North Bay seems an unlikely place to become a hub of cannabinoid research. That, however, is exactly where the Northern Ontario city (population: 51,553) appears to be headed. Almost a year ago, North Bay’s Canadore College announced that it was bringing aboard research scientist Dr. Pritesh Kumar.
The cannabinoid pharmacologist is responsible for developing the college’s medicinal-cannabis programming. This includes full-time postsecondary programs as well as professional-development modules for health-care professionals.
In addition, Kumar’s responsibilities include the development of a cannabinoid analytical testing laboratory and cannabinoid genomics lab at Canadore. The research at these facilities will focus on, among other things, analyzing the efficacy of cannabis strains for specific treatments and determining optimal methods of transmission.
Apothio enters the picture
This past August, Southern California–based Apothio announced that it intends to establish its Canadian head office in North Bay. The company develops proprietary hemp and cannabis strains for various applications, from culinary to pharmaceutical.
Apothio will partner with Canadore’s Innovation Centre for Advanced Manufacturing and Prototyping (ICAMP) and the college’s DNA lab to conduct the company’s research and development projects. Kumar will supervise the research.
CannCentral caught up with Kumar recently to ask him about his work and the state of cannabinoid research in general.
Q&A with Pritesh Kumar
CannCentral: Tell us a bit about yourself and the nature of your work.
Pritesh Kumar: I’m a pharmacologist by training. I did my PhD in pharmacology and toxicology a number of years ago from the Univeristy of Louisville, Kentucky, in the States. My entire doctoral thesis was on cannabis pharmacology—basically looking for new mechanisms of actions for how cannabinoids interact with the biological cannabinoid receptors. So most of my work at that time was clinical.
After that I did some work in cannabinoids as a treatment for nonalcoholic fatty liver disease, and then transitioned into looking at it as a possible mitigator of opiate withdrawal symptoms.
CannCentral: You have done research in the U.S. and in Canada. In the U.S.—and this is a big deal with this coming election—at the federal level cannabis is still criminalized. Does that make your work easier in Canada, or are there still a lot of hurdles to jump?
Pritesh Kumar: Canada is years ahead of the U.S. when it comes to cannabis research because it is federally legal through Health Canada. So, to answer your question in brief, it opens up the door to research. It removes all of the red tape and legal restrictions you face in the U.S.
More research needed
CannCentral: In terms of the medical uses of cannabis, and the amount of research that’s been done on them, would you say that we still need a ton of research and a much larger body of evidence? Or is there a strong case already to be made for, say, CBD as an inflammatory, for instance?
Pritesh Kumar: I would say quite a bit of research. The double-blind, randomized clinical trials need to be done. I’d say for two indications that data is there. Recently, here in the States the FDA approved a CBD-based drug called Epidiolex for seizures. So obviously there’s enough evidence for that. In Canada, Health Canada a few years ago approved Sativex, which is a 1:1 CBD to THC for MS patients with neuropathic pain.
For those two, there’s enough clinical data for two regulatory bodies to approve those formulations. For the rest of them, quite a bit of anecdotal evidence, not enough large-scale trials have been done.
CannCentral: Why do you think that is? Is it because the funding hasn’t been there for it?
Pritesh Kumar: It’s a good question. Tough to answer. I know that there are a number of studies ongoing in different phases through the FDA, or even at Health Canada. I think in the next year or two we might see some new indications coming out.
But the challenge is, taking a plant-derived substance through a regulatory path is notoriously difficult. It takes many years. It takes quite a bit of investment—which is usually reserved for large pharmaceutical companies. So I think that’s why we haven’t seen quite a bit of activity. I think we will in the next two years. We’ll see a few formulations or drugs that are cannabis-based become approved for a number of indications.
Cannabis as analgesic?
CannCentral: In terms of the efficacy of cannabis in treating pain—chronic pain in particular—how does it compare with opioids? Does cannabis have those kinds of analgesic or pain-mitigating effects? If so, what sort of doses does it need to be taken in?
Pritesh Kumar: There are a number of studies in small patient populations showing a significant analgesic effect in cannabinoids for different types of pain—whether it’s chronic pain, acute pain, neck pain, lower back pain, et cetera. The dosage varies from study to study, and I think that’s why we have yet to see a cannabis drug that’s been approved for a direct pain-control mechanism.
The challenge is, both are drugs of abuse—opiates and cannabis. While they have similar properties in terms of pain relieving at different intensities and efficacies, they’re still both drugs of abuse. So there’s still some careful titration that needs to occur.
CannCentral: What are you currently working on?
Pritesh Kumar: At Canadore College we’re doing a few things. Northern Ontario has the unfortunate problem, like a lot of areas of economic depression, of drug abuse in certain Indigenous populations. We don’t have the permits yet, but we have prepared the file to have Canadore College issued a research permit for cannabis.
Once we have that, we will open up first an observational trial among the population in Northern Ontario to look at how they’re using opiates, and are they using cannabis. Just mainly data collection on that kind of thing. If they are using cannabis to treat their chronic pain, at what dosage are they using it? What’s their route of administration?
Interventional trial
CannCentral: What happens after the observational phase?
Pritesh Kumar: After that, we would go into some kind of interventional trial and categorize different types of pain. So, if we have data on a population that has lower back pain that was using cannabis instead of opiates, we’d take that same population and enroll more patients so we can actually do a proper study. That’s the direction we’re looking to focus on in Northern Ontario.
CannCentral: How much does COVID-19 interfere with what you intend to do?
Pritesh Kumar: It does interfere, especially with new protocols for patient enrollment in clinical trials. It does play a factor. The red tape is only a matter of time. We initially planned to start some of this work in 2021 anyway. So we’ll see what happens with COVD.
But I think at least for the observational part of it, that shouldn’t be affected too much, because we won’t be directly intervening yet. The interventional trial where we want to look at substitution, safe weaning mechanisms, and also using certain cannabinoid compounds to mitigate withdrawal symptoms, those kinds of things are going to have to be properly navigated with COVID.
