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Cannabis & Sustainable Development (2019 working report)

Authors:
  • Knowmad Institut gemeinnützige UG (haftungsbeschränkt) | European Institute for Multidisciplinary Studies on Human Rights and Science

Abstract

Updated toolkit available at www.cannabis2030.org – También en español: www.cannabis2030.org/es –––––– Subtitled "Recommendations for the implementation of Cannabis policies aligned with international Human Rights standards, the 2030 Agenda for Sustainable Development and the 2016 UNGASS outcome document", this report explains how the reform of hemp and cannabis policies can sustain or make harder – depending on the policy options chosen – the attainment of the 2030 United Nations agenda for Sustainable Development. | The reformist trend in Cannabis policy globally is an ongoing movement unlikely to be stopped. A deficit of democratic monitoring of the generalization of legal Cannabis markets could represent a threat for affected populations and public health. Ethics are needed. A renewed interest and takeover of the topic Cannabis by all categories of the population are urgent. A one-size-fits-all policy seems neither desirable nor possible, both for geographical imperatives and for the diversity of uses and products of the plant. This makes consensual policy models (exportable and generalizable) difficult to emerge. Rather than trying to solve the equation of the perfect Cannabis policy and its infinite variables, a more feasible approach would be to step aside, list all the different public policies that affect, or are involved with Cannabis, and address them individually. The 2030 Agenda for Sustainable Development and its 17 Goals is but a perfect tool for this purpose. This discussion paper highlights important research and experiential outcomes from scholars, civil society organizations, affected populations, and market stakeholders. It seeks to show the potential of the Cannabis plant in appropriately regulated settings as transformative for our societies – so long as ethical practices and sustainable approaches are kept central. This document is not intended to be an exhaustive guide. It is designed as a valuable resource to contribute to post-prohibition studies, and help understand, from diverse public policy perspectives, the links between the policies of Cannabis and the Sustainable Development Goals, and the impact of the former on the latter. The latest updated 2021 version is available at www.cannabis2030.org
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... It can be applied in various economic industries, different from health care, beauty and well-being, like building materials (hempcrete), seed-pressed oils for paints and sealants, biocomposites, green energy and others. (Riboulet-Zemouli et al. 2019). To implement the win-win strategy, value orientations should be formed in a society that can create long-term benefits for all stakeholders. ...
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Background Nowadays, medical cannabis still remains inaccesible for patients in the former Union of Soviet Socialist Republics (USSR). Even registered medicinal products based on herbal or synthetic cannabinoids, like Sativex, are practically unavailable due to their high cost and narrow scope of application (for example, in Lithuania). However, before the absolute prohibition of medical cannabis in the USSR, in line with Single Convention of 1961, the State Pharmacopoeia of the USSR (eighth edition) published monographs on such medicinal products as “Herba Cannabis indicae”, “Extractum Cannabis indicae spissum” and “Fructus Cannabis”, which could be prescribed by physicians with precaution. Objectives Formation of a holistic approach aimed at the creation of appropriate conditions for the development of medical cannabis market and the improvement of life quality and health of Ukrainian patients. Methods We analyzed legislation and regulation mechanisms for medical cannabis in the USSR, and the present availability of these products for patients in the former USSR, such as Lithuania, Georgia, Estonia, Russian Federation, and Ukraine. Four hundred thirty-five Ukrainian pharmacy students participated in the quantitative analysis (a survey) that took place on April–May, 2019 at Bogomolets National Medical University (Kyiv, Ukraine). They were surveyed about legalization of medical cannabis in Ukraine, advisability of including cannabis and cannabinoids related data into educational programs, and other issues. Qualitative analysis we applied consisted of the stakeholder analysis and Strength, Weakness, Opportunity, and Threat (SWOT) analysis. We classified the key stakeholders into the patients, healthcare professionals, legislative and regulatory bodies, pharmaceutical companies, pharmacies, etc., and ranked them based on their power and interest in the development of potential medical cannabis market in Ukraine. We also identified their expectations and goals. SWOT analysis allows us to evaluate predictable risks and opportunities, as well as strong and weak aspects of the effective development of medical cannabis industry in Ukraine. Results According to the survey among pharmacy students, about 80% support the legalization of cannabis for medical purposes. However, two-thirds of them think that there is a risk of illicit turnover. Nearly half of the respondents are not informed or poorly informed about cannabis therapeutic properties. At the same time, nearly 90% consider that materials on medicinal properties of cannabis and cannabinoids should be included in the training program. Nowadays, such stakeholders as legislative and regulatory bodies have the highest power over the development of potential medical cannabis market in Ukraine: more than two million Ukrainian patients still cannot access an effective cannabinoids based treatment. There are over 20 thousand children among them suffering from drug-resistant epilepsy due to the lack of adequate legislation. Moreover, a lot of stakeholders with high level of interest, such as growers, manufacturers of cannabidiol (CBD) products, pharmaceutical companies, pharmacies, higher education institutions, even scientists and healthcare professionals are still waiting for the legalization of cannabis for medical and scientific purposes in Ukraine. SWOT analysis shows that present business structures, educational and scientific institutions, regulatory bodies, and the competency of domestic specialists are strong enough to develop a new market of cannabis-based medicinal products in Ukraine. However, a long-term ban on medical cannabis requires more time for creating the entire ecosystem. This market can be quite attractive in Ukraine. It is characterized by high growth rates, low entry barriers and a substantial demand. Yet, its advancement depends significantly on the appropriate regulatory framework, high level of awareness among health professionals and society as a whole, and involvement in scientific study to become a part of the global medical cannabis market. Discussion The holistic approach is aimed to improve health and life quality of Ukrainian patients through cannabis-based medicinal products. It consists of three components: changes in legislation and regulation procedures; changes to value orientations in society; observance of stakeholders’ interests and purposes. Specific recommendations are worked out to realize this approach in Ukraine.
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Background: Benzodiazepines are a class of medication with sedative properties, commonly used for anxiety and other neurological conditions. These medications are associated with several well-known adverse effects. This observational study aims to investigate the reduction of benzodiazepine use in patients using prescribed medical cannabis. Methods: A retrospective analysis was performed on a cohort of 146 medical cannabis patients (average age 47 years, 61% female, 54% reporting prior use of cannabis) who reported benzodiazepine use at initiation of cannabis therapy. These data are a part of a database gathered by a medical cannabis clinic (Canabo Medical). Descriptive statistics were used to quantify associations of the proportion of benzodiazepine use with time on medical cannabis therapy. Results: After completing an average 2-month prescription course of medical cannabis, 30.1% of patients had discontinued benzodiazepines. At a follow-up after two prescriptions, 65 total patients (44.5%) had discontinued benzodiazepines. At the final follow-up period after three medical cannabis prescription courses, 66 total patients (45.2%) had discontinued benzodiazepine use, showing a stable cessation rate over an average of 6 months. Conclusion: Within a cohort of 146 patients initiated on medical cannabis therapy, 45.2% patients successfully discontinued their pre-existing benzodiazepine therapy. This observation merits further investigation into the risks and benefits of the therapeutic use of medical cannabis and its role relating to benzodiazepine use.
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