The afternoon periods at Tuesday’s inaugural Hashish Well being Symposium 2025 moved past the basics of hashish medication and its potential, to the sensible realities of prescribing this comparatively new medication within the UK.
These in-depth talks spanned every thing from pharmacy requirements and product high quality to the particular challenges of prescribing for girls’s well being, ache administration, and weak affected person teams.
What grew to become abundantly clear all through the day was that that is, and at all times has been, an trade pushed by sufferers and their highly effective tales, a theme that got here into sharp focus throughout the day’s closing panel dialogue.
The Function of the Pharmacist: Greatest Apply for Shelling out CBPMs
Zul Mamon, Associate at Pharma Specialists and Senior Accountable Individual, opened the afternoon by illustrating the fragility of the present affected person expertise by the story of Sarah, a 45-year-old affected person with power ache.
After lastly securing a prescription, Sarah was left with delays, silence from each clinic and pharmacy, and no concept the way to use her remedy. Mamon confused that her journey is “way more widespread than we wish to admit.”
Key findings from the GPhC report
Referring to the October 2025 Basic Pharmaceutical Council inspection report, Mamon famous:
- 24 CBPM pharmacies have been inspected
- 68 issues have been recognized throughout them
- Main points centered on lack of entry to medical information, incomplete danger assessments, poor communication, and inappropriate prescribing, which pharmacists have been unable to problem
With out entry to affected person historical past, Mamon warned, pharmacists can’t reliably establish contraindications, drug interactions, or duplication of remedy.
Pharmacists as medical gatekeepers
Mamon outlined that the pharmacist’s position begins lengthy earlier than dishing out:
- Prescription verification: Legality, completeness, prescriber legitimacy
- Scientific security checks: Interactions, contraindications, product suitability
- Affected person training: Dosing, administration, negative effects, storage, red-flag signs
- Monitoring and intervention: Encourage reporting, liaise with prescribers, regulate plans
Presently, CBPM dishing out has ‘devolved into placing it in a field and transport it,’ with little or no pharmacist-patient contact.
Coaching, provide chain, and communication gaps
- Coaching is commonly primarily based on unverified sources; some groups had no CBPM-specific coaching
- Frequent inventory shortages, due largely to complicated imports and short-dated merchandise
- Poor communication meant clinics have been unaware of points, and sufferers have been left confused
Options included digital stock-tracking, proactive clinic-pharmacy communication, strong procurement processes, and shared affected person data assets utilizing plain-language explanations.
Three pillars for elevating requirements
Mamon proposed a sector-wide framework constructed on:
- Steady medical training: Skilled networks (MCCS, symposiums, peer boards)
- High quality assurance: Audits, documentation requirements, and safeguarding
- Affected person-centred care: Lively pharmacist involvement all through remedy journey
He closed by reimagining how Sarah’s journey would have modified if she had been supported by a well-trained pharmacist with medical information, clear communication traces, and an lively position in care.
Exploring the Proof Base: CBPMs in Psychiatry & Neurodiversity
Dr Niraj Singh explored the usage of CBPMs in psychological well being and neurodivergent populations, an space he described as promising however complicated.
Psychiatric and neurodevelopmental circumstances
Singh outlined that psychiatric displays differ broadly and sometimes overlap with neurodevelopmental problems, together with nervousness and melancholy, PTSD, OCD, autism, ADHD, mental incapacity, and dyspraxia. These circumstances not often exist in isolation, and people typically current with intertwined organic, psychological, and environmental components.
What the proof exhibits
The proof base is heterogeneous however rising, with research protecting nervousness, PTSD, ADHD, agitation, temper instability, and autism-related signs. Actual-world knowledge recommend significant enhancements for chosen sufferers.
THC and CBD present totally different benefit-risk profiles, and matching affected person phenotype to formulation is essential.
Singh cautioned that psychiatric sufferers might reply in non-linear or surprising methods, so cautious titration and monitoring are important.
Scientific classes from follow
Key insights:
- Some neurodivergent sufferers expertise paradoxical reactions (e.g., CBD inflicting sedation or agitation)
- Many profit most from balanced oils or high-CBD daytime formulations
- Girls, on common, might require decrease THC doses than males, although not universally
The emphasis was on personalisation and recognising that ‘one dimension doesn’t match all.’
Moral and security concerns
Singh highlighted the necessity for clinicians to know vulnerabilities equivalent to co-morbid trauma, emotional dysregulation, or sensory sensitivity. The significance of knowledgeable consent and shut follow-up can’t be overstated, and future analysis ought to concentrate on granular subgroups, not broad diagnostic labels.
From Plant to Affected person: Security, High quality & Consistency in CBPMs
Dr Callie Seaman, plant scientist and formulation chemist, delivered a densely informative deep-dive into how pharmaceutical-grade hashish is grown, processed, and standardised.
Chemotypes and cannabinoid profiles
Seaman outlined three core chemotypes:
- Kind I: Excessive THC
- Kind II: Balanced THC:CBD
- Kind III: Excessive CBD, low THC
She famous rising Kind IV/V merchandise wealthy in minor cannabinoids (e.g., CBDV), although few seem on UK formularies.
Why solely the feminine flower issues
Male crops produce little biomass and minimal cannabinoids. The medically related compounds reside in glandular trichomes of unfertilized feminine flowers, which include cannabinoids, terpenes, flavonoids, lipids, and different secondary metabolites.
Environmental affect and stress response
Cannabinoid and terpene expression is very depending on gentle spectrum and depth, temperature, nutrient availability, abiotic and biotic stress, and genetics. Stress triggers elevated manufacturing of defensive secondary metabolites—lots of which have therapeutic exercise.
Cannabinoids, terpenes, and flavonoids
Seaman highlighted:
- 147+ cannabinoids, many of great pharmacological curiosity
- Over 200 terpenes with roles in synergy and anti-microbial protection
- Beneath-researched flavonoids, together with cannabis-specific cannflavins A, B, and C
Flavonoids, she famous, warrant way more consideration given their potential therapeutic relevance.
Cultivation, harvesting, and manufacturing
Seaman in contrast cultivation strategies:
- Indoor: Excessive management, excessive price
- Greenhouse: Blended pure/supplementary gentle
- Outside/discipline: Cheaper however excessive contamination danger
She detailed processes together with phenohunting, cloning, flowering, trimming, curing, moisture management, extraction, and GMP packaging.
Why full-extract issues
Seaman contrasted full-plant extracts (retaining secondary compounds) with isolates:
- Isolates typically require increased doses for comparable impact
- Full-spectrum preparations show extra sturdy outcomes resulting from synergy
Affected person expectations vs medical actuality
Seaman warned clinicians to know what sufferers could also be used to from the illicit market—”bag attraction,” frostiness, sure aromas—and put together them for variations in pharmaceutical-grade merchandise.
