Do medical cannabis strains matter?

Not all medical cannabis is created equal. Mamedica founder Jon Robson explores why it’s important to prescribe the right strains for optimum relief for a patients condition. 

How do you establish the difference, medically speaking, between different strains?

All products that are released to be prescribed in the UK have to go through rigorous testing. Within that testing process, you are able to identify exactly what’s in that particular cannabis strain or a particular vape cartridge, in terms of THC (tetrahydrocannabinol), CBD (cannabidiol) and terpenes. Our understanding of cannabis strains and how they can benefit people differently is growing rapidly. The U.S has the largest medical pool of data from patients, which we follow closely to guide us on what strains have helped patients. We’re also fortunate that the UK cannabis community is small yet aligned with advocating on what individuals personal experiences have been with certain dosages and strains.

How many strains are there?

The number of strains in terms of cultivation is absolutely huge. There are different families, which have different characteristics.

In terms of medical effects, is it just CBD and THC that are important?

Until recently, the focus has been almost exclusively on the therapeutic benefits of cannabinoids such as THC and CBD. But evidence suggests that all plant compounds in cannabis work together in synergy – this is known as the entourage effect. That is how you would differentiate one strain from another.

All strains have different terpene profiles, which will give a different effect when compared to one another.

What are terpenes, and how do they work?

Medical cannabis contains over 150 types of terpenes. Terpenes are naturally-occurring compounds that cover the surface of cannabis flower. Although most terpenes are present in only trace amounts, the most prominent combine to give cannabis strains their signature scent profiles. Terpenes also hold diverse functions in the plant and can produce a range of therapeutic and mood-altering effects for medical patients.


How does a doctor decide which strain to prescribe?

All strains have different terpene profiles, which will give a different effect when compared to one another. When a specialist prescribes one of these strains they’ll be looking for something that combines a certain set of characteristics that they want for treating that particular ailment.

How does the Mamedica algorithm come into it?

Within our clinic management system, we have a built-in algorithm, which uses real world patient data from the U.S., to help our specialists make more robust prescribing decisions using the information collected in our initial evaluation. If we had a patient who came to us and said, “I’m an experienced user, I consume certain type of strain, with X THC content and Y CBD content,” that would be used to recommend something which was similar or a few substitutes based on what we have available on our approved list of medicines.


Why is it important that consultants speak to patients about strains?

There is no one size fits all. Let’s say for example, you’ve got a pain in your elbow. We come up with a treatment plan and over a period of months, we’ve worked out that Godfather OG is most effective for your pain. But we might get someone else, the same age as you with a very similar problem, but because their endocannabinoid receptors are different to yours, the same strain may not provide relief for that person.

How can you be confident that a particular strain is produced to a high standard?

All products which are listed on the Mamedica preferred list of medicines (formulary) are sourced from cultivators/manufacturers who are certified to supply products which comply with a medical grade standard called EU-GMP (good manufacturing practice). This is a minimum set of requirements that a manufacturer must meet in order to ensure that their products are consistent, high-quality and safe for their intended use.


What are your plans for the future in terms of strains?

At inception, our primary concern is to ensure that we have the widest range of medication available to patients in the UK, for next day delivery. As we build up patient numbers, we will be introducing our own branded cannabis-based prescription medicines: flower and vape cartridges. We have selected strains and profiles which have a high number of reviews and patient feedback from North America relating to certain conditions.