Forbidden leaflet: why it is difficult to study cannabinoids

Заборонений листок: чому вивчати канабіноїди складно

Why cannabinoids need to be studied and why it is impossible in Ukraine, but quite legitimate in the United Arab Emirates.

Every year on March 26, events around the world are being held to bring attention to epilepsy. This day is also called the Purple Day.

According to WHO, epilepsy is one of the most common neurological diseases. According to various estimates, from 4 to 14 people per 1,000 of the population suffer from it.

Patients with epilepsy may be exposed to discrimination or biased attitudes. For example, according to WHO, in India and China, this disease is often the reason for the prohibition of marriage or divorce. And in the USA, until the 1970s, people who suffered from epilepsy, could legitimately not be allowed into restaurants, theaters or other public places.

There are different approaches to the treatment of this disease, but, according to the WHO, only about 70% of epilepsy cases respond to therapy.

Experts believe that one of the promising approaches to the treatment of epilepsy may be related to the use of cannabinoids. It was this approach that was discussed at the meeting held on March 26 within the Purple Day at the Bogomolets Institute of Physiology of the National Academy of Sciences of Ukraine. It was organized by the Fundamental Production company, which demonstrated its social video on cannabidiol (one of the cannabinoids). Dmytro Isaev, Ph.D. in Biology, a leading researcher at the Institute of Physiology, who specializes in the study of mechanisms for the development of epilepsy, was one of those who took part in the event.

At the end of the meeting, the “Innovation House” interviewed Dmytro Sergiiovych about what epilepsy is, how can cannabinoids be useful in medical sense and why scientists cannot study them in Ukraine, while they can do it in other countries.
Forbidden leaflet: why it is difficult to study cannabinoids
— You mentioned that about 1% of the population of Ukraine, as well as on average in the world, suffers from epilepsy. What treatment in terms of medical science do these people get, how effective is it and what are its disadvantages?

— Unfortunately, there is currently no cure for epilepsy, there are drugs that take off seizures, and thanks to them people can live without seizures. But epilepsy itself is still incurable, except for possible surgical operations in some cases, but they are not always available. Drugs for epileptic seizures are divided into different classes, but all of them are sedatives, that is, they reduce the activity of the nervous system. All of them have some side effects, which often are rather strong. These drugs are especially dangerous in the treatment of childhood epilepsy, since a child has to remember a lot of information, and the drugs impede this process, as well as epilepsy itself does. Therefore, children with epilepsy can often be slow in intellectual development.

— Do you need a prescription from a doctor to buy these drugs in Ukraine?

— Yes. They are prescribed by a neurologist or a psychiatrist.

— In simple words, what happens in the human brain in case of epilepsy?

— Speaking in the simplest way, imagine that all the programs on your computer run simultaneously — you will see that the computer is “crashed”. The same thing happens in the brain in case of generalized epilepsy.

— And if you now add some physiological details?

— The brain contains 100 billion neurons, and each of our actions is due to the work of certain chains of neurons. If all the chains are excited at the same time, one cannot distinguish any information from this chaotic flow and will see just white noise. Therefore, people during an epileptic attack feel neither pain, nor time. They are simply absent in this world.

PEOPLE DURING AN EPILEPTIC ATTACK FEEL NEITHER PAIN, NOR TIME. THEY ARE SIMPLY ABSENT IN THIS WORLD.

— What are cannabinoids, and how are they related to epilepsy?

— Cannabinoids are the class of substances found for the first time in cannabis. Initially, THC (tetrahydrocannabinol — Ed.) was discovered — a psychoactive cannabinoid that has the ability to bind to cannabinoid receptors in our body. These receptors can be of two types: those in the nervous system and the other ones in the immune system. After binding to these receptors cannabinoids affect their work.

It should be noted that the cannabinoid system differs from other systems in a number of parameters, and therefore the addiction to cannabinoids develops rather rarely. It occurs less often than, for example, addiction to coffee. Due to the lack of resources for research, cannabinoids are perhaps the least studied substances in the world, that can potentially be used in medicine.

— Are they actually used somewhere in medical practice? Or there are just some scientific results indicating that they can be used?

— They are used in practice in some states of America, but those are synthetic cannabinoids. It means that those cannabinoids are not extracted from plants, but are obtained as a result of chemical reactions.

— Periodically, we read or hear that in one or another country the use of cannabis for medical purposes was allowed. What is usually meant in such cases?

— I can tell you about it on the example of the USA. In this country the list of diseases, which may vary depending on the state, is approved. Usually the list includes epilepsy, cancer, insomnia etc. — in total, a few dozen items. If a person has a disease from this list, a doctor can prescribe this person some dose of cannabinoids per month. The drugs can have different forms — it can be a liquid, a special patch, you can smoke it.

— How does this differ from the legalized synthetic cannabinoids, which you mentioned before?

— In the latter case, the use of cannabinoids is like an additional medical service. The doctor does not prescribe cannabis as medicine, but allows using it, if the patient wants to try it and the law does not prohibit this.

— Cannabinoids are drugs or they are not?

— The very word “drug” is not scientific, such a classification was invented by the state. I can answer by comparison: if coffee is not a drug, then cannabinoids are definitely not a drug. If tea is a drug, then cannabinoids are also a drug.

CANNABINOIDS CAN REDUCE THE CONSUMPTION OF OPIATES BECAUSE THEY HAVE ANESTHETIC EFFECT

— Besides the treatment of epilepsy, where else cannabinoids can be potentially used?

— Cannabinoids can reduce the consumption of opiates, because they have an anesthetic effect. Also, there is such a terrible mental disease — anorexia, when people die because they refuse to eat. The only known medicine for this state at the moment is THC. In addition, cannabinoids can be effective in the case of post-traumatic syndrome, various diseases of the immune system, and also they have a potential in the treatment of cancer.

— How are the studies of cannabinoids regulated in Ukraine? Are such studies carried out at all?

— They cannot be carried out in Ukraine. Actually, the Constitution does not prohibit such studies, but they have to be carried out according to the approved procedure. And such a procedure does not exist.

— And who is supposed to create such a procedure?

— The procedure should be established by the State Medical Service (State Service of Ukraine for Drugs and Drug Control — Ed.), but at the request of the Cabinet of Ministers. The procedure itself has already been written, and the National Academy of Sciences of Ukraine, the Ministry of Education and Science, the Ministry of Health, together with the National Academy of Medical Sciences of Ukraine fully support it and ask the Cabinet to accelerate the process of its approval. We raise this question in different offices for ten years, but it is still unresolved.

WE RAISE THIS QUESTION IN DIFFERENT OFFICES FOR TEN YEARS, BUT IT IS STILL UNRESOLVED

— How many researchers in Ukraine work in this field?

— Worldwide there are about 17,000 scientific papers on cannabinoids…

— Is that a lot or a few?

— This amount is very small. The Ukrainian authors, who contributed to these articles are less than 20 people, including three works done by myself abroad.

— And who did the other Ukrainian works?

— There is the Institute of Bast Cultures, they are engaged in the cultivation of technical hemp. Their goal is to remove cannabinoids from hemp, which is good for industry, but has no value for medicine.

— And what about other countries, do scientists study cannabinoids without any problems there?

— Yes, except for the post-Soviet countries. I did my research in the Arab Emirates, where any illegal use of drugs is punished by the death penalty — and yet such research activity is allowed there.

— Why are cannabinoids all over the world studied (though not enough, as you claim), but they are almost not used in medical practice?

— The history of cannabis and human is long, it has thousands of years. Cannabis was used already in Ancient China. In the 30s of the last century, the struggle against hemp began, which ended in 1961 when the UN came to the conclusion that cannabinoids are dangerous drugs that do not and will never have a medical use. And only 20 years later, the receptors in human body were found, which cannabinoids interact with. But we still live under this “law” of 1961. The United Nations is trying to reconsider its position, but it all moves very slowly. At the same time, there is no such bias against alcohol and tobacco, although they are considered harmful.

— Which countries are most progressive in the use of cannabinoids in medicine?

— In Canada and Germany insurance companies cover the expenses for cannabinoids for their customers. Israel also has a progressive policy in this matter.