WHO finds no addiction risk in cannabidiol review

The World Health Organisation issued a positive view of the natural cannabis oil CBD, which could be next in line for legalisation in the Maltese medicinal register.

The WHO’s initial review of CBD oil – a herbal remedy containing cannabidiol that is one of two main active ingredients derived from cannabis – said it was “not likely to be abused or create dependence”.

The positive recommendation from the WHO’s drug dependence committee came on the same day Maltese doctors urged caution on the prescription of cannabis products.

“Cannabis is an addictive drug, there have been various studies which documented its side effects that could even result in mental illness,” Martin Balzan, president of the Medical Association of Malta said earlier this week, calling for more research before government decides whether or not to legalise medical cannabis for medical use.

“There are a lot of drugs which are safer and more effective,” Balzan said, as he hoped doctors will prescribe medical cannabis as a last resort.

“It’s no wonder drug,” he added.

But in its review, the WHO said that international prohibitions against pure cannabidiol were unwarranted, because CBD oil poses no public health threat. The expert committee met in November to evaluate several psychoactive substances. The complete review of cannabidiol will be finalised in May 2018.

Malta is among several countries showing interest in using cannabis and its active ingredients, known as cannabinoids, as medical products. The WHO committee report said several clinical trials demonstrated that pure cannabidiol is an effective treatment for epilepsy. Preliminary evidence also suggests that cannabidiol may offer additional therapeutic benefits.

“CBD is generally well tolerated with a good safety profile,” the authors of the report wrote.

“To date, there is no evidence of recreational use of CBD or any public health related problems associated with its use. While the number of studies is limited, the evidence from well controlled human experimental research indicates that CBD is not associated with abuse potential.”

The WHO said that a 2017 study listed Parkinson’s, Alzheimer’s, Huntington’s, MS and other diseases (where pain and rheumatism set in) as being responsive to the relief that cannabinoids provide.

Meanwhile, the WHO committee categorised carfentanil (a synthetic opioid used by vets to restrain elephants and other large animals) under Schedules I and IV of the 1961 UN Single Convention on Narcotic Drugs – which impose strict controls on substances. The committee’s scheduling recommendation indicates that carfentanil is a drug with high potential for harm and dependence.

Medical cannabis has been used for the treatment of severe spasticity in multiple sclerosis, chronic pain, nausea and vomiting due to cytotoxics, and loss of appetite and cachexia associated with AIDS.

The MAM, however, said evidence supporting the use of cannabis for medicinal purposes is of low to moderate quality, and inconsistent.

Health minister Chris Fearne said legal amendments on medicinal cannabis are expected to come into force by February.
Both sides of the House are in agreement with the forthcoming legislation.

The new regulations will allow doctors to prescribe cannabis products that are not, strictly speaking, medicinal products and that are manufactured under Good Manufacturing Practice (GMP) – a strict standard used in the pharmaceutical industry.

“In other words, they are held at the same standards as medicines and when doctors are prescribing them, they can know what they are prescribing,” Fearne said.

What is cannabidiol?

Cannabidiol, also known as CBD, is found throughout the seeds, stalk and flowers of cannabis plants — including hemp and marijuana. Unlike many of the 85+ cannabinoids present in these plants, cannabidiol occurs naturally in significant quantities in cannabis, so it is relatively easily extracted from the plant.

Studies have shown that cannabidiol is not psychoactive the way THC — the well-known high inducing molecule found in marijuana — is.

CBD has instead been shown to have significant antioxidant and neuroprotective properties, suggesting that it could be a potential treatment for neurological disorders.

Cannabidiol is produced naturally in the cannabis plant: while marijuana is grown specifically to contain significant levels of THC usually for recreational use, hemp has only trace amounts of THC. Cannabidiol can also be produced synthetically in a laboratory.