Cannabis is still in its legal infancy, gone are the days where your stash can get you sacked, now the debate swirls not around the law-breaking stigma, but instead, the health ramifications behind your consumption method. Technology and it’s impact on cannabis consumption has meant a decline in traditional smoking, and a steady uptick towards vaping. While the perils of smoking are widely known and documented, we’re only just now discovering what the health consequences will be for those who vape.
We sat down with Dr. Guy Chamberland – CEO & Chief Scientific Officer, Tetra Bio-Pharma Inc. and Dr. Jeremy Hirota who holds a PhD in Physiology and Pharmacology from McMaster University to ask all our most burning questions about the safe consumption of cannabis, and how this research began.
Ginger Leaf– First up, Dr. Guy Chamberland. Thanks for making time to answer these questions. As Canada’s Leader in Bio Pharmaceutical Cannabis Research and Development what is the purpose of this research?
Dr. Guy Chamberland– The most critical gap in having greater access to cannabinoids for therapeutic use, is the lack of scientific knowledge. The goal of Tetra Bio-Pharma’s collaboration with the Lung Association – Ontario is to build knowledge that will help patients make informed decisions and help physicians learn about the impact of cannabis use in treating various pulmonary conditions and associated symptoms.
GL- How the industry has been evolving since legalization, and how this will impact / is impacting the research?
Dr. GC– We are a biopharmaceutical company that focuses on the discovery and development of cannabinoid-derived pharmaceuticals for chronic pain, oncology and ophthalmic. It’s important that I make this distinction, because we are not a cannabis company and so legalization has had no impact on the research we do. That’s not to say that we are not concerned about legalization. Canadians need to know that medical cannabis and cannabis medicines are not the same thing. One day, hopefully not too long, we will be able to introduce our Health Canada approved cannabinoid-derived products that will have a Drug Identification Number (DIN), be available in pharmacies and be covered by insurance plans.
GL-What medical changes do you see on the horizon from this research and how it will impact the health of cannabis users?
Dr. GC-The recipients of the research grants under the Tetra Bio-Pharma and Lung-Association Ontario partnership have submitted projects that are entirely novel and we are excited to see what these investigators uncover. The change we hope for comes in the form of a broader appreciation for scientific evidence. We are all about proof and we expect that time and higher expectations will result in a better understanding about the exacting process required to bring a cannabinoid-drug to market. We shouldn’t lose sight of the fact that cannabis is a drug and thus, if we expect regulators to approve it, physicians to prescribe it and insurance companies to cover it, we need to deliver the same rigorous evidence that is required for every other drug. Once this happens, it will be a game-changer.
GL– Next up, we have the privilege of speaking with Dr. Jeremy Hirota from McMaster University. You’ve spent your last few years dedicated to respiratory health. What are the health effects for using cannabis orally, smoking and vaping? Is there a “best-practices” method?
Dr. Jeremy Hirota– As a lung health researcher, I cannot comment on oral consumption of cannabis and the impact it may have on the human body. What I can say is that it avoids exposure of the lungs to a combusted or vaped product – which ultimately limits the damage to the lungs. I just cannot say what oral consumption does to other organs (e.g. GI tract). You could contact my brother – Simon Hirota – a GI mucosal immunologist if you wanted some answers to that question. As for smoking – all available evidence suggests that combustion of any plant (tobacco, cannabis) or organic product (wood smoke, animal dung) results in exposure to molecules that can damage the lung, increase inflammation, and impair immune responses. The exact responses will be unique for each individual – but exposures will not be HARMLESS – the extend of HARM of combustion exposure is what our research and those of many others are actively pursuing. Vaping is a diverse topic. Vaping could mean a purified THC solution in a glycerol mix that is heated and inhaled in a battery powered device. It could also mean heat-not-burn devices that do not result in combustion per se, but heat the plant material to a specific temperature designed to liberate the volatile THC and cannabinoids from the plant. This is supposed to minimize combustion particulate matter exposure to the airways – but this is not extensively studied and the data does not exist to substantiate a best practises statement. Indeed – the best practice would be to avoid.
GL– We have all known the effects on lungs when it comes to smoking cigarettes, but it feels like the jury is still out for vaping. How far have we come and how much further do we need to go to understand this new consumption model?
Dr. JH– Inhalation of any substance in the lung that is not normal air can pose risks. This can be as diverse as air pollution, dust, smoke from a campfire, BBQ, etc. It therefore follows that the new mode of exposure – vaping – may negatively impact lung health. The difficulties with nailing down the long-term consequences are exactly because the long-term studies have not been performed due the limited time these products have existed. On top of this – the reality that the market is unregulated, devices can be independently modified, and flavourings to inhaled juices are extremely diverse, all contribute to our inability to make a clear statement to the negative health consequences. Again – best practice would be to avoid.
GL– Are there any specific red flags or pre-cursors to developing respiratory issues from consuming cannabis?
Dr. JH– Great question – if an individual has an underlying respiratory condition (asthma, chronic obstructive pulmonary disease, cystic fibrosis, etc.) – it would be best to avoid inhalation of combusted cannabis and any other vaped material. If an individual has an existing respiratory tract infection – this would also be another red flag – as smoke inhalation, at least tobacco, can impair lung immune responses and impair the ability for the body to fight lung infections.
GL– We are not even at one year post legalization. Do you think Health Canada did a decent job of informing consumers the risks? Have we educated our youth enough?
Dr. JH– I think communication can always be better. I’m not fully aware of all of the political promises and consequences, legal challenges and precedents, but ultimately, the government acted within the constraints they operate in, and in this scenario, they likely did their best. Could it have been better – sure – did they try – yes – so we need to give some credit but also highlight areas for improvement – which could be grounded on evidence generated from government funded research.