Alchimia interviews Guillermo Moreno at Expogrow 2017
In the space set aside for the Cannabis Box Forum at this past Expogrow 2017 in Irún we interviewed Guillermo Moreno, pharmacologist, neuroscientist, who since 2008 has been in the USA obtaining a doctorate in Cannabinoid Pharmacology at the University of California and working in the laboratory of Dr. Daniele Piomelli, a pioneer in the knowledge of endocannabinoid pharmacology.
In this interview for Alchimia, Guillermo Moreno talks about his experiences in the USA and the various current issues on medicinal and recreational cannabis, scientific advances and marijuana legislation.
Here's the video of the interview (you can change the language of the subtitles by pressing config-->subtitles)
And here you have the full transcription of the interview:
A - We are with Guillermo Moreno, pharmacologist, neuroscientist, who has been in the US for the last few years at the University of California, first doing his doctorate and then working there... so, we can talk about different topics with you, because both your thesis and you work is focused above all, I think, on the endocannabinoid system, but you have also cultivated, you’re a consumer I suppose, but you are also in California, a place where they look at cannabis in another way, correct?
GM - Yes, that's true. The truth is that for example, I went to California in 2008 with a Fullbright scholarship to finish my PhD in Cannabinoid Pharmacology in the laboratory of Dr. Daniele Piomelli, who is a pioneer in our knowledge of endocannabinoid pharmacology, especially in the design of drugs that alter or modulate the endocannabinoid system, more than just the effect that plant molecules can have on the system. I remember when I left, everyone asked me how I was going to find good cannabis in the US for recreational use, and I replied, well, I don’t know, I’ll work something out, but then to my surprise I got there and found an industry based on therapeutic cannabis in which people did not smoke, but medicated. The users were not "stoners" but they were "patients" and the cannabis sold it to him in medicine jars, just as they would sell ibuprofen in the pharmacy, since the cannabis was sold in these containers, rather than zip-loc bags that open easily, and it was prescribed for medical use only, so that the children could not open it. So, it was something that made me laugh a lot, but it's a very serious thing. Everyone takes it very seriously. My doctor, my patient card from California, my dispensary gives me this medicine that I feel is the best… and of course, there was a list of maybe 25 different diseases that one could claim to have a prescription . The prescription was made by my Dernigman neighbour who was an acupuncturist, because acupuncturists can also prescribe cannabis in California. So, really, it's a fairly Sui Generis scene.
A - It’s curious isn’t it, the method of dispensing back in those days? Nowadays though, it’s different. Just how has it changed? Now you’ve been living there for almost 10 years…
GM - Yes, well look, the truth is that, well, also because of my research interest. With the aim of bringing a little more knowledge to the field of cannabis, both in risk-reduction and, well, to extract to the maximum the potential offered by the plant, well this led me to interact with different groups involved in activism such as " NORML "(http://norml.org/), for example, that is an organisation that is works tirelessly in activism, in legalisation programs, as well as different Cannabis Fairs, which of course have evolved a lot in the last 10 years.
So, let's say that this a-legal framework has attracted, well, this rather American system of pushing the limits and well, and of forcing things, if I can plant, I can sell the flower but also I can make edibles, brownies and such, well anything you saw, and as of few years ago the whole subject of "extracts" began, and the extracts have really changed the face of cannabis use, because right now in California as there are practically 50% consuming flower and 50% using extracts.
The vaporisers are, well, their use is widespread and is reaching people who have never used cannabis, who do not know what the plant is, or how to roll a joint, nor do they want to smoke, because California in the end tends towards a very healthy lifestyle and towards vaporisation, although we do not know the risks of vaporising oil, we are aware of the risks of vaporising some compounds that have been used to cut this oil and we know that are very harmful, but hey, we’re learning on the fly. This is also very typical of the entrepreneurial spirit in California.
A - Now, you’ve told me how you dispensed, but I suppose this has already changed with the legalisation in the US, not only of medical cannabis but also recreational. I guess now, as a patient, you don’t have to go with the card, at least in California?
GM - Well, California just voted. California, that happened in November of 2016, along with the elections that brought us Trump and what happened is that something called the "Office of Medicinal Cannabis Regulation" was formed. So this office was actually created to legalise medical use, which has been approved since 1996. There was no regulation, so this office was created in 2015 to give regulation to the therapeutic framework, but let's say partly in response to what was to come after the examples of Colorado, Washington, Oregon and Alaska, well, California obviously after Proposition 19 didn't pass in 2012 but stayed at the gates, one could see this was coming, they took one of the heads of the department that manages alcohol and placed her in charge of the department that manages cannabis. And then, well, a series of protocols is being created, regulation that will deal with the plant, from cultivation, processing, storage and sale, to a series of licenses that cities will be able to manage in the way they prefer.
A - You’re in contact with scientists working on cannabis, especially in the US. The National Academy of Sciences recently released a report on cannabis… which I think you know well. What can you tell us about it?
GM - Yes, the truth is that Dr. Piomelli was one of the experts within the panel brought together by the National Academy, and I was given the opportunity to participate by writing the chapter on Biochemistry and Pharmacology of phytochannabinoid compounds and well, in this way I contributed a little to this study.
So, it’s interesting because this is the first time they’ve carried out this review since 1999. There were a couple of requests to the DEA, which is the agency that regulates the classification of cannabis within the non controlled list of substances. Right now, cannabis occupies a place of privilege so to speak, the No.1 ranking with other drugs that have no recognised medicinal effect and have a high power to create addiction… this was created with Nixon in the 70's, and lasts until now. There have been several requests to the DEA for this to be changed. Actually this depends on the Department of Justice, it’s a a cumbersome process but the Institute of Medicine did an evaluation in 1999 and this new effort, well let's say it goes with the changing times a little.
That’s to say, cannabis is coming, there are many States, I think that right now there are 29 that have legalised therapeutic use, eight that have recreational use and well, the Academy does not want to be left behind and so launched an Agenda Research Proposal. Well, this combines public and private entities in something of a call to create a framework in which researchers can work and look at the real risks and the real benefits of cannabis, considering that the US is facing a… let’s say, an increase in consumption and probably a decrease in the age of onset, although that is also unclear.
But, well, I want to say that the truth is that the States which legalised years ago haven’t noticed even a slight increase, but instead something that is, in my opinion, social alarm. So what is curious is that this Academy report clearly adds chronic pain as a new use for cannabis within the therapeutic applications, which until now had always been something that all patients had said, and in fact chronic pain is the complaint for which most US patients use cannabis, 64%, but there was still no official source to support this, so with an analysis of all the literature that is available, this is the message that the National Academy has launched but has not yet been picked up by the authorities that would be responsible for moving the cannabis from Group 1 to Group 2, which would certainly greatly facilitate access for researchers.
A - In this case that would be the job of the FDA or not?
GM - Yes, the person responsible is the attorney general, and the attorney general is a gentleman named Jeff Sessions who has stated that good people do not smoke marijuana. So, it's all pretty grotesque with this new administration, with the press chief saying that medical marijuana is not the same thing as recreational marijuana, and that's going to… well, that gentleman has already resigned, he's gone from his position.
Yes, it can not be taken very seriously but of course, just to give you an idea about whose hands these types of decisions are in. We can say that maybe under the Obama administration… Obama always said that he would do what the scientists advised, that he was not an expert and didn't know, or at least didn’t want to recognise it at that moment, but that it was not a decision that was down to him, and I think he hid a little a behind the Senate, the Congress, by saying that this was a plural decision and not an only an issue of a personal initiative, but it is the Attorney General and the Department of Justice that could make this decision.
A - In any case, the report is there and now to see if they make a decision some day or not. We’ll see…
GM - The industry is booming, the truth is that it would be difficult to imagine the US being left behind. Let's say that Israel has always been a bit of a US lighthouse for many things and with this it’s also the case, Canada is taking the lead with Trudeau, who throughout his campaign was very clear about his position with regards to cannabis, with even Australia considering becoming a likely player on an international level. So, it would be surprising if the US were to be left behind, but maybe if we consider how much the current president loves business, it would be strange if money did not have a significant influence.
A - Speaking of other things, not just legislation, as a scientist you’ve been working with cannabis (endocannabinoid system)… tell me a little about what will happen in the near future? We’re constantly making discoveries, moving forward and seeing how it works. What do you think the near future holds for cannabis? in this case medicinal I suppose…
GM - Yes. Well, it is true that the endocannabinoid system as a therapeutic target is a relatively new system because we only discovered it in the 1990’s, once we found where THC was bound within the body, and although it is a young pharmacology so to speak, much effort has been made. That is, I’ve worked for many years to create synthetic molecules that were able to increase the endogenous levels, let’s say the very molecules that the body creates and that activate the same receptors as cannabis when the body needs the activation of this system. Thus, the endocannabinoid system is very interactive with other hormonal and neurotransmission systems, and generally has what we can describe as a modulating and maintaining effect on homeostasis or physiological balance.
So the truth is that efforts with synthetic molecules, both agonists, which are molecules that activate receptors directly or pharmacological strategies more similar to others known by other systems, such as serotonin or dopamine, have not yet produced clinical results. Truthfully, the drugs that are, forgive me, not drugs but pharmaceuticals on the market that are capable of interacting with the endocannabinoid system are: synthetic THC, a synthetic derivative of THC that is virtually unused, and a plant extract which combines THC and Cannabidiol (CBD) in a 50:50 ratio. So let's say that for now the molecules of the plant have been those that have offered a better safety profile, because there have also been efforts to block these receptors that have given serious problems of side effects and well, what remains for the moment are phytochannabinoids, and in my opinion I think the challenge of these molecules is their availability. Understanding how we deliver these molecules, either plant or extract, to the site in the body where they have to act. Well, the most classic routes of administration are oral, either ingested with food or in the form of drops, and then inhaled, whether smoked or vaporised. So, let's say that this is a systemic application that works to carry these molecules to the whole organism, they are subject to a metabolism in the liver ... well, the inhaled route diminishes this, but this explains to some degree the difference in effect between edibles (or medibles) and what we inhale.
And I think that work is needed on this route, I think the ailments could be more modest. Maybe, well, we can not cure cancer or not all kinds of cancer, or maybe we can not cure the pain or we can not ease the pain or not all sorts of pain right? Or not all sorts of inflammation, but I believe that selective administration, in organs ... maybe something that targets the large intestine for example, speaking of irritable bowel syndrome, ulcerative colitis, Crohn's disease, or maybe a topical application for such issues as acne, or things that maybe…
A - Psoriasis?
GM - Yes, psoriasis, or inflammatory complaints that perhaps aren’t a global threat, but for those who suffer them, they are indeed a problem. Or analgesics, it’s not as if our arsenal of painkillers is infinite. I mean to say, we have 3 or 4 families of analgesics, if you are allergic to any of them as is the case of non-steroidal anti-inflammatory drugs (this applies to a good proportion of the population), then you have paracetamol and you have opioids ... we aren’t exactly so overloaded with therapeutic alternatives as to discard this system as a goal. And truly, well, efforts are also being made with other pharmacological families such as opiates, for example, they are administered… the US military gives fentanyl lollipops to soldiers who are wounded in combat, while at the same time, fentanyl has created a brutal opioid addiction crisis in the United States, because oral mucosal administration ensures faster absorption where a more favorable pharmacology does not… it’s just an example. Actually, right now we have a capacity for technological refinement in which we can inject substances into the body’s joints, I don’t know how to put it, but the tools are there, right? We need to see if, well, if these molecules, when delivered to the correct place in the proper concentration, they allow to increase the therapeutic efficacy and to diminish the side effects.
A - Well, let’s see if we get to that point…
GM - That’s the objective, that’s the utopia. We will see it, I believe, at least in the therapeutic plane.
A - Well, Guillermo, many thanks for your time. Many thanks for relating your experiences, see you soon..
GM - See you soon, thanks.