Tag: Medical

Colorado Poised to Add PTSD as Medical Marijuana Qualifier

DENVER (AP) — Marijuana pioneer Colorado is poised to add post-traumatic stress disorder to its medical marijuana program, joining 18 other states that consider PTSD a condition treatable by cannabis.

A panel of state lawmakers voted 5-0 Wednesday to endorse the addition of PTSD to Colorado’s 2000 medical marijuana law. The vote doesn’t have legal effect; it’s just a recommendation to the full Legislature, which resumes work in January. But the vote indicates a dramatic shift for a state that has allowed medical cannabis for more than a decade but hasn’t endorsed its use for PTSD.

“Cannabis treats all the multiple issues that are going on with PTSD like no other drug,” said Dr. Joseph Cohen, a physician who recommends marijuana to patients for other ailments and testified in favor of adding PTSD to the medical program.

Colorado’s change would put Colorado in line with 18 other states and Washington, D.C., that allow cannabis for PTSD treatment. Montana voters will decide in November whether to make the same change.

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The PTSD vote came over the objections of Colorado’s Health Department, which has opposed the PTSD addition in the past, citing a lack of research.

The agency was absent from Wednesday’s hearing and declined a request for comment on PTSD and marijuana. The Colorado Board of Health has rejected four separate applications to add PTSD to Colorado’s list of eight qualifying ailments, which include cancer, AIDS and glaucoma.

Medical objections were raised Wednesday by a lobbyist speaking for the Colorado Medical Society and Colorado Psychiatric Society. “There’s insufficient medical evidence that marijuana is an effective treatment” for PTSD, said Debbie Wagner, a lobbyist speaking for the medical societies.

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Colorado has already approved a first-of-its-kind medical study of marijuana as a PTSD treatment. The $2 million study has been approved by the U.S. Drug Enforcement Administration and includes 76 military veterans. The study isn’t yet complete.

Colorado has about 100,000 medical marijuana patients. No one has produced an estimate of how many additional patients may join the registry for PTSD treatment.

Though Colorado voted in 2012 to allow marijuana use without a doctor’s recommendation, the medical cannabis program persists. That’s because the marijuana expansion applies only to people over 21. Also, a doctor’s recommendation for cannabis allows patients to possess more marijuana than they’d be allowed otherwise, and the patients pay dramatically lower taxes than their recreational counterparts.

State of the Leaf: Colorado Lawmakers Warm to Cannabis for PTSD

U.S. News Updates

Arkansas

The Arkansas Supreme Court has rejected a challenge to cannabis legalization initiatives headed for the November ballot, the Associated Press reports. The suit, filed by legalization opposition group Arkansans Against Legalized Marijuana, contested that the wording of the initiative ballot language was misleading and failed to inform voters of the consequences of legalization. But as Justice Josephine Linked Hart ruled, “The ballot title is an impartial summary of the proposed measure that will give voters a fair understanding of the issues presented and of the scope and significance of the proposed challenges to the law.” Time to start gearing up for November.

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Colorado

Colorado could soon join the 18 other states that post-traumatic stress disorder as a qualifying condition for medical cannabis. A panel of state lawmakers voted unanimously to add PTSD to the list, but the vote is only a recommendation to the full Legislature, which will not reconvene until January. The state Department of Health has resisted the addition of PTSD, citing a lack of research. The Board of Health has rejected four separate petitions to add PTSD in the past. Colorado, however, has approved one of the first medical studies of the effects of medicinal cannabis as treatment for PTSD. The $2 million study has been approved by the U.S. Drug Enforcement Administration and includes 76 military veterans.

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DEA Finally Approves Study on Cannabis and PTSD

Maryland

A Bethesda-based company that initially qualified for a medical marijuana growing license is suing the state commission after being knocked out of the running. GTI Maryland argues that the state Medical Cannabis Commission did not follow its own guidelines because it granted licenses to two companies that earned lower rankings. GTI was ranked higher but wasn’t selected due to a need for geographic diversity, the company argues. It’s asking the court to reverse this decision. Both GTI and Maryland Cultivation were highly ranked in the state, but they had lower rankings than other applicants in their respective counties. GTI is asking for the opportunity to change locations rather than be rejected outright, claiming the commission “effectively removed merit” as a basis for awarding licenses.

Michigan

The Michigan House gave final approval to a slew of bills that would regulate the state’s medical marijuana system for the first time since the law was passed in 2008. The changes would establish a 3-percent tax on dispensaries, create a new licensing scheme for dispensaries, and allot tax revenue to municipalities and local law enforcement. The changes are set to take place 90 days after the legislation is signed, but the licensing process will be more complicated. Would-be operators seeking to open a licensed cannabis business will not be able to apply until 360 days after the legislation is signed, which means the licenses are unlikely to be available before 2018. License costs would be capped at $5,000.

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Ohio

Lawyers now have official permission to advise medical marijuana clients, thanks to an Ohio Supreme Court amendment this week to the Ohio Rules of Professional Conduct. Before the change, a professional body that regulates lawyers in the state had opined that lawyers were prevented from weighing in — or from using medical marijuana as treatment — because cannabis remains federally illegal.

Tennessee

The Nashville Metropolitan Council voted this week to decriminalize possession of up to a half ounce of cannabis, at least locally. The measure reduces penalties to a $50 civil fine or 10 hours of community service. One of the major arguments against this measure came from state Rep. William Lamberth (R-Cottonwood), who argued that the ordinance violates the equal protection clause of the U.S. Constitution by allowing law enforcement to choose which law to enforce: Statewide penalties, which are much more severe than the new local law, would still apply. As such, if authorities catch someone with cannabis, they issue a $50 ticket under the Nashville rules—or they could arrest the individual under state law and send them to jail for up to a year. Lamberth was so adamantly against the measure, he told Leafly he may sponsor legislation to restrict highway funding to the city.

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International News Updates

Australia

All of Australia’s cannabis grown under a new national licensing scheme for clinical trials will be grown will be grown on just two hectares, or about five acres, according to the Australian Office of Drug Control. By comparison, an individual state-licensed grower in Colorado can operate a farm of up to 16 hectares. The Australian crop’s tiny size is the result of strict criteria that patients must meet in order to qualify for medical cannabis.

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Spain

An initiative in the Catalan Parliament would allow cannabis social clubs to legally cultivate and share their cannabis openly. The clubs currently exist in a legal gray area, in which members pay a small fee to join the club and offer financial “contributions” for cannabis. The consumption is technically considered private, as the club is exclusively for members, but social clubs are under a near-constant threat of raids. The new initiative, called La Rosa Verda, or The Green Rose, would regulate clubs and allow them to grow, process, transport, and distribute cannabis under a not-for-profit model.

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Can CBD and THC in Cannabis be Used for Glaucoma Treatment?

Glaucoma is a common eye condition that often causes optical nerve damage, and when left untreated, can lead to blindness. In the U.S., more than three million Americans live with glaucoma. Globally, the figure is close to 60 million. Glaucoma is recognized as one of the leading causes of irreversible blindness.

Since 1980, surgical procedures and treatments have improved significantly, cutting the risk of developing blindness nearly in half. Nonetheless, while treatment has improved, the number of effective topical drugs remains limited. Recognized near universally in medical marijuana states as a qualifying condition, increasing numbers of people have turned to cannabis to treat their condition. But should they?

Given the improvement of existing glaucoma treatments, do the benefits of medical cannabis outweigh the potential side effects or risks? Likewise, given the vital role the body’s endocannabinoid system plays in disease, what promise does the future hold for developing cannabinoid-derived medications to treat cannabis?

What Causes Glaucoma?

Evidence increasingly suggests glaucoma (now widely considered to be a neurodegenerative condition), has a connection to other neurodegenerative diseases like Alzheimer’s disease. Studies have shown one out of four Alzheimer’s patients also likely has a diagnosis of glaucoma. In fact, glaucoma appears to be a significant predictor of AD. A precise cause of glaucoma, however, remains a mystery and continues to elude the scientific community.

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Current Glaucoma Treatment Options

current treatments for glaucoma

Because intraocular pressure (IOP) influences onset and progression of glaucoma, ophthalmologists prescribe treatments that target intraocular pressure. In fact, the only way to prevent vision loss (or eventual blindness) is to lower IOP levels. Depending on the severity and progression, ophthalmologists may treat glaucoma with medications such as prescription eye drops or, if necessary, surgery.

Can Cannabis be Used for Glaucoma Treatment?

Going back to the 1970s, studies have shown that cannabinoids can alleviate glaucoma-related symptoms because they lower the intraocular pressure (IOP) and have neuroprotective actions. For example, in 1971, one of the first studies of its kind found ingestion of cannabis lowers IOP by 25 to 30 percent.

Despite the findings from early research, very few ophthalmologists support the use of medical marijuana in patients with early to mid-stage glaucoma. The main issue ophthalmologists have with cannabis is that the potential adverse effects — particularly smoking cannabis — outweigh the short term benefits. For example, smoking can lead to unstable intraocular pressure, thereby increasing risk of permanent vision loss.

Further, because its therapeutic effects on glaucoma are short-term, patients would have to consume cannabis frequently — once every three to four hours. Doctors claim that because glaucoma needs to be treated 24 hours per day, patients would need to consume cannabis six to eight times over the course of a day to achieve consistently lowered IOP levels. Such frequency is hard to maintain and could increase the risk of developing a cannabis use disorder.

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However, when it comes to late stage glaucoma, ophthalmologists are more inclined to embrace cannabis as a treatment. At the end stages of glaucoma, it’s less about directly targeting the glaucoma and more about alleviating the accompanying symptoms.

According to ophthalmologist Andrew Bainnson, MD, “We’ve known for some time that medical marijuana is very effective for treating nausea and pain, but not so much for glaucoma,” said Bainnson. “[However,] there are some patients with end stage pain and nausea who may benefit [from medical marijuana], but not from the glaucoma point of view.”

Could Cannabis-Based Treatments Play a Greater Role in the Future?

cannabis based treatments for glaucoma

The body’s own internal cannabinoid system, called the endocannabinoid system (ECS), is one of our most important physiological systems. Nearly every aspect of our health — including inflammation, immune response, neuroprotection, pain modulation — are all dependent on the ECS. Given the vital role of the ECS, particularly in neuroprotection and inflammation, many scientists believe the development of cannabinoid-based medications could be immensely useful in treating (and preventing) glaucoma.

Cannabinoid receptors are prominent in ocular tissues responsible for regulating intraocular pressure. A promising area of research would be to develop cannabinoid-derived medications that target these tissues. Cannabinoid-derived medications could be developed that serve two roles: lowering IOP and protecting retinal cells.

Evidence suggests two cannabinoid agonists — WIN 55212-2 and anandamide — and several cannabinoids including CBD and CBG (cannabigerol), may be good candidates to develop as therapeutic agents, particularly because even when administered topically (directly to the eye), they are well tolerated.

However, challenges not unique to cannabis persist. Oral preparations are not good because bioavailability is poor and absorption is too unpredictable. Inhalation isn’t ideal, because the effects don’t last long enough. That leaves topical preparations. And, currently all forms of eye drops — while superior to oral and inhalation administration — do a poor job at penetrating intraocular tissues. Up to 95% of an administered dose fails to reach the intended target.

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What are Cannabis Topicals and How Do They Work?

While cannabis, as it is administered today, may not be an ideal treatment for glaucoma, the development of cannabinoid-derived medications represent promising future directions. And, whether or not cannabis is an ideal glaucoma treatment, there are some people who swear by it as being a godsend for their glaucoma. Others use cannabis as an adjunct to therapy, but not as their primary treatment.

If you or someone you know has successfully used cannabis to treat glaucoma, share your experience with us in the comments section.

Don’t Laugh. Rectal Suppositories Could Be the Future of Medicinal Cannabis.

Many people can’t help but laugh the first time they hear the phrase “cannabis suppository.” But don’t be mistaken: This method of accessing the active ingredients in the cannabis is no joke. And the benefits are convincing a growing number Europe’s medical patients to make the switch from more traditional methods of consumption.

Until about five years ago, the vast majority of Europeans who treated their ailments with cannabis either smoked or vaporized the plant. But thanks largely to Rick Simpson, a Canadian who treated his cancer with cannabis oil and lived in exile in Eastern Europe between 2009 and 2013, more and more people started to discover the amazing properties of extracts. There was one big problem: Consuming extracts that had a high THC percentage—up to 90 percent in some cases—was overwhelming for many patients, especially those without previous experience with cannabis.

The benefits of suppositories—combined with how easy it is to make them at home—has made them quite popular.

“Some six years ago, after meeting with Rick Simpson, I started to produce extracts and provide them to many sick people. Illegally, of course,” said a producer in the Czech Republic who asked to go by Martin T. “But lots of them could not bear the psychoactive effects of THC.”

This prompted some patients and their caregivers to look for another way of ingesting the medicine. “I tried to infuse cocoa butter—with a little bit of shea butter and coconut oil—with the extract and made rectal suppositories,” Martin said. “Patients immediately loved them, especially those with digestive and urinary issues.”

Rectal suppositories seemed promising for at least two reasons. First, they go to work quickly. Suppositories exert systemic effects when they enter the rectal mucosa, spreading healing compounds quickly through nearby organs and into the bloodstream. Second, it’s an effective way of diminishing the “head-high” psychoactive effects of THC.

The benefits of suppositories—combined with how easy it is to make them at home—has made them quite popular, especially in Central Europe.

Despite the emergence of vaginal suppositories in the U.S., the suppositories Martin makes are for rectal use only. “A vagina has a very sensitive and specific environment, requiring a special gel carrier, which is pretty hard to get,” he explained. About 90 percent of his patients are now using only suppositories, he said, and the results have been amazing.

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One notable case is that of Václav Novák, 67, who suffers from prostate issues. In 2013, doctors found signs of cancer, measuring a prostate-specific antigen (PSA) level of more than 10. They scheduled him to begin chemotherapy three months later.

Immediately after the diagnosis, Novák began using 1-gram suppositories, each containing one-tenth of a gram of cannabis extract with more than 70 percent THC and around 5 percent CBD. “I did not feel any high, which was a big difference from oral consumption, when 0.1 gram would get me couch-locked for half a day,” he said.

“I just felt pretty relaxed and slept much better. And the best thing was, when I went to the hospital after three months, there was no need for chemotherapy or any other treatment. Much to my doctor’s surprise, my PSA was back to zero.”

Cannabis and Migraines: A Possible New Treatment Option?

Cannabis as a medicine has an ancient history with anecdotes dating back to the Vedic period (c.1500 BCE) in India and Nepal. It wasn’t until 1839 that William Brooke O’Shaughnessy introduced the therapeutic potential of cannabis to the western hemisphere, and another 75 years after that until Sir William Osler, the father of modern medicine, proposed its use for the treatment of migraines and headaches. The criminalization of cannabis has since hindered our ability to research its potential; to-date, much of what we understand is largely anecdotal or based on animal or tissue culture experiments.

However, as countries legalize cannabis and as public opinion changes, cannabis research will flourish. What we already know of its ability to treat migraines and headaches is promising.

What is a Migraine and What are the Symptoms?

symptoms of migraines

A migraine is a complex condition with a number of symptoms including the following:

  • Painful headaches
  • Disturbed vision
  • Sensitivity to light (photophobia) and sound (phonophobia)
  • Nausea and vomiting
  • Disorientation
  • Problems with coordination

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These symptoms can last several hours to several days, and in severe cases reversible paralysis or loss of consciousness can occur. Migraines are triggered by a variety of internal (somatic, physiological) and external (chemical, environmental) variables. People who get migraines are thought to have a genetic predisposition toward having abnormal cells in the brain stem.

What Causes Migraines?

MRI Brain Scan results of heads and skulls

Evidence suggests that migraines are the result of a variety of triggers interacting with a dysfunctional brain stem center involved in pain regulation. These triggers activate the trigeminovascular system (neurons in the trigeminal nerve that supply cerebral blood vessels with nerves), and consequently the dilation of cerebral blood vessels, which in turn activate brain circuits associated with pain and inflammation.

Anandamide and 2-arachidonylglycerol (2-AG) are endogenous cannabinoids naturally found in the nervous system that, together with cannabinoid receptors, form the endocannabinoid system (ECS). When anandamide and 2-AG interact with cannabinoid receptors, they inhibit blood vessel dilation and modulate the pain mechanisms activated by an individual’s triggers (e.g. changes in atmospheric pressure, chocolate, or caffeine).

What are the Current Migraine Treatment Options?

Current migraine drug treatments

Migraines are treated with a variety of acute (onset of an attack) and prophylactic or preventative medications. The frequency and severity of a migraine, as well as the lifestyle and constitution of an individual, are all factors to consider when choosing the proper medication.

Examples of acute medications for pain relief (analgesics) include acetaminophen, opioids, triptans, glucocorticoids (steroid hormones), and ergots. In general, preventative medications include a variety of cardiovascular drugs (beta and calcium channel blockers), anti-depressants, anti-convulsants, and non-steroidal anti-inflammatory drugs. Side effects of these medications might include nausea, dizziness, drowsiness, and muscle weakness.

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The Mayo Clinic and the Migraine Trust also recommend a variety of complementary therapies including yoga, tai chi, acupuncture, massage therapy, biofeedback, hypnotherapy, cognitive behavior therapy, as well as a selection of herbs, vitamins, and minerals. Not surprising, there is no mention of cannabis as a potentially viable approach to the treatment and prevention of migraines.

Can Cannabis be Used as Migraine Treatment and Prevention?

cannabis for treating and preventing migraine symptoms

Pain management is the best known medical benefit of cannabis, most notably of the cannabinoid CBD, which is thought to have analgesic properties that may help reduce a patient’s dependence prescription opiates as well as manage a host of negative side effects. Patients also use cannabis to help them sleep, stimulate their appetite, and manage mood and anxiety levels.

Migraine sufferers can experience debilitating pain, nausea, and vomiting. These symptoms are potentially manageable with cannabis due to the anti-emetic (vomit and nausea-preventing), anti-inflammatory, and pain-relieving properties associated with specific cannabinoids, including THC and CBD.

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As with treating any condition with cannabis, there are a number of factors to consider, including confounding ailments, dose, administration and strain, socio-economics, previous experience with cannabis, and the use of other substances such as prescription medication, tobacco, and alcohol. The best thing to do is make an appointment with a family doctor or visit a local cannabis clinic for the best medical advice.

References

  • Baron, E.P. 2015. Comprehensive Review of Medical Marijuana, Cannabinoids, and Therapeutic Implications in Migraine and Headache: What a Long Strange Trip It’s Been… American Headache Society.
  • Greco, R., V. Gasperi, M. Maccarrone, and C. Tassorelli. 2010. The Endocannabinoid System and Migraine. Experiemental Neurology 224:85-91.
  • Greco, R. And C. Tassorelli. 2015. Encocannabinoids and migraines. In Fattore, L. Editor. Cannabinoids in neurological and mental diseases. Cagliari (Italy): Elsevier inc. Pg 173-184.
  • The Mayo Clinic

It’s a Close Money Race in Florida

California legalization advocates may enjoy a 60-to-1 advantage over their opponents in the fundraising race, but the contest in Florida is much tighter. Recent state campaign finance records reveal heavy hitters on both sides have thrown huge amounts of cash into the debate.

As of Sept. 9, the pro-legalization Yes on 2 campaign, a.k.a. United for Care, has raised $3,988,512. Opponents, under the No on 2 banner, have socked away $2,862,811.

Several noteworthy donations stand out during a quick glance through Florida’s state campaign finance database, especially those to the opposition’s PAC, the Drug Free Florida Committee.

This list included a donation by Las Vegas casino billionaire Sheldon Adelson, who donated $1 million to the opposition. Adelson, a major prohibitionist, isn’t afraid of throwing his money into a political fight. His $5 million donation helped defeat medical marijuana legalization in Florida back in 2014.

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Joining Adelson on the opposition list is Carol Jenkins Barnett, heiress of Publix, Florida’s largest supermarket chain. Jenkins Barnett boasts a net worth of $1.72 billion and made a donation of $800,000 to the drug-free PAC. Also on the list: Mel Sembler, the former U.S. ambassador to Italy, who donated $1 million to the PAC.

The biggest donor in support of Amendment 2 in Florida is—no surprise—the Morgan Firm, an Orlando-based law firm primarily focusing on immigration law. Since last year, the firm has made 28 separate donations to date totaling of $2,741,971 dollars. John Morgan, lead attorney at the firm, donated 80 percent of the funds needed to get medical marijuana on Florida’s ballot.

Another top contributor to yes campaign was Coral Cables resident Barbara Stiefel, a member of the family that founded Stiefel Laboratories, the skin care giant purchased by GlaxoSmithKline in 2009 for $3.6 billion. Stiefel has donated around $245,000 toward medical marijuana legalization. Drug Policy Action, the Washington, D.C.-based advocacy group, donated $110,000 to the cause.

Summer in Review: Cannabis News From Central and Eastern Europe

Poland

The debate about medical cannabis continues to grow in scale and impact in Poland as more and more politicians, health professionals, patients, and members of the public dive into the subject. One particularly striking recent example is that of Tomasz Kalita, spokesman for the social-democratic SLD party. In August, Kalita, 38, publicly announced that he is treating his brain cancer with illegal cannabis extracts. “I do not want to become an ‘oncology celebrity,’ or a proponent of cannabis legalization,” Kalita told news channel Polsat News. “I just want to have the right to choose the best available treatment.” It’s absurd that cannabis-based treatments are available in neighboring European countries while he and thousands of other Polish patients have to break the law and buy medicine of doubtful quality on the street, Kalita said. Poland currently allows the import only of Sativex — a peppermint-flavored mouth spray — and two strains of dried cannabis flower from the Netherlands. Individuals who want permission to use cannabis medically must go through a lengthy approval process required by the country’s Health Ministry.

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Czech Republic

A brand-new cannabis research and growing facility opened its doors in the western part of Czechia in August, bringing together researchers from the Czech University of Life Sciences in Prague and agricultural experts from the private sector. “Cannabis is a plant, and who could take better care of plants than professional farmers?” asked Jaroslav Hána, CEO of agricultural company Meclovská zemedělská. Apart from stating a common-sense observation, Hána’s question was also a jab at the only Czech company currently allowed to grow medical cannabis — a producer of waste bins and industrial containers with no prior experience in plant science.

Slovenia

The renowned World Hemp Congress celebrated its fifth year in Slovenia last month. The event, which ran Aug. 20-25, hosted dozens of agricultural experts, scientists, researchers, and health professionals from around the world. The primary focus was on growing and manufacturing practices of industrial cannabis with less than 0.2 percent THC — generally categorized as hemp —but there was also plenty of time devoted to discussing the medicinal properties of cannabis as a whole plant. Thanks to the many attractions, workshops, and the availability of live streams, the World Hemp Congress has grown rapidly in recent years, and the same can be said about the popularity of cannabis in Slovenia. Martin Štiglic, representing the Czech Ministry of Economic Development and Technology, told participants that Congress that the ministry will devote €25 million “to the development of the hemp industry and parallel industries by 2020” and that the government will support foreign hemp investors and partners.

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Macedonia Set to Become Next European Country to Legalize Medical Cannabis

Macedonia

The National Medicines Agency announced on Aug. 22 that pharmacies will begin selling cannabis extracts with high amounts of THC to registered patients. The extracts consist of cannabis concentrates diluted in oil. As Leafly reported in May, the tiny Balkan country legalized medical cannabis this past spring, but the only product available so far has been high-CBD extract with no access THC. Advocates for patient have also criticized the high price of medicine and the fact that the government has yet to disclose identity of the country’s sole cannabis producer.