The use of medical cannabis in chronic conditions is well-known, and some estimates are that medical cannabis can be an adjunct to more than 100 medical conditions. Frequently mentioned conditions include neuropathic disorders such as multiple sclerosis, neuropathy, PTSD, anxiety and depression and certain epilepsies among young children.
Although cannabis is still federally illegal, multiple studies of patients with multiple sclerosis and their providers have acknowledged that cannabis may have a role in improving symptom control, particularly pain, muscle spasticity, and more.
Anne Davis is a successful attorney, mother and community leader in New Jersey. In 2007, she focused her practice on the legal, regulatory, and advocacy issues surrounding use of medical cannabis. In this role, she became a national figure, presenting at conferences, and a sought-after contributor to health care law and advocacy initiatives.
Fast forward to 2013: Anne was thriving in her career and caring for her 2 daughters, ages 8 and 19-a critical time for her young family, whose needs were typical of busy and actively involved children and parents. In 2013, Anne was diagnosed with relapsing-remitting MS.
Devastated by the diagnosis, Anne began to research the impact of the medical regimen, prescribed medications and ongoing testing and lab work that would be required. Anne would need frequent lab tests to ensure treatment was not harming her vital organs, a potential side effect of many medications used in treating MS.
After careful consideration, Anne decided to use her professional knowledge about medical cannabis for herself, a decision not supported by her neurologist and care team.
Much like Anne, studies indicate that most patients conduct their own research when considering medical cannabis. The advice from friends and family are the most frequently cited resources when considering cannabis. A 2014 study indicated that only 18% of patients discussed use of cannabis with their healthcare provider, and less than 1% received assistance from their healthcare team on the kinds of formulations available. This leaves patients in a precarious and potentially harmful situation. Patients rely on and trust their healthcare team.
Surprisingly, despite lack of support and collaboration with their healthcare team, a survey of MS patients conducted in 2019 showed that more than 40% of patients said they used medical cannabis in the past 3 months. This is a striking number, indicating that patients are seeking non-traditional resources in managing their care. These data beg the question: Why are MS patients trying medical cannabis? Are their current prescriptive medicines not working? Do they have ongoing and unresolved symptoms that interfere with their quality of life? What is motivating patients to pay out of pocket costs for medical cannabis on top of their co-pays and health insurance premiums?
For Anne, the answer was “to avoid potential side effects” of her prescription medicines.
“I knew from my years in the industry cannabis was effective and had zero side effects. I was well aware of the research that indicates that cannabis has neuroprotective qualities, in addition to symptom relief. For that reason, I decided to use it every day as part of my treatment plan.
As an MS patient, cannabis is an integral part of my daily life. I use it every night before bed to help with fatigue, muscle cramping and spasticity. It also significantly helps elevate my mood, especially on days when I feel a sense of overwhelm. For me, I struggle with cognitive issues the most from MS. It depends on where the lesions occur in your body, or specific regions of the brain that determines what is impacted the most. It is important to live a healthy lifestyle. For me, that consists of exercise, nutrition, avoiding saturated fats, sugars, beef and dairy. I have reduced stress in my life, get enough sleep, meditate and stay positive. Add cannabis, and I feel like I am doing everything in my power to live my best life.”
Anne is often asked what strains work best? The fact is, there is not one in particular. “I prefer to change strains often. It seems that you build up a tolerance when you use the same strain every day. The therapeutic benefits are best from a blend of strains. I prefer high THC as my use is primarily in the evenings. The level of relaxation that I can experience helps me to fall asleep, stay asleep and get a good night’s rest. I have heard of pharmaceutical companies getting in the cannabis industry and making the argument that cannabis should be mass-produced and you should have the same consistent THC and CBD levels with every plant. Nothing can be further from accurate. Patients need and want variations.”
What can the industry do for patients?
“First, celebrate and recognize your work, no matter if it is behind the counter, in the boardroom, growing, cultivating, and supporting advocacy that directly benefits patients like me. No matter your role in this industry, behind at the end of the supply chain is a patient seeking resolve from one or more symptoms. It could be the nausea associated with cancer, the pain from glaucoma, the night terrors from PTSD.”
What can the industry do to better serve patients?
“Continue to grow and produce quality products. What is a quality product in the opinion of a patient? In my experience, it consists of large green or purple buds with aromatic terpenes. I strongly believe in the “entourage effect “so I like both high THC and CBD combined, another reason that I prefer to mix cultivars and create blends.”
The industry can also advance healthcare and consumer knowledge about cannabis in all its forms. Although peer reviewed articles and scientific evidence are less available than we would like, helping patients and their providers understand what and how to use medical cannabis is essential to its acceptance as an alternative treatment option.
Anne continues to successfully use medical cannabis today. Anne’s neurologist, who was originally against her decision, has since advised her that she made the right choice.
Anne M. Davis, Esq. has been practicing law for 20 years. For the past 12 years, she has been recognized as one of the state’s leading experts in marijuana law and policy. In that role, Davis has presented workshops and seminars nationally about marijuana law reform. Since her diagnosis with MS, she has dedicated her skills and experience to create programs and expand access for medical marijuana patients. As part of that mission, she is a Patient Advocate for Bennabis Health, the first health care plan in the nation covering medical marijuana.
As a community leader, Anne serves as a CASA (Court Appointed Special Advocate) working with foster children; she teaches CCD at her local Church, and has served as a Girl Scout leader for 11 years. Anne was recognized as a “Woman of Distinction” by the Girl Scouts at their annual Gala in 2020. Working with children, keeping them safe and giving them the best opportunities possible are some of her top priorities.
Member Blog: Hemp And CBD Consumer Insights – Who, Why, And How
Hemp CBD became the fastest growing CPG product in 2019, following its legalization in the Farm Bill of December 2018. Consumers show great interest in its use for wellness, health & beauty applications and for pets. Its many distribution channels require integrating convenience store and shipment data not required for most dispensary products.
In U.S. Convenience Stores, total sales of CBD have increased 168% in the first half of 2019 while average weekly dollar sales increased by 235%.
The higher revenue growth accompanied CBD content per package increasing from 100mg on January 5, 2019 steadily to over 350mg on July 20, 2019, after having peaked briefly in June 2019 near 450mg per unit. See graph below.
Mg CBD per SKU at Retail
Medical Conditions Treated with Cannabis
Pain relief is the major reason cited as a medical condition for cannabis use, followed by nausea, PTSD, muscle spasms, IBD and opioid addiction as seen in the following table:
Source: Consumer Research Around Cannabis
Cannabis and Opioid Use Disorder
Of particular note is the growing number of consumers using Cannabis to treat Opioid Use Disorder (OUD). As of August 2019, seven states have approved medical cannabis for treating OUD: PA, NY, NJ, NM, MO, IL & CO. Twenty-one studies (2009-19) show the effect of cannabis on helping opioid users to reduce or eliminate the use of opioids to treat pain. NFL professional athletes have withdrawn from using opioids after they retire, with the aid of CBD and/or adult cannabis.
Consumer Purchase Drivers of OTC Hemp CBD
The top consumer drivers of OTC Hemp CBD are pain relief, reducing anxiety and helping sleep, as shown in the following graph.
Cannabis Product Composition and Patient Outcomes
Over the past several years, advances in technology have greatly enhanced the prospects for cannabis growers, processors, and dispensaries to provide medical cannabis products to patients that efficaciously treat the medical conditions and alleviate the incapacitating symptoms that they suffer.
Pre-clinical scientific research is determining the physiological effects of individual cannabinoids and terpenes on specific medical conditions and symptoms. Mobile apps are enabling the systematic querying of patients about the efficacy of specific cannabis strains and products in alleviating symptoms and conditions.
Collectively, these advances and other medical research are creating volumes of evidence to which human and artificial intelligence will be applied to develop insights for use by patients and medical researchers, growers, and processors in formulating products creating newer therapeutic options. Patients are already making informed decisions that improve individualized treatment of medical conditions progressively over time due to CBD being an approved over-the-counter consumer product.
Advanced Consumer and Patient Targeting to Improve Marketing and Medical Outcomes
Consumer attitudes, perceptions, and usage in local markets create richer, more actionable insights from customer segments, creating advanced quality scores and indices for scoring first-party internal data.
Cannabis consumer data is used for strategic and tactical product development, applications including:
Market Architecture: differentiating dimensions of product form and brand choice
Key Reasons for Use and Purchase
Affinity with Media, Channel, and other Product Categories
Multiple correspondence analysis of hundreds of consumer survey category questions is used to understand dimensional distinctions and differences between clusters. These key spatial dimensions for segmentation illuminate key differentiators, for use in innovation/new products, brand strategy, marketing execution, and digital media tactics.
Create Target Profiles
Merging cannabis consumer data with general consumer data such as Financial, Healthcare, Restaurants, Grocery/Drug Stores, and Media usage & exposure for each respondent facilitates creation of new consumer segments.
Using zip code identified respondent level data, the above Target Profile clusters can be integrated with other market and first–party data to prioritize personalization, enhance brand positioning, inform messaging, new customer marketing & acquisition efforts, and multi-touch attribution databases.
Mr. Stephen J. Gongaware is Sr. Vice President of Business Development at MSA (Management Science Associates, Inc.), a privately held diverse information technology development and service firm that for over 50 years has provided innovative solutions within its three core competencies of analysis, technology and data management. He has played a major role in developing and managing several MSA businesses in addition to his focus since 2014 on the medical value of cannabis for prospective patients, beginning with CBD and 20 other nonpsychedelic cannabinoids then measured by leading edge test labs. Other businesses he’s created and managed at MSA in the last 20 years includes services to develop/market pharma “rare disease” solutions, and MSA Casino Gaming solutions improving operation of slot floors, player satisfaction and also lead smart phone and sports book innovative projects with 6 of the Top 10 global casino operators and with several major gaming equipment manufacturers.
Prior to joining MSA, Mr. Gongaware was CEO of NetworkNext, an innovative national advertising firm; R&D Director at Cellomics, Inc. where he was awarded US Patent #US6365367; and an Electrical Engineer at Westinghouse Electric Corp. He received his BSEE degree from University of Pittsburgh in 1992 and his MBA from its Katz School of Business in 1995.
MSA is an Analytics firm with Big Data integration capability incorporated in 1963 to focus on improving government and management decisions. MSA has 800+ professionals with expertise in data science & AI, software development, test marketing, data management and management consulting and many of its innovations have become industry-standard solutions. MSA has served over 70 Fortune 500 Customers/Clients in the CPG, Media, Metals, Life Sciences & Pharma, and Casino Gaming & Sports Betting industries. It has been engaged in cannabis research since 2013 with the goal of providing the cannabis industry similar services to what has been now provided to the CPG, Steel, Tobacco, Casino Gaming, and Pharma industries for more than 50 years.
NCIA Member Profile: The Giving Tree Wellness Center
This month, NCIA checks in with Lilach Power, Managing Director at The Giving Tree Wellness Center based in Phoenix, Arizona. The Giving Tree Wellness Center has been a member of NCIA since September 2013, taking an holistic approach in supporting their clients by offering a range of medical marijuana products along with alternative healing methods, including massage and acupuncture, to promote the best quality of life possible through both their North Phoenix and Mesa locations.
Cannabis Industry Sector:
Medical Cannabis Providers
NCIA Member Since:
2013
How do you uniquely serve the cannabis industry?
Lilach Power, Managing Director at The Giving Tree Wellness Center
When Gina and I started our business, we had a vision of creating a safe and inviting environment for patients, and I think we have succeeded. We have beautiful spa-like stores that are very inviting. We do not have the traditional pot shop that I think a lot of people think of when they envision a dispensary. There are no bars, bullet-proof glass or tiny bank windows. This is truly a place to get help and find quality medicine.
We understand that patients might be intimidated coming to a dispensary at first, so we like to make them as comfortable as possible. We have private consultation rooms where patients can really sit down and be comfortable discussing their medical issues and see what options we have for them. We encourage patients to schedule one-on-one consultations with our patient consultants or with our medical director (my business partner, Gina Berman, M.D.). We never up-sell or push patients to buy anything. Our goal is only to find the ideal medicine for each patient. We never rush patients – whether they are a first timer, or this is their hundredth visit.
Gina Berman, M.D. of The Giving Tree Wellness Center
The Giving Tree takes pride in its local community philanthropic endeavors. We participate in two big fundraising events annually. Our next one is on April 11th, the Take Steps for Crohn’s and Colitis walk. We match all donations and I am proud to say many vendors have been participating, so we are getting the industry involved in our community as well. Our other big annual event is the breast cancer Walk for the Cure in the Fall. In addition, we raise money and hold canned food drives during the holiday season to help local folks in need.
Realizing that there are patients for whom the cost of this medicine is a burden, we started our own program for discounted medicine for patients on SNAP or long-term disability. We also deliver for patients with physical hardship, with no delivery charge.
Why should patients looking for medical cannabis services go to The Giving Tree Wellness Center?
Service and quality: We have an elite team of patient consultants (PCs) and we are patient-focused. Our PCs are truly passionate and have a fund of knowledge – I am so proud every time I walk into the dispensary and see how much they really care. Our patients really do become part of The Giving Tree Family.
Our medicine: We grow a majority of the medicine we offer. We stress quality over quantity and grow strains based not on their yield but on the merits of their quality and variety. We do not use pesticides, and we always use an independent, third-party lab to test all our medicine. We definitely have learned a lot during this process and our goal is to make each harvest better than the last. We are proud each time we harvest and cure and see our medicine on the menu.
The Giving Tree Wellness Center – Arizona
Can you give us some insight into the medical cannabis community in Arizona, where it’s been and where it’s headed?
Arizona is a really unique cannabis community. There are not many medical marijuana dispensaries operating and there won’t ever be, per statute. That really takes the competition out of the equation for the most part and we can really just focus on creating and maintaining a well-regulated and upstanding industry where the focus is truly just on the patients.
Also, as time goes on and more and more Arizonans are helped by cannabis, our communities will hopefully embrace us as offering a much-needed service instead of being thought of as the criminal-laden underbelly of the cities. The regulated stores are dramatically different than any black market operation. I think this will become more apparent as time goes on as more people in the community are exposed to state-regulated dispensaries.
We see the need for an organization to bring us all together and represent us on the national stage. There is no other organization that does that. We see the importance in supporting it, becoming part of it, and hopefully being more involved in the future. It is the only way to move our industry forward.
If you are a member of NCIA and would like to contribute to the NCIA blog, please contact development officer Bethany Moore by emailing bethany@thecannabisindustry.org.
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