From their small town in southwestern Maine, Meagan and her husband, Ken, took Addy to Boston to consult with neurologists. These epileptic seizures, they concluded, were the result of a congenital brain malformation called schizencephaly. One of the hemispheres of Addy’s brain had not developed fully in utero, leaving an abnormal cleft. She also had a related condition called optic nerve hypoplasia, which caused her eyes to wander—and which, further tests revealed, made her all but blind. By summer Addy was having 20 to 30 seizures a day. Then 100 a day. Then 300. “Everything was misfiring all at once,” says Meagan. “We were afraid we were going to lose her.”
Epidiolex is the first FDA-approved treatment in the U.S. that contains a purified drug substance derived from marijuana -- CBD -- and the first treatment for Dravet syndrome. In September 2018 the FDA rescheduled cannabidiol from a C-I controlled substance to a C-V controlled substance, meaning it has a proven medical use but a low risk of abuse. This change allows Epidiolex to be marketed in the U.S.
Hemp oil — obtained by pressing benefit-rich hemp seeds — is slightly different than cannabis oil, although they both come from the same genus, cannabis, and the same species, cannabis sativa. The term hemp is used to describe a cannabis sativa plant that contains only trace amounts of THC. Hemp is a high-growing plant that’s commonly grown for industrial uses, such as oils and topical ointments, as well as fiber for clothing, construction, paper and more.
The patient continued to use cannabis oil for 65 days. The family changed strains of the oil repeatedly, and some were more effective in increasing appetite and alleviating pain than others. The author of the case report suggests that cannabis oil needs to be explored further because there is potential that cannabinoids might show selectivity when attacking cancer cells, thereby reducing the widespread cytotoxic effects of conventional chemotherapeutic agents. Sadly, the young girl with ALL passed away due to gastrointestinal bleeding and a bowel perforation.
Typically, pharmaceutical companies making cannabis-based medicines have sought to isolate individual compounds from the plant. But Mechoulam strongly suspects that in some cases those chemicals would work much better in concert with other compounds found in marijuana. He calls this the entourage effect, and it’s just one of the many cannabis mysteries that he says require further study.
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