MJBizMag May-June 2021 - 45

" That'll help us home in on anything
that can be improved, " Hull said. " That's
one way we can try and make sure our
products are as effective as possible. "
FINGER ON THE PULSE
In Texas, one of the most restrictive medical
markets in the nation and one where
relatively few doctors have signed on to
the program, Texas Original Compassionate
Cultivation (TOCC) relies heavily
on a medical advisory board comprised
of eight physicians from around the state
who have different specialties. They are
led by Dr. Karen Keogh, a pediatrician
and child neurologist whose practice of
roughly 2,000 patients includes many
who use cannabis to treat epilepsy.
" They provide us feedback on what
they're seeing, what they'd like to see
change, how we might improve our
products, what type of ratios are working
for what type of symptoms, " said Morris
Denton, CEO of TOCC, noting that he
and other executives have telephone
conferences with the medical board at
least once per month. " We stay incredibly
engaged with the patient and medical
community in order to continue to
develop and refine our products based
upon what we know is working-and,
often more importantly, when we think
we can make improvements. "
Feedback has resulted in some changes
for TOCC. For example, some patients
who have tree nut allergies said they are
unable to consume coconut oil, prompting
TOCC to start making some products
with safflower oil, which is nut-free.
Texas has a provision that infused products
can contain only up to 5 milligrams of
THC per serving, but those 5 milligrams
can account for just 10% of the product's
total weight. That means patients
who require more THC to treat their
symptoms must consume large amounts
of coconut or safflower oil. Many
consumers wrote to TOCC seeking an
alternative, so the company created
a lozenge that contains 5 milligrams,
allowing patients to get their daily doses
through a reasonable number of lozengwork
with them to get the best medicine
aligned with their ailment, " Macias said.
She emphasized that her team
Chanda Macias trains staff to recommend
certain marijuana strains based on patient
symptoms. Courtesy Photo
es rather than an unpalatable amount of
cannabis oil.
Denton said TOCC has developed a
large enough clientele and network of
physicians that it can assemble focus
groups of 15-20 patients to test new
formulations and products.
TOCC provides the products for free
in exchange for physicians and patients
filling out questionnaires about their
experiences. The company also gets
information in traditional ways, such
as surveys and conversations between
patients and budtenders.
" It was really challenging at first, but
it's getting easier as we continue to evolve
and grow. And were getting better at how
we do it, too, " Denton said. " There's not
a single product we develop that doesn't
go through an initial patient scrutiny ...
and then a focus group testing process
to ensure that the product is ready for
prime time. "
AILMENT-STRAIN ALIGNMENT
Chanda Macias, CEO of Ilera Holistic
Healthcare in Louisiana and the National
Holistic Healing Center in Washington
DC, counts on her wellness consultants
to serve patients using a method she calls
" ailment-strain alignment " and a mantra
of " listen, guide, treat and heal. "
" We look at their ailment, we match
them with the proper strains and then
the proper form of medicine-whether
it's in a tincture, flower, vaporizer. We
members can't make health claims
about cannabis strains, but they can
share anecdotal evidence and let
customers make their own decisions.
Her companies also built a database with
six years' worth of anecdotal evidence
provided by patients. " We allow people
to treat themselves and then give them
the options that we think align properly
with their ailment and condition. "
Many people assume cancer requires a
high-THC product but forget that there
are different types of cancer. Brain cancer,
for example, might be better treated
with high-CBD products, she said.
If a patient has multiple sclerosis, in
which pain is known to rise suddenly
before dipping down, Macias suggests indica
strains consumed through combustion
or vaporization, so the delivery and
onset are fast. But for chronic pain, she
recommends delivery through edibles or
tinctures because the effects last longer.
" We rely on the patient to say how they
feel, " Macias said.
ANECDOTAL EVIDENCE
Short of sophisticated research studies
that take years to complete, industry
observers say such anecdotal evidence
can be valuable.
" The safety profile of cannabis is fairly
well established. We do post-market surveillance
looking for adverse events. And
there's been very few adverse events and
consequences over the five to six years
that we've been studying that, " Vireo
Health's Kingsley said.
" It's just a matter of time until we have
adequate evidence ... to demonstrate
that, for some segments of the population,
cannabis is a real alternative, " he
said. " In children with severe epilepsy
disorders, there's really solid evidence.
But the only way you're going to convince
mainstream medicine generally is
to go through formal clinical processes
and trials and really develop the real
data. But you can't always wait for that. "
May-June 2021 | mjbizdaily.com 45
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MJBizMag May-June 2021

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