.” Student perspectives ranged from concerns about addiction to a lack of trust in patients knowing what was medically best with their Cannabis use.
The researchers concluded that most students had erroneous beliefs about Medical Cannabis. They used unreliable sources of information and had mixed attitudes about legalization. The students also tended to confuse Medical Cannabis use with recreational use. The researchers described the way the students spoke about Medical Cannabis as “unsettling” and based on “unsubstantiated authority.”
Despite their confusion, the students were all interested in learning more. Most felt that their medical school should offer Medical Cannabis training. They noted that even if a state does not have medical Cannabis laws, they are likely to run into patients using Cannabis sometime in their career and would like to be prepared.
It’s been over 40 years since the Endocannabinoid system was discovered. Typically, new discoveries don’t take long to be included in a medical school curriculum. Outside of the stigma of Cannabis, there are concerns that science has not yet tackled the hurdles presented by variable, multi-agent, Cannabis medicines. There are those who make the argument that Medical Cannabis may require changes in the way we approve medicines. Years of patenting single or dual agent cannabinoids have not captured the revenue and presumed effectiveness of increasingly popular Cannabis. There is also some indication that pharmaceutical industry is losing billions in stock value to burgeoning Cannabis sales. At the same time, pharmaceutical industry’s influence on medical education, may be slowing progress toward implementing changes to medical Cannabis curricular. It’s a perfect storm that must eventually be resolved.
Not all studies are the same. There are good studies. There are bad studies.
Some studies provide preliminary evidence, sort of like clues to a crime. Amy Norton of US News and World Report writes a story titled, “Medical Cannabis for Pain is Linked to Slight Rise in Heart Trouble.” I investigated the finer details of this study noting that it was funded by the National Institute of Drug Abuse with principal investigators admitting to financial relationships with Pfizer, a pharmaceutical company.
Dr. Nina Nouhravesh presented findings from this preliminary study at a European Society of Cardiology meeting in Barcelona, Spain. “In Denmark, there are three approved forms of Cannabis, all taken orally”, says researcher Dr. Nouhravesh. “They include oral solutions and sprays of CBD; teas containing a mix of THC and CBD; and dronabinol, a synthetic form of THC.” Dr. Nouhravesh and other researchers used Denmark’s national database, searching the medical records of 1.6 million patients with chronic pain. Just under 4,600 were medical Cannabis patients who had filled at least one prescription for the three available forms of Cannabis. The study found that those patients who used prescribed Cannabis were 64% more likely to have a heart arrhythmia in six months
Does this sound bad to you? It isn’t. 0.9% or 4,140 patients who used Cannabis had arrhythmias, whereas 0.5% or 800,000 patients who didn’t use Cannabis also had arrhythmias. The relative risk seems significant, but the absolute risk is actually very low. If you don’t pay attention to the math, you can be misled.
It’s known that cannabinoids can influence heart rate, blood pressure, and blood clotting. Add those facts to this study and some people may start to worry. Robert Page, a professor at University of Colorado Skaggs School of Pharmacy sounds concerned as he comments on the study. “Just because something is natural doesn’t mean it’s safe,” he says. Two out of three of the prescribed products in this study are not natural. Why does Professor Page make a comment on natural medicine? I’m not sure. I don’t even know why the quote is in the article.
People with chronic pain often have other health problems and take multiple medications. In this study, 42% of the patients prescribed Cannabis were also taking opiates. Only 12% of patients not taking Cannabis were prescribed opiates. “That’s an important difference,” says Dr. Jim Cheung, chairman of the American College of Cardiology. “Opioid use typically signals severe pain – which itself could trigger arrhythmias.” Dr. Cheung also notes that some arrhythmias are more serious than others, and it’s unclear whether Cannabis is associated with specific types of arrhythmias.
We’ve seen doctors change careers to become politicians. It's also clear that headlines like these are sometimes used as political maneuvers. To uncover truth, scientists discuss or debate facts and repeat studies. As well, scientists usually take a good look at study design and statistics to make conclusions. The answers are not always clear. This story may be a political maneuver or just a misunderstanding of the math by the author. In the end, these authors conclude that more study is warranted. Remember the adage, don’t believe everything you read, especially when it comes to this article about Cannabis in US News and World Report.
An original study recently published in The Journal of North American Menopause Society titled “A Survey of Medical Cannabis Use During Perimenopause and Postmenopause” compares Cannabis use among women experiencing the transition to menopause with women after menopause.
Perimenopause is defined as the time when ovaries gradually reduce the production of estrogen, which can include irregular menstrual flow, hot flashes, and night sweats. Postmenopause is the period after perimenopause and defined as no menstrual flow for 12 consecutive months.
The study is a cross-sectional, observational study designed to collect information at a single time point identifying menopause related symptoms associated with medical Cannabis use. The study did not try to show how well Cannabis worked for menopausal symptoms, which is difficult in an observational study design.
To better understand medical Cannabis use among menopausal women, researchers conducted surveys on 131 perimenopausal and 127 postmenopausal individuals. They found that individuals experiencing perimenopause were more likely to have a diagnosis of depression and anxiety and more likely to use medical Cannabis than postmenopausal women. In other words, the transition period to menopause was associated with more Cannabis use.
92% of the women had tried Cannabis at least once in their lifetime. 84% were regular Cannabis users, using at least once per month. Smoking flower (84%) and using edibles (78%) were the most common methods of using Cannabis. It’s interesting to note that a broad range of products were used by at least 25% of the participants including vape pens, tinctures, vaporizing the flower and topicals. The top three reasons for using Cannabis were poor sleep, anxiety, and to improve sex drive. The top reasons why women were not interested in using Cannabis were because they had a lack of knowledge of Cannabis, or their menopausal symptoms were already well managed. Other reasons were no access to Cannabis products, fear of getting high, and cost.
Hormone replacement therapy (HRT) is the medically recommended treatment for menopause. However, HRT is associated with negative symptoms such as mood swings and fatigue. There is also an increased risk of developing cancer with HRT.
It’s known that Human ovaries produce the endocannabinoid anandamide with peak blood levels occurring at ovulation and correlating with estrogen levels. Giving estrogen to animals that have their ovaries removed (a model for menopause), increases the expression of cannabinoid receptors and levels of anandamide. This indicates that the endocannabinoid system is very likely linked to functioning ovaries. This is molecular evidence why Cannabis may benefit menopause.
The study authors do note some concerns with current Cannabis use for menopause. Smoking tobacco is associated with an increased risk of early menopause. Although smoking Cannabis is different than smoking tobacco (unless you are smoking a spliff or a blunt), it’s uncertain whether it may also affect the onset of menopause. Another concern is that dosage is uncertain with broad spectrum or full spectrum Cannabis products and needs to be studied in prospective clinical trials. And finally, the effect of cannabinoids on liver metabolism is important to consider when prescribed medicines are also being used.
All in all, this study highlights that medical Cannabis has great potential as treatment for the adverse symptoms related to menopause.
Patients Grow to their Needs
That’s right. Medical Cannabis patients in California can grow to their needs, NO LIMITS.
California voters did something right when they enacted Prop 215. The 1996 voter initiative provides a defense for medical patients and their defined caregivers who grow and possess Cannabis at any amount for medical purposes.
Titled the “Compassionate Use Act of 1996”, Prop 215 identifies medical conditions as the underlying defense for growth and possession of Cannabis. The qualifying medical conditions need to be confirmed by physician evaluation. As well, the physician is responsible for guidance. Prop 215 authors, Dennis Peron, Valerie Corral, Dale Gieringer, Tod Mikuriya, and many more, formed an all-star cast of compassionate professionals who chose not to describe Cannabis as a commodity in the law. They emphasized COMPASSION for patients.
There are many who recognize the poor job California regulators have since done in regulating Cannabis. A lot of the problems are attributed to Prop 64, the “Control, Regulate, and Tax Adult Use of Marijuana Act”. Like a tenant of the Evil Empire, the Prop 64 initiative describes Cannabis as a commodity and benefits large corporate growers. As a result, many small crop Cannabis farmers have shut down their licensed operations and sold their farms. Currently, the best access to quality, low-cost medical Cannabis remains the 215 recommendation which allows patients to grow their own.
“How many plants can a qualified medical cannabis user grow in California? Ask law enforcement or various state and county departments, and each agency, in some cases, each individual within each agency has a different answer,” writes Nichole Norris in the Redheaded Blackbelt. Apparently, county officials are confused. Humboldt County Sheriff deputies and code enforcement officers have been caught on camera saying, “There is no medical anymore,” and “215 doesn’t matter.” However, in an interview with Ms. Norris this summer, Humboldt County Sheriff Billy Honsal recognized medical cannabis laws. Sheriff Honsal believes Prop. 215 was not written well. However, he understands that if someone is growing more than six plants deputies must look at the 215 documents.
Adding to the confusion, Humboldt County Building and Planning Department operates on different limits allowing 100 sq-ft, 200 sq-ft, or 400 sq-ft depending on lot size. Cannabis expert and local criminal defense attorney, Eugene Denson, writes “It is important for the Sheriff, the Code Enforcement Unit, and other county officials to understand what is allowed under existing law because I believe they are presently violating the law… due to a mistaken opinion of what the laws of California allow. These actions make the county liable for damages and other legal remedies available to patients.”
Past medical patients uprooted their lives and moved to Humboldt County to benefit from a favorable Cannabis environment. Some patients see Cannabis as the plant that saved their lives from the suffering of chronic illness.. Humboldt County is well known as an epicenter of Cannabis. The tenacity and persistence of Emerald Triangle inhabitants to grow their own Cannabis despite the laws enacted to "control, tax, and regulate" has started a movement to world wide legalization.. However much regulators put their hands out panning for cash to fill government coffers, they cannot bully the medical Cannabis patient. Thankfully, the authors of Prop 215 saw Cannabis as more than a commodity. As a result of their incredible foresight, medical Cannabis patients can continue to produce their own medicine and the legacy the personal medical Cannabis garden continues.
Sometimes there is no solution to a problem. Chronic pain is like that. You don't get rid of it. You just learn to live with it, doing the small things to make the day go by with some small reward of laughter. - Dr. T
Why continue living? Not that there is much choice in the matter.
Thoughts on PAIN!
I have a rather too intense, intimate and enduring personal relationship with pain that continues to intensify. Pain is a unique experience as unique as the individual experiencing the pain. Pain is more than physical. It is emotional and psychological as well. Never belittle another person’s pain. Never consider your pain to be greater than anyone else’s. Invisible does not mean nonexistent. Pain only kills if it causes shock and death is due to shock left untreated. Pain that intensifies over time can seem to endure for eternity. The desire for the end of existence can result from acute chronic pain lasting decades and other major complications of life. As if there is life without complications. Death does not guarantee the end of pain and suffering.
Pain is part of the shit that happens to the living due to living. It is thought that the dead do not experience pain. Pain is the hard way to learn important life lessons. Pain is not something to be distributed, propagated, shared or spread.
Empathy is acceptable; sympathy is not.
I do believe that I have warned you upon several occasions that I have a twisted sense of humor.
After being with hundreds of dying folks, my belief is that this human experience is the bottom rung of the ladder and that as spiritual beings it only gets better! We are spiritual beings having a human experience, not the other way around.
I'd like to introduce you to “Flore”, a newly opened Cannabis retail store. Flore is located at the historic corner of Noe and Market in San Francisco’s Castro neighborhood. More than 25 years ago, Brownie Mary handed out Cannabis infused “treats” to AIDS patients on this corner. Just down the street, Dennis Peron’s Cannabis Buyers Club became the world’s first medical Cannabis dispensary. About the same time, I consulted my first medical Cannabis patient just a few blocks away.
Northern California has been involved in a Cannabis culture since before the "Summer of Love". In the 1960s, anti-war and civil rights were at the forefront of social discussion and debate. Considering current events, it amazes me how history repeats itself. Cannabis stood for rebelliousness, iconoclasm, and radicalism. Although we may have changed, the plant hasn’t changed. As a community, perhaps we have evolved to understand Cannabis heals the prevalent disorders of the day.
After Cannabis and other psychedelic experiences, Harvard psychologists Timothy Leary and Richard Alpert questioned the status quo. Their experiences with Cannabis as a mild mind-altering escape from reality gained popularity. Dr. Leary and Dr. Albert reinforced the prevailing notion that science instructs wellness and medicine. Today, communities find that “turning on” to Cannabis also manages pains, helps addiction, improves sleep, and relaxes a person from the mental and physical stressors. Cannabis bridges the herbal apothecary of the past to the pharmacy of the future.
Our work at the CESC, a nonprofit Cannabis research organization, has always sourced community wisdom. Federal and state regulatory efforts address limited challenges presented by Cannabis. Relying on top down federal and state guidance does a disservice to a community that has used Cannabis for decades. Yet, our community is thirsty for knowledge. Although we have experienced relief of aches, pains, and stressors, we want to understand which Cannabis products give energy, and which helps with a good night’s sleep, which stimulates hunger, or, yes, even arousal.
Dr. Abrams and I started our clinical research by examining how communities use aroma to make distinction between Cannabis flowers. The investigation eventually led to chemical characterizations of Cannabis flowers and predicting the "Sativa" vs "Indica" effects. Our studies are a paradigm shift to traditional FDA clinical studies. Using community sourced data, we learn quickly and at very little expense.
Flore sits at ground zero of the Cannabis culture in northern California. It will be the place where CESC launches its next phase of studies on Cannabis dosage and efficacy.
“Our initial work focused on Cannabis flowers. Today we are ready for a new phase of study,” explains Dr. Abrams. “We want to dive into a broader side of Cannabis - processed (non-flower) products.”
Processed Cannabis products allow choice, provide variability, and are amenable to scientific precision. As well, consumers are interested in reliable and consistent Cannabis products that result in characteristic anticipated effects. As we mature, the Cannabis industry matures, where getting “high” is just one of many available choices at a Cannabis dispensary.
The CESC believes that effect claims are possible through observational study. In fact, large cohort Cannabis observational studies may be more predictive than smaller double blind randomly controlled trials. With help from the community, the CESC will make effect claims available to the public for any product available at Flore. Our mission is to provide information for each Cannabis product categories (gummies, vape carts, topical salves, etc.). We see this information as critical for both consumers and the industry.
Dr. John S. Abrams and Dr. Jean Talleyrand are co-founders of the CESC
Flore is located at 258 Noe St, San Francisco, California
Jean Talleyrand, M.D.,