The Future of Medical Cannabis

1. The Future of Medical Cannabis
Catherine Jacobson, PhD
Director, Clinical Research

2. The Spectrum of Cannabis Use
Recreational MedicalTherapeutic & Wellness

3. The Spectrum of Cannabis Use
MedicalTherapeutic &WellnessRecreational
Responsible Adult Use
Cannabis Use Disorder

4. The Spectrum of Cannabis Use
MedicalTherapeutic &Wellness
Pain
Insomnia
Anxiety
Depression
Recreational
Responsible Adult Use
Cannabis Use Disorder

5. The Spectrum of Cannabis Use
Medical
Cancer pain
Neuropathic pain
Chemotherapy-induced nausea
and vomiting
Appetite stimulation, AIDS
Spasticity, Multiple Sclerosis
Pediatric Epilepsy
Therapeutic &Wellness
Pain
Insomnia
Anxiety
Depression
Recreational
Responsible Adult Use
Cannabis Use Disorder

6. The Spectrum of Cannabis Use
Medical
Cancer pain
Neuropathic pain
Chemotherapy-induced nausea
and vomiting
Appetite stimulation, AIDS
Spasticity, Multiple Sclerosis
Pediatric Epilepsy
Therapeutic &Wellness
Pain
Insomnia
Anxiety
Depression
Recreational
Responsible Adult Use
Cannabis Use Disorder

7. Medical Use
“Medical” cannabis use has been legal in California for 20 years for cancer, etc.
Prop. 215 lists “cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma,
arthritis, migraine, or any other illness for which marijuana provides relief
However, mainstream medicine, federal health authorities and policymakers
do not recognize cannabis as a legitimate treatment

8. Medical Use Requires Chemical Definition

9. What is the active ingredient?
How much of the active ingredient is in one dose?
Is there a reliable, reproducible source available? Chemical composition?
Medical Use Requires Chemical Definition

10. Medical Use Requires Chemical Definition
Whole flower preparations
Inconsistent chemical composition from batch to batch
Metered dose inhaler not approved
Active ingredient definition lacking
Extracts or synthetics
Chemical definition possible
Reliable & reproducible
Active ingredients are defined
Inferior method of delivery
Tetrahydrocannabinol (THC) Cannabinodiol (CBD)

11. Safe dose and titration schedule
Therapeutic/efficacious dose
Basic safety profile in a given patient population
Side effects
Drug-drug interactions
Adverse events
Medical Use Requires Chemical Definition

12. Data for regulatory approval
Phase 2/3Trial in partnership
with the University of Sydney
for chemotherapy-induced nausea
and vomiting
Phase 2/3Trial in partnership with
the Ontario Brain Institute for adult
refractory epilepsy
Data for informed medical use
Open-label trials provide immediate
patient access for specific indications
Database dose, side effects,
indications, adverse events
The Path Forward—Clinical Research

13. FDA and DEA approved
pharmaceutical products
Accessibility
Insurance Coverage/Cost
State-based Medical
Cannabis Regulations
Safety & Reliability of
Products
Appropriate Medical
Supervision
The Current System Fails Patients
ISSUES

14. The Spectrum of Cannabis Use
Medical
Cancer pain
Neuropathic pain
Chemotherapy-induced nausea
and vomiting
Appetite stimulation, AIDS
Spasticity, Multiple Sclerosis
Pediatric Epilepsy
Therapeutic &Wellness
Pain
Insomnia
Anxiety
Depression
Recreational
Responsible Adult Use
Cannabis Use Disorder

15. Thank You
Catherine Jacobson, PhD
Director, Clinical Research