We are changing to Spectrum Therapeutics

Medical cannabis is about more than products.

We are a healthcare company dedicated to research and education.

We are changing to Spectrum Therapeutics

Medical cannabis is about more than products.

We are a healthcare company dedicated to research and education.

Q&A

Here are answers to some of the frequently asked questions about medical cannabis and our company.

Basic facts about medical cannabis

The endocannabinoid system is a signalling system in the body. Activation or inhibition of the system is of particular importance to our cognitive functions, inflammation, blood pressure and digestion. The endocannabinoid system is not unique to humans - all animals have a similar system.

The endocannabinoid system consists of the receptor types CB1 and CB2 and their ligands, referred to as 2-AG and Anandamide. The ligands are formed and degraded again by a number of enzymes, which are also considered to be part of the endocannabinoid system.

Cannabinoids are active compounds that occur in the cannabis plant, which are used for medical purposes.
The cannabis plant contains more than 100 cannabinoids that interact with the body's endocannabinoid system. However, most cannabinoids are found in very small amounts in the plant. Some cannabinoids are psychoactive, meaning that they affect the brain.

The best-known cannabinoids are THC and CBD. The cannabis varieties used for medicinal purposes have a high concentration of these two cannabinoids.

The body also produces cannabinoids, and these are called endocannabinoids. These are positioned throughout the entire body, and help to regulate a variety of physiological processes, which is the basis for the effect of medical cannabis.

Cannabis plants for medical use contain high levels of THC and CBD, and these cannabinoids are the main contributors to the effect of medical cannabis.

THC (Δ-9-tetrahydrocannabinol) is a psychoactive cannabinoid, which is known for having euphoric effects if cannabis is consumed in large doses. THC acts as an agonist on both the CB1 and CB2 receptors in the endocannabinoid system.

CBD (cannabidiol) is also a cannabinoid. There is very little difference in the molecular structure of CBD and THC, but it is enough for CBD to have effects that are significantly different from THC. For example, CBD does not have an intoxicating effect like TCH - even in large amounts.

CBD acts as a negative allosteric modulator of the CB1 receptor, but via several mechanisms it can also increase the activity of the endocannabinoids that the body produces.

Indica and Sativa are botanical terms that were originally used to describe the different varieties of the cannabis plant. Today, these terms are no used very often, as the variants are now categorised based on their chemical composition of compounds.

The terms may also be used to characterise the effect of a particular strain of cannabis, as Indica and Sativa are traditionally associate with certain effects. Although these terms may be useful as a reference, they have no scientific validity.

Production and quality assurance

The production of medical cannabis is subjected to the same criteria as the production of other medications. All products are traceable and manufactured according to the European regulations for good manufacturing practices.

The content of the active substances is measured and guaranteed, and the end product undergoes a number of quality checks for, among other things, bacteria and heavy metals. The plants used in our production are pesticide-free and grown in special climate-controlled greenhouses.

In order to activate the THC and CBD in the cannabis flowers, the flowers must undergo a process called decarboxylation. THC and CBD have a different molecular structure when they are in the plant. Decarboxylation means that THCA and CBDA is converted to THC and CBD and carbon dioxide (CO2) is given off as a by-product. By heating the cannabis flower to over 105°C, the substances are decarboxylated and the cannabinoids are activated. This also means that if you ingest a raw cannabis flower, it would have very little to no effect.

When producing cannabis oil, the cannabis plant material is heated sufficiently for the decarboxylation to take place. Cannabis oil therefore already contains the active cannabinoids and can be ingested without heating or other further processing.

No. All cannabis for our products is grown without pesticides. Every production also undergoes a thorough check, regulated by the Danish health authorities, to ensure the quality.

Cannabis products have to meet requirements for product safety and consistent content of the active substances.

 

The different varieties of cannabis are grown under controlled growth conditions in special climate-controlled greenhouses. This method assures that the content of the active ingredients is consistent from batch to batch. During propagation, cuttings are taken from the plants to ensure that the genetic material is transferred directly to the next plant and not mixed between the varieties. This is called cloning.

 

All medical cannabis products undergo a strict quality assurance programme, which is regulated and inspected by the Danish Medicines Agency.

About the products

Medical cannabis from Spectrum Therapeutics is available as edible oils and softgel capsules for oral ingestion and dried flowers for inhalation. The products contain THC, CBD or a mixture of these.

The risk of dependency with prolonged use of medical cannabis has not been sufficiently studied, but drug research shows that cannabis is less addictive than abuse of comparable painkillers. However, one should pay special attention to patients with documented substance abuse problems of any kind.

Ref.: Anthony, JC et al. Experimental and Clinical Psychopharmacology, 2 (3), 244-268.

The breathing reflex is not affected by cannabis, as for example seen with morphine preparations, and no other possible causes of death linked to cannabis have been reported. You cannot overdose on cannabis.

However, medical cannabis in excessive doses can be dangerous. If a patient ingests too high doses, they may experience symptoms of poisoning in the form of euphoria, sedation, anaesthesia or anxiety. In rare cases, very high doses can lead to psychotic states.

Overdosing can be prevented by the proper use of the medicine and by slowly titrating (adjusting) the dose for the individual patient.

Cannabis does not affect the concentration of opioids in the bloodstream if the medication is taken at the same time. However, results indicate that cannabis may increase the effect of opioids. Many patients can therefore reduce an opioid treatment by supplementing medical cannabis.

Patients should always be careful with combining cannabis with sedative drugs (including alcohol), and patients should always follow their doctor's instructions.

In Denmark, the use of medical cannabis is recommended for the following indications: Chronic neuropathic pain, cancer pain, multiple sclerosis, spinal cord injuries with neuropathic pain and spasms and as part of palliative care.

 

Doctors can, however, prescribe medical cannabis to all patients in cases where it is believed to have a positive effect on the patient.

There are a number of ongoing research projects investigating the potential positive effect of cannabis in patients with epilepsy, anxiety, PTSD, sleep apnea, migraines, fibromyalgia, etc.

To activate the THC and CBD in the cannabis flower, the plant goes through a heat treatment process (decarboxylation). In boiling water, the temperature is just below what it should be in order to activate the cannabinoids, and studies have shown that much of the THC will remain unchanged (inactive) in the finished tea. This means that you get a preparation that is different in the composition of the cannabinoids and contains less THC. Furthermore, the cooking time, quantity of water and subsequent storage of the tea will influence the composition of cannabinoids and hence the dose.

Cannabinoids are fats and are therefore insoluble in water. The presence of other fats (e.g. from cream) in the tea could therefore also change the effect of the preparation. 

No. Cannabis oil and softgel capsules are intended exclusively for oral consumption and should not be inhaled.

To inhale medical cannabis, you need a special inhaler, in which the dried cannabis flowers (either whole or ground) are placed. The flowers are heated to the optimum temperature, at which point the active ingredients are released in vapour form.

The extemporaneous preparation generally means that the final preparation is prepared in the pharmacy and manufactured specifically for the individual patient based on a prescription. In Denmark it is possible to prescribe and obtain purified and extemporaneously produced THC and CBD.

Medical cannabis, however, is an authorised, plant-based preparation, which is manufactured by a company under the trial scheme with medical cannabis.

The burning of the cannabis plant releases toxic and carcinogenic substances, including carbon monoxide, tar and polycyclic aromatic hydrocarbons. These substances can have negative health effects.

 

It is therefore not recommended to smoke cannabis.

Medical cannabis in Denmark

All doctors have the option to prescribe the preparations recorded in the trial scheme on medical cannabis, but no doctor is obliged to do so.

If you feel drowsy or dizzy, you should never drive. If the doctor prescribes medicine containing THC, they should talk to the patient about road safety.

 

Medicating with cannabis does not lead to an automatic driving ban.

The Danish Patient Safety Authority has prepared recommendations for doctors who prescribe medical cannabis.

The trial scheme allows a 50 % subsidy on the price of medical cannabis - with anannual maximum of DKK 10.000 per patient.

Terminally ill patients are entitled to a 100% supplementation.

See the Danish Medicines Agency's website for further information.

When travelling, you can get a certificate for the medicine you bring with you.

The package insert explains how it should be stored. Storage may vary from preparation to preparation, and the recommendations should be followed.

Terms and definitions

Here is a list of definitions of terms related to medical cannabis.

Cannabinoids
Chemical compounds that affect the endocannabinoid system.

 

CB1 and CB2

CB1 and CB2 receptors are in the endocannabinoid system and are the primary targets in the body for medical cannabis.

 

CBD

CBD (cannabidiol) is a psychoactive cannabinoid. There is very little difference in the molecular structure of CBD and THC, but it is enough for CBD to have effects that are significantly different from THC. For example, CBD does not have an intoxicating effect like TCH - even in large amounts.

 

Decarboxylation

In order to activate the THC and CBD in the cannabis flowers, the cannabinoids must undergo a process called decarboxylation. THC and CBD have a different molecular structure when they are in the plant. Decarboxylation means that THCA and CBDA is converted to THC and CBD, and carbon dioxide (CO2) is given off as a by-product. By heating the cannabis flower to over 105°C, the substances are decarboxylated and the cannabinoids are activated.

 

The endocannabinoid system (ECS)

The endocannabinoid system is a signalling system in the body. Activation or inhibition of the system is of particular of importance to our cognitive functions, inflammation, blood pressure and digestion. The endocannabinoid system is not unique to humans - all animals have a similar system.

 

Dronabinol

The original name for synthetic THC, but now often used for THC in general.

 

Endocannabinoids

Molecules formed in the body which affect the endocannabinoid receptors. Two endocannabinoids are formed in the human body: Anandamide and 2-AG (2-Arachidonoylglycerol).

 

Entourage effect

Possible synergy effect arising from several active compounds affecting the endocannabinoid system at the same time. The entourage effect may explain why studies show fewer side effects from the use of plant-based medicines compared with synthetic, pure preparations. This effect may also explain why varieties of cannabis work differently, even though the THC and CBD contents are the same.

 

Vaporizer

Approved medical device for inhalation of medical cannabis (dried flowers).

 

The trial scheme

January 1, 2018 marked the start of the Danish trial scheme for the treatment of patients with medical cannabis. The system allows doctors to prescribe medical cannabis to relevant patient groups.

The purpose of the trial scheme is to give patients an opportunity to test treatment with medical cannabis.

Read more about the trial scheme here.
 
Phytocannabinoids
Naturally occurring cannabinoids in cannabis plants (‘phyto’) which affect the endocannabinoid system.

 

Ligands

Molecules capable of binding to a receptor.

 

Extemporaneous preparation / Magistral cannabis

A magistral/extemporaneous preparation of cannabis is made by a pharmacy. It is made specifically for each patient based on a prescription from a doctor.

 

Marijuana

Dried cannabis flowers.

 

Medical cannabis

Medicines derived from the cannabis plant, in which all active compounds are included.

 

Psychoactive substances

Substances which affect the brain.

 

Receptors

Receptors are found in cells throughout the body. They react to signals in the form of active substances and transmit a response. We have many different receptors in the body which are responsive to specific signals, e.g. the cannabinoid receptors CB1 and CB2, which respond to cannabinoids.

 

Sativa and Indica

Variants of the cannabis plant.

 

Terpenes

Aromatic compounds which are formed in many plants, including cannabis. Terpenes contribute to the scent and taste of the plant. It is hypothesised that some terpenes can affect the body, either on their own or through an entourage effect. Examples of frequently occurring terpenes are myrcene, limonene and pinene.

 

THC

THC (delta-9-tetrahydrocannabinol) is a psychoactive cannabinoid, which is known for having euphoric effects if cannabis is consumed in large doses. THC acts as an agonist on both the CB1 and CB2 receptors in the endocannabinoid system.

 

Dried cannabis flowers

Flowers from the cannabis plant are cut, trimmed clean of leaves and dried at a low temperature and low humidity. These flowers are used to produce medical cannabis.
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