By Nigel Whittle, Director of Medicine and Health at Plextek. The latest news that the NHS is planning a clinical trial of cannabis oil in the UK will come relief to many chronic pain patients who regularly use marijuana to relieve their symptoms. While research is ongoing, there is good reason to believe that non-psychoactive cannabinoids, including THC and CBD, are effective for a wide variety of health conditions. Ensuring proper dosing and effective delivery of a “clean” product through technical innovation will be vital to the growing industry.
Over the past decade, laws governing the use of marijuana for both recreational and medical use in many countries, particularly the United States, have been relaxed. What was once thought of as a noxious “gateway” drug that would lead to the use of increasingly powerful recreational anesthetics now has medicinal properties that can help manage a range of medical conditions. For example, in the UK, Epidyolex, a cannabis-based medicine containing pure cannabidiol (CBD), has been approved for the treatment of rare forms of epilepsy.
Any medical use, of course, requires precise and accurate dosing, preferably based on the results of randomized controlled studies. To some extent, the cat is out of the bag due to the widespread unlicensed use of cannabis and its derivatives for recreational as well as medicinal purposes. However, more and more studies are being carried out which show clear advantages in the treatment of, for example, chronic neuropathic pain.
The original “delivery system” for cannabis products was of course the marijuana cigarette, but in such a form it is virtually impossible to control both the type of product inhaled and the dosage. More importantly, any form of smoking is likely to be harmful due to the presence of toxic compounds produced when burned that can damage the airways and air sacs in the lungs, aside from the increased risk of lung cancer. It was hoped that vaping, which involves vaporizing volatile compounds like nicotine in an e-cigarette, would provide a safe way for people to consume tobacco and other products. However, the widespread incidence of “popcorn lung,” an irreversible lung disease caused by inhalation of diacetyl, an ingredient that gives e-cigarettes flavor, has led to the realization that no inhalation devices are truly safe. In fact, the FDA has also strongly warned consumers against using THC-containing vape products as these products often also contain vitamin E acetate, which breaks down into diacetyl when heated.
As a result, e-cigarettes are a growing concern of doctors, who believe that there is a strong link between increasing consumption of THC-containing products and vape-related illnesses. Yet today we find ourselves in a situation where e-cigarettes are commonplace and medical cannabis use is increasing. Vaping is probably always safer than smoking because the dosage and ingredients can be controlled more effectively. Encouraging people, especially adolescents, to quit smoking and vaping as part of a substance reduction program should have an impact on the incidence of lung disease.
So how can we use technology to improve the safety of inhaled cannabis? There are maybe three areas where we can start:
- Defined and purified ingredients in the vapor mix avoid problems caused by the presence of toxic chemicals and avoid the debilitating lung disease caused by the presence of diacetyl from THC flavors. We can develop closed systems that allow only approved and regulated ingredients to be introduced into cannabis vapers.
- Changes in the way the vapor mixture is heated can enable a cleaner and cleaner dose to be provided, thereby avoiding the pyrolysis caused by overheating in the e-cigarette cylinder. There are several ways to make diffuse heating systems that do not cause pyrolysis.
- Valve control systems that can monitor and regulate the amount of vapor that is generated and delivered to the user can be an effective means of preventing overuse and maintaining safety.
The technology around vaping continues to advance: for example, the ability to control the temperature of the heating element can be used to avoid overheating of the carrier liquid and prevent the element from becoming too dry and burning the ingredients instead of generating steam.
At Plextek, we’ve done extensive research to improve the safety aspects of e-cigarettes for nicotine use. In doing so, we understood that they can be an effective tool in helping people give up the nicotine habit. A significant advance has been the use of RF systems to heat the contents so that a more diffuse heating pattern is created. This in turn avoids burning or pyrolysis of the ingredients so that a purer and cleaner product is produced.
We are examining how we can use the same technologies to improve the safety of cannabinoid vaping products, and we understand again that reducing safety risks can improve access to the medicinal properties of cannabinoid derivatives. Non-contact forms of heating such as RF induction can play a critical role in ensuring the overall safety, quality and purity of the inhaled product, which are of major concern for both recreational and medical users.