The Maryland Medical Cannabis Commission voted unanimously in the first stage of the licensing procedure. It also voted for five growers and five processors as alternates, in the cent that any of the top 15 in each category ends up not receiving a license.

“This is not the end of the race,” said Harry “Buddy” Robshaw. the vice chairman of the commission. “Obviously it may be only the fist or second lap, but this is real important.”

In a surprise twist in Friday’s meeting, the commission announced that two grower applicants initially placed in the top 15 were bumped to spots 16 and 17, because the top 15 did not include the geographic representation noted in the law. Companies that initially placed in the 21st and 20th spots were moved into the 14th and 15th positions.

“The toughest part of the decision was who gets displaced,” Robshaw said. “We wanted to have a fair distribution across the state, and the only fair way it struck us to do that was to look at the places that had the most density of pre-approved applications and take the lowest rank from there so that we could move them down. We then moved those people into the 16th and 17th positions, which is right outside the top 15 but within the top 20. We agonized about this a lot, and the decision was not unanimous.”

The announcement sparked chatter after the meeting in a lecture hall at the University of Maryland Medical School in Baltimore.

“There may be some scrutiny, certainly by applicants who were either No. 14 or 15 who wound up in Place 16 and 17 who weren’t given the opportunity to say they would relocate,” said Rebecca Gasca, a medical marijuana industry consultant associated with two applicants in the process.

The panel chose from 145 grower license applications and 124 processor applications. The state’s law currently allows 15 growers and 15 processors. The commission made its choices based on a double-blind review of applications by Towson University’s Regional Economic Studies Institute. That means the names of the companies and reviewers were redacted.

The names of the companies that are selected Friday won’t be made public until Aug. 15. After initial approval, the commission will conduct financial due diligence and background investigations on the companies.

Maryland lawmakers passed legislation to allow medical cannabis in the state in 2014. Medical marijuana isn’t expected to be available under the state’s regulations until sometime in 2017.

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At this moment in th United States, there are 25 states (including Washington D.C.) that have legalized medical cannabis. That number is likely to grow as more and more states consider making changes to their marijuana laws. Even though it hasn’t been legalized in every state, there’s been enough medical cannabis activity to see what the medical marijuana landscape looks like for certain health conditions.

There have been a couple of important surveys this year that have shed light on how medical marijuana is is used by patients. The first survey was conducted by Hello MD and it was published in January. This particular one was sent to 17,000 medical marijuana patients, but only 1,400 of them responded.

The second survey was published more recently by Marijuana Business Daily. It used data from patients in states that publicly release this kind of data, such as Arizona, New Jersey and Oregon to name a few.

Using these surveys, here are the health conditions most frequently being treated with medical cannabis.

Top 10 Health Conditions Treated With Medical Cannabis

1. Pain
2. Anxiety and Stress
3. Insomnia
4. Depression
5. Severe Nausea
6. Migraines
7. Arthritis
8. Cancer
9. PTSD
10. Epilepsy

There are tons of other conditions that are being treated, that wasn’t included in the list. These include Multiple Sclerosis, Glaucoma and Parkinson’s disease.

Issues Facing Medical Cannabis Patients

The surveys highlight a broad range of health conditions currently being treated with cannabis. Despite all this, there are a few challenges facing the medical marijuana community.

The most obvious one is that medical cannabis isn’t legal in every state. It depends on where you live. This is a reason why waves of people are moving to states where they can get medical cannabis. A term “marijuana refugees” have surfaced and refer to individuals who travel to places in search of medical marijuana.

The other big issue is that not all health conditions can be treated with cannabis. Most states with medical marijuana programs have limited lists of conditions that qualify for it.If your illness isn’t on the list, you simply won’t be able to use it.

The good news is that a lot of states have started adding conditions to their list of illnesses. An example would be New Jersey which added PTSD to its list of qualifying conditions during last month.

The fact, however, remains that most medical marijuana states haven’t made cannabis accessible to any and all health conditions. This limits the degree to which people can use cannabis for medical reasons.

Beyond all that, there are also restrictions that can make it challenging for researchers to study medical cannabis. And some states only let patients use particular types of medical cannabis products. In New York, for example, patients are not allowed to use smokable marijuana, and they can only get certain types of extracts.

The Point

As these patient surveys revealed, medical cannabis is currently being used to treat a wide raange of health conditions. There are still legal challenges if medical cannabis usage is to become more widespread.

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Given that Epidiolex’s clinical trial success may mark the biggest advance for medical marijuana, we will have a better look about the study from GW Pharmaceuticals and its results.

A little background:

Americans attitude towards marijuana have been steadily improving over the course of the past twenty years. According to Gallup, 58% of Americans support marijuana legalization, up from 25% in 1995, and as a result, 23 states, including the District of Columbia (D.C.) have passed medical marijuana laws.

In those states, patients with a doctor’s approval, can be prescribed marijuana to treat various ailments, such as chronic pain and glaucoma.

Marijuana has long been touted by marijuana supporters as an effective medicine for these indications, however, placebo controlled, FDA-worthy studies that support marijuana’s benefits are hard to come by.

An important breakthrough:

GW Pharmaceuticals has been researching the use of medicine that is derived from the chemicals that are found in marijuana since the 1990s. Despite the company’s efforts spanning decades, the company has won regulatory approval for only one marijuana drug so far: Sativex.

Although Sativex is used to treat muscle spams in patients suffering from multiple sclerosis, it has arguably failed to become a commercial success. The company continues to spend millions researching the various chemical cannabinoids found in marijuana. As part of that research, GW discovered that CBD, a non-psychoactive chemical cannabinoid, may be effective in epileptics.

That discovery led to the creation of Epidiolex, a purified formulation of CBD extract, and the launch of studies in Dravet syndrome and Lennox-Gastaut syndrome patients. Dravet syndrome and Lennox-Gastaut syndrome are two forms of childhood epilepsy that is tough-to-treat and don’t respond well to current therapies, including anti-convulsants.

This week GW Parmaceuticals reported data from the first two Dravet syndrome studies, and the findings are very remarkable. Epidiolex reduced the number of monthly seizures in 120 randomized Dravet syndrome patients by 39%. For comparison, patients receiving a placebo only saw an 11% improvement in the number of seizures.

Moving forward

In the second half of 2016, the results of the second Dravet syndrome trial should be available. If that trial also succeeds, then an FDA filing for approval could come shortly thereafter.

Epidiolex has previously been granted FDA fast-track status, as such, a decision from the FDA would be expected to come six months after Epidiolex’s application for approval is accepted by the agency.

Without a doubt, an Epidiolex approval would be a big victory for patients struggling with this form of epilepsy. It would also be an achievement for the company and its investors, especially if results in Lennox-Gastaut syndrome patients are as successful. GW expects to report results from its Lennox-Gastaut studies later this year.

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